Promoting Healthy Women, Infants and Children Action Plan - Recommended Evidence-based Programs, Policies and Practices

Focus Area 1: Maternal and Infant Health

  • Goal #1: Reduce premature births in New York State.
  • Goal #2: Increase the proportion of NYS babies who are breastfed.
  • Goal #3: Reduce the rate of maternal deaths in New York State.

Focus Area 2: Child Health

  • Goal #4: Increase the proportion of NYS children who receive comprehensive well-child-care in accordance with AAP guidelines.
  • Goal #5: Reduce the prevalence of dental caries among NYS children.

Focus Area 3: Reproductive, Preconception and Inter-Conception Health

  • Goal #6: Prevention of unintended and adolescent pregnancy
  • Goal #7: Increase utilization of preventive health care services among women of reproductive ages.

Recommended evidence-based Programs, Policies and Practices - Examples

Focus Area 1: Maternal and Infant Health

  • Goal #1 (Action Plan) (Dashboard) : Reduce premature births in New York State.
    1. Ask all pregnant women about tobacco use and provide augmented, pregnancy-tailored counseling for those who smoke.
      1. Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women
        Smoking cessation counseling sessions, augmented with messages and self-help materials tailored for pregnant smokers from the U.S. Preventive Services Task Force. Includes summary of evidence.
      2. Smoking Cessation During Pregnancy
        American College of Obstetricians and Gynecologists' office-based protocol to systematically identify pregnant women who smoke and offer treatment and referral.
      3. Preventing Smoking and Exposure to Secondhand Smoke Before, During and After Pregnancy
        Centers for Disease Control and Prevention (CDC) fact sheet related to smoking and pregnancies, including recommended strategies and resources for quitting.
    2. Screen sexually active women and pregnant women for sexually transmitted diseases, alcohol abuse, depression, violence and other behavioral and psycho-social risk factors. Provide behavioral counseling where indicated, and link women with identified needs to community resources.
      1. U.S. Preventive Service Task Force. Screening for Gonorrhea
        USPSTF recommends that clinicians screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection.
      2. U.S. Preventive Task Force. Screening for Gonorrhea
        Rationale for screening for Chlamydial infection in all sexually active, non-pregnant young women ages 24 and younger and in older non-pregnant women who are at increased risk. Also recommends screening for Chlamydial infection in all pregnant women ages 24 and younger and in older pregnant women who are at increased risk.
      3. Counseling Interventions in Primary Care
        Rationale for clinicians to screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.
      4. USPSTF. Intimate Partner Violence and Abuse of Elderly and Vulnerable Adults: Screening
        Screening instruments designed for health care settings can accurately identify women experiencing intimate partner violence. Screening could reduce intimate partner violence and improve health outcomes.
      5. USPSTF Screening for Depression in Adults
        Recommendation to screen adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment and follow-up.
      6. Sexually Transmitted Diseases
        CDC site provides information related to STDs, as well as screening and treatment guidelines.
      7. Alcohol Screening and Brief Intervention
        CDC information on alcohol screening and brief intervention, including links to training and educational resources.
      8. Intimate Partner Violence
        American College of Obstetricians and Gynecologists' recommendations for screening for intimate partner violence, including suggested questions, follow-up actions and links to other resources.
      9. Screening for Perinatal Depression
        ACOG Committee opinion, with an estimate of sensitivity and specificity of screening tools.
      10. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    3. Identify and promote educational messages and formats that have been demonstrated to improve knowledge, attitudes, skills and/or behavior related to preterm birth and associated risk factors among target populations before, during and between pregnancies.
      1. CDC Gateway to Health Communication and Social Marketing
        Compilation of resources to help build health communication or social marketing campaigns and programs. Includes tips for analyzing and segmenting an audience, choosing appropriate channels and tools, and evaluating success.
      2. Touching Hearts, Touching Minds
        Comprehensive site of emotion-based strategies and materials developed by the Massachusetts WIC Program to more effectively promote the adoption of healthy behaviors. Site includes extensive implementation tips and tools, including many no-cost reproducible education and counseling materials.
      3. Text4baby
        First service designed to promote maternal and child health through text messaging. The NYS Department of Health has partnered with national Text4baby to customize the campaign for New York.
      4. Go Before You Show
        Social marketing campaign aimed at increasing knowledge about the importance of early prenatal care. The campaign has been implemented by the Westchester County Department of Health.
