Title V Transformation Tools
Recommendations to Support NPM 7 – Child Injury
Jump To: Skills | Knowledge
Significance. The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this NPM as follows:
Injury is the leading cause of child mortality. For those who suffer non-fatal severe injuries, many will become children with special health care needs. Effective interventions to reduce injury exist but are not fully implemented in systems of care that serve children and their families. Reducing the burden of nonfatal injury can greatly improve the life course trajectory of infants, children, and adolescents resulting in improved quality of life and cost savings.
Background. The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures (NPMs) for the 2015-2017 grant cycle. In order to effectively address the NPMs, MCH professionals need to think about not only the evidence and strategies to make change, but also the capacity of the workforce to carry out these activities. These lists identify online learning materials, resources, and evidence-based strategies and programs to support the knowledge sets and skills needed to advance each NPM.
Introduction. Six skill sets have been identified by the National MCH Workforce Development Center to support implementation of this NPM: (1) population health; (2) strategic planning and program design; (3) strategic alliances and effective partnerships; (4) consumer engagement and cultural and linguistic brokering; (5) policy and program implementation; and (6) communication.
In addition, two knowledge areas specific to the NPM topic area have been highlighted that are keyed to the evidence base and promising practices: (1) injury prevention background, recommendations, and guidelines and (2) injury prevention policies and strategies.
The MCH Navigator, in collaboration with the Center, has developed this crosswalk to guide MCH professionals to online learning opportunities and implementation resources to support these skill sets.
Please click on the Read More buttons below for additional information, learning materials, and implementation resources. You can also email us with suggestions for additions.
Six skill sets have been identified to support implementation of this NPM:
1. Population Health
A renewed focus on MCH population health is key to achieving the NPMs in the era of health transformation. These skills enable Title V professionals to analyze how program interventions and their related health outcomes are distributed among a state’s MCH population. Population health skills complement all of Title V’s work, including program design and implementation, strategic partnerships and communication.
- Ability to conduct surveillance of child injury that allows public health practitioners to understand and respond to disparities in injury rates
- Skills to model drug epidemics, motor vehicle accident patterns, mental health issues, homicides, and other systems-level patterns that influence injury and death rates
- Ability to calculate quality-adjusted life years (QUALYs) to quantify impact of child injury in local communities
2. Strategic Planning & Program Design
Effective strategic planning and program design requires the ability to base programs on defined goals and desired outcomes. Strategic planning should include a monitoring and evaluation system to track and monitor progress and inform program alterations as needed. Program design skills must ultimately be coupled with implementation, where program design is carried out.
- Skills to conduct needs assessment using consumer input, especially regarding effective messages about injury prevention
- Ability to appreciate how child injury prevention efforts fit into the larger framework of youth development
3. Strategic Alliances & Effective Partnerships
The wide array of stakeholders and partners in the field of MCH, from providers and insurers to women and children, require a set of skills in strategically aligning Title V goals with those of their partners. In the Title V world, there is an increasing interest in engaging unlikely or nontraditional partners to achieve the NPMs. The skills in this category take that into account and include unique partner groups linked to this measure.
- Ability to create injury topic-specific task forces that align multiple sectors in injury prevention efforts, including in the task force:
- Law enforcement
- Departments of Education and Transportation
- Child Protective Services
- Hospitals and community health centers
- Community coalitions
- Organizations that serve families and youth
- Private sector partners
- Ability to effectively partner with policymakers to create legislation that includes effective injury prevention policies
4. Consumer Engagement/Cultural & Linguistic Brokering
Consumers are arguably the most important stakeholders in MCH work, thus skills in consumer engagement and cultural and linguistic brokering are essential to moving the needle for each NPM. In some cases, consumer engagement includes negotiating with other stakeholders on behalf of MCH populations. Closely linked with this skills category are skills in communication and strategic alliances.
- Ability to understand and leverage cultural context when considering programmatic and policy changes related to childhood injury prevention
- Ability to effectively engage youth as peer educators
- Ability to develop and promote positive social norms for child safety that are culturally relevant
5. Policy & Program Implementation
These skills ensure that MCH priorities are integrated into all aspects of policy and program implementation, as well as ensuring that policies and programs selected are well-aligned with NPMs and other MCH program goals. Implementing policies and programs with fidelity also requires skills in the implementation science drivers: technical and adaptive leadership; selection; training; coaching; systems intervention; facilitative administration; and decision support data systems.
- Ability to ensure health care providers have access to tools and best practices regarding injury prevention and are trained to use the tools in an evidence-based manner
- Skills to ensure high quality injury prevention counseling is embedded in programs for which Title V has authority
- Ability to support regulations that require:
- Smoke detectors, hot water heater temperature controls, and stair safety gates in all homes
- Protective restraints in cars
- Pool fencing, self-closing gates, and pool alarms
- Graduated driver licensing for teens
- Toy manufacturer safety standards
- Use of serialized, tamper-proof prescription forms by prescribing physicians
- Development and use of a prescription drug monitoring program for hospitals
- Prohibitions on cellphone use (including hands-free) by youth while driving
Communication skills support the creation and delivery of effective messages between MCH professionals, professional and community partners, and populations served by Title V. Effective communication ensures the delivery of appropriate messages to audiences in the way that they were intended and is key to all aspects of MCH work. These skills are linked closely with skills in strategic partnerships and cultural and linguistic brokering.
- Skills to effectively reach young adults, parents, and caretakers with injury prevention messages
- Ability to work with media as part of injury prevention campaigns
- Ability to alert the public about emerging injury-related trends
- Ability to describe violence and injury as a health problem
- Ability to communicate with policymakers and other opinion leaders about the health and financial impacts of injuries and proposed policies
In addition to skills, each NPM requires a knowledge base that will help Title V progress effectively in the measure. Knowledge should be considered at the foundation of achieving all measures.
1. Injury Prevention Background, Recommendations & Guidelines
- Ensure state and local MCH staff have baseline understanding of major causes of childhood and adolescent injury, including identification of disparities for each major cause:
- Prescription drug use/abuse
- Motor vehicle crashes
- Suicide and mental health
- Child abuse (shaken baby)
- Drowning, falls, poisoning, suffocation
- Intimate partner violence
- Knowledge of injury and fatality trends among children and adolescents in state/territory
- Knowledge of what it means to be born and thrive in a safe environment
- Knowledge of historical and cultural context of risk factors for injury/death in a given geographic area
2. Injury Prevention Policies & Strategies
- Knowledge of evidence-based policy and environmental strategies that prevent or reduce injury rates among children and adolescents, and the relative effectiveness of these policies (e.g. bike helmet laws, graduated driver's licenses) and strategies
- Knowledge of existing community resources for referrals or collaboration to support injury reduction (e.g. car seat distribution, social marketing campaigns)
See other online learning resources related to health transformation, collected in the Health Transformation Learning Laboratory.
1 Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 80.