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.

You searched for: Prenatal

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TIP 61: Behavioral Health Services for American Indians and Alaska Natives

SAMHSA’s new Treatment Improvement Protocol (TIP), TIP 61, provides practical guidance on Native American history, historical trauma, and critical cultural perspectives for behavioral health work with American Indian and Alaska Native clients. It discusses the demographics, social challenges, and behavioral health concerns of Native Americans and highlights the importance of providers’ cultural awareness, cultural competence, and culture-specific knowledge. Specific topic areas include workforce development strategies, program and professional development considerations, and culturally responsive policies and procedures.

Topics:

Alcohol/Drug Services Health Equity Mental Health

Approaches:

Benchmarks:

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

ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns)

ROSE is a class taught in prenatal clinics that gives pregnant women the skills and information that they need to lower their risk of postpartum depression.Through four 90-minute sessions, the program teaches pregnant women to recognize the signs of depression and how to reduce stress by seeking social support, finding a network of friends and family members, and knowing where to go for help. The ROSES Study (ROSE Sustainment Study) is currently partnering with 90 clinics providing prenatal services to low-income women in all 50 states. The ROSES study will help determine what outside supports are needed to help prenatal clinics implement and sustain ROSE, reducing negative consequences for mother and child.

Topics:

Depression Mental Health Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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

Mothers and Babies

Mothers and Babies (MB) is a program that promotes healthy mood management by teaching pregnant women and new moms how to effectively respond to stress in their lives through increasing the frequency of thoughts and behaviors that lead to positive mood states. Designed as a perinatal depression prevention, the Mothers and Babies targets three specific risk factors: limited social support, lack of pleasant activities, and harmful thought patterns. Mothers and Babies offers a “toolkit” of approaches for women to observe their mood, note factors affecting their mood, and make changes in their daily lives to impact these areas. Based on principles of cognitive-behavioral therapy (CBT), attachment theory, and psychoeducation, the Mothers and Babies Course is designed to be delivered by clinic- or community-based providers from a variety of educational and professional backgrounds, and can be delivered as a group intervention or as a one-on-one intervention in various settings where pregnant women access services (e.g. prenatal clinics, home visiting programs, WIC programs, County Health Departments, etc.).

Topics:

Depression Home Visiting Maternal Morbidity and Mortality Mental Health Parenting Education Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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

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.

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.

Responsible Fatherhood Toolkit: Resources from the Field

This toolkit presents a compilation of resources that highlight the challenges and key issues associated with launching and sustaining a successful fatherhood program. It covers topics such as: building an effective fatherhood program,effectively engaging fathers, cultivating community partners, recruiting and training staff, serving fathers with specific barriers, and promoting sustainability. The toolkit provides tips and suggestions from experienced practitioners, activities for use with fathers in one-to-one or group sessions, tools from model programs to use and share with fathers, and other helpful resources.

Topics:

Intimate Partner Violence Partner Involvement Socio-emotional Development for Children

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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.

Rural Behavioral Health: Telehealth Challenges and Opportunities

This brief looks at common acceptability, availability, and accessibility barriers to mental and substance use disorder (behavioral health) treatment and services in rural communities and presents ways telehealth can help surmount some of these barriers. The term telehealth refers to using internet and communications technologies, such as videoconferencing, chat, and text messaging, to provide health information and treatments in real time.

Topics:

Alcohol/Drug Services Case Management/Care Coordination Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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.

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.

Life in the Margins: Expanding Intimate Partner Violence Services for Women of Color by Using Data as Evidence: A National Technical Assistance Guidance

This guidance presents data, recommendations, and links to best and promising practices and resources to help anti-violence organizations and culturally-specific community organizations effectively address intimate partner violence affecting women and communities of color. The recommendations emphasize developing culturally specific programming, broad-based community engagement, strengthening social and economic safety nets, and increasing access to services and supports for women of color and their communities.

Topics:

Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

Preventing Intimate Partner Violence Across the Lifespan: A Technical Package of Programs, Policies and Practices

This technical package represents a select group of evidence-based strategies and approaches to help programs, communities and states sharpen their focus on prevention activities with the greatest potential to prevent intimate partner violence (IPV) and its consequences across the lifespan. These strategies include teaching safe and healthy relationship skills; engaging influential adults and peers; disrupting the developmental pathways toward IPV; creating protective environments; strengthening economic supports for families; and supporting survivors to increase safety and lessen harms. Commitment, cooperation, and leadership from numerous sectors, including public health, education, justice, health care, social services, business and labor, and government can bring about the successful implementation of this package.

Topics:

Intimate Partner Violence Life Course Model Parenting Education Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Intimate Partner Violence

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

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.

The Good Road of Life

This culture-based program uses sources of strength such as spirituality, humor, and healing to assist Native men and their family members address the impact of colonization, trauma, racism and other challenges that threaten the well-being of children and families. The curriculum for Native men is designed to assist Native men reclaim their roles as brave warriors, fathers, and husbands who provide for and protect their families and communities. The curriculum for Native families is designed to assist Native men, women, and their children to address unresolved conflicts in relationships, improve communication skills, and keep Native families together.

