MCH-MRN E-News Update: August 2019
Coordinated by CAHMI
Unpacking the MCH-MRN Strategic Agenda

Over the past three years, the MCH-MRN Strategic Agenda has been developed and updated to identify measurement priorities and gaps requiring attention in order to promote MCH outcomes and systems performance overall and to advance the healthy development and well-being of children early in life and across the lifespan. The MCH-MRN Strategic Agenda is a result of a multi-step process, including a yearly systematic review of existing measures used across MCH and related programs, expert interviews and continuous use of an ongoing online input tool as well as a periodically updated environmental and literature scan on existing and emerging measurement frameworks and measures. The resulting agenda prioritizes measures related to MCH efforts toward promoting positive and relational health and addressing childhood trauma, family health and social determinants of health, and advancing measures of family engagement.
Enhancements to key areas of importance that are already better represented in existing measures are also recommended. Comprehensive measures related to early childhood development are lifted up as critical, though measures for all age children and families continue to be critical. Also highlighted are the needs to advance the accessibility of MCH measures and data and to specifically address gaps in the measures and data for cities, counties and neighborhoods necessary to understand, guide and track efforts to improve MCH outcomes and systems performance.

After six years of leadership in the MCH-MRN, the MCH-MRN Grant will be moving to a new grantee. As this takes place, there are three critical measurement areas in which the MCH-MRN and CAHMI will continue to focus: positive and relational health , family engagement and assessing measures for young children.

Positive and Relational Health
Positive and relational health are high priority areas for measurement in MCH. Measuring positive and relational health may include parent-child connection, emotional well-being and positive relationships in families and children’s lives. Also included is assessing children’s engagement and sense of meaning in life, curiosity and persistence, and other aspects of positive health such as vitality and optimism. Relational health measures also include the presence of childhood trauma , associated symptoms, and quality of services to prevent and mitigate impacts of trauma and promote healing . It is important to emphasize that measures of positive child health and positive relational health were viewed as both reflective of and a strategy to address the effects of and stem the tide on childhood trauma and the persistent increases in mental, behavioral, and emotional problems among US children and youth associated with such trauma. In this next year, the CAHMI and the MCH-MRN will continue to prioritize opportunities to close measurement gaps related to positive and relational health including conceptual, use, and validity gaps.

If you would like to stay informed of the CAHMI’s work around positive and relational health , please sign up to receive updates and more information by clicking here
Family Engagement
Family engagement has emerged as a critical conceptual gap to address in developing the MCH-MRN Strategic Agenda. Specifically, experts and respondents agree that persistent health problems and needs in the MCH population cannot be resolved without close collaboration with families in defining the problems and efforts to improve at the systems level. Opportunities exist to close gaps in family engagement measurement and conceptual alignment through the development of new measurement tools for use in health care systems. In addition to family engagement in systems policies and practices, family engagement is a multidimensional, dynamic, relational process that is foundational to positive outcomes and well-being of children. For example, engaging families is fundamental to supporting their roles as the primary providers of care for children and as proactive advocates to ensure issues affecting their children and family are addressed in health and related systems and services. Families also need to be engaged in decision making in the care of children, not simply related to more serious medical decisions, but across the continuum of primary, secondary and tertiary prevention, in addressing social determinants of health, and in improving care coordination and effectiveness. Securing engagement cannot be assumed even if mechanisms for engagement are offered. As such, family engagement measurement also includes indicators of success related to family capacity, interest and supports to fully engage in their child and family’s health and the performance of the MCH systems on which they rely.

If you would like to stay informed of the CAHMI’s work around family engagement , please sign up to receive updates and more information by clicking here .

Early Childhood
A third priority area of early childhood cuts across key conceptual measurement areas. Particularly, deeper dives into measurements for positive and relational health and social determinants of health in early childhood exposed the need to further develop validated, meaningful measures for this population. Similarly, measures of parent-child connection, family health and family engagement require improvement and are especially important when children are very young, as their optimal development requires safe, stable, and nurturing relationships. Specific measures of strong families and protective factors for young children will be reviewed and considered for potential future improvements.

If you would like to stay informed of the CAHMI’s work around early childhood , please sign up to receive updates and more information by clicking here
Welcoming the New MCH-MRN Grantee and Transitioning Roles
Beginning September 2019, the MCH-MRN Principle Investigator will be Dr. Larry Kleinman of Rutgers University. Dr. Kleinman, who has also been an advisor in the current MCH-MRN, is the Core Director at Rutgers University Institute for Health Survey/Data Core. He has previously been a director for the Center for Child Health and Policy (CCHP) and has served as a professor in Child and Adolescent Health, both positions at Case Western University. He helped lead efforts to integrate behavioral and primary care and to systematically consider social determinants of health in the planning and delivery of health care. The CAHMI is excited for this transition and sees this as a step forward in advancing the MCH-MRN goals and agenda.

The current MCH-MRN grant with Principle Investigator Christina Bethell, PhD will continue until April 2020 and will culminate in a final in-person meeting –scheduled for early Spring 2020. To ensure a smooth transition to the new HRSA MCHB Grantee, the CAHMI will work with Dr. Kleinman as his team takes the lead. The CAHMI will also be a SubAwardee in the new MCH-MRN with a focus on measurement as summarized above.

While we are in this period of project leadership transition, the MCH-MRN monthly e-newsletters will be on hiatus. CAHMI will be sending out save the dates and important information in the upcoming months regarding the Spring 2020 MCH-MRN meeting.
Save the Date - February 2020: CAHMI MCH-MRN Local Data Resources Webinar

Under the MCH-MRN, the CAHMI and consultants are partnering with CityMatCH and the National Association of County and City Health Officials (NACCHO) in order to create a suite of tools that will provide resources to give local areas (communities, neighborhoods, census tracts, and states) better access to available data around the MCH population with a focus on social determinants of health. Recommendations for improvements in data resources at the local level will also be shared. Ready access to meaningful data is urgently needed to inform local partnerships and to drive action for the health, well-being and equity of the MCH population. Be on the lookout for more information from us regarding the release of these tools and a local data resources webinar coming in February 2020!  
Engage with the MCH-MRN
The MCH-MRN provides a platform to: inspire, support, coordinate, and advance efforts related to MCH measurement, promote measurement innovation and shared accountability, and improve outcomes and systems performance on behalf of the nation’s children, youth, and families. 

MCH-MRN members contribute to setting a strategic agenda, collaborate to address MCH measurement gaps and needs, and receive resources and information relevant to MCH measurement. Here are some further ways to get involved with the MCH-MRN:
  • Engage in the network. Please fill out our engagement tool to help us understand how you would like to be engaged in the MCH-MRN and how best to keep you informed about network activities.
  • Use our website and interactive compendium to quickly browse through over 1000 MCH measures by measure set, data source category, or three levels of topical categories.
  • Download the most recent MCH-MRN Strategic Agenda.
What We're Reading This Month:

  •  Wakschlag LS, Briggs-Gowan MJ, Choi SW, et al. Advancing a multidimensional, developmental spectrum approach to preschool disruptive behavior. J Am Acad Child Adolesc Psychiatry. 2014;53(1):82–96.e3. doi:10.1016/j.jaac.2013.10.011

  • Spencer N, Raman S, O'Hare B, Tamburlini G. Addressing inequities in child health and development: towards social justice. BMJ Paediatr Open. 2019;3(1):e000503. Published 2019 Aug 1. doi:10.1136/bmjpo-2019-000503

The Child and Adolescent Health Measurement Initiative (CAHMI) is a center within the Department of Population, Family, and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health