MCH Priority Needs

 

On May 13, 2010, the Bureau of Family Health (BFH) assembled Title V stakeholders from across the state of Pennsylvania for the purpose of prioritizing Title V needs. The meeting was open to all interested Maternal Child Health (MCH) stakeholders. The BFH contracted with a nationally recognized expert, Andrew C. Rucks, Ph.D, Associate Professor, University of Alabama-Birmingham, to facilitate the priority setting process using the Q-Sort technique. The purpose of the Q-Sort process is to identify priorities among competing needs.  However, not all needs can be the “highest priority” for the state MCH program.  The Q-Sort Technique is effective at getting information from people with different backgrounds.

A set of 50 “priority needs” was provided to the MCH stakeholders based upon the results of the Needs and Capacity Assessment. Each priority need was assigned a numeral as a label, with the labels having no relationship to priority order or value of the priority need. The set of 50 priority needs was converted to decks of 50, 3inch-by-5inch cards. Each card contained a label and its associated Priority Need Statement. Each stakeholder was given one deck of cards and two Q-Sort Log Sheets. Dr. Rucks presented the group with:  1) an overview of the Q-Sort technique; 2) an overview of the strategy for arranging Priority Need Statements into priority sets; 3) specific instructions about placing the cards in descending order of priority and how to complete the Log Sheet; and 4) a presentation of the results of analyzing the data collected using the Log Sheets. 

The assembled stakeholders applied the Q-Sort technique to assign each of the 50 Priority Need Statements to one of nine priority categories. Priorities were ranked according to the various populations to be served by Title V including:  pregnant women and mothers, children, and children with special health care needs.  An overarching priority of developing a comprehensive, cohesive statewide MCH policy is necessary to serve as a “catch-all” for priorities identified that cross multiple state agencies or funding sources and those which require attention at the Governor’s level (these issues include: ensuring all Pennsylvanians have affordable health insurance, integrate behavioral and physical health care, improve access to oral health services, comprehensive programming to address obesity, expanding the number of providers who serve low income and uninsured individuals, expanding availability of dental care providers accepting Medicaid in underserved areas).

As a result of the Q-Sort technique and stakeholder consensus, the BFH selected the following 10 priorities (it should be noted some priorities were collapsed or combined where determined appropriate and feasible and any priority that is a state mandate (e.g. Newborn Screening) or Governor’s Office initiative (e.g. Medical Home) was excluded from the list. 

Items 1-3 are priorities related to Mothers and Infants.  Item number 1 was the highest ranked (weighted) item in the Mothers and Infants category, followed by numbers 2 and 3 respectively.  Items 4-7 are priorities related to Children and Adolescents.  Within this cluster, item 4 was the highest ranked (weighted) item in the Children and Adolescent category followed by numbers 5, 6 and 7 respectively.  Items 8-10 are priorities related to Children with Special Health Care Needs (CSHCN).  Within this cluster, item 8 was the most highly ranked (weighted) in the CSHCN category, followed by items 9 and 10, respectively. 

  1. Decrease barriers for prenatal care for at-risk/uninsured women through implementation of best practices.
  2. Reduce infant mortality rate for minorities.
  3. Increase behavioral health (mental health and substance abuse) screening, diagnosis and treatment for pregnant women and mothers (this includes post partum depression).
  4. Decrease teen pregnancy through comprehensive sex education.
  5. Increase screening for mental health issues among infants, children and adolescents.
  6. Expand access to physical and behavioral health services for high risk youth such as lesbian, gay, bisexual, transgender, questioning, runaway/homeless.
  7. Expand injury prevention activities (including suicide prevention), for infants, children and adolescents.
  8. Increase awareness of and access to comprehensive information about services and programs for CSHCN.
  9. Improve the transition of children and youth with special health care needs from child to adult medical, educational, and social services.
  10. Identify strategies for increasing respite care for caregivers.