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Strengthen the Evidence for Maternal and Child Health Programs

Find State ESMs


Displaying records 1 through 13 (13 total).

ESM 6.1 The number of potential high risk screens referred to early intervention (Marshall Islands)

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=referral+service&NPM=6&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/6-developmental-screening.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: That 100% of high risk screens are referred to an early intervention program and our documented.

Numerator: Percentage of high risk screens referred to early intervention/Part C

Denominator: Text

Significance:

Data Sources and Data Issues: Research shows that healthcare providers’ knowledge of and referral patterns to early intervention services and other community services is quite low. It is important that we increase knowledge through academic detailing and other onsite outreach efforts. Specific attention will focus on ensuring that children identified at risk for developmental delays following a screen are actually linked with and receive the interventions recommended by the referring provider

Year: 2021

Unit Type: Yes/No, Unit Number: MCH Program, Marshall Health Information System

ESM 6.1 Percent of LHDs whose child health staff receive training on appropriate use of valid and reliable developmental, psychosocial, social determinants of health, and behavioral health screening tools for children during state fiscal year (North Carolina)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Provider Training". Find other NPM 6 provider-level strategies in MCHbest.

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

Service Type: Systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: By 2025, 100% of LHDs providing direct child health services will have received training on the use of valid and reliable developmental, psychosocial, social determinants of health, and behavioral health screening tools for children

Numerator: Number LHDs whose child health staff receive training on appropriate use of valid and reliable developmental, psychosocial, social determinants of health, and behavioral health screening tools for children during state fiscal year

Denominator: Number of LHDs providing child health services

Significance: The risk for developmental delay is increased in the population of low income children seen in LHDs. The appropriate use of evidence-based tools in developmental, psychosocial, and behavioral health screening for children greatly improves the ability to elicit and identify developmental concerns from parents. Formal tools are much more effective than in informal interview. Screening examines the general population to identify those children at most risk. Children identified with concerns are at risk for developmental delay and are referred for further evaluation. Evaluation goes beyond screening to ascertain diagnosis and develop recommendations for intervention or treatment. This is generally not done by the primary care medical home, unless co-located or integrated professionals are in the practice. The evaluation determines the existence of developmental delay or disability which generates a decision regarding intervention. Ongoing periodic screening gives a longitudinal perspective of an infant or child’s developmental progress. All concerns must be clarified and a need for a referral for further evaluation and intervention needs to be determined. Early referral for diagnosis and intervention helps to: - prevent or reduce the impact of developmental delays - identify, build and reinforce developmental strengths in the child and family - prevent fully developed developmental conditions or disorders; and - support school readiness.

Data Sources and Data Issues: The Pediatric Medical Consultant in the Children & Youth Branch will collect this information annually as she provides the majority of these trainings.

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.1 Percent of infants and children enrolled in WIC who are monitored using the Learn the Signs Act Early checklist (Massachusetts)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Implementation of Quality Standards" (https://www.mchevidence.org/tools/strategies/6-4.php). Find other NPM 6 practice/patient-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase developmental monitoring of children enrolled in WIC to ensure early identification of delays and facilitate connection to services when needed.

Numerator: Number of children enrolled in WIC who had a completed Act Early checklist

Denominator: Number of infants and children enrolled in WIC who are due for certification or mid-certification appointments

Significance: Early identification of developmental disorders is critical to the well-being of children and their families. Children from low income groups, such as those served by WIC, may experience delays in access to screening and diagnostic services and miss the opportunity to benefit from early intervention services. The WIC Developmental Milestones Program is based on the CDC’s “Learn the Signs. Act Early.” It was developed in Missouri to integrate LTSAE into WIC clinics, promote referral for early identification, and encourage children’s healthy growth and development. Because of its initial success, the program was replicated and refined in four Missouri counties, then expanded statewide and nationally through support from the CDC and the Association of Public Health Nutritionists. The Massachusetts WIC Program launched a pilot program with 7 local programs in 2019 and will initiate statewide rollout implementation by December 2020. https://health.mo.gov/living/families/wic/pdf/wic-developmental-milestones-executive-summary.pdf https://asphn.org/learn-the-signs-act-early/

Data Sources and Data Issues: Massachusetts WIC data system

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.1 Percent of children referred to early intervention who do not complete an evaluation (Colorado)

Measure Status: Active

Evidence Level: There is limited research in the evidence base to support this strategy.

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

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Decrease the percent of children referred to early intervention who do not complete an evaluation from 40.7% (2018-2019) to 38.0% (2025).

