Title V Strengths and Needs Assessment: Creating a method of measurement and assessment of MCH stren

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Title V Strengths and Needs Assessment Creating
a method of measurement and assessment of MCH
strengths in Region 1

• February 21, 2005
• Valerie Ricker, Maine Bureau of Health
• Thomas Rice, National Center for Infants and
  Early Childhood Health Policy
• Sally Kerschner, Vermont Department of Health

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Strengths Based Assessment

• Timeline
• January 2004
• MCHB sponsored Needs Assessment workshop
• Feeling somewhat doomed with continuing state and
  federal deficits
• MCHBG guidance needs-based sense of deficits
• Dialogue among Region I participants on planned
  approaches to 2005 assessment
• Desire broader perspective

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Strengths Based Assessment

• February 2004
• Regional dialogue continues
• Monthly conference call includes some discussion
  about the philosophy of strengths and assets in
  assessing populations
• AMCHP regional breakfast
• Continued discussion of strength and asset
  measures of populations
• Explore possible inclusion of a regional strength
  measure in 2005 assessment

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Strengths Based Assessment

• March 2004 through January 2005
• Discussion continues on monthly call
• Individual state dialogues for planning 5 year
  assessment
• Modify Title V guidance with suggestions for
  inclusion of strengths
• Search for existing strength based measures
• ECCS Learning Collaborative

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Strengths Based Assessment

• School Readiness Indicator Initiative
• Funded by Packard, Ford, Kauffman Foundations
• 17 states, including all of Region I
• Develop a comprehensive set of SRI to inform
  public policy for young children and their
  families

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Strengths Based Assessment

• Three year initiative
• States work individually and collectively to
  develop comprehensive sets of measures to monitor
  and track progress related to physical, social,
  emotional, cognitive, and economic well- being of
  young children
• Population prenatal through 5 years (school
  entry)
• Indicators looking at child outcomes as well as
  system outcomes

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Strengths Based Assessment

• Indicators
• Reflect state policy goals and state investments
  in programs and policies for young children and
  families as well as child outcomes
• Might these provide a foundation for a Region I
  strength based measure or indicator?
• National release of final document February 16,
  2005

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Strengths Based Assessment

• State Early Childhood Comprehensive Systems
  Initiative (SECCS)
• Funded by MCHB in 2003
• Title V to initiate development of early
  childhood systems plan
• Goal children who are healthy and ready to learn
  at school entry

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Strengths Based Assessment

• Five critical components
• Access to health insurance and medical homes
• Mental health and social-emotional development
• Early care and education/child care
• Parent education
• Family support

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Strengths Based Assessment Region I Learning
Collaborative

• Purpose To develop at least one asset-based
  indicator to measure early childhood systems
  include indicator in SECCS strategic plan and
  Title V block grant.
• Participants State teams from CT, MA, ME, NH,
  RI, VT includes SECCS coordinator, Title V
  director, CSHCN director, as appropriate (plus
  others)
• Timeline Begun Fall 2004 Ending Spring 2005
• Staffing National Center for Infant and Early
  Childhood Health Policy

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Strengths Based Assessment

• Rationale A cyclical process among groups with
  similar interests, a common goal in mind, and
  implementing similar strategies can more easily
  overcome obstacles
• Process
• Identified common interest and desired outcome,
• Met repeatedly in-person and by conference call
• Identified assets to build from (e.g., SRII)
• Developed framework for potential indicator
• development

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Strengths Based Assessment

• The Framework
• Any of the school readiness domains health,
  ECE, social and emotional health and development,
  parenting education, family support
• Four levels system, community, family,
  individual
• Each level responds to the level below and
  creates incentives for the level above
• Three types Type IPrevalence
• Type IIPerformance (e.g., quality)
• Type IIIInterconnectivity

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Strengths Based Assessment

• Definitions
• Indicator vs Measure Briefly, an indicator can
  have multiple measures
• Types of Measures Type I Prevalence Type II
  Performance Measure (e.g., quality) Type III
  Interconnectivity
• MCH Pyramid See Handout for
• traditional activities

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Strengths Based Assessment

• Next Steps
• Develop and prioritize indicators based on
  framework being used in workshop
• Complete final indicator selection
• Develop collection and reporting strategies
• Promote indicator selection and process as
• option for other states and regions

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Definition of Resiliency

• Refers to the ability to bounce back from adverse
  experiences and to avoid their long-term negative
  effects. It describes the power of people to
  recover, heal, grow and succeed in the midst of
  stress, which is often overwheming in nature.
• From Richard Aronson, MD
• Maine Bureau of Health, 7/04

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Applying the Concept of Resiliency

• Individuals
• Families
• Communities
• Populations (Title V SNA)

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History of Assets ResearchJohn MacKnight

• Community development is based on the capacities,
  skills and assets of the people and their
  communities.
• Service systems focus on community weaknesses,
  instead of supporting strengths, which empower
  communities.
• Kretzmann, J.and MacKnight, J. (1993). Building
  Communities from the Inside Out. Chicago, IL
• ACTA Publications.

