Maternal And Child Health Epidemiology Research Articles

Recognizing Excellence in Maternal and Child Health (MCH) Epidemiology: The National MCH Epidemiology Awards.

Professionals in the field of maternal and child health (MCH) epidemiology are publicly recognized by the Coalition for Excellence in MCH Epidemiology representing 16 national MCH agencies and organizations. During the CityMatCH Leadership and MCH Epidemiology Conference, the national awards are presented to public health professionals for improving the health of women, children, and families. The awards have evolved over the last two decades with focus on awardees that represent more types of MCH public health professionals. Since 2000, the Coalition has presented 111 national awards in the areas of advancing knowledge, effective practice, outstanding leadership, excellence in teaching and mentoring, early career professional achievement, and lifetime achievement. Effective practice awards were most often presented at 45 awards, followed by early career professional achievement with 20. The awardees varied by place of employment with 37 employed at academic institutions, 33 in federal government positions, 32 in state or county government, seven in non-profit and two in clinical organizations. Awards were almost equally distributed by gender with 49 presented to women and 48 to men. Assessment of career advancement among previous awardees and acknowledging workforce challenges are gaps identified within the national awards process. Recognition of deserving MCH professionals sets the standard for those entering the field of MCH epidemiology and offers opportunity to recognize those who have built capacity and improved the health of women, children, and families.

Biopsychosocial determinants of opioid use disorder (OUD) and implications for maternal and child health research: A scoping review.

Opioid use disorder (OUD) is on the rise among women of reproductive age in the United States, contributing to a marked increase in the incidence of adverse consequences on maternal and child health (MCH). There is a dearth of literature on the biopsychosocial determinants of OUD in MCH populations and their role in the current opioid epidemic. The aim of this study is to examine the epidemiology of OUD in the United States and develop a biopsychosocial research model of OUD among women of reproductive age. Utilizing a scoping review methodology, a systematic search strategy was implemented using MEDLINE/PubMed, Integrated Library searches, and Google Scholar. Scholarly/peer-reviewed articles published up to July 2017, in English, and restricted to populations in the United States were eligible for inclusion. A qualitative synthesis of the selected studies was performed to summarize study findings. Multiple factors play a role at every level of the biopsychosocial model (BPSM) in OUD-from molecular (genetic, epigenetic), cellular-tissue, organ system, the person (psycho-affective, cognitive, and behavioral), to relation-ship-based (family, peers), community environment, healthcare-related, and policy levels. Important research gaps persist at every level and highlight the need for multiple-level biopsychosocial research to enhance our understanding of the nature, extent, distribution, etiology, and consequences of OUD among women of reproductive age. Our biopsychosocial model of OUD can be used to guide innovative MCH epidemiology research.

Power, Politics, and Health: A New Public Health Practice Targeting the Root Causes of Health Equity

Purpose Understanding the WHY, WHAT, and HOW of place-based work in maternal and child health (MCH) is critical to examining the components of the environment that shape health opportunity through the relationship between life expectancy and neighborhood residence. Description On September 18, 2014, during the CityMatCH Leadership and MCH Epidemiology Conference, Dr. Anthony Iton provided the Keynote Address focused on the root causes of health inequities. Assessment The address focused on issues of equity in California and initiatives designed to mitigate and prevent disparities, including the Bay Area Regional Health Equities Initiative framework. Dr. Iton presented information on how the framework translated into investment strategies and a policy and systems change approach to place-based work. Conclusion The field of MCH, because of its focus on supporting health during critical periods of development, is poised to play a significant role in reducing health inequities. Recognizing that human health suffers when low income communities are passive, disenfranchised and disorganized, in order to change this status quo, understanding that human capital is the greatest asset is the urgent challenge to the field of MCH.

Recognizing Excellence in Maternal and Child Health (MCH) Epidemiology: The 2014 National MCH Epidemiology Awards.