Topics:

Alcohol/Drug Services Depression Intimate Partner Violence Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Intimate Partner Violence

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

Obstetric Care for Women with Opioid Use Disorder

This Patient Safety Bundle from the Counsel on Safety in Women’s Health Care provides brief, straightforward guidance on the care of pregnant women with opioid use disorder. The document includes advice in four areas: Readiness (educating patients and staff), Recognition and Prevention, Response, and Reporting and Systems Learning.

Topics:

Alcohol/Drug Services

Approaches:

Benchmarks:

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.

Recruiting and Retaining Men in Responsible Fatherhood Programs: A Research-to-Practice Brief

This research-to-practice brief summarizes several promising practices from the Strengthening Families Evidence Review (SFER) on recruitment and retention. It provides guidance on on how to plan for recruitment, engage fathers in services, and maintain high rates of participation. The strategies can be tailored to meet the needs of specific programs and fathers. Regardless of the strategies used, all programs should be prepared for an intensive effort to recruit and enroll fathers.

Topics:

Participant Recruitment and Retention Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

2018 Prevention Resource Guide

This prevention resource guide offers information, strategies, and resources to support community service providers as they work with parents, caregivers, and children to prevent child maltreatment and promote social and emotional well-being. The guide focuses on protective factors that build on family strengths and promote optimal child and youth development. Information about protective factors is augmented with tools and strategies that help providers, advocates and policymakers integrate the factors into community programs and systems. The guide includes tip sheets for parents in English and Spanish on a range of parenting and child development topics.

Topics:

Intimate Partner Violence Life Course Model Parenting Education Partner Involvement Socio-emotional Development for Children

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Intimate Partner Violence

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

Building on Campaigns with Conversations: An Individualized Approach to Helping Families Embrace Safe Sleep & Breastfeeding

This series of learning modules is designed for a range of health professionals, human service providers, community health workers, home visitors, and peer supporters who interact with families on topics of safe sleep and breastfeeding. The modules are designed to help users understand the Conversations Approach and gain the knowledge and skills needed to implement it to promote breastfeeding and safe sleep practices. Modules cover: A New Approach, How Babies Sleep and Eat, Understanding Current Recommendations, Anticipating Reluctance and Refusal, Respectful Dialogue and Structure of a Conversation,Creating Plans to Support Family Decisions, and Putting It All Together to Make a Difference.

Topics:

Breastfeeding Parenting Education Safe Sleep

Approaches:

Promote Quality

Benchmarks:

Initiating Breastfeeding Safe Sleep Sustaining Breastfeeding

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

NICHQ Infant Mortality Prevention Toolkit

This interactive toolkit allows users to learn from participants in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (Infant Mortality CoIIN). The resource is organized by topics from the initiative, including social determinants of health, pre- and interconception care, risk-appropriate prenatal care, pre- and early- term births, smoking cessation, and safe sleep practices. It features change ideas, model programs, videos, and key insights from teams who are working to reduce infant mortality throughout the country.

Topics:

Life Course Model Prenatal Care and Education Safe Sleep Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Safe Sleep Smoking Abstinence

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

NICHQ Infant Mortality Prevention Toolkit

This interactive toolkit allows users to learn from participants in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (Infant Mortality CoIIN). The resource is organized by topics from the initiative, including social determinants of health, pre- and interconception care, risk-appropriate prenatal care, pre- and early- term births, smoking cessation, and safe sleep practices. It features change ideas, model programs, videos, and key insights from teams who are working to reduce infant mortality throughout the country.

Topics:

Life Course Model Prenatal Care and Education Safe Sleep Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Safe Sleep Smoking Abstinence

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

Promundo: Program P: A Manual for Engaging Men in Fatherhood, Caregiving, and Maternal and Child Health

Program P is a resource developed as part of the global MenCare campaign coordinated by Promundo and the Sonke Gender Justice Network. The manual outlines concrete strategies for engaging men in active caregiving from their partner’s pregnancy through their child’s early years, and preventing violence against women and children. It includes tools to aid in creating open spaces for men in the clinic setting, detailed guidance on providing gender-transformative group education for men, and advice on encouraging community mobilization around fatherhood, child protection, maternal and child health and gender equality. It is available in 5 languages.

Topics:

Intimate Partner Violence Parenting Education Partner Involvement Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

WHO Guidelines for Identification and Management of Substance Use and Substance Use Disorders in Pregnancy

This 244-page publication contains detailed guidelines and recommendations on the identification and management of women who are pregnant or postpartum and use alcohol or drugs or have a substance use disorder. It includes extensive information on screening and brief interventions, psychosocial interventions, detoxification and quitting programs, pharmacological treatment, breastfeeding and maternal substance use, and management of infants exposed to alcohol and other psychoactive substances. The document also features a comprehensive review of the evidence behind the recommendations.

Topics:

Alcohol/Drug Services Breastfeeding Prenatal Care and Education Risk Assessment

Approaches:

Benchmarks:

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

CRAFFT Screening Tool

The CRAFFT is a short, validated behavioral health tool developed to screen adolescents under age 21 for high risk alcohol and drug use. Recommended by the American Academy of Pediatrics, it consists of 6 questions involving Car, Relax, Alone, Forget, Friends, and Trouble. The tool is meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and/or drug use is warranted. It is available in 13 languages.

