Inventory of Evidence-Based Practices (EBPs) for Healthy Start Programs

Evidence-based practices include actions, activities, strategies, or approaches that improve the health of women, before, during, and after pregnancy in order to improve birth outcomes and give infants up to age two years a healthy start. Also included in the collection are informational materials and tools that make it easier to implement evidence-based practices. To search by title, use the main search box located at the top of this page.

Most Recently Added EBPs:

Number of results: 63


MotherWoman

MotherWoman promotes the resilience and empowerment of mothers and their communities by building community capacity and advocating for just policies through evidence based research and grassroots organizing. MotherWoman hosts support groups for postpartum women (in MA, CA and NY), provides training for healthcare and social service providers, supports communities in creating coalitions to address the issue of perinatal emotional complications and perinatal mood disorders on the community level, and works to raise awareness about social and economic justice issues and promote policies that positively impact mothers, children and families on the regional and national levels. The MotherWoman Support Group Model is replicable and has been successful with a broad diversity of postpartum mothers in a wide variety of settings. MotherWoman’s commitment to diversity and inclusion allows for diverse mothers to find common ground, inspiration and community with each other.

Topics:

Depression Health Equity Mental Health

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

ACOG Postpartum Toolkit

Often referred to as “The Fourth Trimester,” the weeks after birth are a critical time for a woman and her infant, setting the stage for long-term health and well-being. This comprehensive toolkit, with an introduction by Dr. Haywood Brown, includes extensive resources on the key components of postpartum care, including support for new mothers, reproductive life planning, infant care, counseling for substance use, long-term weight management, and many more pertinent topics. It also features a sample postpartum checklist for women to complete.

Topics:

Alcohol/Drug Services Breastfeeding Chronic Disease Depression Healthy Weight Immunization Intimate Partner Violence Reproductive Life Planning/Family Planning Safe Sleep Tobacco Cessation

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Initiating Breastfeeding Intimate Partner Violence Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit Reproductive Life Plan Safe Sleep Smoking Abstinence Sustaining Breastfeeding

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

STDs and Pregnancy – The Facts

This colorful and easy-to-read patient brochure can be downloaded or ordered for free from the CDC. It discusses the effects of STDs on pregnancy and the importance of being tested for STDs before and/or during pregnancy. It reviews the preventive measures women can take to avoid contracting an STD before or during pregnancy and emphasizes the importance of being treated during pregnancy if required.

Topics:

Prenatal Care and Education STDs including HIV

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Screening for Syphilis Infection in Pregnancy

The incidence of syphilis in American women doubled between 2012 and 2016, and the incidence of congenital syphilis rose concomitantly. Congenital syphilis can lead to stillbirth, neonatal death, and lasting effects such as bone deformities and neurologic impairment in the newborn. Because of this, the USPSTF has reiterated its guidance that all pregnant women be tested for syphilis at their first prenatal visit. They also point out that many organizations recommend repeat testing of high-risk women in the third trimester and at delivery.

Topics:

Prenatal Care and Education STDs including HIV

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

HIV and Pregnancy

This patient handout in the form of questions and answers is designed to inform pregnant women and women planning a pregnancy about the risks of HIV infection during pregnancy. It covers the basics of HIV infection, its potential risks to pregnant women and their babies, and how these risks can be minimized with early diagnosis, certain preventive measures, and HIV treatment.

Topics:

Prenatal Care and Education STDs including HIV

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Committee Opinion on Prenatal HIV Testing

This recently revised document discusses the rationale and recommendations for “opt-out” HIV testing in pregnancy. It explains how test results can be used to guide treatment for HIV in pregnancy in order to optimize outcomes for both mother and baby.

Topics:

Prenatal Care and Education STDs including HIV

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Committee Opinion on Optimizing Postpartum Care

Because one half of all pregnancy-related maternal deaths occur postpartum, the weeks following childbirth are a critical period for a woman and her infant. In addition, health issues that arise in pregnancy can persist and presage long-term medical problems. In this Committee Opinion, ACOG lays out a new vision for postpartum care, redefining it as an ongoing process beginning within the first 3 weeks postpartum and tailored to a woman’s needs. The document includes practical advice on postpartum care as well as useful charts including a Timeline for Postpartum Care, a listing of The Components of Postpartum Care, and a table identifying Members of the Postpartum Care Team.

