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 AMCHP Working for You: State Efforts to Promote Preconception Health

By Lauren Raskin Ramos 
Director of Programs, AMCHP

Recognizing that implementing policies and programs to improve preconception health is a key area of focus for state MCH programs, AMCHP is supporting several projects to provide information, tools, technical assistance and resources to help advance these efforts. Similar to many state MCH programs, there is no one preconception health effort at AMCHP, rather we are working broadly to support state efforts. We are doing this by building state capacity to address preconception health among adolescents, partnering to create central resources, advancing state efforts to measure preconception health, identifying strategies to optimize implementation of the Patient Protection and Affordable Care Act to address preconception health and collecting state models through Innovation Station, the AMCHP best practices program. The following is a snapshot of some of these efforts.

Preconception and Adolescents Action Learning Collaborative

The Centers for Disease Control and Prevention (CDC) U.S. Recommendations to Improve Preconception Health and Health Care (2006) called for identifying and modifying social, behavioral and medical risks to a women’s pregnancy (and general health) through prevention and management strategies. AMCHP staff viewed the guidelines as a way to facilitate the implementation of a life course approach to maternal and child health by applying these recommendations to adolescents. From 2009 to 2011, the AMCHP Adolescent and Women’s and Infant Health Teams, working in partnership with ASTHO, focused on expanding preconception health efforts to include adolescent and young adult women through a Preconception Health and Adolescents Action Learning Collaborative (PHA ALC).

Over the course of an 18-month period, AMCHP and ASTHO collaborated with six state teams from Missouri, Ohio, Oregon, Pennsylvania, South Carolina and Utah who worked to integrate preconception health concepts into their adolescent and young adult health efforts. The states designed cutting edge strategies such as creating and disseminating reproductive life planning tools for adolescents along with a guide for adults; revising a Family and Consumer Science and health class curriculum to include preconception health topics; integrating preconception health concepts into the state department of education core health curriculum; and developing a model policy for integrating youth with disabilities into preconception health efforts. Check out the presentations given by state team representatives at the AMCHP Annual Conference in 2011 during our Preconception Health Symposium event, which highlight this work.

Advancing the Core State Preconception Health Indicator Project

In order to help guide preconception health initiatives, the CDC supported a multi-state effort in 2007 to define preconception health domains and measureable indicators. This set of indicators is known as the Core State Preconception Health Indicators. AMCHP is partnering with the CDC Division of Reproductive Health to advance the ability of MCH programs to measure preconception health within their communities for applied epidemiology, planning and evaluative work. AMCHP is currently ramping up efforts to enhance state/territorial program capacity to measure preconception health through the AMCHP Core State Preconception Health Indicator Project. In November 2011, AMCHP staff will assess state interest and priorities related to preconception health measurement. We will use the results of the assessment to develop technical assistance opportunities promoting the effective use and dissemination of best practices for preconception health measurement among state and territorial programs that will span a two-year period.

Spreading Best Practices through Innovation Station

AMCHP continues to identify state MCH best practices on preconception health to include in the AMCHP Innovation Station. If you have an effective practice in your state that is promoting the preconception health of women, please let us know by contacting Kate Howe. Help us to grow our database of programs and share your best practices with other states!

Creating a Central Preconception Health Resource Center

AMCHP, in partnership with the CDC National Center on Birth Defects and Developmental Disabilities (NCBDDD), the National Association of County and City Health Officials (NACCHO), CityMatCH and ASTHO, is creating a Preconception Health Resource Center, a web-based tool that will collect effective preconception health and health care practices, as well as other resources. This resource center is expected to launch in late winter and will draw from existing repositories, such as the AMCHP Innovation Station and the NACCHO Best Practices Program. Stay tuned for more information!

Optimizing Health Reform to Improve the Health of Women, Infants and Children

With support from the W.K. Kellogg Foundation, AMCHP is working with state MCH programs and their key partners (e.g., state Medicaid agencies, local health departments, community health centers) in selected states (Florida, Michigan, Mississippi, New Mexico, Oklahoma and Oregon) to increase their effectiveness and capacity to optimize implementation of the Patient Protection and Affordable Care Act to address preconception health, adolescent health and reproductive health. The project focuses on key opportunities within health reform and other related national initiatives to promote preconception health and health care throughout the life course for women and girls, and, ultimately, to improve birth outcomes. The project kicked off in June of this year at an invitational Thought Leaders Round Table Meeting, held in conjunction with the third National Summit on Preconception Health and Health Care in Tampa, FL. The purpose of the meeting was to: 1) identify opportunities in health care reform and other key federal and national initiatives to promote preconception health and, ultimately, improve birth outcomes; 2) describe and highlight the role of state MCH programs and their key partners in advancing preconception health; 3) identify continued challenges to advancing preconception health and overall areas where states need continued assistance in building their capacity to advance preconception health; and 4) determine how opportunities in health care reform and other key federal and national initiatives can help states address these challenges. AMCHP looks forward to highlighting the innovative work of these six state teams at the 2012 AMCHP Annual Conference. A white paper highlighting best practices and related policy recommendations on preconception health for state Title V MCH programs and other key stakeholders, derived from the Thought Leaders Roundtable Meeting, will be released this winter.

Use of Evidence-Based Practices to Inform Preconception Care: The Community Guide

With support from the CDC, AMCHP has developed a policy brief on preconception care and evidence-based practices featured in The Community Guide. The Guide to Community Preventive Services (Community Guide), supported by the CDC, is designed to provide needed information to support state and community leaders as they make decisions on strategies, policies, and programs that are most relevant, productive, and cost-effective for their states, communities and enrolled populations. The Community Guide is the only single source of all recommendations and findings of the Task Force on Community Preventive Services (Task Force), an independent, non-federal, volunteer body of public health and prevention experts. It provides evidence-based recommendations and findings about public health interventions and policies to improve health and promote safety. The Community Guide includes Task Force findings on 19 topics, including adolescent health, birth defects, immunizations, nutrition, physical activity and oral health. The forthcoming policy brief, What Does the Evidence Say About Preconception Care?: Using The Guide to Community Preventive Services to Improve Preconception Health Efforts in States, is the first in a series of documents that highlight evidence-based recommendations in The Community Guide to promote key areas of maternal and child health. It highlights recommendations that are relevant to advancing preconception health, possible uses of The Community Guide, and implications for strengthening public health policy and practice at the state and local levels. This policy brief is expected to be released this fall.

Supporting CDC Select Panel on Preconception Health and Health Care

AMCHP staff and members continue to be engaged in the CDC Select Panel on Preconception Health and Health Care and associated work groups, including the Public Health Work Group and the Policy and Finance Work Group. The Select Panel and the work groups are engaged in strategic thinking and efforts to advance the CDC Recommendations to Improve Preconception Health and Health Care.

AMCHP will continue to advance each of these efforts and share updates through our communications mechanisms. Let us know how else we can support you!