Topics:

Alcohol/Drug Services Risk Assessment

Approaches:

Benchmarks:

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

Bringing Fathers In Fact Sheets

This set of 9 fact sheets for programs that serve families makes the case and provides implementation tips for fully and effectively engaging fathers. The fact sheets describe the importance of involved fathers for improving maternal and child health outcomes, supporting children’s early learning and reducing family and community violence. They also provide best practice do’s and don’ts, tips for attracting fathers to programs, and father-inclusive evaluation strategies.

Topics:

Participant Recruitment and Retention Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

Changing Systems & Practice to Improve Outcomes for Young Fathers, Their Children & Their Families

This policy report highlights the need to support young fathers by providing recommendations for child welfare system policy and practice change. Research shows that the relationship between fathers and their children is essential to the well-being of families and the healthy development of children, however little attention is paid to the importance of engaging young fathers under age 26, particularly young fathers who are involved with child welfare systems. This report provides recommendations on how systems can better focus on father involvement to increase positive outcomes for fathers, their children and families.

Topics:

Case Management/Care Coordination Intimate Partner Violence Parenting Education Participant Recruitment and Retention Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

Smoking Cessation During Pregnancy

Smoking is the one of the most important modifiable causes of poor pregnancy outcomes in the United States, and is associated with maternal, fetal, and infant morbidity and mortality. This ACOG Committee Opinion provides evidence-based guidance on helping pregnant women quit smoking. It contains examples of effective smoking cessation interventions and instructions for use of the 5A’s, a counseling intervention specifically targeted to pregnant women. The potential effects on pregnancy and lactation of alternative forms of nicotine, such as e-cigarettes and vaping, as well as medications used to help with smoking cessation, are also discussed.

Topics:

Prenatal Care and Education Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

Marijuana Use During Pregnancy and Lactation

Marijuana is the most common mood-altering drug used during pregnancy, and with legalization occurring in several states, there is concern that its use may increase. This ACOG Committee Opinion provides a comprehensive summary of current evidence regarding risks of recreational or medicinal marijuana use during pregnancy and lactation to both the mother and the fetus.

Topics:

Alcohol/Drug Services

Approaches:

Benchmarks:

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

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.

IPV Health Partners Toolkit

This toolkit is designed to help health centers to build a comprehensive and sustainable response to domestic violence and sexual assault (DV/SA) in partnership with DV/SA advocacy programs (social service organizations).Through five essential steps, health centers and social service partners can build partnerships, adopt evidence-based interventions, promote patient education around IPV, and enhance practice policies, procedures, and capacities to improve long-term health and safety outcomes for women and their families.

Topics:

Case Management/Care Coordination Intimate Partner Violence Patient-centered Medical Home Risk Assessment

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

Safe Homes, Safe Babies: Perinatal Safety Card

Safe Homes, Safe Babies is a safety card for women that perinatal health care providers can distribute to patients. In addition to providing safety resources for women, this tool also functions as a prompt for perinatal health care providers by providing quick phrases to improve discussions with women about the impact of domestic violence on their parenting and children. The safety card outlines questions women may ask themselves about their relationships, birth control use and parenting, while offering supportive messages and referrals to national support services for help.

Topics:

Depression Intimate Partner Violence Risk Assessment

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Perinatal Depression Screening

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

Futures Without Violence

The American College of Obstetricians and Gynecologists developed this comprehensive and practical guide to dealing with intimate partner violence and reproductive and sexual coercion in any setting involving reproductive healthcare. It provides strategies for addressing IPV and reproductive and sexual coercion (including useful tips and sample scripts), safety cards to use as a brief intervention to ask and educate patients about IPV and reproductive and sexual coercion, guidance on developing relationships with local domestic violence advocates and community programs, and a quality assessment/quality improvement tool to help programs and practices develop a sustained and coordinated response to IPV and reproductive and sexual coercion.

Topics:

Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

ACOG Fetal Alcohol Spectrum Disorders (FASD) Prevention Program

The Fetal Alcohol Spectrum Disorders (FASD) Prevention Program is a collaboration between ACOG and the CDC designed to empower healthcare providers to speak with their patients about abstaining from alcohol use during pregnancy. The program includes evidence-based ACOG Committee Opinions regarding ethics, alcohol use in pregnancy, and motivational interviewing techniques, as well as videos and free downloadable materials for both providers and patients.

Topics:

Alcohol/Drug Services

Approaches:

Benchmarks:

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

WINGS (Women Initiating New Goals of Safety)

Failure to address IPV among women who use alcohol or other drugs has been found to increase the likelihood of continued drug use, relapse, attrition from drug treatment and a host of other negative physical and mental health consequences. WINGS is a single-session intervention that aims to address a critical gap in IPV services for women by identifying women in the community at risk of IPV, enabling them to develop social support and safety planning skills to reduce their risks for IPV and linking them to IPV-related services and substance use treatment. The intervention may be delivered in-person or via a computerized self-paced version.

Topics:

Alcohol/Drug Services Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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 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.

