III.2.b.iii.c Other MCH Data Capacity Efforts

Ongoing data collection and analysis is performed for MCH data to evaluate and monitor state selected MCH priority needs, as well as key national (NPM, NOM) and state (SPM, SOM) performance and outcome measures reported to HRSA.  These measures are also reported annually in an internal spreadsheet called the MCH dashboard. This file, which is shared via SharePoint to all MCH program managers and data staff, reports Title V and SSDI minimum/core data measures for monitoring and MCH program planning. To support these measures, other MCH indicators are developed and monitored annually to find emerging trends among MCH populations in Rhode Island. As more MCH measures are added to the MCH web data page, access to this spreadsheet will likely be phased out except for MCH leadership.   

The MCH team meets with data partners to ensure quality data collection and review.  For example, the MCH team meets with the RI Office of Vital Records to review and discuss access to vital records data and data quality and governance regarding births, deaths, fetal deaths, induced terminations, and race data. The MCH team also participates in advisory and steering committees for the PRAMS, YRBS, and BRFSS to select and report survey questions and modules that inform public health issues regarding the MCH population. The MCH team leads the Pregnancy Postpartum Death Review Committee (PPDRC) to review and identify potential pregnancy-related deaths and to set recommendations for action and participates in the child death review committee. Additionally, our data analysis team has been instrumental in supporting other MCH related initiatives such as the Perinatal Neonatal Quality Collaborative of RI, the RI AIM Bundle, and the Maternal Health Taskforce (MHTF). For instance, for the MHTF, our MCH epidemiologist and MHI evaluator were crucial to shaping and implementing our intensive RI maternal health landscape analysis.

The MCH Program also builds data capacity through ongoing linkages within and outside of RIDOH.  The MCH Epidemiologist develops routine linked files, such as birth-infant death, birth-maternal death, infant/maternal deaths, and birth-hospital files for Title V reporting and assisting MCH programs with data efforts. The MCH Epidemiologist, in collaboration with the PRAMS and Hospital Discharge Data programs, oversees the linkage of PRAMS data to hospital discharge data to study patient-centered outcomes.  The MCH Epidemiologist also links hospital discharge data to maternal death records to enhance case-finding for pregnancy-related deaths. The MCH Program works with other state agencies to link data systems to report key health indicators. KIDSNET is the comprehensive child data system that collects information from various programs such as home visiting, newborn screening, and immunizations.  This data system routinely links to Department of Education data systems monthly, which comprises the state’s Early Childhood Integrated Data System (ECIDS) and statewide longitudinal data system (SLDS). These linkages address the health status regarding the 3rd grade reading level population.  RIDOH also links Vital Records data with the Office of Medicaid through an interagency data collaborative project called the Ecosystem.  This linkage can help the MCH Program analyze and report data, addressing and informing MCH outcomes (such as low-risk cesarean births and dental care during pregnancy) using administrative Medicaid data. Linkage projects using KIDSNET data linked in the EOHHS data Ecosystem that were initiated during the reporting period include a joint analysis of low-risk cesarean births, an analysis to understand who opted into Covid quarantine and isolation support and how the RIDOH Quarantine and Isolation Support Program recipients subsequently engaged with other programs across RI, and an Early Childhood Care and Education (ECCE) Scorecard to answer critical questions on implementing the ECCE Strategic Plan. RIDOH also works with federal partners such as the CDC to share pregnancy-related death information with other states in a national repository called MMRIA (Maternal Mortality Review Information Application), and with the CDC to analyze aggregate newborn hearing screening and immunization data. During the reporting period, the MCH team became a partner to the Lifespan Comprehensive Sickle Cell Clinic which was awarded a HRSA Newborn Screening Sickle Cell Disease Collection grant to support the data collection efforts and requirements.  The MCH Epidemiologist also works with the CDC and the National Center for Fatality Review and Prevention to enter information on RI SUIDs (Sudden Unexpected Infant Death) in their Case Reporting System for data quality assurance, monitoring, and analyses.  The MCH team continues to collaborate in a state-wide effort to link childhood overweight and obesity data to analyze, monitor and publish trends. 

The MCH team supports the use of automated systems for data collection with collaborating RIDOH programs. ESSENCE is a syndromic surveillance system that captures real-time hospital and emergency department visits, reporting MCH outcomes such as teen suicide ideation visits. The Birth Defects Program continues to use automated discharge reporting from maternity hospitals and is populated into a KIDSNET database, which collects birth defects and NAS diagnoses for monitoring and follow-up service assessments. A data sharing agreement between The National Association for Public Health Statistics and Information Systems (NAPHSIS) and the Office of Vital Records allows the automated import of birth, fetal death, and death certificate data unto the MMRIA system to improve timeliness of abstraction and reporting of pregnancy-associated deaths.

