MCHB ALL GRANTEE MEETING

Divisions and Offices

October 4-7, 2004

MICHAEL KOGAN: Okay. We’re ready up here. You know, I was looking over the program for this afternoon, and I noticed there are about 13 or 14 speakers this afternoon. And when I thought about it, it reminded me of something that happened this summer, and this is a true story, by the way. This is one of the best bloopers I’ve seen in a while. I was watching the Tour de France with my kids on TV. And it was Lance Armstrong had just won his third straight stage. You might--if anyone of you were watching it, you might remember it. He was waving one of his teammates along with about seven miles to go to try to give him a victory, but he couldn’t take it. And then it looked like somebody from another country was going to win the stage, but in the last 100 yards, Lance Armstrong came back and beat him by that much of a tire length. So right after he won, of course they then cut away to 438 commercials, but then they went back to the commentators, and the commentators were still breathing heavily and one of them turns to the other and he says, “You know, I have just run out of expletives to describe Lance Armstrong.” And so my fondest hope, by the end of this afternoon, is that you will have not run out of expletives to describe MCHB. Now, I’m going to talk about the Office of Data and Program Development.

And for all of you working the MCH field, you probably know that to design good programs, you need to have good data; you need to know what’s gone on before you in that area. And then to design even better programs, you should evaluate what you’ve done to see how you can make it better. So we have five focus areas in our office. One is to build and enhance human resource capacity in MCH epidemiology. The second is to build and enhance our data systems at different levels. Third is to enhance the data capacity within MCHB. Fourth is to collect and analyze data related in maternal and child health. And the fifth area is, we coordinate the work on program accountability and evaluation and policy analysis. Now, these are the people who work on our staff in the data areas: Dr. Mary Overpeck, Rebecca Tingle, Steph Tumar, Dr. Rosemary Hakeem, Mary K. Kenny, Jennifer Fong, Jack Tinnebaum heads up the program development area with Jamie Resnick, Tonya Englehart, Jimmy Stout and Karen Thorn. Now, this being the political season, you’ve probably heard a lot of talk about mixed messages. You will not get that here. You will get a straightforward, clear presentation.

Let’s talk about the first focus area. That’s building and enhancing human resource capacity in MCH epidemiology. And you’ll notice a couple of things. I’m going to try to go quickly through the programs and maybe give a little more attention to certain programs. But you’ll notice a couple things: First, they’re targeted at different levels. Now, why is that? When different surveys have been done, either of graduate education or state health departments, one of the biggest needs that always comes across when you do needs assessment is more training in data and analysis, having people with better trained skills. So we try to target a number of different areas. And then another thing you'll notice is many of our programs in this area are targeted with the Centers for Disease Control. We’re both dedicated to building up capacity in this area.

So the first program is, we’ve been holding internet web-based data speaks for a number of years on different topics such as youth violence, obesity, integrated child health systems and these have been well attended. If people are interested in learning about the website or going to the archives of these, just please come see me at any time during the conference. To strengthen the ties between academia and state or local health departments, we give fellowships through ten schools of public health to students who work and use data at the state or local level to do their dissertations. We have a program of putting MCH epidemiologists in the states. We co-sponsor the MCH epi-conference with CDC every year. We also sponsor two-day, hands-on training before the conference. We’ve done it the last few years on various topics such as how to analyze Medicaid data, how to analyze complex survey data.

Other programs, we have an MCH EPI. The first program, the graduate student intern program, is targeted at the master’s level. Next, the program you see is targeted at people working in the fields in 18-month certificate program and that you can do through distance learning, primarily. And the next I’d like to highlight a little bit, because one of the things you often hear in maternal and child health is, “Well, what’s the evidence that this program works?” Or you hear from people at public health or medical journals saying, “Why don’t we get more papers from people at the local or state level?” Well, we have a system in place, and it mentions state and local areas, so it’s really targeted to anybody working in MCH to help people write scientific manuscripts to get them published in scientific journals. So one state can find out what another is doing, so maybe they can design a better program. And the last thing I want to mention in this area is, for the last few years, we’ve been sponsoring a training course in MCH Epidemiology. It deals with basic statistics; epidemiology needs assessment, program development, and trend analysis. It’s a five-day course.