Thinking Healthy: A manual for psychosocial management of perinatal depression

This manual is designed for training community health workers on how to support expecting and new mothers with depression, using evidence-based cognitive behavioral techniques. Community Health Workers can assist depressed mothers to change their unhealthy patterns of thinking and behavior, leading to an improvement in their mood and functioning, and prevention of later problems in their infants. The manual provides a step-by-step guide for CHWs implementing the Thinking Healthy intervention in 15 sessions with mothers (from pregnancy through baby’s first 10 months), and includes a structured process for each session, activities, worksheets and charts, and communication tips. This manual is a generic version for global use of a manual originally developed in Pakistan and later used in many other countries.

Topics:

Depression Parenting Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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

Guidelines for Identification and Management of Lead Exposure in Pregnant and Lactating Women

This is a comprehensive source of information on the risks of exposure to lead during pregnancy and lactation. It contains detailed information on sources of lead exposure in adults, and known risks of lead on the mother, developing fetus, and infant. Sample screening tools for assessing possible exposure, and information on management of women found to have elevated lead levels are also included.

Topics:

Breastfeeding Prenatal Care and Education Risk Assessment

Approaches:

Benchmarks:

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

Social Support Survey Instrument

This brief, self-administered Social Support Survey instrument was developed for patients in the Medical Outcomes Study (MOS), a two-year study of patients with chronic conditions. It is thought to also be appropriate for use with other populations. The instrument was designed to be comprehensive in terms of recent thinking about the various dimensions of social support – emotional/informational, tangible, affectionate, and positive social interaction. It is easy to administer and the items are short, simple, and easy to understand.

Topics:

Life Course Model Risk Assessment

Approaches:

Benchmarks:

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

Everyday Discrimination Tool

There is convincing research evidence that people experiencing greater discrimination in day-to-day life tend to have poorer physical and mental health outcomes than their counterparts. The Everyday Discrimination Scale (EDS) is a validated screen widely used to measure perceived discrimination. An original version of the EDS consists of nine items on a 6-point Likert-type response format, and a short version has been modified to five items.

Topics:

Life Course Model Risk Assessment

Approaches:

Benchmarks:

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

NIDA Quick Screen

The NIDA Quick Screen is a validated instrument designed to assist providers in screening adults for substance use. The screen simply inquires whether a participant has used drugs (mood-altering, illegal, or prescription for nonmedical reasons), alcohol, or tobacco products within the past year and how often these substances have been used. The NIDA website also provides guidelines for brief intervention and/or treatment referral for patients who may have or be at risk of developing a substance use disorder.

Topics:

Alcohol/Drug Services Risk Assessment Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

SmokefreeMOM

SmokefreeMOM is a mobile text messaging service designed for pregnant women across the United States to help them quit smoking. The program provides 24/7 encouragement, advice, and tips to help pregnant women and mothers quit smoking and stay quit. The messages in the program have been designed around not only a women’s quit date but also their child’s birthdate. The frequency of messages will vary depending on smoking status. Users can receive additional quit support by texting one of the SmokefreeMOM keywords.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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.

Mental Health First Aid

Mental Health First Aid is an 8-hour course that gives people the skills to help someone who is developing a mental health problem or experiencing a mental health crisis. The evidence behind the program demonstrates that it does build mental health literacy, helping the public identify, understand, and respond to signs of mental illness. Mental Health First Aiders learn a 5-step action plan that guides them through the process of reaching out and offering appropriate support. The “adult course” is available in both English and Spanish, and covers anxiety, depression, psychosis, and addictions in adults. The “youth course” is for adults who interact regularly with young people ages 12-18.

Topics:

Alcohol/Drug Services Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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.

Moms’ Mental Health Matters

This new initiative is designed to educate consumers and health care providers about perinatal mood disorders, emphasizing the newly-appreciated fact that they include both depression and anxiety and can occur both during and after pregnancy. In addition to education, the site provides action plans, referrals, and advice for partners, family, and friends of affected women. Related materials including posters, tear sheets, and postcards, all in both English and Spanish, can be downloaded or ordered for free.

Topics:

Depression Prenatal Care and Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Perinatal Depression Screening

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

The Surgeon General’s Call to Action to Support Breastfeeding

For nearly all infants, breastfeeding is the best source of nutrition and immunologic protection, and it provides remarkable health benefits to mothers as well. Many mothers in the United States want to breastfeed, and most try. Yet within only three months after giving birth, more than two thirds of breastfeeding mothers have already begun using formula. By six months postpartum, more than half of mothers have given up on breastfeeding. This Call to Action describes specific steps people can take to participate in a society-wide approach to support mothers and babies who are breastfeeding. It provides recommendations for women and families, communities, health care providers, employers, public health agencies, and researchers.

Topics:

Breastfeeding Prenatal Care and Education

Approaches:

Promote Quality

Benchmarks:

Initiating Breastfeeding Sustaining Breastfeeding

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

MothertoBaby

MothertoBaby is the leading authority providing up-to-date, evidence-based information to mothers, healthcare professionals, and the general public regarding the effects of medications and other exposures on pregnancy and breastfeeding. The website contains fact sheets in English and Spanish covering the risks of over 50 pharmaceuticals (listed alphabetically), herbal products, and other common lifestyle and occupational exposures. Excellent sections on tobacco, alcohol, and mood-altering drugs are included, as well as information on the safety of vaccines during pregnancy and breastfeeding. Experts are also available to answer individual questions confidentially by telephone, email, or text.

