Maximize Resources: Delivering Injury and Violence Prevention through Integration City MatCH Confere

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Maximize Resources Delivering Injury and
Violence Prevention through IntegrationCity
MatCH ConferenceSeptember 23, 2008

• Jennifer Allison, PhD, State Outreach Coordinator
• Ellen R. Schmidt, MS, National Outreach
  Coordinator
• Childrens Safety Network
• National Injury and Violence Prevention Resource
  Center

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Childrens Safety Network

• National Resource Center for child and adolescent
  injury and violence prevention
• Capacity building for State MCH and IVP programs
• CSN Economics and Data Analysis Resource Center
• Funded by HRSA/MCHB

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What Is Integration?

• Inclusion of IVP in MCH programs
• Enhancement of MCH programs to improve services
• Efficient approach to reducing injuries and
  violence
• Cost-effective alternative to stand-alone IVP
  programs

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Why Is Integration Important?

• Focus on leading cause of death and disability
  for MCH populations
• Achieve better health outcomes for MCH
  populations
• Accomplish MCH program goals

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Integration Examples

• Bike helmets are distributed at health clinics
• Teen parenting groups promote healthy
  relationships
• High schools do drunk driving prevention
  projects and events
• Child maltreatment screening is done at dental
  check-ups

• California
• Idaho
• Maine
• Missouri

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Integration Fundamentals

• Complement an existing program, dont compete
  with it
• Match IVP activities with available resources
• Provide staff training and support
• Be sustainable over the long term

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5 Steps to Successful Integration

• Planning
• Partnerships
• Program implementation
• Training and technical assistance
• Data collection and evaluation

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Step 1 Planning Your Mission and Goals

• Mission Select injury risks that staff and
  clients will see as directly related to a
  programs primary mission
• Goals Emphasize the direct connection between
  preventing injuries and achieving the health
  goals of the program

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Step 1 Planning with Capacity Assessment

• CAST-5 MCH Strategic Capacity Planning Framework
  (http//www.amchp.org)
• Mobilizing for Action through Planning and
  Partnerships (MAPP) (http//www.naccho.org)
• STIPDAs State Technical Assessment Team (STAT)
  process (http//www.stipda.org)

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Step I Planning Your IVP Strategies

• IVP strategies include
• Educational materials and safety messages
• Safety equipment
• Screenings
• Counseling
• Skill development

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Making the Link with IVP

• MCH Programs
• School-based programs

• IVP Activities
• Bullying prevention
• Youth suicide prevention
• Healthy dating relationships
• Teen driving safety
• Prevention of sports injuries

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Making the Link with IVP

• MCH Programs
• Family services

• IVP Activities
• Positive parenting
• Safe travel
• Home safety checks
• Drowning prevention
• Fire prevention

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Step 2 PartnershipsExample

• The Massachusetts Division of Violence and
  Injury Prevention (DVIP)
• Integrates 7 major injury and violence prevention
  topics into MCH
• Partners with 7 programs within MCH to do
  integration

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Partnership Fundamentals

• Common goals that produce mutual benefits
• An understanding of each partners needs,
  capabilities, and constraints
• A reliable champion within each partnering
  organization
• Clarity and buy-in about roles and
  responsibilities

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Finding Partners

• Walk down the hall!
• Serve on an advisory board or invite a
  prospective partner to serve
• Participate on cross-departmental committees or
  task forces
• Send informational e-mails on IVP topics
• Make presentations at conferences and meetings

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Finding PartnersExample

• The Massachusetts Bureau of Family and Community
  Health invited staff from MCH units to sit on
  program advisory boards to pave the way for
  integration.
• Staff from WIC sat on the advisory board of Fire
  Safe Massachusetts

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Step 3 Program ImplementationExample

• To implement domestic violence screening in WIC
  clinics, the Massachusetts DVIP did the
  following
• Started with a small number of pilot sites
• Expanded to statewide effort after pilot phase
• Incorporated IVP into standard operating
  procedures

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Program Implementation Fundamentals

• Start small with a pilot phase
• Create a referral network so staff can connect
  clients with additional services
• Increase your programs visibility
• Make IVP a core element of program operations

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Program Implementation Resources

• Childrens Safety Network at http//www.ChidrensSa
  fetyNetwork.org
• CDCs The Community Guide at http//www.thecommuni
  tyguide.org
• Harborview Injury Prevention and Research Center
  at http//depts.washington.edu/cdreview/main.php
• Your State MCH program and City and State IVP
  programs

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Step 4 Training and Technical Assistance
Example

• Before implementing domestic violence screening
  in WIC clinics, the Massachusetts DVIP
• Used staff surveys to find out what was needed
• Developed and delivered trainings for staff on
  how to identify and help clients who are victims
  of intimate partner violence

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Why Is Training Important?

• Equips staff and management to be full
  participants
• Explains staff roles and expectations
• Builds necessary skills among frontline staff who
  will be implementing IVP activities

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Why Is Technical Assistance Important?

• Continuous improvement of programs
• Peer network of in-house experts
• Customized problem-solving on specific issues
• Infrastructure for dissemination of new
  information

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Step 5 Data Collection and EvaluationExample

• Kentucky studied 3,500 families, comparing
  families in its HANDS home visiting program with
  first-time families in the same counties that
  were not participating in the program. Among
  families in HANDS, the study found
• 58 percent less physical abuse
• 62 percent less neglect

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Why Should You Evaluate?

• Document progress and make your program more
  visible!
• Obtain information necessary to make program
  improvements
• Guarantee accountability
• Persuade funders to provide support
• Contribute to knowledge of effective IVP
  strategies

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What Should You Evaluate?

• Client participation rates and satisfaction
• Number of safety devices distributed and used
  properly after instruction
• Changes in knowledge, attitudes, and behaviors
• Changes in injury rates and health status
• Quality and consistency of IVP services delivered

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How Should You Collect Data?

• Questionnaires and surveys
• Needs assessments
• Interviews and focus groups
• Case studies
• Observation studies

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How Can You Capitalize on Evaluation?

• Produce an evaluation report that contains
• Description of integration goals and activities
• Evaluation plan, including the methods and data
  collection tools that were used
• Client testimonials or case studies

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Evaluation Resources

• Demonstrating Your Programs Worth A Primer on
  Evaluation for Programs to Prevent Unintentional
  Injury http//www.cdc.gov/ncipc/pub-res/demonstr.h
  tm
• CDC Evaluation Working Group http//www.cdc.gov/ev
  al/
• The Community Toolbox http//ctb.ku.edu/en/
• W.K. Kellogg Foundation Evaluation Handbook
  http//www.ojp.usdoj.gov/BJA/evaluation/links/WK-K
  ellogg-Foundation.pdf

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Contact Information

• Jennifer Allison
• State Outreach Coordinator
• Childrens Safety Network
• Education Development Center
• 55 Chapel Street
• Newton, MA 02458
• [phone]
• jallison_at_edc.org