      5. Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality
        Association of Maternal & Child Health Programs' policy and programmatic options to improve birth outcomes, reduce prematurity and narrow health disparities. Recommendations include multiple examples and state profiles on health promotion strategies before, during and between pregnancies.
      6. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    4. Utilize paraprofessionals such as peer counselors, lay health advisors and community health workers to reinforce health education and health care service utilization and enhance social support to high-risk pregnant women.
      1. Community Health Workers Evidence-Based Models Toolbox
        Tool created by the U.S. Office of Rural Health Policy (a program of the Health Resources and Services Administration) to support the development of CHW programming in rural areas in the U.S. It draws on and shares lessons learned from proven CHW program models.
      2. Addressing Chronic Disease through Community Health Workers: A Policy and Systems-Level Approach
        CDC guidance and resources for implementing recommendations to integrate community health workers into community-based efforts to prevent chronic disease.
      3. Policy Statement: Support for Community Health Workers to Increase Access
        American Public Health Association advocates policy and practice changes needed to strengthen the position of community health workers as frontline members of the public health workforce uniquely positioned to address issues of health care access, quality, cost, and disparities.
      4. Paving a Path to Advance the Community Health Worker Workforce in New York City
        Community Health Worker Network of NYC provides recommendations to expand and improve New York's CHW workforce, including establishing a scope of practice for CHWs, implementing statewide training and certification, and securing stable financing for CHWs.
      5. Community Health Workers Forum
        American Public Health Association shares resources and strategies to develop the role of community health workers.
      6. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    5. Provide routine preconception/inter-conception health visits for women of reproductive age that include screening and follow-up for risk factors.
      1. Recommendations to Improve Preconception Health and Health Care
        Report of the CDC Select Panel on Preconception Care includes 10 recommendations with key action steps.
      2. Action Plan for the National Initiative on Preconception Health and Health Care 2012—2014
        CDC report outlines objectives, strategies and action steps to improve preconception care with a renewed vision for achieving change in maternal and child health.
      3. Preconception Health and Health Care: The Clinical Content of Preconception Care
        Supplement of the American Journal of Obstetrics and Gynecology documents the evidence base for preconception care, with recommendations across 14 areas of clinical services.
      4. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    6. Provide timely, continuous and comprehensive prenatal care services to pregnant women in accordance with NYS Medicaid prenatal care standards and other professional guidelines.
      1. Guidelines for Perinatal Care
        Joint recommendations of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists on quality care of pregnant women, their fetuses, and their neonates which address the full spectrum of perinatal medicine.
      2. New York State Medicaid Prenatal Care Standards
    7. Implement innovative models of prenatal care, such as Centering Pregnancy, demonstrated to improve preterm birth rates and other adverse pregnancy outcomes.
      1. Centering Health Care
        The site provides assistance in implementing the Centering Pregnancy model of health assessment, education and support into clinical practice.
      2. Group Prenatal Care and Preterm Birth Weight
        Describes the evidence base for the Centering model.
      3. Prenatal Care and Perinatal Outcomes: A Randomized Controlled Trial
        More evidence for the Centering model.
    8. Provide clinical management of preterm labor in accordance with current clinical guidelines, including use of 17-alpha hydroxyprogesterone caporate (17P) and tocolytics when indicated.
      1. Meis PJ, Klebanoff M, Thom E, et al. Prevention of Recurrent Preterm Delivery by 17 Alpha-Hydroxyprogesterone Caproate.N Engl J Med 2003;348:2379-85.
        New England Journal of Medicine report on clinical trial demonstrating that weekly injections of 17P resulted in a substantial reduction in the rate of recurrent preterm delivery among women who were at high risk for preterm delivery and reduced the likelihood of several complications in their infants. Available from Dickerman Library and NYS Library.
      2. Tocolytics for Preterm Labor
        Cochrane review that focus on medical treatments to inhibit preterm labor.
      3. Practice Bulletin: Management of Preterm Labor
        American Congress of Obstetricians and Gynecologists presents methods to manage preterm labor and reviews the evidence for the roles of these methods in clinical practice.
    9. Educate providers of health care and supportive services to ensure that they have knowledge, skills, tools, cultural competence and motivation to effectively counsel patients on high-impact risk behaviors such as smoking, the importance of adhering to disease management protocols and follow-up on referrals.
