Maximize Resources: Delivering Injury and Violence Prevention

through IntegrationCity MatCH Conference

September 23, 2008

Jennifer Allison, PhD, State Outreach CoordinatorEllen R. Schmidt, MS, National Outreach Coordinator

Children’s Safety NetworkNational Injury and Violence Prevention Resource

Center

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Children’s 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/MCHB2

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

California

Idaho

Maine

Missouri

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

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Integration Fundamentals

• Complement an existing program, don’t 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 evaluation7

Step 1: Planning Your Mission and Goals

Mission – Select injury risks that staff and clients will see as directly related to a program’s 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)

STIPDA’s 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 messagesSafety equipment ScreeningsCounselingSkill 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 partner’s needs, capabilities, and constraints

• A reliable champion within each partnering organization

• Clarity and buy-in about roles and responsibilities14

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 procedures17

Program Implementation Fundamentals

• Start small with a pilot phase

• Create a referral network so staff can connect clients with additional services

• Increase your program’s visibility

• Make IVP a core element of program operations18

Program Implementation Resources

Children’s Safety Network at http://www.ChidrensSafetyNetwork.org

CDC’s The Community Guide at http://www.thecommunityguide.org

Harborview Injury Prevention and Research Center at http://depts.washington.edu/cdreview/main.php

Your State MCH program and City and State IVP programs19

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 delivered25

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 studies27

Evaluation Resources• Demonstrating Your Program’s Worth: A Primer on Evaluation for

Programs to Prevent Unintentional Injury http://www.cdc.gov/ncipc/pub-res/demonstr.htm

• CDC Evaluation Working Group http://www.cdc.gov/eval/

• The Community Toolbox http://ctb.ku.edu/en/

• W.K. Kellogg Foundation Evaluation Handbook http://www.ojp.usdoj.gov/BJA/evaluation/links/WK-Kellogg-Foundation.pdf

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Contact Information

Jennifer Allison

State Outreach Coordinator

Children’s Safety Network

Education Development Center

55 Chapel Street

Newton, MA 02458

(617) 618-2918

jallison@edc.org

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