Topics:

Breastfeeding Chronic Disease Depression Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Birth Spacing Initiating Breastfeeding Perinatal Depression Follow Up Perinatal Depression Screening Postpartum Visit Reproductive Life Plan Sustaining Breastfeeding Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Alcohol Screening and Brief Intervention: A guide for public health practitioners

Screening and brief intervention (SBI) is a structured set of questions designed to identify individuals at risk for alcohol use problems, followed by a brief discussion between an individual and a service provider, with referral to specialized treatment as needed. This manual is designed to provide public health professionals, such as health educators and community health workers, with the information, skills, and tools needed to conduct SBI so that they can help at-risk drinkers reduce their alcohol use to a safe amount or stop drinking. The manual offers background information and practical steps for conducting SBI in a variety of public health settings, including trauma centers, emergency departments, other clinical settings, home visits, and public events.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Risk Assessment

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

AIM Patient Safety Bundles

The Alliance for Innovation on Maternal Health (AIM) is a national data-driven maternal safety and quality improvement initiative based on proven implementation approaches to improving maternal safety and outcomes in the U.S. The AIM supported safety bundles are collections of evidence based protocols and best practices for improving safety in maternity care, and handling obstetric complications and emergencies in hospital and outpatient settings. AIM provides implementation and data support for each AIM supported patient safety bundle.

Topics:

Case Management/Care Coordination Other Prenatal Care and Education Risk Assessment

Approaches:

Improve Women's Health

Benchmarks:

Postpartum Visit

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Black Mamas Matter: Advancing the Human Right to Safe and Respectful Maternal Health Care

This toolkit provides a foundation, framework and resources for advancing maternal health in the U.S. as a human rights issue. It provides a research overview of maternal morbidity and mortality, focusing on trends, health disparities and inequities. Based on the deliberations of a cross-sectoral convening of stakeholders it offers a state policy framework for upholding the right to safe and respectful maternal health care, which offers recommendations in six key areas: improving access to reproductive health care, improving quality of maternal health care, ensuring acceptability of maternal health care for women most at risk, ensuring widespread availability of maternal health services, ensuring non-discrimination in access to care and social determinants of health, and fostering accountability to human rights standards for maternal health care.

Topics:

Case Management/Care Coordination Home Visiting Insurance Coverage Life Course Model Patient-centered Medical Home Prenatal Care and Education Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Health Insurance Postpartum Visit Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Pregnancy & Opioids: What families need to know about opioid misuse and treatment during pregnancy

This guide provides information and resources for family members and friends on specific ways to support pregnant women with opioid use disorders, and help them to get the prenatal care, substance use treatment and other supports they need during pregnancy and postpartum.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Prenatal Care and Education

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Usual Source of Care

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

This update of the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment is intended to address addiction to a wide variety of drugs, including nicotine, alcohol, and illicit and prescription drugs. It is designed to serve as a resource for healthcare providers, family members, and other stakeholders trying to address the myriad problems faced by patients in need of treatment for drug abuse or addiction. It provides an overview of principles of effective treatment and evidence-based approaches to treatment, including behavioral therapies, pharmacotherapies and comprehensive approached. It discusses the unique needs of different groups including women, pregnant women and adolescents.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Tobacco Cessation

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Smoking Abstinence

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders

This guide is intended to support the efforts of states, tribes, and local communities in addressing the needs of pregnant women with opioid use disorders and their infants and families, through a coordinated, multi-sytem approach. The guide is designed to assist healthcare providers, SUD treatment providers, child welfare programs and judicial systems to improve their collaborative practice, and to offer information about additional resources that will strengthen their capacity to provide coordinated, best-practice care and services Collaborative planning and implementation of services that reflect best practices for treating opioid use disorders during pregnancy are yielding promising results in communities across the country. .

