Deriving Best Practices to Preserve MCAH Services in Local Health Departments: Learning from the Economic Downturn

Year: 2011
Funding: NNPHI PHS2 Award
Status: Completed

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This study seeks to: (a) understand the extent, nationally, of cuts to or changes in maternal, child and adolescent health (MCAH) programs/services provided; (b) determine which administrative response strategies are being used by LHDs to balance providing MCAH programs/services with available funds; and (c) ascertain the patterns of program/services provided and of response strategies used that correspond to optimal performance of MCAH based on Essential Public Health Services. The aim is to discover and disseminate best practices (benchmarks) for performance of  MCAH by LHDs. A mixed-methods design will be used that integrates existing NACCHO data spanning four years (2008, 2010, 2012 Profile Surveys), survey of a random stratified sample of NACCHO members using an online questionnaire, and two rounds of semi-structured interviews with MCAH practitioners and administrators. Data analysis, after linking datasets, involves conducting multivariate analyses to identify the best practices. The study findings can be directly used by local and state public health administrators to make best practice decision to maintain optimal levels of MCAH Performance in the face of sever fiscal constraints, health reform, and LHD accreditation. Our approach to determining best practices can serve as a template for identifying best practices for performance related to other populations.                                                                                     


Oral Presentations

  • Using Cluster Analysis to Characterize LHD Responses to the Economic Downturn (PHSSR Keeneland Conference, April 2014)
  • Leveraging Data and Standards-Based Data Sharing to Support a Life Course Approach to Maternal and Child Health: Public Health Informatics and MCH: the Intersection of Data and Design (Public Health Informatics Conference, April 2014)
  • Measuring the Life Course: Can We Do It?: Data Sources for Understanding Local MCH through the Life Course (CityMatCH Annual Conference, September 2013)
  • Local Epidemiology: New Strategies for a Greater Voice: Data Sources for Understanding Local MCH through the Life Course, (NACCHO Annual Meeting, July 2013)

Poster Presentations

  • MCH Service Delivery Profile of LHDs: Relationship with the Performance of the Essential Public Health Services (APHA, November 2014)
  • MCH Service Delivery Profile of LHDs: Relationship with the  Performance of the Essential Public Health Services (CityMatCH Annual Meeting, September 2014)
  • Predictors of Strategic Approaches Used by LHDs During the Economic Downturn (AcademyHealth Annual Research Meeting, June 2014)
  • Local Health Departments Delivery of MCAH Services/Programs and Performance of Essential Services for MCAH Population (PHSSR Keeneland Conference, April 2013)
  • Local MCAH service/program Delivery in Tough Economic Times, (CityMatCH Annual Conference, December 2012)
  • Local Health Department Collaborations in Maternal, Child, and Adolescent Health (CityMatCH Annual Conference, December 2012)


  • Staying resilient in hard times: Local Maternal, Child and Adolescent Health and the ACA, (NACCHO webinar, November 2013)
  • Staying resilient in hard times: Maternal, Child, and Adolescent Health Programs, Services and Collaborations (NACCHO webinar, October 2013)



L. Michele Issel, University of North Carolina Charlotte

Arden Handler, University of Illinois at Chicago

Research Areas