Every year, we have nationally recognized faculty come to the course. And each year, we take about 40 students--we have many more apply. If you’re interested, I really encourage you to apply. Notices will be going out in January or February. Our next area is building and enhancing data systems at national, state and local levels. Dr. van Dyck mentioned this very briefly. For the first time ever in MCH, we will be able to get uniform state level data across all states. There have been other national maternal and child surveys before, but you could only get national level estimates. As you see, it’s 2,000 kids per state; it’s then weighted to a state’s population. We’re doing this with CDC, the National Center for Health Statistics. And we expect the data to be ready around January of 2005, public use. It might be February, but it should be close. Now, the second survey, again mentioned by Dr. van Dyck, let me talk-we conducted one from 2000 to 2002.

The next round is coming up beginning in January 2005. Again, we’ll select about 750 to 1,000 children with special healthcare needs per state. States are using the data from the last survey in a number of ways, and some of which I’ll talk about later. And again, this is focused on gathering information on the healthcare experiences and needs of children with special healthcare needs and their families. A survey that we do in our office with the National Institute of Child Health is a survey of 15,000 children in sixth through tenth grades called the Health Behaviors of School-Aged Children Survey. The same survey is given to kids in 30 other countries. We feel a lot of important information has come out from this survey. There have been articles on youth violence, on bullying. You might have seen it, it was the impedance for the anti-bullying campaign started by MCHB, and it’s also co-sponsored by David Hepple’s division. And it’s done every four years.

The next survey should be beginning in 2005. Other programs in building--we have other programs in building data capacity, such as integrating state’s child/health information systems with newborn screening services, and this we do with our Children With Special Healthcare Needs Division. It’s one of--the main reason we want to improve data systems is so we can develop better services for children. And so we’re trying to put this into practice. This is a grant program to five states seeing if once you work in developing an integrated child health information system, how well does that improve services for newborn screening. Next, you’ve probably--everybody in this room knows about racial disparities in maternal and child health. There’s probably not one of you who doesn’t know about it. And yet, the data you look at often comes from the same data sets: vital statistics; they might come from small studies. This is a program we have with four universities and working with four state or local health departments, to use multilevel modeling, which is, you take individual information as you get on a birth certificate and match it to more macro level information that you would get from the census data.

So you could look at where pockets of infant mortality, how does that correspond to poor housing in an area. How does it correspond to number of incidents of violence against women in an area? To try to look at new ways to give us information--again, how to design better programs. Last on this page, is the child death review that again, we’re doing with David Hepple’s division to look at causes of child death to see what we can do to improve those in the future. In order to make our surveys more useful to people, we’ve developed a web-based data resource center for both the national survey of children’s health and the national survey of children with special healthcare needs. If you’re interested, I’d be happy to give you the website information. You can go to this data resource center and download any data from you. You can run tables from it. You can get information from your states. It’s a very useful tool. Now, let me talk briefly about other data collection analysis activities.

We work on the Healthy People for 2010 in maternal and child health. We produce Child Health USA , which is a yearly compendium of the latest (inaudible) statistics on child health. We’ve been doing that since the early ‘90s. For the last few years, we’ve produced Women’s Health USA in conjunction with our Office of Women’s Health and our Division of Perionatal Systems and Healthy Start. We have produced a chart book on adolescent health using the health behaviors of school children survey. It compared health behaviors in the U.S. to health behaviors of kids in 30 other countries. It’s interesting to see where we rank on a number of variables. And you’ll find on the table of latest news releases, the chart book on children with special healthcare needs. And we’re going to produce chart books on children’s health, oral health and obesity. And they are planning a policy evaluation area. We work on the strategic plans, government performance and research act, SCHP and our evaluation areas. Finally, we provide technical assistance to anybody at almost any time. So if you have any questions, please contact me. I’ll be here all week. And I’ll be giving roundtables on Tuesday, Wednesday, so if you’re interested in more details, please come see me. Thanks very much.