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Division of Reproductive
Health: Activities:
Maternal and Child Health Epidemiology Program: Participating State |
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Maternal and Child Health Epidemiology Program
Massachusetts
Current Assignee: Since October 2003, there has been an assignee
located with the Massachusetts Department of Public Health (MDPH), Boston MA
Current Fellow: Since July 2004, there has been a master’s prepared
fellow working with the assignee
Projects/Impact:
- Addressing Racial Disparities in Perinatal Outcomes: As a result of
the data and strategy presented, Massachusetts was selected as one of five
states to address racial and ethnic disparities in perinatal outcomes. In
collaboration with the Association of Maternal Child Health Programs (AMCHP),
MDPH is working with community partners to target 5 cities where
racial/ethnic disparities in infant mortality/prematurity/low birth weight
are highest. These 5 communities are developing specific community action
plans to address disparities, which will also be incorporated in a
statewide action plan to address disparities. In addition, Massachusetts
targeted its participation in the Matrixed Analytic Training for
Reproductive Maternal and Child Health Training (MATRICHS) on racial and
ethnic disparities on perinatal outcomes. The Massachusetts MATRICHS team,
sponsored by CDC, in collaboration with the University of Rochester,
includes members of the 5 target cities. Analytic capacity has been
improved in these target cities and the state has applied for a grant to
study anthropologic factors contributing to unintended pregnancy in Puerto
Rican women.
- Improving referral to Early Intervention (EI): The assignee is the
lead investigator in the evaluation of the Massachusetts’ EI program, one
of the most extensive programs in the U.S. By analyzing EI referral
patterns for very low birth weight infants, the assignee found that
infants of uninsured or black mothers were less likely to be referred or
referred early. These results were used by the Commissioner to advocate
for Medicaid waivers, and EI program leaders improved minority outreach.
- Improving the measurement of quality care delivery: The assignee is a
Department’s representative in collaboration with Massachusetts' neonatal
intensive care units in the Neonatal Quality Improvement Consortium (NeoQIC).
The assignee is helping to facilitate the linkage of clinical data to MDPH
vital and health services data through the Pregnancy and Early Life
Longitudinal database (PELL). This data will provide valuable information
on quality of care, practice improvement, infant morbidity, and service
utilization. Massachusetts will be one of few states to integrate clinical
and population data for population-based measurement of infant morbidity
and quality care improvement.
- Revising Massachusetts’ regulation on perinatal levels of care:
Provided clinical and policy expertise that helped form a state-wide
perinatal regulation revision workgroup to address highly controversial
issues surrounding hospital certification for levels of maternal and
newborn care. As a result, new state regulations will include more
detailed information regarding maternal and family-centered care,
culturally-competent care, specific staffing and credentials for neonatal
ventilation in level III and level II hospitals (special care nurseries).
The assignee also incorporated statewide reporting of care delivery and
complications to high-risk infants (e.g. very low birthweight infants)
into the revised regulations. This will assure monitoring of
population-based outcomes among the state’s highest risk infants and
provide data for quality assurance measures at the state and hospital
level. Completion of the regulations is anticipated to occur in a timely
manner and in conjunction with newly proposed American Academy of
Pediatrics’ national guidelines.
State-Related Publications
Barfield W, Clements K, Lee K, Kotelchuck N, Wilber N, Wise. Using
Longitudinally Linked Data to Improve Early Intervention Referral.
Pediatr Res 2004; 55(4); 523A:2963.
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Maternal and Child Health Epidemiology Program Page last reviewed: 2/8/08
Page last modified: 3/6/06
Content source: Division
of Reproductive Health,
National Center for Chronic
Disease Prevention and Health Promotion |
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PRAMS
A surveillance project of CDC and state health departments. PRAMS collects state-specific,
population-based data on maternal attitudes and experiences prior to, during
and immediately following pregnancy.
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