Numerator: Number of children referred to early intervention who do not complete an evaluation

Denominator: Number of children referred to early intervention

Significance: Developmental screening is critical to identify a child’s potential developmental delay and need for developmental services. Barriers between child and family-serving systems in Colorado make it difficult to access and share data to know when children are screened, referred and are accessing recommended services. This results in children and families not receiving appropriate and timely services, and providers being unable to coordinate care. The purpose of exploring a resource and referral use case is to improve communication and coordination among providers, partners, and families to: ensure appropriate and timely services; reduce the burden on families; allow information to be shared, in a bi-directional manner; and to inform policy and state and local investments. The value is measured by the completion of a discovery document.

Data Sources and Data Issues: Early Intervention Colorado

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.1 Percent of children aged 0-3 enrolled in MaineCare who had a claim for a developmental screening in the previous year. (Maine)

Measure Status: Active

Evidence Level: This ESM is based on state data and measures access to/receipt of care, thus doesn't align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the percentage of young children screened for developmental delay on an ongoing basis to ensure early detection and referral to appropriate services.

Numerator: Number of children enrolled in MaineCare aged 0-3 years of age with a claim for a developmental screening

Denominator: All children aged 0-3 years enrolled in MaineCare

Significance: Community-based organizations can increase access to developmental screening by referring to health care providers. Increasing developmental screenings for young children is a priority of Maine's Governor's Children's Cabinet. Maine's Medicaid Program has been tracking developmental screening rates among its members since 2011.

Data Sources and Data Issues: Office of MaineCare Services

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.1 Number of providers trained in developmental surveillance and screening (Vermont)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Provider Training". Find other NPM 6 healthcare practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: Achieve a comprehensive, coordinated, and integrated state and community system of services for children.

Numerator: Number of providers trained

Denominator: Number of providers trained

Significance: To assure that children are receiving developmental screening, Vermont Title V aims to train health and social service providers in the most up-to-date and validated tools and increase awareness of referral and support resources, through provider-level, childcare, and community trainings.

Data Sources and Data Issues: Data source: Help Me Grow Annual Reports (https://www.healthvermont.gov/children-youth-families/infants-young-children/help-me-grow-program)

Year: 2021

Unit Type: Count, Unit Number: 1000

ESM 6.1 Number of ASQs provided by WithinReach to callers (Washington)

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM or search for other strategies or promising practices.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Report on the number of Ages and Stages Questionnaires (ASQs) completed through WithinReach

Numerator: Number of ASQs completed through WithinREACH

Denominator:

Significance: WithinReach is a major partner in many of the State’s educational and outreach activities for the MCH population. Having a way to evaluate their work and the population’s access to it will help efforts to offer services and referrals to children and families that need them. A change in the number of people accessing the service might indicate other changes affecting the MCH population in Washington.

Data Sources and Data Issues: The data will come directly from WithinReach. The organization is presently collecting these data so there is no anticipation of difficulty in obtaining these data in the future.

Year: 2021

Unit Type: Count, Unit Number: 999999

ESM 6.1 Increase the number of parents of children 9-35 months who complete the ASQ developmental screening tool (Palau)

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn't align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase by 2% annually, the number of parents of children 9-35 months who complete the ASQ developmental screening tool

Numerator: Number of parents of children ages 9 through 35 months who complete the ASQ developmental screening tool

Denominator: Number of children ages 9 through 35 months

Significance: Family Health Unit (FHU) providers have been trained to administer the ASQ developmental screening tool. With limited specialty services for children in Palau, it is important to assess the children with developmental needs and identify needed services that may require off-island referrals or contracted specialty services.

Data Sources and Data Issues: ASQ Screening Database

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.1 Develop and implement Policy and Public Health Coordination rating scale to monitor developmental screening efforts around the areas of systems development, family engagement, data integration, and addressing vulnerable populations (Hawaii)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy 6.3 "Quality Improvement Programs in Health Care Settings". Find other NPM 6 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of children receiving developmental screening and referred and receiving services among Hawaii Title V direct service programs.

Numerator: Total scale score based on program assessment of 10 steps

Denominator: 30

Significance: The PPHC will help measure Hawaii’s efforts to improve the service delivery and systems development for developmental screening with the end goal of all the strategies and activities completion will signify that the system has been developed. A Policy and Public Health Coordination Scale (PPHCS) has been created to monitor/track progress made on the 5-Year plan strategies for developmental screening. The Title V Screening Workgroup will complete the scale annually starting in FFY 2019 as part of routine evaluation. Element 0 --Not met 1--Partially Met 2--Mostly Met 3--Completely Met Systems Development 1. Develop guidelines and toolkit for screening, referral and services. 2. Work with partners to develop infrastructure for ongoing training, technical assistance, and support for providers conducting developmental screening activities. Family Engagement and Public Awareness 3. Work with families and parent organizations to develop family-friendly material explaining importance of developmental screening and how to access services. 4. Develop website to house materials, information and resources on developmental screening. Data Collection and Integration 5. Develop data system for internal tracking and monitoring of screening, referral, and services data. 6. Develop process for on-going communication to review data findings and make adjustments for better outcomes for children and families Policy and Public Health Coordination 7. Develop Policy and Public Health Coordination Scale. 8. Conduct process for annual assessment of rating scale. Social Determinants of Health and Vulnerable Populations 9. Develop process for identifying vulnerable populations. 10. Work with stakeholders to address supports and targeted interventions for vulnerable populations