      1. Technical Assistance Document: Implementing USPSTF Recommendations into Professional Education Programs
        Document was developed as part of an Agency for Healthcare Research and Quality (AHRQ) initiative. It includes examples of lesson plans and teaching activities from academic institutions that have integrated the U.S. Preventive Services Task Force recommendations into their curricula.
      2. Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality
        Association of Maternal & Child Health Programs policy and programmatic options to improve birth outcomes, reduce prematurity and narrow health disparities. Recommendations include multiple examples and state profiles on health promotion strategies before, during and between pregnancies.
    10. Conduct public health detailing to improve service providers' knowledge, beliefs and skills related to improved use of evidence-based clinical and community-based interventions to reduce preterm birth.
      1. Public Health Detailing of Primary Care Providers: New York City's Experience, 2003-2010
        New York City developed the Public Health Detailing Program, a primary care outreach program, to improve patient care related to public health issues. Journal article describes how the program was developed and implemented, including topic selection, development of messages and action kits, staff recruitment and training, conducting detailing visits, tracking and evaluation results.
      2. Maternal and Child Health Home Visiting Toolkit
        University at Albany School of Public Health, with the NYS Department of Health, designed this toolkit to increase awareness of the benefits of evidence-based home visiting programs in New York.
    11. Implement evidence-based home visiting programs for high-risk pregnant women.
      1. Home Visiting Evidence of Effectiveness (HomVee) Review of the home visiting research literature assesses the evidence of effectiveness for home visiting program models that serve families with pregnant women and children from birth to age 5. Provides information about which home visiting program models have evidence of effectiveness, as well as detailed information about the samples of families who participated in the research, the outcomes measured in each study, and the implementation guidelines for each model.
    12. Utilize community health workers to provide enhanced social support for high-risk pregnant, preconception, inter-conception women and their families to improve practice of healthy behaviors, use of preventive health care and social services, and management of chronic medical conditions.
      1. Community Health Workers Evidence-Based Models Toolbox Tool created by the U.S. Office of Rural Health Policy (a program of the Health Resources and Services Administration) to support the development of CHW programming in rural areas in the U.S. It draws on and shares lessons learned from proven CHW program models.
      2. Addressing Chronic Disease through Community Health Workers: A Policy and Systems-Level Approach
        CDC guidance and resources for implementing recommendations to integrate community health workers into community-based efforts to prevent chronic diseases.
      3. Policy Statement: Support for Community Health Workers to Increase Accessand Reduce Health Inequities
        American Public Health Association advocates policy and practice changes needed to strengthen the position of community health workers as frontline members of the public health workforce uniquely positioned to address issues of health care access, quality, cost, and disparities.
      4. Paving a Path to Advance the Community Health Worker Workforce in New York State
        Community Health Worker Network of NYC provides recommendations to expand and improve New York's CHW workforce, including establishing a scope of practice for CHWs, implementing statewide training and certification, and securing stable financing for CHWs.
      5. Community Health Workers Forum
        American Public Health Association shares resources and strategies to develop the role of community health workers.
      6. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    13. Ensure that women who have experienced a preterm birth or other adverse pregnancy outcome receive inter-conception health care and other supportive services to prevent subsequent preterm births.
      1. Toward Improving the Outcome of Pregnancy: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives
        March of Dimes' monograph explores the essential elements to improving quality, safety and performance across the continuum of perinatal care. Chapter V addresses quality improvement opportunities in preconception and interconception care.
    14. Promote adoption and integration of National Standards on Culturally and Linguistically Appropriate Services (CLAS) in clinical practices and other community service organizations to increase accessibility and effectiveness.
      1. The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care
        Standards intended to advance health equity, improve quality and help eliminate health care disparities by providing a blueprint for individuals, and health and health care organizations to implement culturally and linguistically appropriate services.

