Bill & Melinda Gates Institute
The Challenge Initiative
From May 1 to 4, 2017, The Challenge Initiative (TCI) hosted a meeting in Baltimore with the Chiefs of Party and designees from its four accelerator hubs (East Africa, Francophone West Africa, India, and Nigeria), its partners, representatives of the Bill & Melinda Gates Foundation, and other Gates Institute project staff — about 40 attendees in total. The aim of the meeting was to reflect and build on the progress of the first year of TCI and outline preparations for Year 2 across TCI’s four program objectives.
Advance Family Planning
Advance Family Planning (AFP) convened its annual Partners Meeting in Baltimore from March 27 to 31, 2017. The meeting aimed to create greater synergy among partners and collaborators in working to fulfill the Family Planning 2020 (FP2020) vision through increased political and financial support for family planning. AFP welcomed more than 80 participants from 15 countries. Presentations and resources are available here.
How Advocacy Connects Global Goals to Local Priorities. Smallpox is eradicated; polio nearly so. Can other global health initiatives find the same success? The authors examine how AFP’s SMART advocacy approach enables local actors to influence family planning decisions.
Performance Monitoring and Accountability 2020
More than 50 attendees participated in the fourth annual Performance Monitoring and Accountability 2020 (PMA2020) Principal Investigators (PIs) Meeting, held at JHSPH from March 20 to 24, 2017. PIs from 10 program countries (Burkina Faso, DRC, Ethiopia, Ghana, Kenya, India, Indonesia, Niger, Nigeria and Uganda) shared experiences and knowledge, and discussed long-term project sustainability, data promotion and utilization, and strengthening collaboration with key partners and stakeholders. PMA2020 PIs shared achievements, including the launch of PMA DataLab (PMA2020’s data visualization tool), expansions to new geographies, and use of PMA2020 data to inform policy and program changes. Also highlighted were PMA/Agile and PMA/Plus, two new grants from the Bill & Melinda Gates Foundation now under the PMA2020 portfolio. More than 50 PIs, faculty, staff, students and guests attended.
Laurie Schwab Zabin Conference Room Dedicated in Honor of the Gates Institute’s Founding Director
On April 13, the Gates Institute and the PFRH Department celebrated the dedication of the Laurie Schwab Zabin Conference Room, Room W4517. Zabin is the founding director of the Gates Institute and professor emeritus in the PFRH department. Her groundbreaking research into adolescent sexual and reproductive health has had far-reaching impact, as has her establishment of the Gates Institute in 1999.
The dedication ceremony began with a formal program in W5030, where Zabin’s colleagues and friends spoke about her impact on the reproductive health and population dynamics fields. Speakers included faculty Cynthia Minkovitz, Robert Blum, Henry Mosley, and Amy Tsui, as well as doctoral students Ann Herbert and Suzanne Bell, recipients of the Fund in Recognition of Laurie Schwab Zabin. Afterward, all proceeded to W4517 to enjoy lunch in the renovated conference room, which features a selection of Zabin’s many awards and a commemorative plaque. View photos from the celebration.
The fifth International Conference on Family Planning (ICFP) will take place in Kigali, Rwanda, from November 12 to 15, 2018. The announcement was made on April 13 by the Gates Institute and the Ministry of Health of the Republic of Rwanda, the conference co-hosts.
The ICFP is held biennially, each time in a different host country, and is the largest scientific conference on reproductive health and family planning. It provides an opportunity for political leaders, scientists, researchers, policymakers, advocates, and youth to disseminate knowledge, celebrate successes, and identify next steps toward reaching the Family Planning 2020 (FP2020) goal of enabling an additional 120 million women to access voluntary, quality contraception by 2020. More details, including the call for abstracts, are forthcoming on the ICFP website this year.
Family Engagement Tools
The Child and Adolescent Health Measurement Initiative (CAHMI) recently optimized our free online Well Visit Planner (WVP) tool for mobile use. The WVP helps parents of young children plan for their child's next preventive care visit by answering questions about the child's growth and development, choosing priorities for discussion, and getting a personalized visit guide. The tool takes less than 10 minutes to complete, and is based upon recommendations established by the American Academy of Pediatrics' Bright Futures guidelines.
In addition, the CAHMI is developing a routine care planner for children with special health care needs called RISE (Reflect, Identify, Select, Engage), and are collaborating with Family Voices to make sure that the tool is driven by parent needs.