The impact of programs, policies, and practices developed by professionals in the field of maternal and child health (MCH) epidemiology is highlighted biennially by 16 national MCH agencies and organizations, or the Coalition for Excellence in MCH Epidemiology. In September 2014, multiple leading agencies in the field of MCH partnered to host the national CityMatCH Leadership and MCH Epidemiology Conference in Phoenix, Arizona. The conference offered opportunities for peer exchange; presentation of new scientific methodologies, programs, and policies; dialogue on changes in the MCH field; and discussion of emerging MCH issues relevant to the work of local, state, and national MCH professionals. During the conference, the National MCH Epidemiology Awards were presented to individuals, teams, institutions, and leaders for significantly contributing to the improved health of women, children, and families. During the conference, the Coalition presented seven deserving health researchers and research groups with national awards in the areas of advancing knowledge, effective practice, outstanding leadership, young professional achievement, and lifetime achievement. The article highlights the accomplishments of these national-level awardees. Recognition of deserving professionals strengthens the field of MCH epidemiology, and sets the standard for exceptional research, mentoring, and practice.

Using the Principles of Complex Systems Thinking and Implementation Science to Enhance Maternal and Child Health Program Planning and Delivery

Traditionally, epidemiologic methodologies have focused on measurement of exposures, outcomes, and program impact through reductionistic, yet complex statistical modeling. Although not new to the field of epidemiology, two frameworks that provide epidemiologists with a foundation for understanding the complex contexts in which programs and policies are implemented were presented to maternal and child health (MCH) professionals at the 2012 co-hosted 18th Annual MCH Epidemiology Conference and 22nd CityMatCH Urban Leadership Conference. The complex systems approach offers researchers in MCH the opportunity to understand the functioning of social, medical, environmental, and behavioral factors within the context of implemented public health programs. Implementation science provides researchers with a framework to translate the evidence-based program interventions into practices and policies that impact health outcomes. Both approaches offer MCH epidemiologists conceptual frameworks with which to re-envision how programs are implemented, monitored, evaluated, and reported to the larger public health audience. By using these approaches, researchers can begin to understand and measure the broader public health context, account for the dynamic interplay of the social environment, and ultimately, develop more effective MCH programs and policies.

The evolving role of leadership and change in maternal and child health epidemiology.

The evolving role of leadership and change in maternal and child health epidemiology.

Training maternal and child health epidemiologists: leaders for the twenty first century.

This paper reports on the structure, implementation and outcomes of the Maternal and Child Health (MCH) Epidemiology (MCHEPI) program at the University of Illinois School of Public Health (UIC-SPH) and discusses the successes and challenges in developing MCH Epidemiology leaders for the local, state, and national public health workforce. The MCHEPI program at UIC-SPH offers both the MPH and PhD degree and is based on six key components: integration across school divisions, competency-based training, tailored curricula, practica/dissertations with public health agencies, personal leadership training and development, and socialization. Based on data from the 1998-2012 cohorts, all former and current MCHEPI MPH students (n = 28) have participated in practica with local or state public health agencies and former and current MCHEPI doctoral students at the dissertation stage (12 out of 15) have partnered with local, state or national public health agencies in conducting their dissertations. The alumni of the MCHEPI MPH program (n = 25) appear to serve in higher level positions in their second compared to their first placements post-graduation. All MCHEPI doctoral alumni (n = 8) serve at the emerging senior level or senior scientist level upon graduation, in local, state and federal agencies, or in academe. Explicit linkage of MCHEPI students to practice through tailored curricula, practica, and dissertations with public health agencies, and the development of an identity as a member of the MCHEPI field appear to be important to the generation of epidemiology leaders for the MCH workforce. Leadership development is a lifelong process and as such, snapshots of current students and alumni at any one point in time do not provide the entire picture of the impact of MCH epidemiology training programs. Examining the trajectories of emerging leaders over time is essential for evaluating the true success of Maternal and Child Health Bureau workforce and training investments.