Data Sources and Data Issues: Program Data. The ESM 6.2 is using the Hawaii Title V Developmental Screening Workgroup’s Policy and Public Health Coordination (PPHC) rating scale to monitor infrastructure development on developmental screening and services within FHSD. It will be a self-assessment of the team’s efforts to improve efforts to develop the infrastructure for FHSD screening and services and will be measured annually.

Year: 2021

Unit Type: Scale, Unit Number: 30

ESM 6.2 A) Increase % of individuals identified as having a birth defect through the SCBDP who are referred to Babynet, and B) percent of referrals who are eligible for services who have scheduled an intake appointment (South Carolina)

Measure Status: Active

Evidence Level: Moderate. Aligns with Home Visiting Programs. Find other NPM 6 systems-level strategies in MCHbest.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase referrals and intervention among those SC individuals identified as having a birth defect.

Numerator: A) Number referred to BabyNet B) Number with an intake appointment scheduled

Denominator: A) Number of individuals identified as having a birth defect B) Number of individuals with a birth defect who are referred to BabyNet who are eligible for services

Significance: Early intervention is key to better outcomes for individuals identified with a birth defect; better efforts are needed to promote referral and services.

Data Sources and Data Issues: SC Birth Defects Program

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.3 Percent of families who participated in community outreach activities hosted by MCH to promote developmental screenings. (American Samoa)

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 4. Support and mobilize partners

Service Recipient: Activities directed to families/children/youth

Goal: Implement 4 community outreach activities by September 30, 2022 to promote developmental screenings for .

Numerator: Number of families of children ages 0 -35 months who participated in community outreach activities.

Denominator: Total number of children ages 0 to 35 months.

Significance: Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percent of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics recommends screening tests begin at the nine month visit. Early detection and referral to Helping Hands Early Intervention Program is critical for it helps children improve their abilities and learn new skills. Timely provision of developmental services can improve outcomes for children 0 to 3 years old with developmental delays.

Data Sources and Data Issues: SILAS

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.3 Percent of children participating in an evidence-based home visiting program who received age appropriate developmental screening, (Guam)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Home Visiting Programs". Find other NPM 6 caregiver-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Achieve a comprehensive, coordinated, and integrated state and community system of services for children, and promote a universal system of developmental screening

Numerator: Percent of children participating in an evidence-based home visiting program who received age-appropriate developmental screening

Denominator: Percent of children participating in an evidence-based home visiting program

Significance: Home visitors build a trusting relationship with families and, therefore, are well equipped to help families complete an ASQ developmental screening. Studies show that the earlier a delay is recognized and intervention is begun, the better the child’s chance of substantial improvement. Developmental screening is one of the best things you can do to ensure a child’s success in school and life. Home visitors need to receive training so they use the ASQ correctly, including how it is communicated to families and, if needed, how to make an appropriate referrals

Data Sources and Data Issues: program-level data from Guam's evidence-based home visiting programs; data issues: quality of data is dependent on home visitor data entry

Year: 2021

Unit Type: Percentage, Unit Number: 100

ESM 6.3 Percent of children enrolled in home visiting who received a referral for developmental services and have a complete referral. (Arizona)

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Home Visiting Programs". Find other NPM 6 strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: By 2025, 100% of children enrolled in home visiting who received a referral for developmental services will have a completed referral.

Numerator: Number of children enrolled in home visiting who received a referral for developmental services and have a completed referral

Denominator: Number of children enrolled in home visiting who received a referral for developmental services

Significance: Home visiting programs regularly connect families with community resources related to mental health, housing, employment, and other crucial services, and ASQ can help inform and ease the referral process. Once a child’s ASQ-3 or ASQ:SE-2 questionnaire is scored, the results will help inform what kind of follow-up steps will be appropriate, whether it’s referring the child for further evaluation, sharing learning activities with parents, or providing information about parent support groups and other community resources.

Data Sources and Data Issues: Home Visiting Programs

Year: 2021

Unit Type: Percentage, Unit Number: 100

   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.