Topics:

Alcohol/Drug Services Case Management/Care Coordination Patient-centered Medical Home Prenatal Care and Education

Approaches:

Improve Women's Health

Benchmarks:

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Moms2B

Moms2B provides weekly education and support sessions for expectant mothers to promote healthy lifestyle choices and link women with support services. Topics covered include: breastfeeding, child development, family planning, goal setting, prenatal labor and delivery, maternal-infant health, positive parenting, reproductive health, and safe sleep. Moms2B is provided free of charge, with transportation assistance, on-site childcare and a hot, healthy meal. Ohio State University and community social service organizations support Moms2B participants with ongoing access to healthcare providers, lactation counselors, social workers, parenting educators and community health workers. The Moms2B program is based on an evidence-based pilot curriculum shown to increase breastfeeding and improve infant health.

Topics:

Breastfeeding Nutrition Parenting Education Prenatal Care and Education Reproductive Life Planning/Family Planning Safe Sleep

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Initiating Breastfeeding Reproductive Life Plan Safe Sleep

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

American College of Nurse-Midwives Position Statement on Screening and Brief Intervention to Prevent Alcohol-Exposed Pregnancy

ACNM encourages CNMs, CMs, and other professionals who provide care for reproductive-aged women to routinely use evidence-based strategies to prevent alcohol exposed pregnancy, including:
–Conduct universal alcohol screening and appropriate follow-up at least annually for all adults. For pregnant women, screen at the initial prenatal visit and during each trimester thereafter.
–Be aware of state reporting laws and potential practice implications regarding the use of ICD-10 codes to indicate alcohol use during pregnancy if recording alcohol exposure in the prenatal problem list.
–Provide education about the potentially harmful effects of alcohol on a developing fetus
–Advise use of effective contraception to prevent pregnancy; if the woman is not using contraception consistently, advise her to consider abstaining from alcohol use.
–Encourage women who are attempting to become pregnant to abstain from alcohol.
–Provide a brief behavioral intervention and appropriate follow-up plan for those who screen positive for symptoms or dependency, including a referral to specialty services as needed.
In addition,CNMs and CMs should seek information and training to enhance their knowledge and build theclinical skills needed to address alcohol use with women, especially those of reproductive age.

Topics:

Alcohol/Drug Services Prenatal Care and Education

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Committee Opinion on Opioid Use and Opioid Use Disorder in Pregnancy

This Committee Opinion states ACOG’s recommendations for screening and treatment of opioid use during pregnancy. Pregnancy provides an important opportunity to identify and treat women with substance use disorders, Universal screening for substance use should be a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman. Multidisciplinary long-term follow-up should include medical, developmental, and social support. Infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome by a pediatric care provider. Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes.

Topics:

Alcohol/Drug Services Prenatal Care and Education

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

A Public Health Response to Opioid Use in Pregnancy

This policy statement from the AAP advocates a public health response to the opioid epidemic and substance use during pregnancy, and recommends: a focus on preventing unintended pregnancies and improving access to contraception; universal screening for alcohol and other drug use in women of childbearing age; knowledge and informed consent of maternal drug testing and reporting practices;improved access to prenatal care, including opioid replacement therapy; gender-specific substance use treatment programs;and improved funding for social services and child welfare systems.

Topics:

Alcohol/Drug Services Prenatal Care and Education

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Family Spirit

Family Spirit is an evidence-based early childhood home-visiting program designed for and by American Indian communities. Family Spirit combines the use of paraprofessionals from the community as home visitors and a culturally focused, strengths-based curriculum as a core strategy to support young families. From pregnancy through the child’s 3rd birthday, parents gain knowledge and skills to promote healthy development and positive lifestyles for themselves and their children. Family Spirit addresses intergenerational behavioral health problems, optimizes local cultural assets, and overcomes deficits in the professional health care workforce in low resource communities. Evidence from three randomized controlled trials has documented important results including: increased parenting knowledge and involvement; decreased maternal depression; increased home safety; decreased emotional and behavioral problems of mothers; and decreased emotional and behavioral problems of children. The Family Spirit curriculum modules cover: Prenatal Care, Infant Care, Your Growing Child, Toddler Care, My Family and Me, and Healthy Living.

