Minnesota Family Home Visiting Evaluation: January 1 – December 31, 2011 Aggregate Data Collection Form Training

What is Different about the 2011 Reporting Period? Data dictionary clarification for –“Closure” –“Not home/Not found” –“Current with immunizations” and addition of additional immunization schedule guidelines in Appendix A. –“Primary caregivers or prenatal clients who have had a home safety checklist completed” Economic Self-Sufficiency  Deleted the income questions Child Maltreatment  Clarification of source of information for each CM question.

Birth or Pregnancy –Addition of Denominator Vd: Number of infants 6 to 12 months of age. –Addition of Descriptor Ve. Number of prenatal clients delivering during the reporting period who were first time parents (no previous live or still births). –Deleted the “Initiation of prenatal care in the first trimester” question. –Simplification of breastfeeding initiation question by collecting data only on prenatal clients delivering the reporting period who fed their baby breast milk at time of birth, and the duration question only on infants ages 6 to 12 months who were breastfed for six months or greater. –Simplification of tobacco use question by only collecting change in tobacco use data on prenatal clients and by removing the references to gestational age (before/after 35 weeks gestation). What is Different about the 2011 Reporting Period?

Population Subgroup Definitions Primary Caregivers and Prenatal Clients = Adults and pregnant/parenting teens. Prenatal Clients = Clients that were seen for at least one family home visit prenatally during the reporting period. –This is a subset of the “Primary Caregivers and Prenatal Clients” group. –Includes clients who delivered and those undelivered during this reporting period. Infants and Children = Infants and children ages 0 to 6.

Primary Caregivers and Prenatal Clients served for 12 or more months = Clients that were served by FHV for at least one year by the end of the reporting period. Prenatal Clients Delivering During the Reporting Period = Clients that were seen for at least one family home visit prenatally during the reporting period and delivered during the reporting period. Pregnant or Parenting Teens = Primary caregivers or prenatal clients up to age 20. Infants 6 to 12 months = Infants ages 6 to 12 months at the time served by FHV during the reporting period. Population Subgroup Definitions

Use the denominators to help decide who to include in each question. Denominators V. Birth or Pregnancy: To be completed by FHV programs directing resources to this area (i.e., Does your FHV program provide outreach to pregnant women? Does your FHV program target pregnant women?). Denominator Va. Prenatal clients delivering during the reporting period: Denominator for B1,B2, C1, D1, D2, E1, and E2. Denominator Vb. Births to prenatal clients delivering during the reporting period: Include all births (e.g., twins=2). Denominator for A2. Denominator Vc. Full term singleton births to prenatal clients delivering during the reporting period: Denominator for A1 Denominator Vd. Number of infants 6 to 12 months of age. Denominator for B2. Descriptor Ve. Number of prenatal clients delivering the reporting period who were first time mothers (no previous live or still births): A. Birth outcomes 1. Infants born at healthy birth weight (2500 grams or 5.5 lbs and higher): Exclude multiple births (i.e., twins) and infants less than 37 weeks gestation. 2. Infants born at full term (greater than or equal to 37 weeks gestation):. e.g., Denominator Vc is the denominator for question A1.  This shows that A1 should only include infants that were full term, infants that were not multiple, and infants that were born at a healthy weight. All denominators will give reference to the corresponding question(s). The denominator total should be greater than or equal to the outcome/Indicator total.

When to Report/Collect the Data During the reporting period = January 1, 2011 to December 31, 2011 –“Infants and children eligible for developmental screening during the reporting period” = Infants and children that were eligible for developmental screening between 1/01/2011 and 12/31/2011. –Collect data throughout the reporting period. Report at the end of the reporting period. End of the reporting period = December 31, 2011 –“Infants and children current with immunizations at the end of the reporting period.” = Infants and children that are current with immunizations by 12/31/2011. –Collect data throughout the reporting period. Report at the end of the reporting period.