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    Goal #2 (Action Plan) (Dashboard) : Increase the proportion of NYS babies who are breastfed.
    1. Multiple Interventions (cross-cutting resources)
      1. Counseling Interventions to Promote Breastfeeding
        Summary by Canadian Task Force on Preventive Health Care of specific counseling interventions to promote breastfeeding. Includes table of evidence level.
      2. Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies
        Guide helps state and local community members choose the breastfeeding intervention strategy that best meets their needs. Support for breastfeeding is needed in hospitals, birth centers, worksites and communities. Guide builds upon the research evidence demonstrating effective intervention strategies and offers program examples and resources.
      3. The Surgeon General's Call to Action to Support Breastfeeding
        Outlines 20 sector-specific actions to improve support for breastfeeding. Includes links to resources for patients, employers and other sectors.
      4. Promoting Breastfeeding in Hospitals, Primary Care and Worksites
        NYS Department of Health fact sheet aims to increase breastfeeding exclusivity for the first six months of life, and continued breastfeeding for the first 12 months of life.
      5. La Leche League of New York
        This international, nonprofit, nonsectarian organization provides education, information, and encouragement to women who want to breastfeed. Resource list offers strategies.
      6. International Lactation Consultant Association
        Directory to find International Board-Certified Lactation Consultants locally.
    2. Provide structured, comprehensive breastfeeding education and professional lactation counseling, including the use of Internal Board Certified Lactation Consultants (IBCLCs) during pregnancy, in the hospital and at home.
      1. Primary Care Interventions to Promote Breastfeeding
        Summary of Preventive Services Task Force evidence to support counseling to promote breastfeeding.
      2. International Lactation Consultant Association
        Directory to find International Board-Certified Lactation Consultants locally.
      3. NYS Medicaid Benefit for Lactation Services
        Describes NYS Medicaid coverage for lactation consultation services provided by IBCLCs.
    3. Train physicians, nurses and other health care providers about breastfeeding and lactation support.
      1. Primary Care Interventions to Promote Breastfeeding
        Summary of Preventive Services Task Force evidence to support counseling to promote breastfeeding.
      2. Supporting and Promoting Breastfeeding in Health Care
        Four hour-long health provider education and training modules from the University at Albany School of Public Health.
    4. Address breastfeeding support needs for women with physical disabilities such as spinal cord injuries, multiple sclerosis or arthritis.
      1. Pregnancy Planning for Women with Mobility Disabilities
        This resource for providers includes a section on breastfeeding support considerations.
    5. Engage high-risk pregnant women and families in evidence-based home visiting programs that have demonstrated positive impact on breastfeeding.
      1. Home Visiting Evidence of Effectiveness (HomVee) Review of the home visiting research literature assesses the evidence of effectiveness for home visiting program models that serve families with pregnant women and children from birth to age 5. Provides information about which home visiting program models have evidence of effectiveness, as well as detailed information about the samples of families who participated in the research, the outcomes measured in each study, and the implementation guidelines for each model.
    6. Implement maternity care practices consistent with the World Health Organization's Ten Steps to Successful Breastfeeding and increase the number of Baby Friendly Hospitals in New York State.
      1. Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies
        Guide helps state and local community members choose the breastfeeding intervention strategy that best meets their needs. Support for breastfeeding is needed in hospitals, birth centers, worksites and communities. Guide builds upon the research evidence demonstrating effective intervention strategies and offers program examples and resources.
      2. Baby Friendly USA
        Comprehensive site for the Baby Friendly USA accreditation and Baby Friendly Hospital initiative. Includes FAQs, implementation resources for hospitals and birthing centers and links to Baby Friendly Hospitals.
    7. Link pregnant and post-partum low-income women to local WIC services for breastfeeding and other nutritional supports.
      1. Welcome to WIC - Breastfeeding …For my baby. For me
        Resources from NYS WIC Program. Includes educational materials, information on WIC breastfeeding peer counselors, and resources for employers, women returning to work, and health care providers.
      2. Breastfeeding
        Web site designed for women interested in learning more about breastfeeding and for breastfeeding counselors.
    8. Ensure that employers create an environment to support breastfeeding.
      1. The Business Case for Breastfeeding
        Comprehensive program designed to educate employers about the value of supporting breastfeeding employees in the workplace. Program highlights how such support contributes to the success of the entire business. Offers tools to help employers provide worksite lactation support and privacy for breastfeeding mothers to express milk. Also provides guidance to employees on breastfeeding and working. Includes resources to help lactation specialists and health professionals educate employers in their communities.
      2. Making It Work Toolkit
        Toolkit for breastfeeding mothers returning to work or school includes tools and information for mothers, businesses and families.