Increasing Scientific and Analytic Capacity in States: Extending Epidemiology Collaborations Beyond Traditional Workforce Development

Many of the articles in this issue of the Maternal and Child Health (MCH) Journal showcase examples of the high-level applied research currently being conducted by MCH epidemiologists working in state health agencies. This work is in part a product of a collaboration between the MCH Epidemiology Program (MCHEP) at the Centers for Disease Control and Prevention (CDC) and MCH epidemiology faculty at the University of Illinois at Chicago School of Public Health (UIC-SPH)—a collaboration that provided ongoing, distance-based, advanced training and technical assistance in analytic methods for 7 years. For an in-depth description of this collaboration, see the article by Rankin et al. [1] later in this supplement. This collaboration was one of the many workforce development initiatives designed to build analytic capacity in state and local health agencies sponsored by the CDC, HRSA/MCHB, City-MatCH, the Council of State and Territorial Epidemiologists (CSTE) and others over the past 25 years. As discussed in the commentary in this issue by Phillips et al. [2] these capacity building efforts have taken many forms, including face-to-face workshops, distance-based courses, blended trainings, academic degree programs, fellowships, and internships

Building Analytic Capacity, Facilitating Partnerships, and Promoting Data Use in State Health Agencies: A Distance-Based Workforce Development Initiative Applied to Maternal and Child Health Epidemiology

The purpose of this article is to summarize the methodology, partnerships, and products developed as a result of a distance-based workforce development initiative to improve analytic capacity among maternal and child health (MCH) epidemiologists in state health agencies. This effort was initiated by the Centers for Disease Control's MCH Epidemiology Program and faculty at the University of Illinois at Chicago to encourage and support the use of surveillance data by MCH epidemiologists and program staff in state agencies. Beginning in 2005, distance-based training in advanced analytic skills was provided to MCH epidemiologists. To support participants, this model of workforce development included: lectures about the practical application of innovative epidemiologic methods, development of multidisciplinary teams within and across agencies, and systematic, tailored technical assistance The goal of this initiative evolved to emphasize the direct application of advanced methods to the development of state data products using complex sample surveys, resulting in the articles published in this supplement to MCHJ. Innovative methods were applied by participating MCH epidemiologists, including regional analyses across geographies and datasets, multilevel analyses of state policies, and new indicator development. Support was provided for developing cross-state and regional partnerships and for developing and publishing the results of analytic projects. This collaboration was successful in building analytic capacity, facilitating partnerships and promoting surveillance data use to address state MCH priorities, and may have broader application beyond MCH epidemiology. In an era of decreasing resources, such partnership efforts between state and federal agencies and academia are essential for promoting effective data use.

Promoting a Trained MCH Epidemiology Workforce in State Public Health Agencies Through Strategies Developed From Continued Partnerships

Maternal and child health (MCH) epidemiology has become a major program component of most state Title V MCH programs [1]. MCH epidemiology is ‘‘the systematic collection, analysis and interpretation of population-based and program-specific health and related data in order to assess the distribution and determinants of the health status and needs of the maternal child population for the purpose of planning, implementing, and assessing effective, science-based strategies and promoting policy development’’ [2], a definition derived from the work of others [3]. Increasing ‘‘the proportion of Tribal, State, and local public health agencies that provide or assure comprehensive epidemiology services to support essential public health services[4],’’ including MCH epidemiology, is of national importance and continues to be recognized as a Healthy People objective [4]. Maternal and child health epidemiology capabilities in state and territorial public health agencies have increased over the last decade. According to national surveys, the percentage of jurisdictions reporting substantial epidemiology and surveillance capacity has increased from 35 % in 2001 to 55 % in 2009, and the percentage reporting minimal to no capacity has decreased from 25 % in 2004 to 12 % in 2009 [5]. Moreover, 46 % of jurisdictions have an MCH epidemiologist with a doctoral degree (M.D., Ph.D., and other doctoral degrees), the highest percentage of any public health epidemiology specialty area. This advancement in the MCH workforce occurred because of the strong collaborative efforts of federal public health agencies, academia, and national public health membership organizations [such as the Association of MCH Programs (AMCHP), Council of State and Territorial Epidemiologists (CSTE), and CityMatCH] to bolster MCH epidemiology training at every stage of professional development. The beginnings of these national efforts to promote a trained MCH epidemiology workforce have been described by others [3, 6, 7]. These early efforts included: (1) the Centers for Disease Control and Prevention’s (CDC) MCH epidemiology program (MCHEP) assigning doctoral-prepared career MCH epidemiologists to state and local public health agencies since 1986, with support from the Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB); and (2) MCHB awarding grants to train existing staff through regional perinatal data projects and continuing education programs such as the Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Building Leadership Skills and Promoting Workforce Development: Evaluation Data Collected from Public Health Professionals in the Field of Maternal and Child Health