When to Report and Collect the Data Collect at enrollment. Report annually = Collect data when opened or when the home visitor first started seeing the participant. Report the data from enrollment annually at the end of the reporting period. Enrollment information only has to be collected once during time of enrollment. –Education attainment. Collect data at enrollment. Report annually. = Collect data on level of education attainment when enrolled. Report enrollment data annually at the end of the reporting period. –Current with well-child care at enrollment Collect at enrollment. Report annually. = Collect data on well- child care status at enrollment. Report enrollment data annually at the end of the reporting period.

Closure = Collect data when closed and/or when the participant is no longer considered active or is no longer seen by FHV. –Changes in current well-child care at closure = The change that occurred from enrollment (before or during the reporting period) to closure (during the reporting period). When to Report and Collect the Data

The purpose of this section is to get a “snapshot” of the population being served by your FHV program. A. Primary caregivers, prenatal clients, and infants and children –Count unduplicated numbers 1. Total enrollment = Number of clients open during the reporting period If a woman starts as a prenatal client and then is enrolled as a primary caregiver, count her once I. A-D: Population Descriptors

A. Primary caregivers, prenatal clients, and infants and children (continued) 2. Total newly enrolled = Number newly opened during the reporting period. 3. Total closed = Number discharged during the reporting period. I. A: Population Descriptors

A. Primary caregivers, prenatal clients, and infants and children (continued) 4. Total home visits completed = Number of visits completed on enrolled participants. -Visits do not have to take place in the home.* -For a visit to count as a FHV, the content of the visit needs to be the same as if the visit had been in the home.** -If the visit was with an enrolled primary caregiver and an enrolled child, count one visit for primary caregiver and one visit for the child. *** 5. Major medical care resource: Collect data at enrollment. Report annually = Report major medical care resources when enrolled into the program. I. A: Population Descriptors

B. Primary caregiver and prenatal client descriptors 1. Total home visits planned but not home/not found = Number of intended visits that were planned and attempted for primary caregivers and prenatal clients but were not home or were not found. Do not include visits that were cancelled or rescheduled by the client or home visitor prior to the visit attempt being made. 2. Female clients = This number will be subtracted from the total number of primary caregivers/prenatal clients to get the number of males. 3. Marital status: Collect data at enrollment. Report annually. = “Married” as reported by the family. I. B: Population Descriptors

B. Primary caregiver and prenatal client descriptors (continued.) 4. Education attainment: Collect data at enrollment. Report annually. Post secondary education = College, vocational technical school or equivalent. 5. Primary language: Collect data at enrollment. Report annually. = Language the client is most comfortable with when client was enrolled. 6. Employment: Collect data at enrollment. Report annually. = Employment can be part time or full time and can include any adult (≥18 yrs) in the household who is employed. 7. Total length of enrollment at closure = Only include participants that closed during the reporting period. I. B: Population Descriptors

C. Race and age of participants: Unduplicated number served during the reporting period. Collect data at enrollment. Report annually. –1. Primary caregiver and prenatal client age –2. Prenatal client age = include all clients who delivered and those undelivered during the reporting period. –3. Child age D. Hispanic ethnicity = Individuals reported here should also be included in the race by age section (I.C). I. C-D: Population Descriptors

Denominator IIa. Infants and children eligible for developmental screening = Infants and children eligible for developmental screening during the reporting period. Denominator IIb. Infants and children eligible for social-emotional screening = Infants and children eligible for social-emotional screening during the reporting period. Eligible  based on the age of the child and schedule for the standardized screening instrument used. Do not count children who have already been assessed and diagnosed with a developmental or social-emotional delay. II. A-D: Early Childhood Development

Infants and children that are current with the instrument’s schedule means that they received the most recent screening for which they were eligible A list of approved standardized instruments can be found at: Only include those that are in Denominator IIa and IIb. II. A: Early Childhood Development Only include those that are in Denominator IIa.

II. B: Early Childhood Development Referrals can be written or verbal and can include referrals to public health nurse for re-screening. Follow-ups can be verbal and by phone. The follow-up should be for the referral made for the development/social-emotional delay. Assessment and/or services should be for the referral made for the developmental/social-emotional delay.

