Title V MCH Needs Assessment

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Title V MCH Needs Assessment

• Stakeholder Training
• November 1, 2004

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Stakeholder Training Agenda

• Overview of Needs Assessment Process
• Review of MCH Identified Needs
• Using the Q-sort methodology to rank priorities
• Q-Sort Data Analysis
• Consensus building, set priorities, identify
  solutions and strategies
• State performance measures, program direction and
  allocate resources
• Questions and wrap-up

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Handouts for Training

• Agenda
• Instructions for using the Q Sort Technique
• Q Sort Priority Log
• Maternal and Child Health Potential Needs
• Copy of 44 squares
• Example of data detail sheet
• 39 Smoking among pregnant women
• Q Sort Priority Log (for filling out)

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Presenters

• Linda Spaans Esten - State SSDI Coordinator
• Elizabeth Oftedahl - CSHCN Epidemiologist
• Kate Kvale - MCH Epidemiologist
• Randy Glysch - Research Scientist, Injury Program
• Dan Miner-Nordstrom - UW Wisconsin
• Masters Candidate, UW School of Social Work
• WI MCH LEND Program
• Susan Kratz - SPHERE State Coordinator
• Susan Uttech - Chief, Family Health Section

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Title V MCHNeeds Assessment

• Federal Requirement
• Title V of the Social Security Act
• In 1935, President Roosevelt signed legislation
  into law to promote and improve maternal and
  child health
• WI Dept of Health Family Services, Division of
  Public Health (DPH)
• receives funds through the federal Maternal and
  Child Health (MCH) Services Block Grant
• Required statewide needs assessment every 5 years
• In 1990s greater sophistication in assessing
  unmet needs
• Increased accountability in measuring program
  performance

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MCH Needs Assessment Purpose

• Direct decisions toward the most appropriate
  programs and policies that promote the health of
  women, children, CSHCN and their families.
• Needs assessment is a fundamental element of
  program planning
• Needs assessment is about CHANGE

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MCH Needs Assessment is part of an ongoing cycle

• Assess problems, needs, assets strengths
• Develop and implement solutions
• Evaluate activities
• Monitor performance

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Title V MCH Needs Assessment

• We undertake needs assessment because
• We recognize the dynamic nature of MCH
• We wish to be good stewards of the publics trust
• We must set priorities within limited resources

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MCH Needs Assessment

• Should be data driven and engage stakeholders
• Process must bridge
• Science and politics
• Data and values of the community
• Needs and the strategies for their solution

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Stakeholders

• Needs assessments must engage and involve the
  community of interest, the stakeholders
• Understand the values of the community
• Know the needs
• Help to identify strategies and solutions

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Who are the stakeholders?

• Local Health Departments (LHDS)
• Regional CSHCN Centers
• Family Planning/Reproductive Health
• Professional organizations
• Advocacy organizations
• Parents
• Professional staff from hospitals/clinics
• Minority health
• Division of public health
• Department of Public Instruction

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Needs Assessment is data driven

• Population based data
• Census, Vital Records
• Surveillance systems data
• SLAITS, BRFSS, YRBS, PedNSS, communicable disease
  incidence
• Survey data from Family Health Survey
• Program and service data
• Listening Sessions

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MCH Identified Needs

• 44 Identified Needs
• 16 Listening sessions reaching 350 people
• Federal MCH needs
• State and local identified MCH needs
• Data detail sheet developed for each need
• Packets of data detailed sheets mailed week of
  November 1, 2004

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Using Q Sort Technique to select priorities

• Purpose To identify priorities among competing
  needs
• Stakeholders have unique expertise, perspectives
  and passions about needs
• All needs cannot be the highest priority for
  the state MCH program
• Q Sort Technique is effective at getting
  information from people with different backgrounds

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Brief History of Q-Sort Methodology

• Developed in 1935 by British physicist-psychologis
  t William Stephenson
• Associated with quantitative analysis due to
  involvement with multiple factor analysis
• Reveals subjectivity involved in a situation

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What should the table look like?

• Create Nine Columns

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Inserting Needs on the Q-Sort Priority Log
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Completed Q-Sort Priority Log
Sixth Highest Priority
Seventh Highest Priority
Eighth Highest Priority
Fourth Highest Priority
Fifth Highest Priority
Second Highest Priority
Third Highest Priority
Highest Priority
Lowest Priority
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How will these data be analyzed?

• Look at the mean score of each need after
  gathering responses.
• Scores will be assessed for their variability by
  using the standard deviation.
• Some scores may be weighted if they are from
  under-represented fields or regions.

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Scoring and Standard Deviation

• If Health Insurance Coverage for Children rates a
  score of 2.5 and has a very small standard
  deviation, you know that most everyone agreed
  this was a high priority
• Conversely, if Unintended Pregnancy also rated
  high at 2.5, but had a large standard deviation,
  you know some rated it high while others rated it
  low

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Where to Get More Information on the Q-Sort Method

• Detailed information on the Q-Sort Method can be
  found at http//www.qmethod.org

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Next Steps After Q Sort.

• Consensus building

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Our needs assessment process is not done until
we

• Set priorities
• Identify solutions and strategies
• Determine Wisconsins State Performance Measures
  for the federal Title V Block Grant Application
• Determine program direction, and
• Allocate available resources

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In January 2005

• We will invite a smaller group of
• stakeholders to a face-to-face meeting to
• help us
• Establish priorities
• Identify solutions and strategies

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Things to Consider(to bring a method to the
madness)

• Reach consensus and set priorities
• Size of problem extent, number
• Seriousness of problem urgency, severity,
  economic loss, impact on population
• Availability and effectiveness of interventions
• Economic feasibility
• Acceptability of intervention by public
• Legal and/or political issues

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Things to Consider(to bring a method to the
madness)

• Identify solutions and strategies to
• Determine whether or not we can do anything about
  the need and what precisely it is we can and wish
  to do.

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Generate possible solutions related to a priority

• Compare the priority to strategies such as
• Provide service directly
• Contract with others to provide service
• Provide education to public and/or providers
• Systems development
• Data system improvement

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Generate possible solutions related to priority

• Then ask the following questions for each
  strategy
• How effective would this solution be?
• Low, medium, high
• How efficient would this solution be?
• Low, medium, high
• How acceptable would this solution be?
• Low, medium, high

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Determine Wisconsins Title VState Performance
Measures

• Compile results and internally finalize
  recommendations for
• State Performance Measures
• Program Direction
• Resource Allocation
• Present findings to Department
• Include final recommendations for annual Title V
  Block Grant Application

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Stakeholder responsibility

• Review the data detail packets
• Use the Q-sort method to prioritize the 44 needs
• Complete the Priority Log
• Insert 44 numbers in the boxes
• Provide demographic data (required/optional)
• Add (optional) additional high priority

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Return priority log by December 8, 2004

• Mail or email to Jayne McCredie
• 1 West Wilson Street-Room 351, Madison, WI 53702
• Mccrejh_at_dhfs.state.wi.us
• Questions about the process?
• Email Linda Spaans Esten
• Spaanln_at_dhfs.state.wi.us

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View archive of this presentation

• Archive will be on the web for 2 weeks
• All stakeholders will receive the URL address for
  viewing the archived presentation

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QUESTIONS FOR PRESENTERS?