Topics:

Alcohol/Drug Services Breastfeeding Immunization Prenatal Care and Education Risk Assessment Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Initiating Breastfeeding Smoking Abstinence

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

4Ps Plus©

4Ps Plus© is the first validated instrument that has been developed to screen for alcohol, tobacco, and illicit drug use; depression; and domestic violence, specifically in pregnant women. In addition, brief intervention strategies, grounded in motivational interviewing techniques, are integrated into the screening process. “I am concerned…” is an interactive, multisensory psychoeducational approach that takes about five minutes and is administered to all women who are found through the screening process to be using alcohol, tobacco, or illicit drugs.

Topics:

Alcohol/Drug Services Depression Intimate Partner Violence Prenatal Care and Education Risk Assessment Tobacco Cessation

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence Perinatal Depression Screening 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.

National Resource Center for Healthy Marriage and Families

The National Resource Center for Healthy Marriage and Families (Resource Center) helps agencies develop the capacity to promote healthy relationship skills in a way that meets both their needs and those of the families they serve. As a service of the Office of Family Assistance, Administration for Children and Families, HHS, the Resource Center supports the integration of healthy marriage and relationship education into safety-net service delivery systems as part of a comprehensive strategy to strengthen families and promote family self-sufficiency.

Topics:

Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

Strong Families/Healthy Relationships Resources

This section of the National Responsible Fatherhood Clearinghouse provides resources on healthy relationships for programs that serve families. Healthy marriages and healthy relationships can serve an important role in promoting responsible fatherhood initiatives. Whether the fathers and families in your programs are currently married or not, integrating healthy relationship skills into your programs can better support fathers’ relationships with their partners and improve their co-parenting situations, leading to healthier models and environments for their children.

Topics:

Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

New Benefits for Breastfeeding Moms: Facts and Tools to Understand Your Coverage under the Health Care Law

This toolkit is designed for women, advocates, community-based organizations, and health care providers to provide information on the coverage of breastfeeding support, supplies, and counseling in the health care law (Affordable Care Act) and offer tools to women who encounter problems with this coverage. The toolkit also includes detailed instructions on how to call insurance companies, how to file an appeal if the plan denies coverage, and provides draft appeal letters tailored to commonly encountered scenarios.

Topics:

Breastfeeding Insurance Coverage

Approaches:

Promote Quality

Benchmarks:

Initiating Breastfeeding Sustaining Breastfeeding

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.

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.

Final Recommendation Statement: Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening

The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services. This recommendation statement provides information on several screening instruments that accurately detect IPV in the past year among adult women: Humiliation, Afraid, Rape, Kick (HARK); Hurt, Insult, Threaten, Scream (HITS); Extended–Hurt, Insult, Threaten, Scream (E-HITS); Partner Violence Screen (PVS); and Woman Abuse Screening Tool (WAST).

Topics:

Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

HITS

HITS (Hurt, Insult, Threaten, Scream) is a short (four items) instrument for intimate partner violence screening in health care settings. HITS is used in settings around the world in multiple languages.

Topics:

Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

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.

4Ps

The 4Ps (Parents, Partners, Past and Pregnancy) was developed for use with pregnant women and women of child bearing age. The tool has 4 questions intended to facilitate discussion regarding substance use.

Topics:

Alcohol/Drug Services

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

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.

ASSIST – Alcohol, Smoking, and Substance Involvement Screening Test

The ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) is an 8-item questionnaire designed to be administered by a health worker to a client using paper and pencil, and takes about 5-10 minutes to administer. The ASSIST provides information about the substances people have ever used in their lifetime; those used in the past three months; problems related to substance use; risk of current or future harm; dependence; and injecting drug use. The ASSIST was designed to be culturally neutral and usable across a variety of cultures.

Topics:

Alcohol/Drug Services Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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.

Community-Based Doula Programs

The Community-Based Doula Program connects underserved pregnant women to other women in their communities who are specially trained as doulas to provide support during the critical times of pregnancy, birth, and postpartum/early parenting. The program is based on the power of peer-to-peer support. Because doulas are of and from the same community as their clients, they are able to understand language and cultural needs and create long-term links to support networks. Women in the program have been shown to have higher breastfeeding rates, lower C-section rates, and more positive mother-infant interaction. HealthConnect One can assist in developing these programs.

Topics:

Breastfeeding Parenting Education Prenatal Care and Education

Approaches:

Promote Quality

Benchmarks:

Initiating Breastfeeding Sustaining Breastfeeding

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 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.

Growing Great Kids: Prenatal to 36 Months Curriculum

Growing Great Kids (GGK) is a comprehensive and skills-focused home visiting curriculum that takes a strength-based approach to growing nurturing parent-child relationships and supporting healthy childhood development. GGK modules are specifically designed to build protective factors for children, strengthen family foundations, and cultivate parental resilience. Training for home visitors to be certified to deliver the curriculum builds their competencies for: nurturing parental resiliency; advancing individual and family functioning; reducing a child’s exposure to toxic stress; nurturing parents’ problem-solving skills; strengthening the families’ support networks; and enabling parents to construct protective buffers around their children.

