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Using the "Shaping Policy for Health” analysis tools to develop an action-oriented Plan to Improve Birth OutcomesRebecca Allen, Senior Manager, CT Community for Addiction Recovery (CCAR)
Marjane Carey, Owner and Principal, Carey Consulting
Jordana Frost, State Director of Program Services, March of Dimes
Erin Jones, Regional Director of Program Services, March of Dimes
Agenda
The charge: how it all came about
The process: DHPE Policy Analysis Tools
The players and their experience: from energy to synergy
Current status and future directions: we’re a force to be reckoned with!
1 out of 9 babies in the U.S. is born before 37 weeks of completed gestation. Premature birth is the number of killer of children under the age of 5.
Many of the surviving babies and their families face a lifetime of physical, emotional, and financial difficulties tied to the complications and sequelae of premature birth.
These include developmental delays and complications affecting breathing, vision, hearing, and digestion, just to name a few.
If you need a frame of reference…
Background Dept. of Public Health Commissioner
accepted the “ASTHO” Challenge (Association of State and Territory Health Officials) to reduce preterm birth by 8% by June 30, 2014. CT added additional component to reduce race and ethnic disparities in preterm birth.
Simultaneously, CT was 1 of 4, states selected to participate in National Governor’s Association (NGA), Learning Network to Improve Birth Outcomes. Partners include; Dept. of Public Health and Dept. of Social Services, Governor’s office, March of Dimes, New Haven Healthy Start
Background (cont’d) NGA had (3) Action Steps: 1. convene a statewide meeting,
2. Conduct (10) statewide consumer focus groups, and 3. by June 30, 2013 seeking sustainable funding. Step 1, Convene a meeting. March 13, 2013, over 8- MCH statewide
partners joined together and discussed the current MCH landscape in CT. Agreed to participate in a statewide coalition to improve birth outcomes, special attention to disparities, within current statewide structure.
Step 2, Conduct focus groups. (8) consumer focus groups we held throughout CT. Included pregnant and post partum woman in (8) CT communities.
Step 3, find sustainable funding. This is where we take an up expected, but exciting turn in our project and the Plan to Improve Birth Outcomes (PIBO) came to be.
Todays presentation will take you on our journey to become an actionable coalition.
The long and arduous process…
Prioritization Process
1) Brainstormed strategies
2) Conducted Impact Analysis
3) Conducted Stakeholder Power
Analysis
4) Combined Impact Analysis and
Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretation notes
7) Scan of other “plans” to identify
synergies
8) Aligned with AMCHP compendium to further organize strategies into nationally-recognized
framework
9) Selection of top strategies to be tackled by Coalition in the next
1-5 years
Directors of Health Promotion and Education (DHPE) is a professional association founded in 1946 with voting members representing the health promotion function in each state, territory, or indigenous nation
Key areas include: school health, health equity, and shaping policy for health
Shaping Policy for Health (SPH) Curriculum was developed through a CDC cooperative agreement with DHPE
Curriculum developers are from UNC (Chapel Hill) – James Emery, MPH and Carolyn Crump, PhD
Background on DHPE and the Shaping Policy for Health tools
Prioritization Process
1) Brainstormed strategies
2) Conducted Impact Analysis
3) Conducted Stakeholder Power
Analysis
4) Combined Impact Analysis and
Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretation notes
7) Scan of other “plans” to identify
synergies
8) Aligned with AMCHP compendium to further organize strategies into nationally-recognized
framework
9) Selection of top strategies to be tackled by Coalition in the next
1-5 years
HANDOUT
Impact Analysis
Prioritization Process
1) Brainstormed strategies
2) Conducted Impact Analysis
3) Conducted Stakeholder Power
Analysis
4) Combined Impact Analysis and
Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretation notes
7) Scan of other “plans” to identify
synergies
8) Aligned with AMCHP compendium to further organize strategies into nationally-recognized
framework
9) Selection of top strategies to be tackled by Coalition in the next
1-5 years
HANDOUT
Stakeholder Power Analysis
Prioritization Process
1) Brainstormed strategies
2) Conducted Impact Analysis
3) Conducted Stakeholder Power
Analysis
4) Combined Impact Analysis and
Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretation notes
7) Scan of other “plans” to identify
synergies
8) Aligned with AMCHP compendium to further organize strategies into nationally-recognized
framework
9) Selection of top strategies to be tackled by Coalition in the next
1-5 years
Here’s How We Pull it All Together!
