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State and Local Health Departments
What you Can Do
What your state can do to help prevent neonatal group B strep disease:
I. Educational & promotional campaigns
II. Assessment & surveillance activities
Learn more about CDC's group B strep mission and program
I. Educational & promotional campaigns
A. | Establish a local coalition of key partners to support implementation of the CDC and the American College of Obstetricians and Gynecologists (ACOG) guidelines for group B strep disease prevention issued in 2002. Partners within the health department may include: health communications specialists, epidemiologists, and behavioral scientists. They may come from a variety of departments: communicable diseases, maternal and child health, and groups working on perinatal Hepatitis B and HIV prevention. Partners outside the health department may include: local hospitals with obstetric services, HMOs, local chapters of ACOG or the American Academy of Pediatrics (AAP), or American Academy of Family Physicians (AAFP), local clinical microbiologists, local nurse midwife organizations Activities the coalition can undertake include: |
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a. | Presentation of Grand Rounds, educational workshops and conferences about the new group B strep prevention guidelines. | ||
b. | Assistance to local HMOs or hospitals attempting to develop group B strep prevention protocols consistent with the new guidelines | ||
c. | Promotion of existing health communication tools for providers and the general public (for examples click here (link to order form)) | ||
d. | Development of new communication tools appropriate to your state; in particular materials addressing barriers to implementation of universal screening may be useful. | ||
B. | Develop and pilot test new health communications materials targeted at the following populations:
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II. ASSESSMENT & SURVEILLANCE ACTIVITIES:
A. | Conduct surveys of clinical laboratories to assess compliance with CDC recommendations for prenatal screening specimen collection and processing, providing feedback and follow-up with laboratories that are not complying. Sample copy of the laboratory survey used in this study ( 4 pages) |
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B. | Survey hospitals with obstetric services, or health care providers to collect data on group B strep prevention strategies and how they are implemented. In addition, provide feedback and follow-up with hospitals that are not complying with the recommendations in the 2002 guidelines. MMWR article summarizing results of a hospital survey (MMWR 2000:49:936-940) View a copy of the hospital survey that was used in this study ( 7 pages) View a copy of a recent prenatal care provider survey used in Minnesota ( 2 pages) |
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C. | Review a random sample of labor and delivery records to assess the prevalence of prenatal GBS screening and the proportion of GBS positive women who receive intrapartum antibiotics in your state. To read an article about such a survey, consult the following reference: Sample data collection form ( 2 pages) Sample instructions for chart abstraction ( 10 pages) Sample instructions on how to select a random sample of births in your survey ( 2 pages) |
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D. | Convince your state to implement two group B strep-related questions that are available to all states on the optional component of the Pregnancy Risk Assessment Monitoring Survey (PRAMS) (exit site). Provide feedback to prenatal care providers based on survey results for your state. View the PRAMS questions available to states on the optional component ( 2 pages) |
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E. | Require that invasive neonatal GBS Disease be reportable to State Health Departments. | |
F. | Solicit support for the addition of GBS prenatal testing or maternal GBS colonization to your state’s birth certificates for tracking purposes. | |
G. | Develop and pilot test new health communications materials addressing the following groups that are transitioning to the screening based approach:
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H. | Conduct Laboratory-based surveillance for invasive neonatal Group B Strep Disease. (Nationally, incidence of neonatal disease in the 1st week of life ranges from 0.2 to 1 case per 1,000 live births; late-onset disease typically has an incidence of 0.3-0.4 cases per 1,000 live births.) Sample data collection forms ( 3 pages) Learn more about the CDC’s laboratory based surveillance for group B strep |
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I. | If your state has a prenatal testing law, incorporate prenatal testing for group B strep into the law |
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J. | If you choose to conduct any of the above surveillance activities, you may want to track how your state is doing relative to two federal targets for early-onset group B strep disease prevention: |
Healthy People 2010 Objectives
Objective 14-16 : Reduce invasive early onset group B streptococcal disease.
The target set in this objective is 0.5 new cases per 1,000 live births for all racial and ethnic groups.
Government Performance and Results Act Target
II-J. Infectious Diseases Control
Group B Streptococcal Disease
Performance Measure set in FY01: Reduce the incidence of perinatal group B streptococcal infections to 0.3 per 1,000 live births.