Topics:

Home Visiting Parenting Education Partner Involvement

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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.

Partners for a Healthy Baby

Nationally recognized, research-based, practice-informed curriculum used by many home visiting models to meet their program goals including improving birth outcomes, reducing rates of child abuse, strengthening families, enhancing child health and developmental outcomes, and promoting family stability and economic self-sufficiency. The curriculum addresses issues of child health and development within the context of the multifaceted needs of expectant and parenting families. Five-volume book series for different stages in pregnancy/parenthood, accompanied by a set of handouts for the home visitor to use when planning visits. Handouts for families can be purchased in English or Spanish and help the home visitor introduce subjects that may otherwise be difficult to talk about.

Topics:

Father/Partner Involvement Home Visiting Parenting Education

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Initiating Breastfeeding Reading to Child Daily Safe Sleep Sustaining Breastfeeding

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.

The Nurturing Parent Programs

The Nurturing Parenting Programs are a family-centered trauma-informed initiative designed to build nurturing parenting skills as an alternative to abusive and neglecting parenting and child-rearing practices. The long term goals are to prevent recidivism in families receiving social services, lower the rate of teenage pregnancies, reduce the rate of juvenile delinquency and alcohol abuse, and stop the intergenerational cycle of child abuse by teaching positive parenting behaviors.

Lessons can be delivered in home setting, group setting, or combination. Nurturing Parents offer targeted programs for prenatal families, parents of babies and toddlers, parents of older children, Spanish speaking parents, parents of children with health challenges, teen parents, military parents, parents in substance abuse treatment and recovery, and more.

Topics:

Parenting Education Socio-emotional Development for Children

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Intimate Partner Violence

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

Parents as Teachers (PAT)

PAT aims to increase parent knowledge of early childhood development and improve parenting practices, provide early detection of developmental delays and health issues, prevent child abuse and neglect, and increase children’s school readiness and school success. The PAT model consists of one-on-one home visits, group connections/meetings, health and developmental screenings for children, and a resource network for parents. Program lasts for at least two years, beginning as early as pregnancy and ending at the child’s 3rd birthday or at kindergarten entry.

Topics:

Home Visiting Parenting Education Socio-emotional Development for Children

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Reading to Child Daily Well Child Visits

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

Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program

CBFRS program, which targeted first-time mothers living in rural counties in Oklahoma, was developed to improve maternal and child health and child development. Weekly or biweekly home visits beginning before 28 weeks gestation continued to the child’s first birthday. The frequency of the home visits varied based upon the program phase. Home visits followed a standardized curriculum that covered maternal and child health, child growth and development, and parenting skills.

Topics:

Home Visiting Parenting Education Socio-emotional Development for Children

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement

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

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.

Healthy Families America

Designed for parents facing challenges including single parenthood, low income, and history of domestic violence, substance abuse, or mental health issues. Families are enrolled prenatally or at birth, and services are provided until the child’s 3rd or 5th birthday. Includes 1 home visit a week for the first 6 months, and less frequent visits after the child is 6 months of age.

Topics:

Case Management/Care Coordination Home Visiting Parenting Education

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Father/Partner Prenatal Involvement Perinatal Depression Screening

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.

Early Head Start – Home Visiting

Early Head Start is a comprehensive, two-generation federal initiative aimed at enhancing the development of infants and toddlers while strengthening families. Targets low-income pregnant women and families with children birth to age 3 years. 1 home visit per week per family for 90 minutes each, and 2 group socialization activities per month for each family. Early Head Start programs are operating in all 50 states, DC, and Puerto Rico.

Topics:

Home Visiting Parenting Education Socio-emotional Development for Children

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement Reading to Child Daily Well Child Visits

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.

Edinburgh Postnatal Depression Scale (EPDS)

The Edinburgh Postnatal Depression Scale was developed to screen postpartum women for depression in an outpatient setting. It is a 10 question screen that takes about 3-5 minutes to complete, and is easy to score. The EPDS asks the patient how she has been feeling over the last seven days. It has been validated for use during both pregnancy and the post-partum period. It has been translated into 23 languages.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

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

Depression During and After Pregnancy: A Resource for Women, Their Families, and Friends

Informational booklet for new mothers suffering from postpartum depression, published online in English and Spanish by the HRSA Maternal and Child Health Bureau.

For the Spanish version please click Here.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

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

Birthing Project USA

African-American maternal and child health program that encourages better birth outcomes by providing support to women during pregnancy and for one year after birth. Aims to assist local communities in improving health status by addressing the systemic causes, including lack of education, lack of social justice, and economic disparities compounded by institutional political and personal barriers. Birthing Projects actively engage community residents in identifying their needs; implementing and evaluating services; and working collaboratively with other agencies, organizations and individuals. Also provides guidance and support to fathers. The Birthing Project concept has grown into a nationally recognized model which has been replicated in more than 90 communities.

