Find State ESMs

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of pregnant women who receive Smoking Cessation Reduction in Pregnancy Treatment (SCRIPT) services.

Numerator: Number of SCRIPT services provided to Healthy Start clients.

Denominator: N/A

Significance: Smoking during pregnancy creates risks for adverse outcomes.

Data Sources and Data Issues: Well Family System

Year: 2017/2019

Unit Type: Count, Unit Number: 50,000

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: By 2022, increase by 5% the number of pregnant smokers who call the quitline annually.

Numerator: # of pregnant smokers who call the Maryland tobacco quitline

Denominator: N/A

Significance: Women who smoke during pregnancy are more likely to experience a fetal death or deliver a low birth weight baby. Further, secondhand smoke (SHS) is a mixture of mainstream smoke (exhaled by smoker) and the more toxic side stream smoke (from lit end of nicotine product) which is classified as a “known human carcinogen” by the US Environmental Protection Agency, the US National Toxicology Program, and the International Agency for Research on Cancer. Adverse effects of parental smoking on children have been a clinical and public health concern for decades and were documented in the 1986 U.S. Surgeon General Report. The MDH Center for Tobacco Prevention and Control launched a Pregnancy Rewards Program in 2014, which offers pregnant and postpartum women (up to six months) rewards for series of completed calls with a Quit Coach. Though initially requiring referral by physician, that barrier was removed and now a pregnant smoker can simply call and let the Quitline know that she is pregnant and interested in the rewards/incentive program. This ESM will measure the impact of the Pregnancy Rewards Program and accompanying media campaigns/health communication interventions on the number of pregnant Quitline callers.

Data Sources and Data Issues: 2016-2022 MDH Center for Tobacco Prevention and Control Quitline Data

Year: 2017/2019

Unit Type: Count, Unit Number: 200

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: Assess the implementation of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiative in which SC Medicaid reimburses prenatal providers for screening.

Numerator: Number of Medicaid providers providing screening for smoking, alcohol and drug use, domestic violence, and depression, and making appropriate referrals

Denominator: Number of Medicaid provider practices who could support the program.

Significance: Screening allows for a broader catchment of public health issues to be identified and addressed.

Data Sources and Data Issues: Medicaid data

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Colorado intends to decrease the number of women who smoke during pregnancy. Colorado also intends to decrease the number of children (ages 1-4) who are exposed to secondhand smoke.

Numerator: Number (weighted) of women who report that a doctor, nurse, or other health care worker talked with them about how smoking during pregnancy could affect their baby

Denominator: Number (weighted) of live births

Significance: Exposure to secondhand smoke in utero can result in low birth weight, SIDS, and cognitive impairments. Furthermore, exposure to secondhand smoke in early childhood has ramifications later in life, including: behavioral problems (ADHD), respiratory problems, asthma, metabolic syndrome, difficulty conceiving, and an increased risk of smoking in early adulthood.

Data Sources and Data Issues: The Colorado Pregnancy Risk Assessment Monitoring System (PRAMS) is the data source for this measure. Data are available on an annual basis and reflect the population of all women giving birth.

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To ensure supportive programming promoting and/ or facilitating tobacco and eCigarette cessation, referral and follow up.

Numerator: Number of pregnant women program participants who smoke referred to an evidence-based program enrolled/accepted services

Denominator: Number of pregnant women program participants who smoke referred/enrolled to an evidence-based program

Significance: Secondhand smoke is a mixture of mainstream smoke and the more toxic side stream smoke which is classified as a“known human carcinogen” by the US Environmental Protection Agency, the US National Toxicology Program, and the International Agency for Research on Cancer. In addition,women who smoke during pregnancy are more likely to experience a fetal death or deliver a low birth weight baby.

Data Sources and Data Issues: Data Application and Integration Solution for the Early Years (DAISEY): Web-based comprehensive data collection and reporting system/shared measurement system used by all MCH grantees to capture client and visit/service data

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: By 2020, 30% of pregnant women Ashline callers will be enrolled in smoking cessation services

Numerator: Number of pregnant women enrolled in smoking cessation services

Denominator: Number of pregnant women callers

Significance: Smoking during pregnancy can cause a baby to be born prematurely or to have low birth weight. Smoking during and after pregnancy is a risk factor of Sudden Infant Death Syndrome (SIDS). Due to an alarming trend in the percentage of children who live in households where someone smokes; Arizona’s Title V Program partners with the Arizona Smokers’ Helpline to conduct media outreach and smoking cessation services to pregnant women in Arizona. This measure will goal set and continuously assesses how Arizona’s Title V Program can further support smoking cessation efforts around the State.

Data Sources and Data Issues: Internal program data Arizona Smokers’ Helpline (Ashline)

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: To identify pregnant women who smoke and provide them with best practice interventions to quit.