The 2011 reporting period will continue to collect is outcome measures. Outcome measures will be determined by collecting information when enrolled and when closed or are considered to be inactive. The aggregate measures at enrollment and closure are to see what the population looked like at those two points in time. The “Change in ___ at closure” is the actual outcome measure. –Enrollment = Of those served during this reporting period, where were they at when enrolled? –Closure = Of those closed during this reporting period, what are their outcomes? Areas that already have an enrollment measure in the population descriptors will not be entered again in the outcomes portion. Enrollment-Closure Outcome Measures

Closure Questions = Participants whose case was closed or no longer considered active during the reporting period. Do not include: –Clients that still have an open case by the end of the reporting period. –Clients that were served for an unanticipated short period of time. –Clients that were served by a universal home visiting program. Enrollment-Closure Outcome Measures

Example of an outcome question: Enrollment-Closure Outcome Measure “..at enrollment”= status (in food insecurity, parent-child interaction, well child care etc) when enrolled in the program. Outcome measure “..at closure”= change in status (in food insecurity, parent- child interaction, etc) from enrollment to closure 1. Food insecure at enrollment: Collect at enrollment. Report Annually Primary Caregivers and Prenatal Clients a. Yes, food insecure b. No, food secure 2. Change in food insecurity at closure: a. Negative change: Still food insecure b. No change: Still food insecure c. No change: Maintained food secure status d. Positive change: Became food secure e. Unknown

Example of an outcome question with an enrollment measure in the population descriptors. Enrollment-Closure Outcome Measure E. Major medical care resource available for medical services Primary Caregiver and Prenatal ClientsInfants and Children 1. Change in insurance status at closure: a. Negative change: No longer insured Insured (enrollment)  Uninsured (closure) b. No change: Still uninsured Uninsured (enrollment)  Uninsured (closure) c. No change: Still insured Insured (enrollment)  Insured (closure) d. Positive change: Acquired insurance Uninsured (enrollment)  Insured (closure) e. Unknown

Areas with enrollment-closure outcome measures: –Parent-child interaction (optional for 2011) –Access, Utilization of Services and Supports Current with well child care status Health care home Major medical care resource –Birth or Pregnancy Tobacco use during pregnancy (optional for 2011) –Economic Self-sufficiency Education Food insecurity Housing insecurity Enrollment-Closure Outcome Measure

This section is optional for the 2011 reporting period. The examples provided in the answer choices in III. A (next slide) are to be used as a guideline. They are not definitions. III. A. Parent-Child Interaction

A. Connection to community resources –1. Referred to community resources and/or services = Include referrals made to primary caregivers for child developmental or social-emotional concerns –2. Received follow-up by a family home visitor on that referral = Follow up can be by visit or phone. B. Current with well child care (outcome) C. Immunization status = report at the end of the reporting period. –Infants and children are “not current” if they have not received the appropriate vaccinations according to the recommended 4:3:1:3:3:1:3 series. D. Health care home (outcome) E. Major medical care resource available for medical services (outcome) IV. Access, Utilization of Services, Resources and Supports

Denominator Va. Prenatal clients delivering during the reporting period Denominator Vb. Births to prenatal clients delivering during the reporting period = include all live births that occur during the reporting period to women seen prenatally. –Count twins as 2, triplets as 3, etc. Denominator Vc. Full term singleton births to prenatal clients delivering during the reporting period. = Include all live, singleton (no multiples), full term births delivered during the reporting period to women seen prenatally. V. Birth or Pregnancy

The 2011 forms have one additional denominator: Denominator Vd. Number of infants 6 to 12 months of age. Denominator for B2 = Include all infants 6 to 12 months of age while served by FHV during the reporting period. Descriptor Ve. Number of prenatal clients delivering during the reporting period who were first time mothers (no previous live or still births). V. Birth or Pregnancy

A. Birth outcomes –1. Infants born at healthy birth weight = only include full term singleton infants born during the reporting period and whose mother was seen prenatally. –2. Infants born at full term = only include infants born during the reporting period and whose mother was seen prenatally. We are no longer collecting initiation of prenatal care data V. Birth or Pregnancy

Breastfeeding Initiation is measured on prenatal clients delivering during the reporting period Breastfeeding Duration is measured on Infants ages 6 to 12 months Breast milk includes breastfeeding and pumped breast milk. The 2010 reporting period measured all breastfeeding questions on prenatal clients.