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    Goal #3 (Action Plan) (Dashboard) : Reduce the rate of maternal deaths in New York State.
    1. All maternal deaths should be identified and reviewed by the New York State Maternal Mortality Review Committee
      1. State Maternal Mortality Review: Accomplishments of Nine States
        CDC report examines the circumstances of women's deaths during or around the time of pregnancy and identifies gaps in services and systems that should be improved to prevent future deaths.
    2. Expand provider use of guidance for clinical management of chronic disease and other risk factors or events, such as obesity, hypertension, and hemorrhage, during pregnancy and delivery.
      1. Prevention of Maternal Deaths Through Improved Management of Hemorrhage
        NYS Department of Health lists steps for hospitals to prevent maternal deaths by managing hemorrhages.
      2. Hypertensive Disorders in Pregnancy: Executive Summary
        NYSDOH guidance document aims to promote quality services and enhance communication among providers who care for pregnant women, including obstetricians, family practice physicians, emergency department physicians, midwives, anesthesiologists, nurses and others.
    3. Reduce early elective deliveries that lack a medical reason.
      1. Elective delivery at less than 39 weeks
        Implementation of hospital quality improvement programs has successfully reduced elective early-term and late-preterm deliveries, as well as associated neonatal morbidity and mortality.
      2. American College of Obstetricians and Gynecologists Bulletin: Induction of Labor
        Practice guidelines classify the indications for and contraindications to induction of labor and other considerations.
    4. Support evidence-based home visiting programs for high-risk pregnant women
      1. Home Visiting Evidence of Effectiveness (HomVee) Review of the home visiting research literature assesses the evidence of effectiveness for home visiting program models that serve families with pregnant women and children from birth to age 5. Provides information about which home visiting program models have evidence of effectiveness, as well as detailed information about the samples of families who participated in the research, the outcomes measured in each study, and the implementation guidelines for each model.