The MCH team developed an interactive web based PowerBI presentation https://health.ri.gov/data/maternalandchildhealth/ of selected MCH measures by MCH domain for the public to access and query.  Data can be filtered by key demographic factors. Additional data will be added in the future. Data made available during the reporting period include Adolescent (bullying and suicide), Child (reading to infants), Children with Special Healthcare Needs (Medical Home and Transition of Care), Infants (preterm births), and Pregnancy and Postpartum (postpartum depression and severe maternal morbidity). Once additional data are included, the SSDI team plans to integrate the data into an MCH data hub that includes PRAMS and YRBS data also. 

An SSDI activity includes working to improve data collection of substance exposed newborns and creation and authorized sharing of electronic Plans of Safe Care.

Behavioral Risk Factor Surveillance System (BRFSS): BRFSS is an annual state-based telephone survey assessing the health status and behavioral risk factors of the non-institutionalized adult population 18 years of age and older. About one half of the questions asked on the 2022 survey were recommended by the Rhode Island Department of Health. BRFSS collects data related to 17 of the 23 Population Health Goals of RIDOH's Strategic Framework. BRFSS also provides data to inform some of RIDOH's Health Equity Indicators, which addresses RIDOH's three leading priorities: 1) Integrated Healthcare: Healthcare Access (percentage of adults who reported not seeking medical care or dental care due to cost, 2) Community Trauma: Discrimination (percentage of adults reporting racial discrimination in healthcare settings). The Youth Risk Behavior Survey (YRBS): The Youth Risk Behavior Survey (YRBS) is a collaboration among the Centers for Disease Control and Prevention (CDC), the Rhode Island Department of Health (RIDOH), the Rhode Island Department of Education (RIDE), and the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH). The survey is administered every two years in a sample of Rhode Island public high schools and middle schools. At RIDOH, data from the Youth Risk Behavior Survey are used to develop health programs for adolescents throughout Rhode Island and to understand how students are disproportionately affected by different health issues. Understanding these disparities allows an opportunity to address the factors at the community-level that affect students' decisions and behaviors. Key activities of the YRBS for the current reporting period, included:

• Develop a state YRBS questionnaire
• Produce an up-to-date sampling frame and develop sampling parameters to support scientific selection of state samples that will generate jurisdiction-wide and sub-site estimates of at least all public-school students in grades 9-12
• Conduct the YRBS (in odd-numbered calendar years) according to survey administration procedures
• Collaborate with other CDC-funded agencies and organizations to coordinate data collection for state YRBS
• Disseminate YRBS results through fact sheets, reports, Web sites, and other products and then use the results to help target and improve interventions, establish funding priorities, and support development of policies and practices to reduce priority health-risk behaviors among youth

Rhode Island Department of Health (RIDOH) Academic Institute: The RIDOH Academic Institute was created in 2015 to enhance RIDOH’s capacity to integrate scholarly activities and evidence-based practices into public health policy and practice by establishing and facilitating collaborations with academic and research colleagues. The RIDOH Academic Institute works to build upon internal and external partnerships to promote and manage learning for public health and healthcare professionals, guide effective strategic planning, lead continuous quality improvement and performance management, and achieve public health department accreditation to address Rhode Island’s public health needs. The RIDOH Academic Institute focuses on the following areas to achieve these goals: Education and Research, Strategic Planning, Performance Measurement and Continuous Quality Improvement, Public Health Department Accreditation, and Public Health and Healthcare Workforce Development.  

Between October 2022 – September 2023, RIDOH staff authored the following MCH related journal articles:

1. Cooper E, Haskell J, Viner-Brown S, Gardner RL. Use of Telemedicine by Rhode Island Physicians. R I Med J (2013). 2022 Oct 3;105(8):67-69. PMID: 36173915.

2. Xie S, Monteiro K, Gjelsvik A. The association between adverse birth outcomes and smoking cessation during pregnancy across the United States-43 States and New York City, 2012-2017. Arch Gynecol Obstet. 2023 Oct;308(4):1207-1215. doi: 10.1007/s00404-022-06792-x. Epub 2022 Sep 29. PMID: 36175683.

3. Ayala NK, Schlichting L, Lewkowitz AK, Kole-White MB, Gjelsvik A, Monteiro K, Amanullah S. The Association of Antenatal Depression and Cesarean Delivery among First-Time Parturients: A Population-Based Study. Am J Perinatol. 2023 Mar;40(4):356-362. doi: 10.1055/a-1960-2919. Epub 2022 Oct 13. PMID: 36228650; PMCID: PMC9970759.

