Assessment Initiative (AI) And The NAPHSIS Training Resources Sukhjeet Ahuja MD, MPH

Assessment Initiative (AI) Assessment Initiative is a cooperative program between the CDC and state health departments that supports the development of innovative systems and methods to improve the way data is used to provide information for public health decisions and policy.

Assessment Initiative (AI) Through the Assessment Initiative, funded states work together with local health jurisdictions and communities to improve: Access to data, Skills to accurately interpret and understand data, and Use of the data so that assessment findings ultimately drive public health program and policy decisions

Assessment Initiative (AI) Began in 1992 and now in its fourth 5-year funding cycle States Funded in cycle:  Arkansas  Florida  Illinois  Missouri  New Hampshire  New Mexico  North Carolina  Rhode Island  Virginia

Assessment Initiative (AI) The Assessment Initiative supports work in two main focus areas: Community health assessment practice Data dissemination systems

Assessment Initiative (AI) Community health assessment practice Development, implementation, and evaluation of tools, strategies, and approaches to improve the capacity of local public health agencies and communities to conduct effective community health assessments Demonstrate how the resulting data have been used to affect public health programs and policies

Assessment Initiative (AI) Data dissemination systems Implementation of electronic systems for user-friendly analysis and dissemination of public health data (i.e. Internet-based interactive data query systems) Evaluation of the effect of these systems on primary users

Assessment Initiative (AI) NAPHSIS goals for second year out of three years funding cycle: 1. Improve the capability of states to disseminate health information 2. Improve the consistency of use of vital statistics statistical measures 3. Develop a more effective state health statistics work force

Assessment Initiative (AI) 1. Improve the capability of states to disseminate health information Objective: Develop an analysis resource for the states  Identify the on line state statistical reports  Develop a topical classification system for categorizing the reports  Develop a NAPHSIS web page for the statistical reports links  Create the links of the state statistical reports on the NAPHSIS web page 

Statistical Report Topics Abortions Assessment Births Birth Defects Fetal Alcohol Syndrome Inadequate Prenatal Care Low Birth Weight PRAMS Smoking during Pregnancy Teen Births/Pregnancies Behavior Risk Factors Cancer Incidence Deaths Adolescent AIDS Infant Cancer Chronic Diseases Diabetes Elderly Firearms Race Heart Disease Heat Related Homicide Injuries Leading Causes Maternal Pneumonia and Influenza Smoking Related Suicide Other Dissolutions Environmental Public Health Tracking Head and Spinal Cord Injuries Marriages Motor Vehicle Crashes Vital Statistics Annual Reports Other

Assessment Initiative (AI) 2. Improve the consistency of use of vital statistics statistical measures Objectives: Determine key statistical measures used and needed for vital statistics analysis Create a NAPHSIS website on vital statistics measures

Assessment Initiative (AI)  Establish a NAPHSIS committee to assist with the project  Contact key states and the NCHS on published statistical measures (NC, SC, PA, NY, and WA)  Inventory the measures and determine if there are any inconsistencies  Define measures needed but not found from key sources  Post the measures, definitions and explanations on the web site  Inform the NAPHSIS membership and AI states of the NAPHSIS website.  Develop the web site format 

Statistical Measures Committee NAPHSIS Members  Jerry Orris (Chair)  Alvin Onaka  Glenn Copeland  Lois Haggard  Lou Saadi  Mark Flotow  Meade Grigg  Scott Fujimoto  Garland Land  Sukhjeet Ahuja NCHS Contributors  Kenneth Kochanek  Marian MacDorman

Assessment Initiative (AI) INFANT MORTALITY RATE 1. Definition: INFANT MORTALITY RATE is the number of resident newborns in a specified geographic area (country, state, county, etc.) dying under one year of age divided by the number of resident live births for the same geographic area (for a specified time period, usually a calendar year). 2. Calculation: (Number of resident infant deaths/Number of resident live births) x 1,000 Number of Resident Infant Deaths × 1,000 Number of Resident Live Births Additional links to State/National websites with calculation and/or definition - New Mexico Glossary North Carolina Statistical Primer

Assessment Initiative (AI) 3. Examples: 1,300 infant deaths in 2005 among state residents 150,000 live births in 2005 to state residents 1,300/150,000 x 1,000 = 8.7 infant deaths per 1,000 live births in 2005 among state residents Links to examples of use in ongoing published reports - National Center for Health Statistics State Vital Statistics 4. Tools: Click on the following links to access and download program files to assist you with calculating this measure. Excel spreadsheet file SAS programming code

Assessment Initiative (AI) 5. Technical Notes: An infant mortality rate (or IMR) is considered a primary and important indictor of a geographic area’s (country, state, county) overall health status or quality of life. There are some concerns about the quality of reporting of infant mortality internationally and within states, especially in terms of defining a live birth and/or complete reporting of both birth and death certificates for very low birth weight babies. The IMR is usually calculated using the annual number of resident infants who died during a year in the numerator and the total annual number of resident live births during the same year in the denominator. By matching infant death certificates to the corresponding birth certificates, much more additional and valuable data are obtained (birth weight, smoking status of mother, when prenatal care began, etc.) for infant mortality risk analysis. In less densely populated areas, annual numbers of infant deaths may be small (<10 or 20) which would result in an infant mortality rate considered to be too unstable or unreliable for analysis. Adding additional years (three or five-year average annual rates) and/or expanding the area to be studied should result in a larger number of deaths and more reliable rates for analysis.

Assessment Initiative (AI) 3. Develop a more effective state health statistics work force Objectives: Determine the training resources available Develop and implement a training plan

Assessment Initiative (AI)  Determine the on-line training resources available  Post on-line training resources on the NAPHSIS web site  Coordinate with NAHDO on roles and responsibilities  Analyze with NAHDO the results of the training survey conducted in year 1  Prioritize training subjects based upon need and available resources 

Assessment Initiative (AI) 40 Training Courses under 7 Categories  Epidemiologic Methods  Statistical Analysis  Program Evaluation  Data Management  Data Presentation  Grant Writing/Proposal Writing  Other Public Health Courses

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