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: 27


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.

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.

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.

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.

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.

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.

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.

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.

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.

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.