Professional development, including training and leadership skill building, is important for maternal and child health (MCH) epidemiologists. Current workforce development and training opportunities vary, but lack an emphasis on linking leadership competencies with MCH epidemiology. This paper describes efforts at the annual MCH Epidemiology Conference (the "Conference") to promote leadership activities and workforce development, and recommendations to enhance professional development. An evaluation of attendee opinions on Conference workforce development activities was conducted during the 2009 and 2010 Conferences (70 and 66% response rates, respectively). Frequencies and percentages were calculated overall and by attendee profession. Qualitative responses to questions regarding workforce and professional development were classified by theme in 2009, and a categorical question was developed for the 2010 evaluation. A combined 38% of Conference attendees in 2009 and 2010 were MCH epidemiologists and 62% were other MCH professionals. Attendees recommended more support and access to training, mentoring, and resources including job opportunities. Continuing education (41%), special knowledge and skills-building training (51%), and development of online resources for training (57%) were highly recommended by attendees. Career (47%) and leadership (49%) mentoring by senior-level professionals in the field were also highly recommended. Promotion of leadership can be achieved by integrating the concept of leadership into the Conference itself; by publishing and disseminating MCH epidemiologic research in scientific, program, and policy settings; and by communicating the importance of epidemiologic findings to stakeholders and other non-scientific audiences.

Factors Associated with Improved MCH Epidemiology Functioning in State Health Agencies

This paper discusses characteristics that are associated with enhanced maternal and child health (MCH) epidemiology functioning in state health agencies. The concept of the "MCH Epidemiology Effort" is introduced as "the epidemiologic work carried out by multiple units and agencies aimed at informing program planning and policy development on behalf of women, children and families." This concept focuses attention on MCH epidemiology functioning at the organizational level rather than on individual MCH epidemiologists. The analysis used data from all 50 states and the District of Columbia. Each state participated in a telephone interview and submitted material that demonstrated the breadth, depth, and capacity of its MCH Epidemiology Effort. Several organizations, including the Council for State and Territorial Epidemiologists, the Health Resources and Services Administration/Maternal and Child Health Bureau, and the Centers for Disease Control and Prevention provided additional secondary data. The outcome for analysis was a three-category measure of MCH epidemiology functioning. The findings are consistent with, and add specificity to, those from prior assessments. In a multivariable model, agenda-setting by consensus, involvement of external stakeholders, the total of doctorally trained staff, and accessing CDC assignees or other staff were all significantly related to higher level MCH epidemiology functioning (ORs of 6.1, 6.6, 2.5, and 6.4, respectively; P<0.05). Organizational visibility of the MCH Epidemiology Effort and a data environment marked by routine data-sharing and data integration were marginally related. We provide recommendations for action at the state and federal level for advancing evidence-based decision-making in maternal and child health.

Recognizing Excellence in Maternal and Child Health (MCH): 2009 National MCH Epidemiology Awards

Recognizing Excellence in Maternal and Child Health (MCH): 2009 National MCH Epidemiology Awards