4. Kienbacher CL, Tanzer JR, Wei G, Rhodes JM, Roth D, Williams KA. Increases in Ambulance Call Volume Are an Early Warning Sign of Major COVID-19 Surges in Children. Int J Environ Res Public Health. 2022 Dec 2;19(23):16152. doi: 10.3390/ijerph192316152. PMID: 36498225; PMCID: PMC9736099.

5. Hauptman M, Rogers ML, Scarpaci M, Morin B, Vivier PM. Neighborhood disparities and the burden of lead poisoning. Pediatr Res. 2023 Aug;94(2):826-836. doi: 10.1038/s41390-023-02476-7. Epub 2023 Mar 10. PMID: 36899126; PMCID: PMC10000346.

6. Kienbacher CL, Wei G, Rhodes J, Herkner H, Williams KA. Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis. West J Emerg Med. 2023 Apr 28;24(3):572-578. doi: 10.5811/westjem.59107. PMID: 37278807; PMCID: PMC10284529.

7. Wu PC, de Banate MA, Kim H, Viner-Brown S, High P. The Association Between Maternal Depressive Symptoms and Toddlers' Developmental and Behavioral Problems: A Population-Based Study. Clin Pediatr (Phila). 2024 May;63(4):494-505. doi: 10.1177/00099228231179672. Epub 2023 Jun 13. PMID: 37309802.

8. Barbero C, Vagi KJ, Clayton H, Holland K, Hertz M, Krause KH, Brittingham R, Bunge S, Saka SM, Marchessault N, Hynes N, Green D, Spell L, Monteiro K, Murray K, Reilly-Chammat R, Tignor L, Mercado MC. Bullying Victimization and Associations With Substance Use Among US Middle School Students: 2019 Youth Risk Behavior Survey. J Sch Health. 2023 Dec;93(12):1111-1118. doi: 10.1111/josh.13354. Epub 2023 Jun 13. PMID: 37311692; PMCID: PMC11167627.

9. Abdullahi NN, Werner E, Vivier P, Berger B, Schlichting LE. How Close Are You to Gestational Diabetes Mellitus? R I Med J (2013). 2023 Jul 5;106(6):24-29. PMID: 37368830.

10. Dumont D, White JC, Gargano LM. Rhode Island Adolescents and Routine Vaccinations: Can We Get Back on Track? R I Med J (2013). 2023 Jul 5;106(6):30-34. PMID: 37368831.

11. Nitenson AZ, Paiva TJ, Onyejekwe C, Hallowell BD. Trends in Initiate Pediatric Opioid Prescriptions in Rhode Island: 2017-2021. R I Med J (2013). 2023 Aug 1;106(7):44-49. PMID: 37494627.

12. Tollefson J, Frickel S, Gonsalves S, Marlow T, Sucsy R, Byrns M, Orpen-Tuz M. Early Childcare and Education in a Post-Industrial Landscape: Inequalities in Proximity to Active and Relic Manufacturing in Metropolitan Providence, Rhode Island. Environ Justice. 2023 Aug 1;16(4):309-320. doi: 10.1089/env.2021.0121. Epub 2023 Aug 1. PMID: 37614720; PMCID: PMC10443121.

13. Neelam V, Woodworth KR, Chang DJ, Roth NM, Reynolds MR, Akosa A, Carr CP, Anderson KN, Mulkey SB, DeBiasi RL, Biddle C, Lee EH, Elmore AL, Scotland SJ, Sowunmi S, Longcore ND, Ahmed M, Langlois PH, Khuwaja S, Browne SE, Lind L, Shim K, Gosciminski M, Blumenfeld R, Khuntia S, Halai UA, Locklear A, Chan M, Willabus T, Tonzel J, Marzec NS, Barreto NA, Sanchez C, Fornoff J, Hale S, Nance A, Iguchi L, Adibhatla SN, Potts E, Schiffman E, Raman D, McDonald MF, Stricklin B, Ludwig E, Denson L, Contreras D, Romitti PA, Ferrell E, Marx M, Signs K, Cook A, Leedom VO, Beauregard S, Orantes LC, Cronquist L, Roush L, Godfred-Cato S, Gilboa SM, Meaney-Delman D, Honein MA, Moore CA, Tong VT. Outcomes up to age 36 months after congenital Zika virus infection-U.S. states. Pediatr Res. 2024 Jan;95(2):558-565. doi: 10.1038/s41390-023-02787-9. Epub 2023 Sep 1. PMID: 37658124; PMCID: PMC10913023.

14. MacKinnon KM, Risica PM, von Ash T, Scharf AL, Lamy EC. Barriers and motivators to women's cancer screening: A qualitative study of a sample of diverse women. Cancer. 2023 Sep;129(S19):3152-3161. doi: 10.1002/cncr.34653. PMID: 37691528.