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Title V Transformation Tools

Title V Transformation Tools

TransformationRecommendations to Support NPM 8 – Physical Activity

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:

Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability. Physical activity in children and adolescents reduces the risk of early life risk factors for cardiovascular disease, hypertension, Type II diabetes, and osteoporosis. In addition to aerobic and muscle-strengthening activities, bone-strengthening activities are especially important for children and young adolescents because the majority of peak bone mass is obtained by the end of adolescence.

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) physical activity background, recommendations, and guidelines and (2) physical activity 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.


  1. Ability to conduct surveillance of physical activity during childhood and adolescence that allows public health practitioners to understand and respond to disparities in physical activity rates
  2. Ability to analyze obesity trends and select leverage points for physical activity interventions
  3. Ability to develop estimates of death rates related to physical activity rates
  4. Ability to calculate quality-adjusted life years (QUALYs) to quantify impact of physical activity in local communities

Learning Materials:


2. Strategic Planning & Program Design

Effective strategic planning and program design require 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.

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.

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.

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.


  1. Ability to ensure health care providers have access to tools and best practices regarding physical activity counseling and are trained to use the tools in an evidence-based manner
  2. Skills to advocate for mandatory evidence-based physical activity interventions during school
  3. Ability to effectively engage in park/land/school joint-use agreements in support of activities that promote physical activity for children and adolescents

Learning Materials:


6. Communication

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.


  1. Ability to effectively communicate with the public about the importance of physical activity
  2. Ability to navigate sensitivities about obesity and provide nuanced communication with children, adolescents and parents to ensure positive engagement
  3. Ability to effectively communicate with policy makers and community leaders about the importance of investing in physical activity policies

Learning Materials:



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. Physical Activity Background, Recommendations & Guidelines

  1. Knowledge of current physical activity guidelines for children and adolescents, including description of what constitutes physical activity
  2. Knowledge of benefits of physical activity among children and adolescents, including emerging science about lifelong impact of early physical activity
  3. Knowledge of common barriers to physical activity among children and adolescents
  4. Knowledge of public school requirements for physical activity and/or physical education for children and adolescents
  5. Knowledge of Bright Futures and other best practice recommendations regarding physical activity for children and adolescents

Learning Materials:


Evidence Base:

2. Physical Activity Policies & Strategies

  1. Knowledge of the difference between population-level interventions and individual-level exercise interventions
  2. Knowledge of current physical activity policy and program initiatives at population health level, as well as private sector activities that support physical activity among children and adolescents
  3. Knowledge of policy and environmental strategies that improve physical activity rates among children and adolescents and their relative effectiveness
    1. Knowledge of the level at which the policies/strategies occur (informational, behavioral, social, environmental, policy)
  4. Knowledge of role of other public health partners and community development, housing and transportation sectors on physical activity

Learning Materials:


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. 81.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UE8MC25742; MCH Navigator for $225,000/year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.