Maternal and Child Health Measurement Research Network
The CAHMI also recently launched our Maternal and Child Health (MCH) Measurement Portal, housed on the DRC website. On this portal you can search over 800 measures of maternal and child health from a range of existing MCH programs in the US. Explore these in the interactive MCH Measures Compendium, which will be updated over time. The compendium allows users to quickly sort through measures by measure set, data source, topic, and key words. Users can also find at-a-glance summary profiles of the MCH program measure sets and initiatives included in the compendium.
This portal is a product of the Maternal and Child Health Measurement Research Network (MCH-MRN), a project coordinated by the CAHMI and funded by HRSA/MCHB. During the 2013-2016 grant cycle, the CAHMI was co-PI on the project and is the lead organization for the 2016-2019 cycle. The purpose of the MCH-MRN is to advance the availability and effective use of valid and actionable MCH measures to ensure data-driven innovation and shared accountability for improving MCH outcomes and systems performance.
Data Resource Center for Child and Adolescent Health
The CAHMI recently added two new data visualization tools to the Data Resource Center website. The first tool is a series of U.S. maps which show the state-level prevalence of individual Title V National Performance Measures (NPMs) and National Outcome Measures (NOMs). These maps allow users to quickly and easily compare their state's average to the national average on many Title V topics.
The second tool, Title V Hot-Spotting Tables, allows users to compare state performance across all Title V NPMs or NOMs at once, and also quickly see state vs. nation comparison data. The interactive tables also allow users to hover over measure titles to learn more about each measure, sort by increasing or decreasing prevalence, and click on individual prevalence values to get additional related data.
The CAHMI is also preparing for the release of the 2016 National Survey of Children’s Health data. The NSCH is a national survey which provides rich data on multiple, intersecting aspects of children’s lives, including physical and mental health, access to quality health care, and the child’s family, neighborhood, school, and social context.
In 2016, the NSCH was conducted for the first time since 2011/12 with several key changes. Among these changes, the survey was conducted by the US Census Bureau, integrated two surveys (the NSCH and the National Survey of Children with Special Health Care Needs), and was designed to be an annual survey from 2016 onward. We are preparing to receive the initial data sets shortly, and we hope to have data available on our website this summer and data sets available to download this fall. In the meantime, we have developed several supporting documents, including a Guide to Topics and Questions and an overview of the sampling and administration process.
The center has been engaged in multi-institutional and trans-disciplinary investigations on environmental, nutritional, genetic and epigenetic factors across critical developmental windows (preconception, in-utero, infancy, childhood, adolescence), aiming to elucidate the root causes of high-impact pediatric and adult diseases, including preterm birth, obesity, diabetes, hypertension, asthma, food allergies, and neuro-developmental outcomes, by leveraging well-established study cohorts and biorepository. Below is a highlight of ongoing research projects:
Faculty Led Research Projects
Early Life Determinants of Obesity in U.S. Urban Low Income Minority Birth Cohort
The major goals of this NIH/NICHD funded project are to identify early life risk and protective factors to inform preventive strategies for childhood obesity, by integrating molecular biomarkers, clinical and epidemiological data and computer simulation/modeling.
Preterm Birth, Maternal and Cord Blood Metabolome, and Child Metabolic Risk
The major goals of this NIH/NICHD funded project are to investigate whether prematurity and maternal and fetal metabolic characteristics can jointly affect the future development of child adverse metabolic outcomes and to inform early prevention of diabetes, under a life course framework.
Prenatal Multi-Level Stressors and Alterations in Maternal and Fetal Epigenome
The major goal of this NIH/NICHD funded project is to investigate the effect of prenatal multi-level stress on maternal and fetal epigenome in the Boston Birth Cohort.
Prospective Birth Cohort Study on Pre- and Peri-natal Determinants of Autism Spectrum Disorders and Developmental Disabilities
The goal of this HRSA/MCHB funded study is to investigate preconception, pre- and peri-natal risk factors and diagnostic and service patterns for autism and related disorders in a prospective birth cohort.
Reproductive Trajectory, Neighborhood Dynamics, and Preterm Birth: Li Liu, PhD won a grant from the Hopkins Population Center (HPC) to conduct this pilot project in the Boston Birth Cohort. Li also won a Bloomberg Faculty Innovation Award to further expand this project.
Gene-by-Stressor Interactions and Epigenetic Mechanisms in Preterm Birth among African Americans: Xiumei Hong, MD, PhD won a grant from the HPC to conduct this pilot project in the Boston Birth Cohort.