Focus Area 2: Child Health

Focus Area 3: Reproductive, Preconception and Inter-Conception Health

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    Goal #6 (Action Plan) (Dashboard): Prevention of unintended and adolescent pregnancy
    1. Identify and promote educational messages on delaying sexual activity, consistent contraceptive use, preventive health care, taking individual responsibility, and the male's role in preventing pregnancy. Messages should be put in formats that have been demonstrated to improve knowledge, attitudes, skills and/or behavior related to pregnancy prevention among targeted populations such as young women and men, women and teens with disabilities, and disparate populations.
      1. Healthy People 2020: Family Planning
        Evidence-based resources selected by subject matter experts at the U.S. Department of Health and Human Services. Each resource has been rated and classified by criteria based, in part, on publication status, type, and number of studies.
      2. National Prevention Strategy
        The U.S. Surgeon General’s strategy indicates that healthy reproductive and sexual practices can play a critical role in enabling people to remain healthy and contribute to their community. Access to quality health services and support for safe practices can improve physical and emotional well-being and reduce teen and unintended pregnancies, HIV/AIDS, viral hepatitis, and other sexually transmitted infections.
      3. The National Campaign to Prevent Teen and Unplanned Pregnancy: Promoting Responsible Fatherhood through Pregnancy Planning and Prevention
        Policymakers should intensify their focus on the responsibilities of men in preventing teen and unplanned pregnancy by addressing pregnancy planning and prevention in federally funded programs serving significant numbers of men, and reaching men more effectively in family planning programs.
      4. Understanding Youth Development Principles and Practices
        Act for Youth Upstate Center of Excellence's strategic approach focuses on engaging entire communities in helping all youth thrive. It builds on traditional youth service approaches by emphasizing long-term, systemic strategies for cultivating qualities and traits desirable in young people through the creation of environments that support their developmental needs and capacities.
      5. Components of Promising Teen Pregnancy Prevention Programs
        Document summarizes ingredients of successful teen pregnancy prevention programs and may guide development of new strategies and strengthening interventions.
      6. Teen Pregnancy and Social Media
        CDC social media tools can be used to promote teen pregnancy prevention efforts. This quick reference guide highlights social media tools with credible, science-based teen pregnancy prevention messages.
    2. Promote the use of the most effective contraception, including long-acting reversible contraceptives (LARCs).
      1. Healthy People 2020: Access to Health Services
        Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. Site focuses on coverage, services, timeliness, and workforce.
      2. U.S. Selected Practice Recommendations for Contraceptive Use 2013
        CDC recommendations address some common, yet sometimes controversial or complex, issues regarding initiation and use of contraceptive methods. Although many of the recommendations are the same as those provided by the World Health Organization, they have been adapted to be more specific to U.S. practices or have been modified because of new evidence. In addition, four new topics are addressed, including the effectiveness of female sterilization, extended use of combined hormonal methods and bleeding problems, starting regular contraception after use of emergency contraception, and determining when contraception is no longer needed. The recommendations are a source of clinical guidance for health care providers.
      3. Journal of Adolescent Health Special Issue: Long Acting Reversible Contraceptives (LARC) for Adolescents and Young Adults
        Articles discuss counseling adolescents about contraception, the myths and misconceptions about LARC, awareness of LARC among teens and young adults, the effect of LARC on rapid repeat pregnancy in adolescents, and cost as a barrier to LARC use in adolescents.
      4. Leveling the Playing Field: The Promise of Long-Acting Reversible Contraceptives for Adolescents
        Information for health care professionals, teens and young women about the benefits and risks of LARC for birth control.
    3. Implement comprehensive, evidence-based, age-appropriate sex education in schools.
      1. The National Campaign to Prevent Teen and Unplanned Pregnancy: What Works
        Overview of what is known about carefully evaluated interventions that help delay sex, improve contraceptive use, and/or prevent teen pregnancy.
      2. The President's Teen Pregnancy Prevention Initiative: Teen Pregnancy Prevention 2010-2015
        The CDC’s Office of Adolescent Health supports public and private funding of medically accurate, age-appropriate evidence-based or innovative program models to reduce teen pregnancy. The program’s purpose is to demonstrate the effectiveness of innovative, multicomponent, communitywide initiatives in reducing rates of teen pregnancy and births in communities with the highest rates, with a focus on reaching African American and Latino/Hispanic youth aged 15-19 years.
    4. Promote healthy choices, provide comprehensive health information and enhance the skills/self-efficacy required to act on that knowledge.
      1. The National Campaign for Preventing Teen and Unplanned Pregnancy: Tips for Using Digital Media
        Basic principles to keep in mind when engaging with teenage audiences online.
      2. Helping Adolescents Transition to Adult Care
        American Academy of Pediatrics’ detailed guidance to pediatricians, family physicians and internists to support adolescents, including those with special health care needs, as they transition to an adult model of health care.
      3. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    5. Ensure access to, and affordability of, confidential contraceptive services and access to no-cost contraception in accordance with the federal Affordable Care Act (ACA).
      1. NYS Medicaid Family Planning Benefit Program
        Public health insurance program for New Yorkers who need family planning services, but may not be able to afford them. It is intended to increase access to confidential family planning services and to enable teens, women and men of childbearing age to prevent and/or reduce the incidence of unintentional pregnancies.
      2. NYS Comprehensive Family Planning & Reproductive Health Program (Family Planning Program)
        Program provides comprehensive, confidential family planning and reproductive health care services to low-income uninsured and underinsured women, men and adolescents in New York State.
      3. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    6. Increase the number of school-based health centers in middle and high schools providing comprehensive reproductive health care/family planning services, or foster relationships between schools and nearby reproductive health care providers.
      1. Inner-City School Health Center's Comprehensive Reproductive Health Services: Enhancing Access to Screening for Sexually Transmitted Diseases, Prenatal Care, and Contraception
        Rush University College of Nursing operates health centers in three Chicago public schools that provide convenient, comprehensive reproductive and sexual health services to a primarily African-American student body. In addition to typical clinic services, the centers provide regular school-wide screenings for sexually transmitted diseases, with an opt-out option for both parents and students; contraceptive education and care; human papillomavirus vaccinations; and prenatal and postnatal care.
      2. Contraceptive Access at School-Based Health Centers: Three Case Studies in New York State
        Study by Advocates for Youth summarizes lessons learned from three SBHCs in successfully mobilizing community support for contraceptive services for teens, designing effective programs, and sustaining program financing.
      3. Principles and Guidelines for School Based Health Centers in New York State
        School-based health centers provide age-appropriate primary health, mental health, social, and health education services as primary and preventive care, acute or first contact care, chronic care and referral as needed. They provide services for children and adolescents within the context of their family, social/emotional, cultural, physical and educational environment. Services must comply with New York State Child/Teen Health Plan requirements.
      4. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.