Topics:

Alcohol/Drug Services Breastfeeding Depression Home Visiting Parenting Education Partner Involvement Prenatal Care and Education Reproductive Life Planning/Family Planning Socio-emotional Development for Children

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Father/Partner Prenatal Involvement Initiating Breastfeeding Perinatal Depression Follow Up Perinatal Depression Screening Reproductive Life Plan Safe Sleep Smoking Abstinence Sustaining Breastfeeding

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Effectiveness of Family Planning Methods

This webpage provides basic information on a variety of contraceptive methods, including a link to a poster comparing typical effectiveness of contraceptive methods. The poster can be used to show women and men the range of contraception choices available to them, and which methods work best at preventing pregnancy. The webpage also provides additional resources on contraception for health care providers and consumers.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Reproductive Life Plan

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Components of the Well-Woman Visit

Annual well-woman visits provide an excellent opportunity for health maintenance and preventive care, including preconception and interconception counseling. Under the Affordable Care Act of 2010, Medicaid and most private insurance plans cover these visits without copay. The American College of Obstetricians and Gynecologists released these guidelines on recommended components of the annual visit based on previous evidence-based guidelines, current expert opinion, and the recommendations of a multidisciplinary task force. Recommendations on screening, laboratory tests, evaluation and counseling, and immunizations are organized into the age ranges 13-18, 19-45, 46-64, and >64.

Topics:

Alcohol/Drug Services Chronic Disease Depression Healthy Weight Immunization Intimate Partner Violence Nutrition Reproductive Life Planning/Family Planning Risk Assessment STDs including HIV Tobacco Cessation

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

From Coverage to Care

From Coverage to Care is an initiative to help people with new health care coverage understand their benefits and connect to primary care and preventive services that are right for them. These informational resources for newly insured consumers include print materials and videos in multiple languages, as well as social media widgets and infographics. All resources are easy to read and understand and help to improve people’s “health insurance literacy,” assisting them to use their new coverage to get the health services they need.

Topics:

Insurance Coverage

Approaches:

Improve Women's Health

Benchmarks:

Health Insurance

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Preconception and Interconception Care

This website contains an easy reference chart outlining the essentials of preconception/interconception care, a patient questionnaire exploring these elements, and references supporting both resources.

Topics:

Chronic Disease Immunization Reproductive Life Planning/Family Planning Risk Assessment STDs including HIV

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Baby Basics

Baby Basics is a set of materials (book, planner, posters) and programs designed specifically to provide lower-income and lower-literacy populations with crucial prenatal health information and support. The materials are designed to be beautiful and easy to read, serving as a catalyst for learning and family literacy. Both materials and programs strive to engage and educate underserved parents to become effective users of the healthcare system and advocate for themselves and their families.

Topics:

Prenatal Care and Education

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Birth Spacing Father/Partner Prenatal Involvement Initiating Breastfeeding Postpartum Visit Safe Sleep Sustaining Breastfeeding Well Child Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

National Center for Medical-Legal Partnership

Medical‐legal partnership (MLP) is an approach to health that integrates the work of healthcare, public health, and civil legal aid to more effectively identify, treat, and prevent health‐harming legal needs for patients, clinics, and populations. MLP addresses legal needs in the areas of income supports and insurance; housing and utilities; employment and education; legal status; and personal and family stability. MLP:

  • Trains healthcare, public health, and legal teams to work collaboratively and identify needs upstream;
  • Treats individual patients’ health‐harming social and legal needs with legal care ranging from triage and consultations to legal representation;
  • Transforms clinic practice and institutional policies to better respond to patients’ health‐harming social and legal needs; and
  • Prevents health‐harming legal needs broadly by detecting patterns and improving policies and regulations that have an impact on population health. 

Topics:

Case Management/Care Coordination Insurance Coverage Other Risk Assessment

Approaches:

Achieve Collective Impact Improve Women's Health

Benchmarks:

CAN Implementation Health Insurance

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Health Insurance Marketplace

This is the official government website where participants can find out if they qualify for health insurance, what their options are, and what assistance may be available to them (including Medicaid and CHIP). They can then proceed to apply for insurance at this site

Topics:

Insurance Coverage

Approaches:

Improve Women's Health

Benchmarks:

Health Insurance

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

UNCOPE – Used, Neglected, Cut Down, Objected Preoccupied, Emotional Discomfort

The UNCOPE consists of six questions and may be used free of charge for oral administration in any medical, psychosocial, or clinical interview to provide a simple and quick means of identifying risk for abuse and dependence for alcohol and other drugs.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

