Evaluating Maines Lead Education Project

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Evaluating Maines Lead Education Project
Presented by Teresa Hubley, Ph.D.,
M.P.A MaryAnn Amrich, R.N.
What is the Lead Education Project?
This project is a partnership between the
University of Southern Maines Institute for
Public Sector Innovation (IPSI) and the Maine
Childhood Lead Poisoning Prevention Program
(MCLPPP) conducted from 1999 to 2002 through CDC
funding
What were the goals of the project?
Increase the use of primary and secondary
prevention measures for childhood lead poisoning
by raising the awareness of parents, health care
providers and child care workers regarding their
importance.
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Background Issues
Government Services
MCLPP provided health care education and case
management. Other agencies (DEP, MSHA, etc.)
provided complementary services (licensing,
enforcement, environmental education, etc.).
State law requires all test results processed by
HETL and investigation over 20ug/dl.
Recommended Blood Lead Testing Rates
CDC sets requirements. Children lt 6 are most
vulnerable. Children should be tested at 1 and 2
if at elevated risk. Most poisoning is due to
exposure to deteriorating lead paint. A study
found Maine testing rates in 1999 near 11 and no
geographical pattern. Rates were low for
Medicaid, the only population found at
statistical risk.Screening is required by
Medicaid.
Redefining Case Management
Using Public Health Nurses and private inspectors
to deliver care and providing services at lower
levels of exposure
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Education Program Content

• Educational Partnerships
• Brochures
• Mailing Campaigns
• PSAs
• Newsletter
• Trainings
• Displays and Presentations
• Website
• http//www.state.me.us/dhs/bohdcfh/led/index2.
  htm

Lead is a problem Lead is a problem in Maine Lead
hurts children You can do something about lead
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Measures of Effectiveness
The RE-AIM Model (Glasgow, et.al.,1999 AJPH 89(9))

• Reach
• Efficacy
• Adoption
• Implementation
• Maintenance

Blood Lead Testing Rates (Efficacy, Adoption,
Maintenance)
Program Measures (Reach and Implementation)
Number of items Sent Trainings and other Public
Presentations Case Management Reports Qualitative
and Anecdotal Data Partner Activity
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Blood Lead Testing Rates Ages lt6
More mail, PHN Training, MMAF Rpt, Newsletter
PSAs, Website
1st Mailings, brochures partnerships
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Blood Lead Testing Rates for Ages 1 - 2
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Program Measures

• Number of Items Sent (70,611)
• Number of persons (380) requesting items beyond
  the basic three
• Trainings (89 PHN/CHN, 117 HeadStart, 400 total)
• Case Management reports (90 in 3 days of target)
• 147 cases 20ug/dl and above, 84 at 15-19, 214 at
  10-14
• Qualitative (PSA calls 29, Nurse Surveys 22,
  Supervisor surveys7, Family Surveys 52,
  Focus Groups 3) and Anecdotal Evidence (various)

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Other Activities

• PCPIP Medicaid Incentives
• MKRBU Physician Trainings (110)
• MELAP and HomeDepot project
• DEP and MSHA Lead Safe Renovators

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Outcomes and Further Needs
Outcome Blood Lead testing rate rises 3.1 and
new case management policies are
institutionalized, with 298 cases below 20 ug/dl
being served for the first time.
Needs

• Reinforce Public Health Nursings Role in
  prevention
• Support Medicaids role in promoting testing
• Show General Public how to adopt prevention
  measures
• Refocus local efforts
• Promote program services
• Determine the appropriate screening rate
• Promote screening of 2 year olds