Division of Research, Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, 5600 Fishers Lane, Suite 18N-118, Rockville, MD, 20857, USA.
Policy Lab, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19146, USA.
Matern Child Health J. 2021 Feb;25(2):221-229. doi: 10.1007/s10995-020-03018-x. Epub 2021 Jan 4.
The Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) developed a three-tiered performance measure framework for the Title V Maternal and Child Health Block Grant program (MCH Title V). The third tier, evidence-based/informed strategy measures (ESMs) are developed by states to address National Performance Measures (NPM) goals. To support states' efforts, MCHB funded the "Strengthen the Evidence for Maternal and Child Health" (STE) to: (1) define the concept of evidence for the field with an emphasis on strength; (2) identify available evidence for each NPM, (3) translate ESM research for use at the state level; and (4) provide technical assistance (TA) to states to facilitate implementation.
The program conducted evidence reviews defining an "evidence continuum" emphasizing a continuum of strength, provided individual and group TA to MCH Title V grantees, launched a TA referral system, and reviewed state ESMs to assess use of evidence-based/informed strategies.
Ten evidence reviews identified multiple strategies as having "emerging" or "moderate" evidence. TA reached all MCH Title V programs, encompassing 59 US states and jurisdictions, and the TA referral system effectively partnered with MCHB resources. All MCH Title V states and territories submitted ESMs for the Block Grant program's first year reporting requirement.
STE is the first program to review available evidence on effective strategies addressing NPMs for MCH Title V. Identifying actionable next steps responsive to state needs will be a key factor for continued implementation of ESMs and achieving improvements in MCH.
卫生资源与服务管理局(HRSA MCHB)下属的母婴健康局(MCHB)为《Title V 母婴健康拨款计划》(MCH Title V)制定了一个三级绩效衡量框架。第三层是基于证据/知情的策略衡量(ESMs),由各州制定,以实现国家绩效衡量(NPM)目标。为了支持各州的努力,MCHB 为“加强母婴健康证据”(STE)项目提供了资金:(1)为该领域定义证据概念,重点强调证据的强度;(2)确定每个 NPM 的现有证据;(3)将 ESM 研究转化为州级使用;(4)为各州提供技术援助(TA),以促进实施。
该计划进行了证据审查,定义了一个强调强度连续性的“证据连续体”,为 MCH Title V 受赠人提供了个人和小组 TA,启动了 TA 转介系统,并审查了州 ESM,以评估基于证据/知情策略的使用情况。
十项证据审查确定了多种策略具有“新兴”或“中等”证据。TA 覆盖了所有 MCH Title V 项目,包括美国 59 个州和地区,TA 转介系统有效地与 MCHB 资源合作。所有 MCH Title V 州和地区都提交了 ESM,以满足拨款计划第一年的报告要求。
STE 是第一个审查针对 MCH Title V 的 NPM 的有效策略的现有证据的计划。确定响应州需求的可操作的下一步将是继续实施 ESM 和改善母婴健康的关键因素。