DAST – Drug Abuse Screening

The DAST is a 20-item instrument for clinical and nonclinical screening to detect drug abuse or dependence disorders. It is most useful in settings in which seeking treatment for drug use problems is not the patient’s stated goal.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

TWEAK – Tolerance, Worry, Eye-Opener, Amnesia, Cut-Down

The TWEAK (Tolerance, Worry, Eye-Opener, Amnesia, Cut-Down) is a five-item scale originally developed to screen for risk drinking during pregnancy. The items are not gender specific, however, and the scale can be used with either women or men.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ImmunizationforWomen.org

This website, with tabs for both providers and patients, provides current recommendations on immunizations for women. It includes information on vaccines for specific conditions, timing regimens, safety, and guidelines for use in pregnancy.

Topics:

Immunization

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Folic Acid and Multivitamins

This web page provides information on the importance of folic acid for women of reproductive age. Links describe why folic acid is important and give advice on dosage, the difficulty of obtaining this amount consistently in the diet, and folic acid and/or multivitamin supplementation.

Topics:

Nutrition

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

The Tampa Bay Doula Program

This Doula Program, targeted to low income pregnant women, provides free perinatal services, including community-based childbirth education classes, labor and delivery support, postpartum care, and instruction focusing on mom/baby attachment, extension of breastfeeding duration, and interconception care. Participants in the program have been shown to have a decreased infant mortality rate, reduced need for medical interventions during labor and delivery, and longer duration of breastfeeding their infants.

Topics:

Breastfeeding Other Prenatal Care and Education Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Birth Spacing Initiating Breastfeeding Reproductive Life Plan Sustaining Breastfeeding

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Oral Health Care During Pregnancy: A National Consensus Statement

This national consensus statement was developed to help health professionals, program administrators, policymakers, advocates, and other stakeholders respond to the need for improvements in the provision of oral health services to women during pregnancy. This statement is the product of the Oral Health Care During Pregnancy Consensus Development Expert Workgroup Meeting convened by HRSA’s MCHB in collaboration with ACOG and the American Dental Association.

Topics:

Oral Health

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Partners in Pregnancy

The Partners in Pregnancy program aims to improve pregnancy outcomes for high-risk pregnancies through home visits by nurses and outreach workers, in combination with a medical home and regular nurse consultations. Studies suggest that the program has reduced neonatal intensive care unit use and overall costs, due to more patients receiving comprehensive prenatal care and adopting healthier behaviors.

Topics:

Case Management/Care Coordination

Approaches:

Improve Women's Health

Benchmarks:

Usual Source of Care

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Nurse Family Partnership

The Nurse Family Partnership program provides home visits by registered nurses to first-time mothers, beginning during pregnancy and continuing through the child’s second birthday. The program aims to: improve pregnancy outcomes by promoting health-related behaviors; improve child health, development, and safety by promoting competent caregiving; and enhance parent life-course development by promoting pregnancy planning, educational achievement, and employment. Secondary goals include providing links with needed health and social services, and promoting supportive social relationships.

Topics:

Home Visiting Parenting Education Reproductive Life Planning/Family Planning Socio-emotional Development for Children

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Every Child Succeeds

Provides home visits focused on child development to first-time at-risk mothers, from pregnancy until the child’s third birthday. Goals are to decrease abuse and neglect, reduce unintentional injuries, strengthen the parent-child relationship, improve utilization of diagnostic services, encourage good health practices, link families with primary care, promote an optimal environment for learning and emotional growth, encourage development and self-care of mothers, and begin the school readiness process. ECS uses both the Healthy Families America and Nurse-Family Partnership models. Evaluation showed a 60% reduction in infant mortality compared to control group, and more children on track for language development.

Topics:

Case Management/Care Coordination Home Visiting Parenting Education

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Intimate Partner Violence Reading to Child Daily Usual Source of Care Well Child Visits Well Woman Visits

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Early Intervention Program (EIP) for Adolescent Mothers

Designed for adolescents (14-19) from underserved minority groups who are pregnant with their first child and planning to keep the infant. Objective is to improve maternal health behaviors during and after pregnancy, improve birth outcomes, build maternal caretaking skills , improve the quality of mother-child interaction, prevent rapid repeat pregnancy, increase educational achievement, and build social competence. Program consists of 2 prenatal and 15 postpartum home visits until the child’s first birthday.