Numerator: Number of local Title V grantees who have selected smoking as a priority area who are implementing the 5A’s with their clients.

Denominator: Number of local Title V grantees who have selected smoking as a priority area.

Significance: Many Local Public Health Department MCH Programs have chosen to conduct 5As best practice screening in the work they do with pregnant women. Because use of the 5As increases the likelihood of quitting smoking, this measure will ensure that clients receive the optimal interventions toward smoking cessation.

Data Sources and Data Issues: Local grantee report

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: Increase the number of adults who complete Baby and Me Tobacco Free.

Numerator: N/A

Denominator: N/A

Significance: Original research on the Baby and Me Tobacco Free model measures success at six months postpartum which aligns with other similar study designs. Gadomski, A., Adams, L., Tallman, N., Krupa, N., Jenkins, P. (2011). Effectiveness of a combined prenatal and postpartum smoking cessation program. Maternal and Child Health Journal, 14:188-197. DOI 10.1007/s10995-010-0568-9.

Data Sources and Data Issues: The national Baby and Me Tobacco Free Program Office: BABY & ME-Tobacco Free Online Data Portal by Salesforce. Data points include: Date Field: Date equals Custom (1/1/2015 to 12/31/2015) 1 AND 2 AND 3 AND 4 AND (5 OR 6) 1. Participant: Agency: Billing State/Province equals IN, Indiana 2. Participant: Participant's Name not equal to 3. Session equals 6 4. Record Type equals Postpartum 5. CO Level # less or equal 6 6. Voucher Number (Mother's) not equal to For FY15 Title V all above is true except: Date Field: Date equals Custom (10/1/14 to 9/30/15)

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of pregnant smokers referred to the Quitline from the Healthy Baby Home Visitation Program

Numerator: # of smoking HB clients referred to the Quitline

Denominator: N/A

Significance: The Wyoming Quit Tobacco Program is focused on increasing the number of pregnant women that call the Wyoming Quitline. The Quitline is an evidenced based strategy for quitting tobacco. Wyoming has an incentive program for enrollment in the program during pregnancy. This indicator will measure the success of the partnership between home visiting, MCH, and tobacco in getting women who smoke during pregnancy to enroll in the Quitline services.

Data Sources and Data Issues: Best Beginnings Database

Year: 2017/2019

Unit Type: Count, Unit Number: 100

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Reduce the number of Vermont women who smoke during and after pregnancy.

Numerator: # of pregnant smokers who register with the QuitLine or QuitOnline

Denominator: # of pregnant smokers

Significance: Quit Lines and online Quit support are proven strategies to increase quit attempts and sustained quitting. Vermont's pregnancy protocol includes: 9 calls with a personal coach, text messaging support available for free, fee Nicotine Replacement Therapy with doctor’s prescription, and up to $65 in incentive payments

Data Sources and Data Issues: Data sources: 802Quits Network registration information; and Vermont’s Vital Statistics birth certificate data. Data issues: we are not able to track the number of pregnant women participating in Quit-in-person, so we are limited to contacts by phone or internet.

Year: 2017/2019

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To decrease the percent of women who smoke during pregnancy and decrease the percent of children who live in households where someone smokes

Numerator: Number of women of reproductive age (15 to 44 years) who received at least one counseling session from the tobacco QuitlineNC in the prior 12 months

Denominator: N/A

Significance: Smoking during pregnancy can cause premature birth, certain birth defects, and infant death. Children exposed to secondhand smoke are at an increased risk for ear infections, more frequent asthma attacks, and death from Sudden Infant Death Syndrome.

Data Sources and Data Issues: QuitlineNC Data Report

Year: 2017/2019

Unit Type: Count, Unit Number: 5,000

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Annually increase the number of women receiving Title V funded prenatal care or home visiting who are screened for behavioral health risk factors.

Numerator: The numerator is the number women in home visiting, centering pregnancy and the IMPLICIT program who are screened for behavioral health risk factors.

Denominator: Not applicable.

Significance: Moving forward the Department is including in Title V Grant Agreements with the County Municipal Health Departments that Grantees conduct behavioral health screenings for women in prenatal and home visiting programs using the 5Ps. The IMPLICIT program was created around behavioral health screenings in the postpartum period. Increasing the number of women enrolled in these programs will allow more women to be screened and possibly identified as needing behavioral health interventions and in turn lead to healthier women and children as help is received. This ESM is not directly linked to NPM 14, but is linked the following priority: Women receiving prenatal care or home visiting are screeend for behavioral health concerns and referred for assessment if warranted.

Data Sources and Data Issues: Data will be collected through Quarterly reports from the home visiting, centering pregnancy and IMPLICIT programs.