Prioritization Process1)
Brainstormed strategies
2) Conducted Impact
Analysis
3) Conducted Stakeholder
Power Analysis
4) Combined Impact Analysis and Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretatio
n notes
7) Scan of other “plans” to
identify synergies
8) Aligned with AMCHP compendium to further
organize strategies into nationally-
recognized framework
9) Selection of top strategies to be
tackled by Coalition in the next 1-5 years
Monstrous Documents
Plan to Improve Birth Outcomes (PIBO)
24
Prioritization Process1)
Brainstormed strategies
2) Conducted Impact
Analysis
3) Conducted Stakeholder
Power Analysis
4) Combined Impact Analysis and Stakeholder Power Analysis
5) Sorted by Impact Score
6) Brief interpretatio
n notes
7) Scan of other “plans” to
identify synergies
8) Aligned with AMCHP compendium to further
organize strategies into nationally-
recognized framework
9) Selection of top strategies to be
tackled by Coalition in the next 1-5 years
Recommendations address:
Lifecourse education
Social determinants of health
Trauma prevention and trauma-informed systems of care
Family-supportive policies and program
Fatherhood
Health care integration (holistic wellbeing throughout the lifecourse)
Family planning, preconception and inter-conception health
Quality, content, and format of prenatal care
Health care systems incentives and payment reform
Additional strategies featured in the appendices address:
Provider knowledge of community resources Racism Supportive housing initiatives Financial literacy Community health workers The language of mental health and stigma Undocumented families Midwifery care Doula care
We have all the right buzzwords…
Pie in the sky?
We stumbled upon the concept of Collective Action… only to realize that’s the path we were already on!
Consider a flock of birds…
The Five Conditions of Collective Impact
Phases of Collective Impact
Determinants of Partnership Synergy
Resources
•Money•Space, Equipment and Goods•Skills and Expertise•Information•Connections to people, organizations and groups•Endorsements•Convening Power
Partner Characteristics
•Heterogeneity•Level of Involvement
Relationships Among Partners
•Trust•Respect•Conflict•Power Differentials
Partnership Characteristics
•Leadership•Administration and Management•Governance•Efficiency
External Environment
•Community Characteristics•Public and Organizational policies
Lasker R, Weiss E, Miller R. (2001). “Partnership synergy: a practical framework for studying and strengthening the collaborative advantage.” New York Academy of Medicine. The Millbank Quarterly Vol. 79 No. 2
SynergyResources
Skills and expertise of coalition members.
top level positions
working for many years in the MCH field
Information
members work in different areas of MCH
Partner Characteristics
Heterogeneity
diverse group of state, federal, and community stakeholders
Level of Involvement
69% report involved/very involved
Relationship Among Partners
Trust & Respect among members
worked together on past projects
group connectedness very strong.
Partnership Characteristics
Leadership
strength of coalition leadership
efforts to promote collaborative
listen and hear coalition members
Administration & Governance
high degree of formality
planning committee communicated frequently
Survey Results
Highest Satisfaction - 5 Commitment of Coalition to build
and sustain diverse membership (4.47)
Effort to promote collaborative (4.41)
Extent to which Coalition member are listened to and heard (4.35)
Coalition meetings stay on task and run smoothly (4.27)
Lowest Satisfaction - 1 Communication between the
Coalition and the broader community (3.31)
State needs assessment process (3.65)
Capacity of the Coalition to advocate effectively (3.53)
• Members appeared satisfied with coalition activities. 71% responding they were satisfied or very satisfied to the
statement my time is well spent. *SIBO is a great example of a collective impact initiative.
Where we have been…
The MCH Advisory Committee - up to March 2013 ·Quarterly networking meetings
The Coalition to Improve Birth Outcomes - March 2013 to September 2015 Charge to the Coalition: Produce
a Plan to Improve Birth Outcomes (PIBO)
Where we are going…
The MCH Coalition – Started September 2015 Serves as the MICH action planning team for
the State Health Improvement Plan (SHIP) Is implementing the PIBO Is changing MCH’s culture and tone by
Facilitating communication among Coalition members
Supporting coordination and alignment of efforts
Identifying opportunities for integration
Moving from Planning to Action in unison.
2016 Action Agenda for Maternal, Infant, and Child Health
PIBO
SHIP
MCH Block Grant
Becoming a vehicle to move from…
Thank you!
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