Topics:

Case Management/Care Coordination Home Visiting Parenting Education Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Patient Centered Primary Care Collaborative List of Patient Centered Medical Homes

The Patient-Centered Primary Care Collaborative is the leading national coalition dedicated to advancing the patient-centered medical home. This searchable list contains a list of available programs providing medical homes. The programs are listed by state and with publically-reported outcomes on cost savings, increased preventive services utilization, fewer ED/hospital visits, improved access, and patient and provider satisfaction.

Topics:

Patient-centered Medical Home

Approaches:

Improve Women's Health

Benchmarks:

Usual Source of Care

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides Federal grants to States for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.

Topics:

Breastfeeding Nutrition

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Initiating Breastfeeding Sustaining Breastfeeding Well Child Visits Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

ACOG Recommendation for Postpartum Management of Gestational Diabetes

ACOG (The American College of Obstetricians and Gynecologists) Practice Bulletin #137 on Gestational Diabetes Mellitus (GDM) contains a flow chart for postpartum management of women with gestational diabetes. The purpose of the document is to provide a brief overview of the understanding of GDM, provide evidence-based management guidelines, and identify needs for further research.

Topics:

Chronic Disease

Approaches:

Improve Women's Health

Benchmarks:

Postpartum Visit

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care

Published by the Association of State and Territorial Health Officials (ASTHO), this document contains the most recent (2014) guidelines for the screening, referral, and treatment of Neonatal Abstinence Syndrome.

Topics:

Alcohol/Drug Services Other Risk Assessment

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

CDC’s Recommendations for Vaccines for Pregnant Women

The CDC offers vaccination recommendations for preconception/interconception, prenatal, and postpartum women. An Immunization and Pregnancy Vaccine Flyer, recommended immunizations schedule, and vaccine quiz are all available online. The influenza vaccine is recommended for all women, including pregnant women.

Topics:

Immunization

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

AAFP Updated Guidelines for Prenatal Care

Recommendations for providers of prenatal care.  Includes current evidence-based guidelines and easy-to-reference charts and tables on recommended prenatal screenings, vaccinations, dietary guidelines, counseling topics, sexually transmitted infections, and complications of pregnancy.

Topics:

Prenatal Care and Education

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

PASOs

“PASOs (or “steps” in Spanish) aims to improve health of Latino families in South Carolina by educating Latino parents and caregivers on issues related to healthy pregnancies and prenatal care, as well as appropriate child development and resources for child health, and by advocating for better, more accessible services for Latinos. PASOs provides a free, comprehensive 14-hour prenatal empowerment course, community health outreach and individual interventions to Latino families, and consultative services for maternal and child health providers and policymakers throughout South Carolina.

Topics:

Parenting Education Prenatal Care and Education

Approaches:

Improve Women's Health Promote Quality Strengthen Family Resilience

Benchmarks:

Initiating Breastfeeding Reading to Child Daily Reproductive Life Plan Sustaining Breastfeeding Well Child Visits Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Centering Pregnancy

CenteringPregnancy is a multifaceted model of group care that integrates the three major components of care: health assessment, education, and support, into a unified program within a group setting. Eight to twelve women with similar gestational ages meet together, learning care skills, participating in a facilitated discussion, and developing a support network with other group members. Each Pregnancy group meets for a total of 10 sessions throughout pregnancy and early postpartum. The practitioner, within the group space, completes standard physical health assessments.

CenteringPregnancy starts around the beginning of the second trimester and goes through delivery.

Topics:

Other Risk Assessment

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Well Child Visits Well Woman Visits

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Living Smart, Living Fit

Intervention program that provides comprehensive care to low-income pregnant and postpartum women with high BMI and depressive symptoms. Links patients to clinical care coordinators trained in motivational interviewing who promotes participation in a portfolio of mental and physical wellness activities.