No longer asking cigarette smoking status at enrollment No longer specifying weeks gestation Report on all prenatal clients that deliver during the 2011 reporting period V. Birth or Pregnancy

Count unduplicated numbers (of prenatal clients screened and screened positive for possible postpartum depression) Referrals can include information on how to access emergency medical health are, telephone hotlines, counseling services, further assessment, etc). V. Birth or Pregnancy

Complete this section if your program directs resources to this area. Denominator VIa = The number of women that were previously served by FHV for at least one year and was closed during the reporting period. (Subsequent pregnancy denominator) No longer collecting income data for the 2011 reporting period. VI. Economic Self-sufficiency

B. Education Pregnant or Parenting Teens Primary Caregivers and Prenatal Clients 1. Change in education at closure for those without a high school diploma or GED at enrollment: a. No change: Not enrolled in a a high school or GED program b. No change: Remains currently enrolled in high school or GED program c. Positive change: Enrolled in high school or GED program d. Positive change: Achieved high school diploma or GED e. Positive change: Enrolled or completed post secondary education f. Unknown 2. Change in education at closure for those with a high school diploma or GED at enrollment: a. No change: Not enrolled in a post secondary education program b. No change: Enrolled or completed post secondary education c. Positive change: Enrolled or completed post secondary education d. Unknown B1. Include clients without a high school diploma or GED when the they were enrolled into FHV. B2. Include clients with a high school diploma or GED when they were enrolled into FHV.

C. Food Insecurity (outcome measure) –Determined by answering the following questions: 1. We worried whether our food would run out before we got money to buy more a. Often true b. Sometimes true c. Never true 2. The food that we bought just didn’t last, and we didn’t have money to get any more a. Often true b. Sometimes true c. Never true VI. Economic Self-sufficiency Food Insecure = Answered “Often true” or “Sometimes true” to both questions.

D. Housing insecurity (Outcome measure) = Participant moved 2 or more times or was homeless in the previous 12 months. –Homeless = lacking a fixed, regular and adequate nighttime residence, living in a primary residence that is a shelter designed to provide temporary living accommodations, or sleeping in a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings. –Only include participants served for 12 or more months. E. Subsequent pregnancy –Only include participants served for 12 or more months. VI. Economic Self-sufficiency

A. Infants and children 0-6 years experiencing determined (substantiated) child maltreatment during the time enrolled in Family Home Visiting –Do not include children who were referred to FHV with an existing substantiated child maltreatment report. –Source of information is county or state human service records. Alternative A = Only complete this question if your county is not able to collect VII.A. –Source of information can be the family. VII. Child Maltreatment

Complete this section if your program directs resources to this area A. 1. Primary caregivers or prenatal clients who have had a home safety checklist completed –You may use any recognized home safety checklist. A list of recognized home safety checklists can be found at: –To determine if another checklist is acceptable, contact the FHV consultant of your area. Contact information and FHV consultant regional assignments can be found at: assignments.htmlhttp:// assignments.html –Include only those primary caregivers and prenatal clients from whom a home safety checklist or age-appropriate checklist was used. B. Rates of Injury = include the number of emergency room visits or hospitalizations due to injuries in/within the vicinity of the home (i.e., the yard). –Do not include emergency room visits for primary care services or any other service that does not relate to injury in the home. VIII. Injury Prevention

Additional Resources The aggregate form, individual form, data-related topics, –Data Dictionary – Provides more in-depth information about each question. Located on the FHV evaluation website. –Joni Geppert, MPH, RD, LN Epidemiologist Senior –Rose Kim, MPH Epidemiologist Family home visiting, contact our MCH/Home Visiting consultants of your area. –Contact information can be found at: Websites: –Standardized instruments for developmental and social-emotional screening: –Federal Poverty Guidelines –Home Safety Checklists