Year: 2017/2019

Unit Type: Count, Unit Number: 5,000

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of reproductive-aged female tobacco users (15-44 years) who received online or phone counseling services through the Tennessee Tobacco Quitline

Numerator: Number of reproductive-aged female tobacco users (15-44 years) who received online or phone counseling services through the Tennessee Tobacco Quitline

Denominator: N/A

Significance: Tobacco use is the number one cause of preventable death in the US and six of the top 10 leading causes of death of Tennessee residents were linked to smoking. In Tennessee, 21.9% of adult women smoke (BRFSS 2015). Tobacco cessation during preconception care can prevent adverse birth outcomes associated with prenatal smoking, such as low birth weight and preterm birth. Prenatal smoking rates have significantly declined in Tennessee, yet 14.3% of Tennessee women smoked during pregnancy in 2015. Smoking cessation also prevents nonsmoker exposure to secondhand and third hand smoke. Telephone-based cessation services like the Tennessee Tobacco Quitline adopt a public health-oriented approach by not only helping tobacco users who desire to quit, but also by actively promoting cessation among the general population.

Data Sources and Data Issues: Tennessee Tobacco Quitline Vendor Reports. Due to Tennessee’s external operation of the Quitline (current vendor is based out of state), data are not available in-house.

Year: 2017/2019

Unit Type: Count, Unit Number: 1,075

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: To decrease the number of women who smoke during pregnancy

Numerator: Number of women referred to the Tobacco Quit line

Denominator: N/A

Significance: Tobacco smoking and pregnancy is related to many effects on health and reproduction, in addition to the general health effects of tobacco.

Data Sources and Data Issues: Referral log to the Tobacco Quit line

Year: 2017/2019

Unit Type: Count, Unit Number: 100

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase utilization of the Idaho Quitline among pregnant women and thereby increase the percentage of pregnant women who have attempted to quit smoking in the past 12 months

Numerator: Number of pregnant or breastfeeding women who called the Quitline for cessation services

Denominator: Not Applicable

Significance: In 2015, 10.7% of Idaho pregnant women reported smoking while pregnant, and 13% of all Idaho women aged 18 and older were smokers (BRFSS, 2015). Idaho ranks 25th highest in the nation for tobacco use among pregnant women. To address the priority need of decreasing substance abuse, specifically tobacco use, among MCH populations, the MCH program will leverage the work currently underway by the Infant Mortality CoIIN team to reduce smoking among pregnant women and women of reproductive age. According to the Association of State and Territorial Health Officials (2013), offering pregnancy specific and postpartum Quitline services to women is a recommended strategy to improve smoking cessation. In 2015, the Idaho QuitLine implemented a Pregnancy Cessation Program, which offers up to 10 calls during pregnancy and postpartum for women who want to quit smoking compared with the 5 calls for the general population. This program also provides participants with a $5 incentive card for each session they participate in before birth and $10 for each session after the baby is born. This enhanced program includes several intervention calls in the two-week period following a quit attempt, one just before the due date and two calls within two months after the baby’s delivery. These calls help the participant to develop skills to remain tobacco free and to reduce the health risks to the baby from exposure to secondhand smoke. Pregnant women may request nicotine replacement therapy (NRT), however they must obtain approval from their primary care provider. Up to 8 weeks of free NRT is offered through the Idaho QuitLine, if approved through their primary care provider. Any pregnant or new mother that expresses interest in quitting tobacco through the QuitLine is automatically referred to the new 10-call Pregnancy Program.

Data Sources and Data Issues: Idaho Quitline

Year: 2017/2019

Unit Type: Count, Unit Number: 2,000

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to professionals

Goal: To increase knowledge of tobacco cessation among perinatal staff through training.

Numerator: Number of perinatal staff that received training in tobacco cessation

Denominator: N/A

Significance: Data for 2012 revealed that 3.5% of pregnant women were smoking in the third trimester of pregnancy, and overall 13.6% of women in DC are current smokers. Higher rates of tobacco use are seen among African-Americans (21.5% are current smokers). (Center for Policy, Planning and Evaluation, 2014 Infant Mortality Report) African-Americans have a disproportionally high smoking rate compared to other groups, 28.4% compared with 18.8% among the entire population (DC BRFSS 2013).

Data Sources and Data Issues: 1. Healthy Start 2. Breathe DC

Year: 2017/2019

Unit Type: Count, Unit Number: 100,000

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: Increased number of trainings, providers reached.

Numerator: N/A

Denominator: N/A

Significance: This is part of a strategy to maintain the Non-Clinical Outreach (NCO) activities by providing tobacco education and treatment training to social service providers across the State that serve pregnant women and women of child bearing age.

