Division of Research, Training and Education

The work of all Maternal and Child Health Bureau divisions, programs, and staff is in support of the Bureau’s Strategic Plan (2003-2007) for meeting the needs of the maternal and child health populations of the United States and its Jurisdictions. The Bureau focuses—through leadership, performance, and accountability—on accomplishment of five over-arching goals: 1) Provide National Leadership for Maternal and Child Health; 2) Promote an Environment that Supports Maternal and Child Health; 3) Eliminate Health Barriers and Disparities; 4) Improve the Health Infrastructure and Systems of Care, and 5) Assure Quality of Care. The Bureau’s progress—or accountability—toward goal achievement is reported annually.

The Division of Research, Training and Education (DRTE) is one of five divisions of the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB). DRTE provides leadership to assure the health of infants, children, adolescents and their families by

• supporting applied research to advance and improve the operation and effectiveness of maternal and child health (MCH) services and address priority MCH needs;
• investing in innovative long-term training and continuing education programs that increase the numbers of highly qualified MCH leaders;
• funding innovative community-based solutions to increase access to quality health care; and
• developing guidelines and tools to improve the quality of health promotion and preventive services for infants, children and adolescents.

MCH Training Program
In 1939, Title V of the Social Security Act was amended to provide grants to institutions of higher learning to support the training of public health professionals in maternal and child health. Today, MCHB funds 15 categories of training, which are focused primarily on long-term training at the graduate and postgraduate levels with the goal of developing high levels of skill, competence, and leadership in maternal and child health. In addition, continuing education grants are awarded for short-term, non-degree training in maternal and child health. In FY 2007, 126 grants were awarded, an investment of $36.4 million.

Interdisciplinary Training These programs have faculty from several professional disciplines who function as a team to provide interdisciplinary training, including:

Leadership Education in Adolescent Health (LEAH). Prepares trainees from a variety of professional disciplines (nurses, nutritionists, physicians, psychologists, and social workers) for leadership roles in clinical care, research, public health policy, and advocacy for adolescents.

Maternal and Child Health Leadership Education in Neurodevelopmental Disabilities (LEND). Trains individuals from a wide variety of professional disciplines to improve the health of children who have, or are at risk of developing, neurodevelopmental or other related disabilities such as autism and mental retardation. Interdisciplinary faculty and trainees include audiologists, dentists, family members, health administrators, nurses, nutritionists, occupational therapists, physical therapists, physicians, psychologists, social workers, special education professionals, & speech language pathologists.

Pediatric Pulmonary Centers. Prepares health professionals for leadership roles in the development, enhancement, or improvement of community-based, family-centered care for children with chronic respiratory diseases, including asthma. Interdisciplinary faculty and trainees include nurses, nutritionists, pharmacists, physicians, occupational therapists, physical therapists, respiratory care practitioners, and social workers.

Schools of Public Health. These programs train health professionals for leadership roles in solving public health problems, conducting applied research, and improving the health status of women, children, and families through participation in community activities.

Discipline-Specific Training--Selected Examples:
Developmental-Behavioral Pediatrics. Enhances the behavioral, psychosocial, and developmental aspects of general pediatric care. The programs support fellows in developmental-behavioral pediatrics to help prepare them for leadership roles as teachers, researchers, and clinicians.
Nutrition. Promotes healthy nutrition of children, adolescents, women, and families by providing graduate training to nutritionists and registered dietitians; trainees are prepared for leadership roles in public health nutrition. In addition, short-term training is provided to individuals from a variety of disciplines focused on both clinical and public health approaches to maternal and child nutrition.

Pediatric Dentistry. Addresses the need for access to dental treatment and preventive care for children at highest risk of suffering from oral disease, e.g., children in low-income families and children with special health care needs (CSHCN). Trainees work toward a graduate degree in public health and pediatric dentistry.

Continuing Education
Continuing Education (CE)—Offers short-term programs sponsored by institutions of higher learning to facilitate timely transfer and application of new information, research findings, and technology related to MCH and to update and improve the new knowledge and skills of professionals in programs serving mothers and children. Workshops, seminars, institutes, distance learning, and other related activities are targeted to the practicing public health workforce.

MCH Pipeline Program—Promotes the development of a culturally diverse and representative health care workforce by recruiting students from under-represented minorities into maternal and child public health professions. Faculty in MCH Pipeline training programs educate, mentor, guide and provide enriching experiences to increase students’ interests in MCH public health professions.

Complete MCH Training Program Information, including a map of current investments, the MCH Training Strategic Plan and other helpful information is available at: http://www.mchb.hrsa.gov/training/ .