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    Goal #7 (Action Plan) (Dashboard) : Increase utilization of preventive health care services among women of reproductive ages.
    1. Identify and promote educational messages that have improved knowledge, attitudes, skills and/or behavior related to the use of preventive health services among selected targeted populations, including women of reproductive age, men, and women with disabilities. Key topics should include nutrition, folic acid supplementation, safe sex practices, contraceptives, exposure to hazardous chemicals, and general preconceptions topics.
      1. CDC: Preconception Care and Health Care
        "Show Your Love"; is a national campaign designed to improve the health of women and babies by promoting preconception health and health care. The campaign goal is to increase the number of women who plan their pregnancies and engage in healthy behaviors before becoming pregnant. Buttons, posters, videos, and other resources are available.
      2. March of Dimes: Getting Healthy for Pregnancy
        Informational checklist of important health topics and areas for child-bearing age women prior to pregnancy.
      3. Preconception Care for Improving Perinatal Outcomes: The Time to Act
        Summarizes the importance of improving the health of women through prevention strategies that should be implemented before conception to improve future pregnancy outcomes. Opportunities exist to improve preconception health through wellness care, through maintenance care for women with chronic health conditions associated with increased preconception risk (e.g., maternal diabetes), and in settings where women seek medical support for one specific risk such as smoking or obesity.
      4. The Business Case for Preconception Care
        Paper provides methods, data needs, and other issues involved with preparing an economic analysis of the likely financial return on investment in preconception care.  This is accompanied by a review of economic evaluations of preconception care for women with recognized diabetes.
      5. Centers for Disease Control and Prevention: Disability and Health
        Women with disabilities may need specialty care to address their needs. In addition, they need the same general health care as women without disabilities, and they may also need additional care to address their specific needs. Site provides tools and resources for women with disabilities.
      6. State-Level Differences in Breast and Cervical Cancer Screening by Disability Status
        Describes the use of state surveillance data to identify disparities in breast and cervical cancer screening among women by disability status. Epidemiologic evidence identifies an opportunity for federal and state programs, as well as other stakeholders, to form partnerships to align disability and women's health policies.
      7. Fact Sheet: Access to Preventive Health Care Services for Women with Disabilities
        An overview of the public health issue of access to preventive health care services for women with disabilities and some major barriers these women face when accessing preventive health care. It also provides solutions that can be considered to eliminate these barriers.
    2. Engage parents of at-risk populations, such as adolescents, LGBTQ and women with disabilities, to improve their use of health care services, and provide information and support to assist young adults with their transition to the adult health care system.
      1. Integrated Perinatal Health Framework: A Multiple Determinants Model with a Life Span Approach
        Paper proposes a framework which integrates a “life span” - perspective, which focuses attention toward the preconceptional and interconceptional periods as targets for intervention in improving perinatal health. The model distinguishes among concepts of disease, health and functioning, and well-being for women and their offspring.
      2. Centers for Disease Control and Prevention: Strategies for Involving Parents in School Health
        Guide for engaging parents in school health. “Parent engagement in schools” is defined as parents and school staff working together to support and improve the learning, development, and health of children and adolescents
      3. National LGBT Education Center
        The Center provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual and transgender people.
      4. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    3. Empower teens and young adults to demand access to preventive health care, and to make decisions about reproductive health.
      1. Reducing Unintended Pregnancy in the United States
        Paper reports on contraceptive care and unintended pregnancies. Although advances in technology in the form of long-acting reversible methods not requiring adherence may be helpful, as might the development of hormonal contraceptive methods for men, technology alone is not sufficient. Many policies discourage consistent, effective contraceptive use and deserve to be reconsidered.
      2. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    4. Engage men in health care decision-making to provide support and promote their well-being.
      1. Healthy Men: Learn the Facts
        Information on men’s health includes recommended screenings, preventive medicines, immunizations, and steps for leading healthy lifestyles.
      2. Men’s Health Network
        This national non-profit organization works to reach men, boys, and their families where they live, work, play and pray with health prevention messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation.
      3. Environmental Chemicals in Pregnant Women in the United States
        Little is known about the extent of multiple-chemical exposures among pregnant women. Study found the percentage of pregnant women with detectable levels of an individual chemical ranged from 0 to 100 percent.
      4. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    5. Utilize every health care encounter to address preconception health for women of childbearing age.
      1. Healthier Women, Healthier Reproductive Outcomes: Recommendations for the Routine Care of All Women of Reproductive Age
        Paper describes the importance of addressing the health promotion needs of every patient and examining and addressing her health profile for reproductive risks. Irrespective of her desire for pregnancy, it is likely that more women will enter pregnancy with high levels of preconception wellness and that healthier women and healthier pregnancies and infants will result.
      2. Integrated Perinatal Health Framework: A Multiple Determinants Model with a Life Span Approach
        Paper proposes a framework which integrates a “life span” perspective, which focuses attention toward the preconceptional and interconceptional periods as targets for intervention in improving perinatal health. The model distinguishes among concepts of disease, health and functioning, and well-being for women and their offspring.
      3. A New Agenda for MCH Policy and Programs: Integrating a Life Course Perspective
        Concept paper developed as a first step in assisting the Health Resources and Services Administration, Maternal and Child Health Bureau explore how life course theory might be used as a strategic planning framework, guiding the work of MCHB, its grantees, and partners over the next five years.
      4. American Family Physician: Recommendations for Preconception Care
        This article describes how every woman of reproductive age who is capable of becoming pregnant is a candidate for preconception care, regardless of whether she plans to conceive. Preconception care is aimed at identifying and modifying biomedical, behavioral, and social risks through preventive and management interventions.
      5. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