Topics:

Depression Healthy Weight

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

The Parent Child Assistance Program (PCAP)

Evidence-based home visitation case-management model for mothers who abuse alcohol and/or drugs during their pregnancies. PCAP’s goals are to assist substance-abusing pregnant women and mothers in obtaining treatment for substance abuse and staying in recovery, to ensure that children are in safe and stable home environments and are connected to health care, to connect mothers to community resources, and to prevent future births of alcohol and drug-affected infants. Piloted in Washington State, PCAP has been replicated in 7 states, and across Canada and New Zealand.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Home Visiting

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Well Child Visits Well Woman Visits

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

T-ACE

T-ACE is a measurement tool with four questions that are significant identifiers of risk drinking (i.e., alcohol intake sufficient to potentially damage the embryo/fetus). The T-ACE is completed at intake. The T-ACE score has a range of 0-5. The value of each answer to the four questions is totaled to determine the final T-ACE score. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

CAGE-AID

Commonly used, 5-question tool that screens for drug and alcohol use/abuse. The CAGE-AID Assessment is a quick questionnaire to help determine if further assessment is needed. If a person answers yes to two or more questions, a complete assessment is advised. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

AUDIT (Alcohol Use Disorders Identification Test)

10-item questionnaire that screens for hazardous or harmful alcohol consumption. Developed by the World Health Organization (WHO), it correctly classifies 95% of people into either alcoholics or non-alcoholics. The AUDIT has been used with a variety of populations and cultural groups. It should be administered by a health professional or paraprofessional. Included on the Healthy Start National Evaluation Program Survey.

Topics:

Alcohol/Drug Services

Approaches:

Improve Women's Health

Benchmarks:

Well Woman Visits

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Pathways Model

The Pathways Model employs community health workers who connect at-risk women to evidence-based care using individualized pathways designed to produce healthy outcomes. The model promotes timely, efficient care coordination through incentives. It prevents service duplication by using a Community Hub, a regional point of patient registration, and quality assurance to support a network of agencies involved in providing care to the target population. The first implementation of the model in Richland, Ohio, resulted in increased services to at-risk women and a decline in the rate of low-birth-weight babies.

Topics:

Case Management/Care Coordination

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Well Child Visits Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

MCH Life Course Toolbox

This toolbox is an online resource for Maternal and Child Health researchers, academics, practitioners, policy advocates, and others in the field to share information, innovative strategies, and tools to integrate the Life Course Perspective into MCH work at the local, state, and national levels. Includes resources and tools to learn about the Life Course Perspective and strategies to incorporate the Life Course model into practice and policy.

Topics:

Life Course Model

Approaches:

Improve Women's Health

Benchmarks:

Usual Source of Care

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

CDC’s Information for Men on Preconception Health and Health Care

Men’s portion of the CDC’s information on preconception health and health care. Includes information on making a reproductive life plan for men, preventing and treating sexually transmitted diseases, tobacco and drug cessation, infertility, maintaining a healthy weight, learning about family history, getting help for violence, getting mentally healthy, and supporting one’s partner.

Topics:

Alcohol/Drug Services Chronic Disease Depression Healthy Weight Intimate Partner Violence Partner Involvement Reproductive Life Planning/Family Planning STDs including HIV Tobacco Cessation

Approaches:

Improve Women's Health Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Strong Healthy Women

Health behavior intervention that aims to improve women’s preconception and interconception health. Developed for low-income rural communities in Central Pennsylvania. Enrolls non-pregnant women capable of becoming pregnant in the future. Provides education about health-related factors associated with poor pregnancy outcomes; facilitates increased physical activity and improved nutrition; and encourages self-efficacy for personal healthcare. Enrollees attend six 2 hour group sessions over 12 weeks. Intervention was found to have improved attitudes and behaviors related to nutrition, folic acid supplementation, physical activity, and stress management, increased internal control of birth outcomes, lowered weight and BMI, and lowered pregnancy weight gain.

Topics:

Healthy Weight Nutrition

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan Well Woman Visits

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

CHOICES: A Program for Women About Choosing Healthy Behaviors

Brief intervention for non-pregnant women of childbearing age that are at risk for Alcohol Exposed Pregnancy. The intervention consists of four motivational interviewing sessions with a counselor/interventionist and one contraception counseling visit with a health care provider over a 12- to 14-week period. Program participants receive in-depth assessment of alcohol use and contraceptive use patterns; counseling about the consequences of alcohol use during pregnancy; advice and counseling, referral to community treatment services for alcohol-dependent drinkers; reproductive health education, and contraceptive services. Can be adapted, and has been implemented in about 30 sites.

