Maternal & Child Health Epidemiology - PowerPoint PPT Presentation

Loading...

PPT – Maternal & Child Health Epidemiology PowerPoint presentation | free to download - id: 3d6b5c-MWQyZ



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Maternal & Child Health Epidemiology

Description:

Maternal & Child Health Epidemiology: An Overview of Selected Data Systems Data Users Conference November 17, 2004 Presented by Susan Nalder, EdD, MPH, CNM – PowerPoint PPT presentation

Number of Views:58
Avg rating:3.0/5.0
Slides: 31
Provided by: hscUnmEdu5
Learn more at: http://hsc.unm.edu
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Maternal & Child Health Epidemiology


1
Maternal Child Health Epidemiology An
Overview of Selected Data Systems
Data Users Conference November 17, 2004 Presented
by Susan Nalder, EdD, MPH, CNM MCH Epidemiology
Program Manager New Mexico Department of Health
2
MCH Epidemiology, Population Based
  • Uses data variety of data and data sources
    covering population characteristics, health
    status by natality, mortality, morbidity and
    injury, healthy health risk behaviors, access
    to and use of primary preventive care
  • Hand-out shows kinds of data used to monitor this
    population
  • Presentation will focus on PRAMS
  • Special mention of selected projects

3
MCH Epidemiology, Population Based
  • National Survey of Children with Special Health
    Care Needs
  • Federal MCH-B and NCHS
  • New Mexico sample 751
  • Data collected in 2001 reported in 2002
  • Used SLAITS methodology need to use STATA or
    combination of SASSUDAAN
  • Data files and data reports may be accessed
    www.cdc.gov/slaits
  • Data report www.cdc.gov/nchs/slaits.htm

4
MCH Epidemiology, Population Based
  • National Survey of Child Health
  • Federal MCH-B and NCHS
  • New Mexico sample 2,000
  • Data collected in 2004
  • Data files available early 2004
  • Used SLAITS methodology need to use STATA or
    combination of SASSUDAAN
  • Data files and data reports will be posted
    www.cdc.gov/slaits

5
MCH Epidemiology, Population Based
  • NM Child Fatality Review and NM Maternal
    Mortality Review
  • Data bases developed and in testing 2004
    reviews ongoing since 1996
  • Reports are at www.doh.state.nm.us
  • Program contact
  • Anne Worthington, MPH
  • Anne.Worthington_at_doh.state.nm.us
  • tel 505-476-8888

6
MCH Epidemiology, Population Based
  • Comprehensive MCH data and information available
    through the Title V MCH Block Grant program
  • Over 60 indicators of health status and access
    to/use of care
  • www.mchb.hrsa.gov
  • Online data can see NM data and any other state

7
From Data to Action NM Pregnancy Risk Assessment
Monitoring System
8
Acknowledgements
  • The NM PRAMS team
  • Ssu Weng, MD, MPH, PRAMS Epidemiologist
  • Dorin Sisneros, PRAMS Operations Manager
  • Eirian Coronado, MA, PRAMS Coordination and
    Epidemiology
  • The PRAMS Sample Source
  • - The team in the NM Office of Vital Records
    and Health Statistics
  • The Telephone Follow-up
  • - The team in the Survey Unit, Division of
    Epidemiology Response
  • The CDC PRAMS Team
  • - Nedra Whitehead, PhD, NM PRAMS Advisor

9
Funding Support and TA
  • The Title V Maternal Child Health Block Grant
    (1995 to present)
  • The PRAMS Project in the Program Services Branch,
    Division of Reproductive Health, Centers for
    Disease Control Prevention in Atlanta
    (1996-present)
  • The Medicaid Program, NM Human Services
    Department (1998 to present)
  • The Family Preservation Support Project,
    Prevention Intervention, NM Children, Families
    and Youth Department (1995-1999)

10
PRAMS is a multi-state, ongoing surveillance
project (32 states)
11
The Purpose of NM PRAMS
  • To improve the health of New Mexicos mothers,
    infants and families

12
The Purpose of NM PRAMS
  • To reduce significant disparities in maternal,
    infant and family health measures
  • Disparities geographic areas, age, race or
    ethnicity, education, poverty, families with
    Medicaid paid services
  • Measures health status, healthy health risk
    behaviors, exposure to stressors, access to/use
    of health health related services

13
The Purpose of NM PRAMS
  • To produce data and information, and foster its
    use for
  • Strategic analysis with local groups, translation
    of data to action
  • Informed Policy
  • Informed decisions about programs, selection of
    evidence-based services
  • Education of policy makers, providers, present
    and future mothers fathers, and the public
  • Monitoring and reporting status and trends over
    time

14
About NM PRAMS
  • A multi-year, population-based surveillance
    system
  • Monitors over 100 selected behaviors and
    experiences of mothers and infants that occurred
    before, during or after a pregnancy live birth
    against a background of socio-demographic,
    economic and cultural characteristics