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Research by Search Institute

• Extensive research on assets resulted in 40
  concrete, positive experiences and qualities
  the developmental assets of youth
• These assets are powerful influences on
  adolescent behavior both protecting youth from
  problem behaviors and promoting positive
  attitudes and behaviors.
• Research described the cumulative effect of
  assets as linked to a reduced likelihood of
  high-risk behavior in teens.
• Research has described assets for children in
  age groups other than adolescents
• www.search-institute.org

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Questions Pondered By Region 1

• There has been much work done in assessing
  strengths and needs of individuals and families
  and communities
• How to apply concept of assets to populations?
• How to reflect this in a population-based needs
  assessment
• How to create a true assets-based measure that
  reflects population health status
• What is the continuing role of deficit-based
  measures - to use as a tool for measuring
  effectiveness of asset based measures?

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Definitions

• Public Health Activities that a society
  undertakes to assure the conditions in which
  people can be healthy
• Population Based Public Health Services
  Interventions aimed at disease prevention and
  health promotion that affect an entire population
• Public Health System That part of the larger
  health system that seeks to assure condition in
  which people can be healthy
• Community A group of people who have common
  characteristics
• Turnock, B. (1997). Public Health What it is
  and how it works.
• Gaithersburg, MD Aspen

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Strengths and Needs Assessment

• Examples from Vermonts experiences with assets
  measurement and community programs

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Measuring Population Assets Youth

• It is the role of every society to prepare their
  youth for positive productive adult roles
• We have no way of measuring this all-important
  process
• Traditional social/health indicators have focused
  on risk behavior
• Murphey, D., Lamonda, K., Carney, J., Duncan, P.
  Relationships of a brief measure of youth assets
  to health-promoting and risk behaviors. Journal
  of Adolescent Health. 2004, 34184-191.

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One Approach used in Vermont to Measure Youth
Assets

• Vermont wanted a method of measuring youth assets
• Needed a brief measure of assets that could be
  incorporated into an existing tool Use of the
  YRBS
• Brief measure can be used to guide community
  based efforts to address youth asset-building
• Brief measure can be adapted for a
  screening-and-intervention tool for health care
  providers
• 40 Search Institute assets were too many chose
  six
• Murphey, D. et al. (2004). Journal of Adolescent
  Health

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Youth Risk Behavior Survey in Vermont

• Administered every two years
• 153 Schools participate (this is all the Vermont
  public high schools except one)
• Total of 30,916 students, grades 8-12,
  participated in 2003
• Traditional indicators measure risk behaviors
  such as tobacco use, substance abuse, sexual
  activity
• Vermont added six questions to the YRBS that
  reflected six assets from the Search Institute

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Six Assets on the YRBS

• Grades in school
• Talking with parents about school
• Representation in school decision making
• Participation in youth programs (excluding
  sports)
• Volunteering in the community
• Feeling valued by the community

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Results

• Risk behaviors decline with number of assets
• Healthy behaviors increase with number of assets
• The number of assets was significantly related to
  the likelihood of engaging in each of the risk
  and health promoting behaviors
• A student need not have all six assets to be
  doing well
• Students assets, even if relatively few, may
  make important contributions to wellness
• Limitations of the study
• Murphey, D. et al. (2004). Journal of Adolescent
  Health

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Community Application of Assets Based
Intervention by a Vermont school district

• Vermont school district of 1,500 students
• SDFSP prevention program planned strategies using
  their districts data from the YRBS
• District personnel wanted to increase parent and
  community connectedness with their teens
• Produced 130 Stars with 8 asset based messages
  (Search Inst.) aimed at both parents and other
  adults in the community
• Stars posted in windows on property owned by
  local businesses
• Informal feedback indicates enthusiasm from
  business owners who say they are more aware of
  the connection
• between community and its youth

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How to Create a Strength Based Indicator

• Begin with what is presently existing in the
  community, system, or population
• Describe the connection between what exists and
  what are the assets
• Recognize that this process can empower
  communities, systems to embrace positive outcomes
• Recognize that by measuring and building assets,
  communities and systems can prevent deficits
• Measure how the systems empower communities,
• not take care of them

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Ideas for Creating a Strengths Needs Assessment

• Gather data on population assets
• YRBS asset questions
• Key Informant Interviews ask about strengths
• Strengths in organizational capacity (CAST V)
• Identify 10 Needs and describe within assets
  framework
• Set annual indicators using asset approach
• Create SNA using guidelines that reflect assets

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Next Steps for Region 1

• Continue with Learning Collaborative
• Collaborate with SRII ECCS
• Use of guidance with draft language of assets
• Each state creates a SNA unique to their MCH
  populations and public health and community
  systems

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Strengths Based Assessment Work Session

• Instructions
• 8 groups
• 1-4 Develop one asset based indicator for each
  level of the MCH pyramid
• 5-8 Develop at least one asset based measure
  for each level of the pyramid
• As time permits Provide a rationale and
• discuss existing or possible activities related
• to indicator/measure

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Strengths Based Assessment

• Take Home
• Choose an indicator to consider what might be
  useful strategies for implementing this indicator
  in your state?
• How might this discussion impact your ten Title V
  Block Grant priorities and state performance
  measure selection?

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Strengths Based Assessment
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Strengths Based Assessment