Topics:

Life Course Model Partner Involvement Risk Assessment

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Parenting Involvement

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.

Medicare and Medicaid Electronic Health Records Incentive Programs

The Medicare and Medicaid Electronic Health Care Record (EHR) Incentive Programs provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Contains information on the incentive programs, an eligibility assessment took, and information on getting started to implement EHRs.

Topics:

Other

Approaches:

Increase Accountability

Benchmarks:

Quality Improvement/Evaluation

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

Ohio Perinatal Quality Collaborative (OPQC)

The Ohio Perinatal Quality Collaborative (OPQC) is a statewide consortium of perinatal clinicians, hospitals, and policy makers and governmental entities that aims, through the use of improvement science, to reduce preterm births and improve birth outcomes across Ohio. OPQC uses monthly action period calls and face-to-face sessions with teams to review individual and aggregate data, learn from teams that have been successful at making changes and achieving improved outcomes, and apply the Model for Improvement to test specific strategies. OPQC was founded in 2007, and is seen as a national model in statewide perinatal improvement.

Topics:

Case Management/Care Coordination Prenatal Care and Education Risk Assessment

Approaches:

Promote Quality

Benchmarks:

Reducing Early Elective Deliveries Well Child 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.

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.

Why the Last Weeks of Pregnancy Count

A variety of bilingual materials explain why it is important not to schedule an induction or Cesarean section for non-medical reasons before 39 weeks gestation. Fetal growth and development in the last few weeks of pregnancy is highlighted.

Topics:

Prenatal Care and Education

Approaches:

Promote Quality

Benchmarks:

Reducing Early Elective Deliveries

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

Healthy Babies are Worth the Wait

Objective was to decrease the preterm birth rate in Kentucky by addressing preventable preterm births. Selected activities included the formation of Local Advisory Committees to inform the work; ongoing comparison of current practice to new science and best practice; identifying and addressing gaps in the system of care; education of providers, patients, and public about new information around prematurity and risks of early births; implementation of evidence-based practices; strengthening systems of care; and measuring progress. The HBWW model has been expanded to many sites in Texas.

Topics:

Prenatal Care and Education

Approaches:

Promote Quality

Benchmarks:

Reducing Early Elective Deliveries

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.

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.

Text4Baby

Text4baby is a free mobile information service designed to promote maternal and child health through text messaging. Lasts through pregnancy until baby’s first birthday. The messages address topics such as prenatal care, labor signs and symptoms, urgent alerts, breastfeeding, nutrition, exercise, oral health, immunizations, birth defect prevention, developmental milestones, safe sleep, family violence, injury prevention, mental health, substance abuse, car seat safety, and more.

Topics:

Alcohol/Drug Services Breastfeeding Depression Intimate Partner Violence Nutrition Parenting Education Safe Sleep

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Initiating Breastfeeding Intimate Partner Violence Perinatal Depression Follow Up Safe Sleep Sustaining Breastfeeding

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

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.

Beginnings Guide

The Beginnings Guide is an easy to understand pregnancy and childcare guide developed to improve health literacy. Used in 6+ home visitation programs serving low-income, ethnically diverse pregnant women and new parents, the guide was found to lead to significant improvements in functional health literacy scores across three ethnic groups and all reading levels and age groups. The approach/curriculum includes regular assessments of health literacy and should be integrated into established home visit programs. The guides are available to order online.

Topics:

Health Literacy Parenting Education

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Initiating Breastfeeding Intimate Partner Violence 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.

Health Cares About IPV

This toolkit for providers offered by Futures without Violence® includes assessment tools for screening women for IPV in a clinical setting, and information on supported referral and counseling. Accompanying materials available for purchase include promotional materials for healthcare settings, and the publication Addressing Intimate Partner Violence, Reproductive and Sexual Coercion: A Guide for Obstetric, Gynecologic and Reproductive Health Care Settings.

Topics:

Intimate Partner Violence

Approaches:

Strengthen Family Resilience

Benchmarks:

Intimate Partner Violence

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

Prenatal Plus Program

Prenatal Plus is a program that provides care coordination, nutrition and mental health counseling to Medicaid-eligible pregnant women in Colorado who are at a high risk for delivering low birth weight infants. The program uses the client-centered counseling approach with all participants to address a variety of issues that have been shown to have a negative impact on birth outcomes. The key health areas targeted by this program are healthy weight, smoking cessation and depression. The program has been demonstrated to decrease the rate of low-birth weight infants and resolve the risks putting women at risk of delivering low-birth weight infants.

Topics:

Case Management/Care Coordination Depression Healthy Weight Tobacco Cessation

Approaches:

Strengthen Family Resilience

Benchmarks:

Father/Partner Prenatal Involvement Perinatal Depression Follow Up Perinatal Depression Screening

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.

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.

You Quit Two Quit

You Quit Two Quit aims to ensure that there is a comprehensive system in place to screen and treat tobacco use in women, pregnant women, and postpartum mothers. You Quit Two Quit focuses on low-income women, new mothers, and recidivism prevention. Project activities include increasing the number of providers who screen, advise, and refer patients to the North Carolina Quitline, distributing patient and provider education materials statewide, developing best-practice, sustainable, community based smoking cessation projects for women, pregnant women, and new moms, and creating continuity of care by focusing on the preconception, prenatal and perinatal periods, and including an emphasis on preventing postpartum relapse and eliminating second-hand smoke exposure.