Data Sources and Data Issues: MaineHealth monthly report

Year: 2017/2019

Unit Type: Count, Unit Number: 500

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to professionals

Goal: To increase the number of health professionals trained in tobacco prevention and cessation interventions to enhance their understanding and skill in providing tobacco cessation counseling and intervention to women of reproductive age and their partne

Numerator: Number of health professionals trained on tobacco risks and cessation interventions as it relates to risks associated to maternal and infant exposure to tobacco per state fiscal year.

Denominator: NA

Significance: Tobacco use is one of the most preventable risk factors of poor birth outcomes. Smoking during pregnancy increases the risks of spontaneous abortion, ectopic pregnancy, cancers, stillbirth, premature birth, stunted growth, cleft palate, low birth weight, and sudden infant death syndrome (SIDS). As of 2016, the Centers for Disease Control and Prevention reports that Texas is one of the better performing states for maternal smoking, largely due to the higher number of births to Hispanic women who are less likely to smoke. However, there is geographic disparity in this behavior with higher rates of maternal smoking in the north and east of the state.

Data Sources and Data Issues: Data source: DSHS Maternal and Child Health Section (MCHS) and Tobacco Prevention & Control Branch (TPCB). State fiscal year data for number of health professionals trained will be collected from the following program: 1. OPE Module: Preconception and Prenatal Health: Identifying and Intervening in High-Risk Behaviors The goal of this module is to equip Texas Health Steps providers and other health-care professionals to improve the preconception and prenatal health of women in Texas. Target audience is primary care providers and other health professionals who treat adolescent and adult female patients who may become pregnant again or for the first time. This module discusses the risks of tobacco use and smoking during pregnancy, provides examples of smoking cessation interventions, and provides listed resources for smoking cessation. 2. CHW Trainings. Trainings will address the needs of maternal and child health by expanding the number of CHWs that are educated about the hazards of tobacco to maternal and child health populations in order to better serve their communities and educate women about the hazards of tobacco and cessation support. 3. NAPPSS-IIN - In early 2018 DSHS was chosen to represent Texas as one of five pilot states in the National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN). DSHS will provide outreach and technical assistance to the selected pilot hospital to support the creation, testing and implementation of the NAPPSS-IIN safe infant sleep and breastfeeding care bundle. One critical element of the bundle is health care professional (provider) training to increase knowledge and skills around policies and practices for optimal safe sleep and breastfeeding; smoking prevention and intervention will be part of this training. Healthy Texas Babies Community Coalitions: DSHS support 8 perinatal community coalitions across the state to engage local stakeholders and communities in evidence-based interventions

Year: 2017/2019

Unit Type: Count, Unit Number: 0

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities related to systems-building

Goal: Promote increased use of the state-funded quitline

Numerator: number of calls received by New Hampshire Quitline

Denominator: N/A

Significance: Promoting increased use the state-funded quitline is included in the April 2016 Sample Strategies and Evidence-Based or Informed Strategy Measures compiled by the Strengthen the Evidence for Maternal and Child Health Programs Initiative and is a strategy supported by the associated Environmental Scan of Strategies for NMP #14.

Data Sources and Data Issues: Source: QuitLogix Tobacco Quitline database (New Hampshire), operated by National Jewish Health Total number of quitline calls received is defined as: 1. linked to NH birth record AND... 2. Up to 3 months prior to estimated conception date OR 3. During pregnancy OR 4. Up to 3 months after live birth Establish cohort of NH mothers with live birth in 2017. This allows a full assessment of the time window (see above) around pregnancy. Linkage to birth certificate data is possible for pregnancies resulting in a live birth (NH residents). Timing of quitting may be prior to the pregnancy, during pregnancy, or postpartum. Pregnancies not resulting in a live birth may not be captured, though the system does have a data field to capture responses to question regarding currently pregnancy (very small number flagged for 2015). Time window of three months prior to pregnancy through three months after live birth narrows the cohort of mothers (by about 50%) who can be comprehensively assessed for this measure. De-duplicate mothers (i.e. adjust for multiple births). Can provide context by citing percent of cohort reporting smoking on birth certificate, but this is not appropriate to use as a denominator due to data quality. Analysis of NH birth records and PRAMS data show significant underreporting of smoking on the birth certificate.

Year: 2017/2019

Unit Type: Count, Unit Number: 12,076

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Reduce household smoking (NPM# 4) by increasing referrals of pregnant women to Mom's Quit Connection.

Numerator: The number pregnant women referred to Mom's Quit Connection during the calendar year.

Denominator: The number of women delivering a newborn during the calendar year.

Significance: Maternal smoking is one of the most significant and preventable risk factors of adverse birth outcomes.

Data Sources and Data Issues: Mom's Quit Connection data

Year: 2017/2019

Unit Type: Rate, Unit Number: 1,000