Health: Public Health

First Steps Phase III Initiative: Improving Oral Health and Healthy Weight in Children

Abstract: 

This is the final evaluation report of the First STEPS (Strengthening Together Early Preventive Services) Phase III Improving Oral Health and Healthy Weight in Children learning initiative. The evaluation assessed changes in rates of oral health and healthy weight preventive services and evidence-based office processes among practices that participated in the initiative, as well as related systems changes. This report presents key findings, summarizes lessons learned in implementing practice changes, and describes challenges in using CHIPRA, HEDIS and other oral health and healthy weight measures at the practice-level to inform quality improvement.

This report was written by Carolyn Gray and Kimberley Fox at the Cutler Institute of Health and Social Policy, Muskie School of Public Service at the University of Southern Maine. The work was conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) authorized by Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA).

These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and one should not assume endorsement by the Federal Government. The views expressed are those of the authors and do not necessarily represent the views of either the Department or the School. For further information regarding this report, or the broader evaluation of the local IHOC initiative, please contact Kim Fox at kfox@usm.maine.edu.

Suggested Citation:Gray, C., & Fox, K. (2015). First STEPS Phase III initiative: Improving oral health and healthy weight in children. (Final Evaluation Report). Portland, ME: University of Southern Maine, Muskie School of Public Service.

Publication Type: 
Report
Publish Date: 
June 10, 2015
URL: 
http://www.maine.gov/dhhs/oms/provider/ihoc.shtml

Early Lessons Learned in Implementing MaineCare Health Homes

Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights key lessons learned from the first year of implementation of the MaineCare Health Homes Initiative.

Key Findings:

  • MaineCare's Health Homes Initiative has expanded Maine's capacity for chronic care management in primary care practices and community care teams (CCTs);
  • CCTs provide valuable additional support to patients of Health Homes, including home visits and social supports in the community;
  • Flexibility in program design allowed for wide variation of service delivery models within CCTs;
  • Three percent of Health Home members were referred to CCTs by the end of the first year, but overall practice referral rates varied by CCT--from 1% to 7% of Health Home members within their associated practices.

To view or download the full study, click here

To view or download the Issue Brief on enrollment in the first year of MaineCare Health Homes implementation, click here

Suggested Citation: Fox K, Gray C, Rosingana K. Early Lessons Learned in Implementing MaineCare Health Homes. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Implementation.pdf

MaineCare Health Homes Enrollment in the First Year of Implementation

Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights enrollment trends and characteristics of MaineCare's Health Homes initiative during the first year of implementation.

Key Findings:

  • MaineCare initially estimated 42,000 members were Health Home eligible; 48,000 members were enrolled by December 2013;
  • Health Homes practices increased referrals to Community Care Team (CCT) services over the course of the first year of the initiative, increasing from 60 members enrolled in CCTs in January 2013 to 1,392 in Decmber (3% of Health Home members);
  • Health Home members had an average of three chronic conditions.  Two out of the five most common conditions were behavioral health related.

To view or download the full study click here

To view or download the Issue Brief on implementation in the first year of MaineCare's Health Home Initiative click here

Suggested Citation: Fox K, Gray C, Rosingana K. MaineCare Health Homes Enrollment in the First Year of Implementation. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Enrollment.pdf

Rural and Remote Food Environments and Obesity

Abstract: 

Researchers at the Maine Rural Health Research Center Rural have published a review in the January 2015 issue of Current Obesity Reports describing the rural community, home, and individual food environments and what is known about their roles in healthy eating.

Abstract: Rural residents are more likely to be obese and overweight compared to their urban counterparts. Studies of specific rural communities have found that the limited availability of healthy foods in the community and home as well as individual characteristics and preferences contribute to poor diet and overweight. The rural food environment is varied and may be affected by climate, regional and cultural preferences, transportation access, and remoteness among other factors. Given this diversity and the vulnerabilities of rural residents, who are more likely to have low-income, substandard housing or low educational attainment compared to their urban counterparts, policy and programmatic interventions should target specific needs and communities.

Suggested Citation: Lenardson, J. D., Hansen, A. Y., & Hartley, D. (2015). Rural and remote food environments and obesity. Current Obesity Reports. doi: 10.1007/s13679-014-0136-5

Publication Type: 
Journal Article
Publish Date: 
January 30, 2015
URL: 
http://link.springer.com/article/10.1007%2Fs13679-014-0136-5#page-1

Transforming Public Health Practice Through Accreditation (A User Guide for the Special Accreditation Issue)

Abstract: 

This editorial highlights the progress of public health accreditation efforts as discussed by the articles in this special issue. This issue represents an important step toward establishing a stronger evidence base for the national accreditation program, and the articles within this issue address many of the research agenda topics, including technical assistance, connections with public health categorical programs, readiness, and the impact of accreditation on public health departments of many sizes, types, and structures.

