First STEPS Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine\u27s CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine\u27s First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine\u27s Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in participating practices before and after the initiative, as well as related systems changes. They also summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement

Achieving Consensus on Measure-Driven Child Health Quality: Maine’s Improving Health Outcomes for Children Initiative

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes)

Maine Pediatric and Family Practice Survey Chartbook: Improving Health Outcomes for Children

As part of the IHOC initiative, the Muskie School of Public Service at the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines and office systems to monitor and improve children’s healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data will be used to inform IHOC activities and to monitor changes over time. The web-based survey was conducted in the winter of 2011-2012 and sent to practice managers at a sample of 168 practice sites, of which 64% responded. Responding practices represent more than one-quarter of family practices and nearly two-thirds of all pediatric practices in the state. This report summarizes the results of the initial survey and assesses quality improvement activities in pediatric and family practices at baseline

Rural Opioid Prevention and Treatment Strategies: The Experience in Four States [Working Paper]

Although opioid use rates are comparable in rural and urban counties, rural opioid users tend to be younger, unmarried, have lower incomes, and are more likely to lack health insurance, all vulnerabilities that may negatively impact their ability to seek treatment and recover. Additionally, the rural health care system is characterized by numerous resource, workforce, access, and geographic challenges that complicate the delivery of specialized care for OUDs in rural communities. The nature and scope of the opioid crisis vary across rural communities and require multifaceted, community-based strategies to address the problem. Based on interviews with key stakeholders in Indiana, North Carolina, Vermont, and Washington State, this qualitative study explores promising state and community strategies to tackle the opioid crisis in rural communities and identifies rural challenges to the provision of OUD prevention, treatment, and recovery services

Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, and the State of Maine Use and Exchange Specific Clinical Data Related to Child Health Quality Measures

The purpose of the As Is assessment is to provide a description of Maine’s current HIT environment specifically pertaining to how EPSDT and other clinical data are entered, used, and exchanged electronically through information systems at pediatric practices, health systems, the State of Maine, and HIN. This information will inform plans currently under development by IHOC for electronic data exchange and child health measure calculation

Early Detection and Intervention for the Prevention of Psychosis. Outreach Evaluation Report: Year 1 Annual Report

Under contract with the Robert Wood Johnson Foundation, researchers at the Muskie School of Public Service are evaluating the community outreach and training efforts of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP). This Year One report (8/15/2007 - 8/15/2008) provides an overview of the initiative and the five demonstration sites; a description of the evaluation framework and design; the evaluation questions and methods; preliminary evaluation results; and a summary of preliminary findings and next steps. Preliminary Findings: Outreach and training efforts are reaching the intended audiences; Trainings are a critical component of the outreach model; EDIPPP is perceived as a credible program; Most referrals are appropriate and given by a professional; Several factors are associated with intentions to refer; EDIPPP operates in different community and policy contexts

Rural Opioid Prevention and Treatment Strategies: The Experience in Four States [Policy Brief]

Little is known about what states with large rural populations are doing to combat opioid use disorders (OUD) in rural communities. This qualitative study identified rural challenges to the provision of OUD prevention, treatment, and recovery services and explored promising strategies to tackle the opioid crisis in rural communities