    6. Promote risk screening, review of medications, and management of chronic diseases by health care providers before pregnancy.
      1. Recommendations to Improve Preconception Health and Health Care: Strategies for Implementation
        Paper describes current and future activities to implement CDC's recommendations to improve preconception health and health care.
      2. National Preconception Curriculum and Resources Guide for Clinicians
        Includes Web-based educational modules for addressing preconception care, integrating preconception care into primary care, and preconception care for those with high-risk conditions.
    7. Conduct oral health assessments and provide appropriate referrals.
      1. Periodontal Therapy May Reduce the Risk of Preterm Low Birth Weight in Women with Periodontal Disease
        Paper describes a randomized controlled trial conducted to further evaluate the proposed association between periodontal disease and preterm low birth weight (PLBW). Conclusion: Periodontal disease appears to be an independent risk factor for PLBW. Periodontal therapy significantly reduces the rates of PLBW in this population of women with periodontal disease.
    8. Conduct multi-component nutrition counseling interventions to reduce weight or maintain weight loss for obese patients.
      1. Consumer Health on the Internet
        Site identifies CDC consumer health sites, giving attention to the CDC Kids web page and CDC en Espanol, which have been developed for specialized consumer audiences.
      2. American Medical Association Learning Modules
        AMA resources for providers to help their adult patients promote healthy eating and physical activity for themselves and their children. Includes two video modules, a more detailed monograph and patient handouts.
      3. Maternal Obesity and Diabetes as Risk Factors for Adverse Pregnancy Outcomes: Differences Among 4 Racial/Ethnic Groups
        Paper reports on study examining links between obesity, diabetes, and three adverse pregnancy outcomes. Obesity and diabetes were independently associated with adverse pregnancy outcomes, highlighting the need for women to undergo lifestyle changes to help them control their weight during childbearing years and beyond.
    9. Promote use of preventive care and preconception health visits by adolescents through incentives to providers to improve rates of adolescents' preventive visits. Encourage clients to develop a reproductive health plan.
      1. Lower Hudson Valley Perinatal Network: Healthy Baby Network
        Tips for keeping your baby healthy, like taking prenatal vitamins for better brain development.
      2. Perinatal Network of Monroe County: “Healthy Life Plan Journal”
        Journal focuses on creating and maintaining healthy life choices, including preconception health information and resources. The journal is designed for teens ages 13-19 who do not have children, to be presented in 60- or 90-minute workshops in five sessions. Workshops can be weekly or monthly, depending on your program’s needs.
      3. Centers for Disease Control and Prevention: Preconception Health and Health Care Resources
        Educational materials from the CDC and other organizations for women and men of childbearing age.
      4. Involving Men in Reproductive Health: The Young Men’s Clinic
        Report describes the population of young men who use the Young Men's Clinic in New York City, profiles their reproductive behaviors, and describes the clinic's model of service delivery.
    10. Develop and disseminate to providers evidence-based clinical guidelines and tools to promote patients' optimal well-being through use of preventive health services.
      1. Healthier Women, Healthier Reproductive Outcomes: Recommendations for the Routine Care of All Women of Reproductive Age
        Article stresses the importance of integrating reproductive planning and health promotion into women's routine healthcare.
      2. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.
      3. Recommendations outline how to provide quality family planning services
        Describes recommended contraceptive services, pregnancy testing and counseling to help clients achieve pregnancy; basic infertility services; preconception health services; and sexually transmitted disease services. The recommendations can help women, men, and couples achieve their desired number and spacing of children and increase the likelihood that those children are born healthy. The report provides recommendations for how to help prevent and achieve pregnancy, emphasizes a full range of contraceptive methods for persons seeking to prevent pregnancy, highlights the special needs of adolescent clients, and encourages the use of the family planning visit to provide selected preventive health services for women, in accordance with the recommendations for women issued by the Institute of Medicine and adopted by HHS. The recommendations are now being used to guide the clinical component of the federal Title X Family Planning Program, so it is an important document for any provider offering family planning services.
    11. Increase awareness of effective communication techniques with parents concerning the importance and benefits of providing confidential services to adolescents.
      1. Confidentiality, Consent and Caring for the Adolescent Patient. Current Opinion in Pediatrics. 2009; 21(4): 450-456.
        Paper reviews the health care-related rationale for providing confidential care to adolescents, as well as the legal framework for the provision of such care. Available through Dickerman Library or NYS Library.
    12. Engage high-risk pregnant women and families in evidence-based home visiting programs that have demonstrated positive impact on use of primary and preventive health care services.
      1. Home Visiting Evidence of Effectiveness (HomVee) Review of the home visiting research literature assesses the evidence of effectiveness for home visiting program models that serve families with pregnant women and children from birth to age 5. Provides information about which home visiting program models have evidence of effectiveness, as well as detailed information about the samples of families who participated in the research, the outcomes measured in each study, and the implementation guidelines for each model.
      2. NYS Department of Health: Maternal, Infant, and Early Childhood Home Visiting Initiative
        This initiative uses home visiting programs proven to be effective to help improve outcomes for mothers and babies.
      3. NYS Office of Children and Family Services: Healthy Families New York
        This visiting program is a comprehensive prevention program that focuses on the safety of children while at the same time supporting families.
      4. Nurse Family Partnership
        A voluntary, free maternal and childhood health program, which provides first-time moms valuable knowledge and support throughout pregnancy and until their babies reach two years of age.
    13. Provide comprehensive, evidence-based health education, including health literacy, for children and youth in schools.
      1. The Case for Investing in Youth Health Literacy: One Step on the Path to Achieving Health Equity for Adolescents
        National Institute for Health Care Management discusses opportunities for health plans and foundations to potentially reduce future health care spending by investing in efforts to improve health literacy during adolescence, a critical developmental time when many health behaviors are initiated. This issue brief shares recent proposals to achieve health equity and improve health literacy, including strategies relevant to health plans and foundations.
      2. The New York State Youth Sexual Health Plan is a guide to ensure that accurate sexual health information addressing HIV, STD and pregnancy prevention is made available to all New York State youth.

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