Publication Type: 
Journal Article
Publish Date: 
January 1, 2014
URL: 
http://journals.lww.com/jphmp/Fulltext/2014/01000/Transforming_Public_Health_Practice_Through.2.aspx

Introduction to Case Reports: One Goal - Many Journeys

Abstract: 

This article describes case reports that highlight the journey of accreditation through the lens of 11 health departments at various stages in the process. These case reports call attention to the link between accreditation and quality improvement.

Suggested Citation: Joly, B., & Davis, M. V. (2014). Introduction to case reports: One goal-many journeys. Journal of Public Health Management and Practice, 20(1), 64-65. doi: 10.1097/PHH.0b013e3182a958da

Publication Type: 
Journal Article
Publish Date: 
January 1, 2014
URL: 
http://journals.lww.com/jphmp/Fulltext/2014/01000/Introduction_to_Case_Reports___One_Goal_Many.17.aspx

First Steps Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children

Abstract: 

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine's CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine's First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine's Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in participating practices before and after the initiative, as well as related systems changes. They also summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement.

Suggested Citation: Fox K, Gray C, Elbaum-Williamson M. First STEPS Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children. Portland, ME: University of Southern Maine, Muskie School of Public Service; August, 2013. Improving Health Outcomes for Children (IHOC) Final Evaluation Report.

Publication Type: 
Report
Publish Date: 
August 30, 2013
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/FirstSTEPS-PhaseII-Developmental-Austism-Lead-Screening.pdf

First Steps Phase I Initiative: Improving Immunizations for Children and Adolescents

Abstract: 

This evalution report, authored by research staff at the USM Muskie School, assesses the change in immunization rates in participating pediatric and family practices that serve a high volume of children insured by MaineCare (Maine's Medicaid system). The authors also summarize lessons learned in implementing changes in practices and challenges in using the immunization measures at the practice-level to inform quality improvement.

Background: Through the Improving Health Outcomes for Children (IHOC) grant, Maine Quality Counts is leading the First STEPS (Strengthening Together Early Prevention Services) Learning Initiative to support Maine’s primary care practices in improving preventive and screening processes for children and building medical homes. The First STEPS Learning Initiative is being implemented in phases, with the first phase (September 2011 - August 2012) focusing on improving immunizations for children and adolescents. As part of the initiative, IHOC identified specific immunization measures to be improved. First STEPS provides wide-ranging and in-depth quality improvement, coaching, andata monitoring of standard quality measures, and educations support to pediatric and family medicine practices as they continue to enhance health outcomes for children. The goal of Phase I was to improve immunization rates in participating practices by at least 4 percentage points within one year of project initiation by implementing changes in office procedures advocated by the American Academy of Pediatrics’ Bright Futures curriculum.

Suggested Citation: Fox K, Gray C. First STEPS Phase I Initiative: Improving Immunizations for Children and Adolescents. Portland, ME: University of Southern Maine, Muskie School of Public Service; March, 2013. Improving Health Outcomes for Children (IHOC) Final Evaluation Report.

Publication Type: 
Report
Publish Date: 
March 1, 2013
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/FirstSTEPS-PhaseI-Immunizations.pdf

The Affordable Care Act: What's Next for Maine?

Abstract: 

As part of its on-going Health Policy Colloquium series, the Muskie School will provide information and convene leaders to explore in detail how the ACA will affect Mainers, what preparations are in place to transition to the new law and to raise and respond to questions as the law is implemented. This policy brief provides background information and lays out some of those questions of affordability, coverage, and impact on small businesses. We hope to provide an on-going forum for interested parties to work together with the Muskie School to address these and other issues in a timely and accurate way.

Suggested Citation:

Riley, T. (2013, August). The Affordable Care Act: What's next for Maine? (Health Policy Colloquium Brief). Portland, ME: University of Southern Maine, Muskie School of Public Service

Publication Type: 
Research and Policy Brief
Publish Date: 
August 19, 2013
URL: 
http://muskie.usm.maine.edu/Publications/HealthPolicy/Brief-ACA-Whats-Next-For-Maine.pdf

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