15
About NM PRAMS
  • Preconceptional Period up to 12 months before
    pregnancy
  • Health insurance before pregnancy
  • Use of multivitamins
  • Height Weight, BMI calculations
  • Intention of pregnancy
  • Tobacco, Alcohol, Physical Abuse
  • Knowledge about Emergency Contraceptive Pill

16
About NM PRAMS
  • Pregnancy
  • When knew she was pregnant
  • Prenatal care, including barriers
  • Payor of care
  • Health education received (11 topics)
  • HIV testing
  • Oral health services
  • Services including WIC and 11 supportive services
  • Prenatal health problems (diabetes, pregnancy
    related, injuries)

17
About NM PRAMS
  • Pregnancy Delivery
  • Experience of feeling treated unfairly when
    getting health care
  • Prenatal hospitalizations
  • Tobacco, alcohol, physical abuse
  • Life stressors (13 topics)
  • Payor of care for delivery
  • Length of stay after delivery

18
About NM PRAMS
  • Post-Partum to 2 months
  • Post partum check up
  • Use of family planning method(s)
  • Barriers to using family planning
  • Supportive services (11 kinds)
  • Working or in school, or at home
  • Depression
  • Food security for the family
  • Household utilities

19
About NM PRAMS
  • Early Infancy to 2 months
  • Hospitalization or NICU after delivery
  • Infant feeding
  • Several questions about breastfeeding
  • Second hand smoke exposure
  • Infant sleep position
  • Well child care
  • Infant car seat
  • Home visiting services
  • Family support for infants care

20
More About NM PRAMS
  • The Sample random selection from NM live birth
    registration files
  • IN NM Residents, live birth in NM,
    singleton-triplet
  • Excluded Non-resident, Resident but out of
    state birth, adoption
  • Timing 2-6 months post-partum
  • Method mailed survey with telephone follow-up

21
Data collection
  • Up to 3 mailings
  • Telephone interview for non-responders
  • Recall bias minimized
  • Mailed 2-6 months after delivery

22
More About NM PRAMS, 1997-2000
  • 1997-2000 Sample Design stratified sample,
    oversampled low birth weight Native Americans
  • Statewide, 8,182 sampled 5,711 responded, 70
    response rate
  • 2001-Present, the Sample Design stratified
    sample, oversampled by Health District

23
PRAMS Reports Mothers Residence by Public
Health Districts
  • District I Urban Bernalillo, Torrance, Valencia,
    and zip codes for Bernalillo town Rio Rancho
  • District I Rural Sandoval (excludes Bernalillo
    town Rio Rancho zip), McKinley, San Juan,
    Cibola
  • District II Colfax, Harding, Los Alamos, Mora,
    Rio Arriba, San Miguel, Santa Fe, Taos, Union
  • District III Catron, Dona Ana, Grant, Hidalgo,
    Luna, Otero, Sierra, Socorro
  • District IV Chaves, Curry, DeBaca, Eddy,
    Guadalupe, Lea, Lincoln, Quay, Roosevelt

24
More on the PRAMS
  • Statewide Estimates and Other Analysis
  • Selected characteristics of the mothers are
    associated with outcomes, behaviors or other
    findings.
  • Age Groups
  • Race and Ethnicity
  • Education Levels
  • Marital Status
  • Any Previous Live Birth
  • Residence by Public Health District
  • Public Assistance
  • Payor of Care and I.H.S.
  • PNC Delivery, Delivery Only

25
Point estimate Analysis weights
  • Each respondent speaks
  • for about 12 other women
  • Not selected for sample or who
  • did not respond
  • Weighting process complex
  • Done by CDC PRAMS
  • See PRAMS reports on DOH website

26
Potential bias from
  • Less than 100 response about 30 do not
    participate
  • Mail survey appeals to more educated women, but
    many less-advantaged women participate
  • Phone respondents vs. mail
  • Recall (2-6 months after birth)
  • Self-report by respondent

27
NM PRAMS
  • Annual Surveillance Report
  • Detailed reporting gt20 topics
  • Multi-year reporting gt20 topics
  • Special Reports
  • Teen report
  • Medicaid report
  • Topics of interest

28
NM PRAMS
  • Use of PRAMS by outside researchers
  • CDC PRAMS working on a public use data set
  • NM PRAMS, qualified researchers may propose an
    analysis project and obtain data, a process is in
    place

29
Contact information for NM PRAMS
email us at nmprams_at_doh.state.nm.us Erian
Coronado, MA, PRAMS Coordinator Tel
505-475-8895 Ssu Weng, MD, MPH, PRAMS
Epidemiologist Tel 505-476-8892 Susan Nalder,
EdD, MPH PRAMS Director Tel 505-476-8890 Matern
al and Child Health Epidemiology Program Family
Health Bureau NM Department of Health 2040 South
Pacheco St, Santa Fe, NM 87505
30
(No Transcript)
About PowerShow.com