MCH Research Program
The MCH Research Program began in 1965 with the purpose of supporting applied research to promote, safeguard, and improve the health of all mothers and children. Today, the Program continues to support research relating to maternal and child health services, including those for children with special health care needs, which shows promise of substantial contribution to advancement of the current knowledge pool especially in the areas of health access and services. Findings from the research supported by the MCH Research Program are expected to have potential for application in health care delivery programs for mothers and children. Funded research projects address critical MCH questions such as public health systems and infrastructures, health disparities, quality of care, and promoting the health of MCH populations, which also support the goals of the Health Resources and Services Administration.

Over 50 projects are currently supported. Examples include: pregnancy psychosocial risk screening, birth outcomes and early health trajectories, and caries prevention in inner city children. A complete list of projects funded in fiscal years 2000 through 2007 can be found at: http://www.mchb.hrsa.gov/research/. Findings from supported projects are published in leading Medline-refereed journals such as Pediatrics, JAMA, Obstetrics & Gynecology, and Child Development.

In addition to multi-year research projects, in January 2007, the MCH Research Program initiated support for one-year studies that analyze existing MCH data. These projects allow for researchers to study important MCH issues by analyzing secondary data. Also, the MCH Research Program supports research network programs: the Pediatric Research in Office Settings (PROS) Network at AAP and the Collaborative Ambulatory Research Network (CARN) at ACOG, and the Pediatric Emergency Care Applied Research Network (PECARN). These projects support the infrastructure behind practice-based research networks that are linked to larger organizations and result in dissemination and application of study findings.

The MCH Research Program encourages applications that address any of the four MCHB Strategic Research Issues: Fiscal Years 2004-2009:

• Public health service systems and infrastructures at the community, State and/or national levels, as they apply to different maternal and child health (MCH) populations based on demographic, epidemiological, and other factors.
• MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations. These health disparities and barriers to health care access may include racial/ethnic, cultural, linguistic, gender, developmental, geographic, immigrant, underserved, economic considerations, etc.
• Services and systems to assure quality of care for MCH populations.
• Promoting the healthy development of MCH populations.

Healthy Tomorrows Partnership for Children Program
The Healthy Tomorrows Partnership for Children Program promotes child health by encouraging communities to enhance prevention programs and to make health care for every child more accessible.

Healthy Tomorrows, which began in 1989, is a grant program funded by HRSA’s Maternal and Child Health Bureau and administered by the Bureau in partnership with the American Academy of Pediatrics. To date, over 136 Healthy Tomorrows projects have been funded in 44 states, the District of Columbia and Puerto Rico. Grantees have included, but are not limited to, medical centers, schools, local foundations and nonprofit agencies, community-based clinics, community health centers, hospitals, and local and state health departments.

Healthy Tomorrows supports the development of family-centered, community-based initiatives that:

• Plan and implement innovative and cost-effective approaches for focusing resources to promote community-defined preventive child health and developmental objectives for vulnerable children and their families, especially those with limited access to quality health services;
• Foster/promote cooperation among community organizations, individuals, agencies, businesses, and families;
• Involve pediatricians and other pediatric health professionals in community-based service programs; and
• Build community and statewide partnerships among professionals in health, education, social services, government, and business to achieve self-sustaining programs to assure healthy children and families.

Additional information about the Healthy Tomorrows program, including a listing of current grantees and information for prospective applicants, can be found at: http://www.aap.org/commpeds/htpcp/ (not a government web site).

Bright Futures for Infants, Children and Adolescents
Launched by HRSA’s Maternal and Child Health Bureau (MCHB) in 1990, with additional support from the Medicaid Program, Bright Futures is a major ongoing initiative to improve the quality of health promotion and preventive services for infants, children and adolescents.

Through Bright Futures, MCHB, its grantees and other partners:

• enhance the knowledge and skills of health care and oral health providers to help them practice developmentally appropriate, preventive health care in the context of family and community;
• develop, implement, evaluate and disseminate guidelines, strategies and tools for health care, oral health and public health professionals to implement the Bright Futures approach to prevention and health promotion;
• foster partnerships among families, health professionals, and communities to more effectively promote health and decrease morbidity; and
• encourage and enable families to actively participate in health promotion and disease prevention for their infants, children and adolescents.

Bright Futures Guidelines for Health Supervision for Infants, Children and Adolescents, the cornerstone of the initiative, is a set of comprehensive health supervision guidelines addressing health promotion and disease prevention in infancy, early childhood, middle childhood, and adolescence. Originally published in 1994, the Bright Futures Guidelines are currently undergoing a comprehensive revision which will be released in 2007. Pediatricians, family practitioners, nurse practitioners, dentists, nutritionists, nurses, behavioral health specialists, family representatives and others have actively participated in this current revision of the Guidelines, which will, for the first time, incorporate prevention and health promotion for children with special health care needs.

MCHB works with the American Academy of Pediatrics and many other partners to implement Bright Futures. Further information can be found at: http://www.brightfutures.aap.org (not a government web site).

For more information, please contact DRTE at 301-443-2340.