Student Led Research Projects
- Maternal Folate Status and Preterm Birth in the Boston Birth Cohort led by Bolanle Olapeju MBBS, MSPH. PhD candidate.
- Prenatal Nutritional and Metabolic Factors and Development of Autism Spectrum Disorder led by Kripa Raghavan, MPH, MSc. DrPH candidate.
- Prenatal Nutrition and Exposure to Environmental Toxins and Development of Attention Deficit Hyperactivity Disorder (ADHD) led by Yuelong Ji, MSPH. PhD candidate.
Global Early Adolescent Study Moves to Longitudinal Phase
The Global Early Adolescent Study (GEAS) has recently completed its instrument development phase of work and is now moving into the longitudinal phase of the study. Over the past 3 years the GEAS has developed and normed a suite of measures for assessing gender norms, gender equality, health and a range of related factors; and they have developed and tested the measures in 15 countries on 5 continents. As part of this work the research team developed a series of manuscripts on transitions into adolescence based on narrative interviews with parent/caregiver and young adolescent diads; and those papers will be published in October in the Journal of Adolescent Health. Additionally, a systematic review was published in PLOS One with Anna Kågesten, a recent doctoral graduate of the department, as the lead author. The instruments are now available on the GEAS website.
The longitudinal phase of the project will follow cohorts of 10-14 year old boys and girls in 10 sites in 9 countries: Ecuador, USA, Belgium, Tanzania, Kenya (two sites), Malawi, South Africa, DRC and China. Data collection begins in late May with the first of three rounds of data collection slated for Kinshasa. Other sites will begin later in the summer and fall. Across the sites 5 will be doing gender transformative interventions with partners such as Save the Children, Population Council and Promndo. The other sites will be following a cohort of young adolescents across the teenage years. Where there are interventions the study aims at understanding whether the gender transformative interventions not only change attitudes and increase gender equality in the short term but whether they have a sustained impact on adolescent depression, school retention, gender-based and interpersonal violence and sexual and reproductive health. For the longitudinal research the researchers are interested in understanding the extent to which gender norms explain the changing health gradient of adolescents across the teenage years. Additionally, they are interested in understanding the similarities and differences in the factors that explain gender equal and discriminatory norms across geography and time.
The study is led by Robert Blum with Caroline Moreau and Kristin Mmari as co-PIs and Linnea Zimmerman, Mark Emerson and Lori Heise (who will be joining the PFRH faculty in September) rounding out the faculty team. For further information contact Robert Blum.
This has been a busy Spring for the Women’s and Children’s Health Policy Center (WCHPC). Work on the HRSA sponsored Strengthen the Evidence Base for Maternal and Child Health initiative continues in full force! This project aims to support states in their development of strategies to promote the health and well-being of maternal and child health (MCH) populations in the United States. Partnering with the Center are the Association of Maternal and Child Health Programs and the Welch Library at Johns Hopkins. Some of the initiative’s activities are creating an MCH Digital Library and providing technical assistance to State Title V programs in the US.
A team of students, faculty and staff also have conducted reviews to synthesize available evidence regarding strategies to address the National Performance Measures in MCH. The reviews completed thus far focus on low risk cesarean deliveries, risk appropriate perinatal care, safe sleep and bullying. The reviews synthesize available evidence from both peer-reviewed and gray literature sources and plot interventions along an evidence continuum, adapted from the Robert Wood Johnson What Works for Health program. These evidence reviews and additional reviews soon to be completed can be found on the Strengthen the Evidence website.
In December 2016, Cynthia Minkovitz, MD, MPP, Donna Strobino, PhD, and Stephanie Garcia, MPH led a 2-part workshop focused on the use of evidence in public health programming at the State/Federal MCH Partnership Meeting. The session recognized how four factors influence evidence-based decision making: best available research evidence; population characteristics; available resources; and the environment and organizational context.
As part of the Strengthen the Evidence activities, Stephanie Garcia, MPH also moderated a well-attended session at the March 2017 Association of Maternal and Child Health Programs annual conference entitled, “Implementing Evidence: How, What, When and With Whom?“ Speakers included Donna Strobino, PhD (PFRH), Michael Kogan, PHD (MCHB) and Title V colleagues Marcus Johnson Miller, CPM (Iowa) and Karin Downs, RN, MPH (Massachusetts).
Evidence Review and Brief Focused on Low-Risk Cesarean Deliveries
led by PFRH doctoral student Celia Karp.