Cutler Institute for Health and Social Policy

Population Health and Health Policy

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


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.

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Publish Date: 
March 1, 2013

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

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