Topics:

Alcohol/Drug Services Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: I. Evidence-based practices—have been rigorously evaluated and shown to be effective by MCH experts.

Every Woman North Carolina: North Carolina Preconception Health Campaign

This statewide initiative aims to improve birth outcomes in North Carolina. The goals of the March of Dimes North Carolina Preconception Health Campaign are to reduce infant mortality, birth defects, premature birth, and chronic health conditions in women, while also aiming to increase intended pregnancies. Key objectives are to improve women’s wellness, improve reproductive outcomes, and reduce health disparities. The campaign provides wellness and reproductive life planning resources for women, and training and resources for healthcare providers.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Healthy Women, Healthy Futures

Healthy Women, Healthy Futures aims to improve the physical, emotional, social, dental, and vision health of low-income, at-risk mothers before they become pregnant again, as a strategy to reduce rates of LBW and infant mortality. Participants attend weekly workshops , develop health and reproductive life plans, and consult with HWHF trained staff at home visits. Evaluation data to this point show health improvements due to improved knowledge and resultant behavior change; lifestyle improvements, such as increased exercise and better nutrition; and healthy, full-term pregnancies among participants.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: II. Promising practices—Innovative practices employed in the field, based on state-of-science knowledge about what works to improve outcomes, and gathering evidence of effectiveness.

Method Match

Method match is an interactive web site designed to assist women in choosing a method of contraception that meets their unique lifestyle and contraceptive needs. The tool allows women to sort, filter, and compare contraceptive methods to arrive at a decision that is right for them.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Birth Control Methods: Frequently Asked Questions

This webpage of the Office on Women’s Health answers in plain language frequently asked questions about birth control methods. It includes a chart comparing the various methods on effectiveness, risks, and side effects.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Show your Love Campaign

Show Your Love is a national campaign designed to promote wellbeing and support young adults as they strive to achieve their goals and make healthy lifestyle choices today. The campaign provides wellness/healthy living resources for young women and men, promotes the well visit, and funds projects that will help diversify preconception wellness and reproductive life planning messages and improve capacity to reach different consumer groups. The campaign also provides preconception and interconception tools and resources for healthcare providers.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

One Key Question Initiative (OKQ)

The One Key Question Initiative encourages all primary care providers to ask women the question “Would you like to become pregnant in the next year?” as a routine part of primary care. Asking this simple question ensures that more pregnancies are wanted, planned, and healthy. OKQ has been endorsed by American Public Health Association, American Academy of Family Physicians, and National Association of Nurse Practitioners in Women’s Health.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health

Benchmarks:

Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Before, Between, and Beyond Pregnancy : The National Preconception Curriculum and Resources Guide for Clinicians

A “one stop” resource for clinicians and others who want to learn more about preconception health, its history, the evidence supporting it and strategies for incorporating relevant content into daily clinical practice. Contains a Preconception Care Clinical Toolkit designed to help providers meet their patient’s needs in response to the question “Are you hoping to become pregnant in the next year?” Also includes CME opportunities, key articles, clinical guidance, and practice resources.

Topics:

Reproductive Life Planning/Family Planning

Approaches:

Improve Women's Health Promote Quality

Benchmarks:

Birth Spacing Reproductive Life Plan

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.

Getting the Coverage You Deserve: What to Do If You Are Charged a Co-Payment, Deductible, or Co-Insurance for a Preventive Service

This toolkit provides information on women’s preventive health services covered under the Affordable Care Act, and tools women can use if they encounter problems with this coverage. Includes templates for appeal letters to insurance companies in case of being wrongfully charged co-pays or deductibles for preventive services, birth control, breastfeeding counseling, BRCA testing, colonoscopy, or well-woman visits.

Topics:

Insurance Coverage

Approaches:

Improve Women's Health

Benchmarks:

Health Insurance

Evidence Rating: III. Expert guidelines—Protocols, standards of practice, or recommendations based on expert consensus.