Topics:

Tobacco Cessation

Approaches:

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.

The Smoking Cessation Reduction in Pregnancy Treatment (SCRIPT) Program

The SCRIPT program is designed to be a component of a patient education program for prenatal care providers. The program includes A Pregnant Woman’s Guide to Quit Smoking, a 40 page guide outlining a self-evaluation process to help women quit smoking over a 7 day period; a 15 minute motivational DVD; comprehensive counseling to help pregnant smokers quit or reduce their smoking; and follow up programming to help mothers establish a non-smoking home after birth.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

Smoking Cessation in Pregnancy and Beyond: A Virtual Clinic

An updated online training, based on the “Virtual Practicum” model, designed to help health care practitioners assist female patients in quitting smoking, in particular women who are pregnant or in their child-bearing years. The training is intended for physicians, physician assistants, nurse-midwives, registered nurses, licensed practical/vocational nurses, nurse practitioners, certified health educators, other health educators, pharmacists, health professional students, and other professionals who may interact with women of reproductive age.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

Prenatal and Postpartum Behavioral Counseling

An in-person and telephone-based counseling program for pregnant African-American women with the goal of reducing behavior-related risk factors during pregnancy and in the postpartum period. In addition to receiving standard prenatal care, pregnant women attend an average of four behavioral counseling sessions during pregnancy and one session after giving birth. The intervention significantly reduced health risks from baseline to 10 weeks postpartum. Early results from a study evaluating the program’s impact on birth weight and infant mortality are encouraging.

Topics:

Depression Intimate Partner Violence Tobacco Cessation

Approaches:

Promote Quality Strengthen Family Resilience

Benchmarks:

Perinatal Depression Follow Up Smoking Abstinence

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

Clinical Effort Against Secondhand Smoke Exposure (CEASE) Program

In an effort to reduce children’s exposure to tobacco smoke, the Clinical Effort Against Secondhand Smoke Exposure program uses pediatric offices to provide smoking cessation assistance to parents who smoke, as well as to help families establish rules for a completely smoke-free home and car. Trained pediatricians and office staff consistently and systematically use a streamlined, three-step version of the traditional five-step (i.e., ask, advise, assess, assist, arrange) approach to smoking cessation and smoke-free home and car rule support. The program has led to an increase in the provision of cessation assistance and higher quit rates.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

Baby & Me – Tobacco Free

Incentive based program to increase smoking cessation among women during and after pregnancy. Demonstrated quit rate of 60% at 6 months post-partum. Developed in New York, now implemented in 8 states. Mothers commit to quitting smoking while pregnant, and stay nonsmoking after the birth. Mothers must attend at least 4 smoking cessation counseling sessions, and agree to submit to breath tests. If mothers remain smoke free, they receive monthly vouchers for free diapers up until their baby’s first birthday.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

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.

Patient Health Questionnaire-9 (PHQ-9)

Nine item questionnaire for patients to measure depressive symptoms over the past two weeks. Questions are linked to the DSM-IV depression criteria, and therefore scores can be used to track changes in depression as a response to treatment. Included on the Healthy Start National Evaluation Program Survey

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

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

Center for Epidemiologic Studies Depression Scale Revised CESD-R

The CESD-R is a screening test for depression and depressive disorder. The CESD-R measures symptoms defined by the American Psychiatric Association’ Diagnostic and Statistical Manual (DSM-V) for a major depressive episode. The scale is well known and remains as one of the most widely used instruments in the field.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

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

BDI-FastScreen

The BDI-FastScreen is a 7-item self-reporting instrument used to quickly screen for depression in adolescents and adults. The screen can identify depression while excluding symptoms that might be related to medical problems, and was specifically designed for evaluating depression in patients whose behavioral and somatic symptoms attributable to biological, medical, alcohol and/or substance abuse problems may confound diagnosis.

Topics:

Depression

Approaches:

Strengthen Family Resilience

Benchmarks:

Perinatal Depression Screening

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

Smokefree MOM, women.smokefree.gov

Women.smokefree.gov includes resources for women at any stage hoping to quit smoking tobacco, and has an entire section devoted to pregnant women and mothers. Smokefree MOM is a free texting service that provides tips, advice, and support for pregnant mothers in the process of quitting smoking.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

5A’s – Five Major Steps to Intervention

An easy-to-implement, evidence-based clinical counseling approach. The 5 A’s: Ask, Advise, Assess, Assist, and Arrange are 5 steps providers can use to identify appropriate interventions based on a patient’s willingness to quit.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

1-800 Quit Now

Calling 1-800-QUIT-NOW will connect you directly to your state quitline. All states have quitlines in place with trained coaches who provide information and help with tobacco cessation. Specific services and hours of operation vary from state to state.

Topics:

Tobacco Cessation

Approaches:

Promote Quality

Benchmarks:

Smoking Abstinence

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

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.

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.