CHAMPS has compiled this listing of resources to support Region VIII health centers with meeting the clinical performance measure goals established by the Health Resources and Services Administration (HRSA)/Bureau of Primary Health Care (BPHC) related to women’s reproductive health.
Please click or scroll down for the following items related to women’s reproductive health:
BPHC Clinical Performance Measures
Evidence-Based Clinical Guidelines
Provider Tools
Patient Education
Other Online Resources
BPHC CLINICAL PERFORMANCE MEASURES
HRSA-funded health centers must have ongoing quality improvement programs that include clinical services and quality management. To this end, HRSA’s primary care branch, BPHC, has established a set of performance measures, including clinical measures, which health centers must report through the Uniform Data System (UDS). Three of the required clinical performance measures that are related to women’s reproductive health are as follows:
- Percentage of Women 21-64 Years of Age Who Received Appropriate Cervical Cancer Screening
- Percentage of Pregnant Women Beginning Prenatal Care in the First Trimester
- Percentage of Births Less than 2,500 Grams to Health Center Patients
On October 23, 2012, BPHC revised two clinical measures for UDS reporting in 2013 (childhood immunization and cervical cancer screening), per Program Assistance Letter (PAL) 2013-02. Following are the most current criteria including the revised criteria for the cervical cancer screening measure.
Cervical Cancer Screening
Measure: Female patients aged 24 to 64 years who received a Pap test every 3 years and women aged 30 to 64 years who chose a 5-year interval for Pap tests when accompanied by an HPV test.
Note: the revised measure for 2013 allows 5-year intervals for women aged 30 to 64 years with a Pap test accompanied by an HPV test which aligns with the 2012 recommendation of the U.S. Preventive Services Task Force.
Percentage of Pregnant Women Beginning Prenatal Care in the First Trimester
Measure: Female patients who received care during the year (regardless of when they began care) who initiated prenatal care in the first trimester either at the grantee health center’s location or with another provider.
Percentage of Births Less than 2,500 Grams to Health Center Patients
Measure: Women who gave birth and were seen at the health center for prenatal care during the year whose child weighed less than 2,500 grams, regardless of who performed the delivery.
For each of the three measures, BPHC utilizes the goals set by Healthy People 2020. Please see the following section for more information on these goals.
EVIDENCE-BASED CLINICAL GUIDELINES
U.S. Preventive Services Task Force
Risk Assessment, Genetic Counseling, and Genetic Testing: BRCA-Related Cancer
www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing
August 2019
Screening for Breast Cancer
www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
January 2016
Screening for Cervical Cancer
www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening
August 2018
Screening for Depression in Adults including Pregnant and Postpartum Women
www.uspreventiveservicestaskforce.org/uspstf/recommendation/depression-in-adults-screening
January 2016
Screening for Hepatitis B Virus Infection in Pregnant Women
www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-b-virus-infection-in-pregnant-women-screening
July 2019
Prenatal Care in the First Trimester
American Academy of Family Physicians (AAFP)
Prenatal, including Recommendations for Preconception Counseling and Care, Evidence-Based Prenatal Care Part I and Part II
www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=25
October 2013
Update on Prenatal Care
https://www.aafp.org/pubs/afp/issues/2014/0201/p199.html
February 2014
American Academy of Pediatric Dentistry
Guideline on Oral Health Care for the Pregnant Adolescent
www.aapd.org/globalassets/media/policies_guidelines/bp_pregnancy.pdf
2016
American Academy of Pediatrics
Guidelines for Perinatal Care, 7th Edition
ebooks.aappublications.org/content/guidelines-for-perinatal-care-7th-edition
2013
Low Birth Weight
National Institute for Health and Clinical Excellence (NICE)
Maternal and Child Nutrition
www.nice.org.uk/guidance/PH11
November 2014
World Health Organization (WHO), Department of Reproductive Health and Research
Integrated Management of Pregnancy and Childbirth Series
Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors
whqlibdoc.who.int/publications/2007/9241545879_eng.pdf
2000, Updated 2017
PROVIDER TOOLS
Academy of Breastfeeding Medicine (ABM)
Position Statements and Clinical Protocols
www.bfmed.org/protocols
Clinical practice protocols for breastfeeding and lactation management as well as human milk storage guidelines
Academy Cancer Society (ACS)
Cervical Health Awareness Month
www.cancer.org/cancer/news/specialcoverage/cervical-health-awareness-month
Clinical practice protocols for HPV prevention and cervical cancer screening
Agency for Healthcare Research and Quality (AHRQ)
Library of Resources for Women’s Health
www.ahrq.gov/professionals/clinicians-providers/resources/womens-health.html
Research updates and educational information to enhance the understanding and response to women’s unique health needs
American Medical Association (AMA)
Onset Timing, Thought of Self-harm, and Diagnoses in Postpartum Women with Screen-Positive Depression Findings
www.champsonline.org/assets/files/ToolsProducts/ClinicalResources/ClinicalDocs/PostpartumWomenWithScreenPositiveDepressionFindings.pdf
This article presents the findings from a study focused on screening for depression in postpartum women and evaluating positive screen findings to determine the timing of onset, rate and intensity of self-harm ideation, and primary and secondary DSM-IV disorders to inform treatment and policy decisions.
Centers for Disease Control and Prevention (CDC)
National Breast and Cervical Cancer Early Detection Program (NBCCEDP)
www.cdc.gov/cancer/nbccedp
Information on the NBCCEDP program which provides access to breast and cervical cancer screening services to underserved women in all 50 states, the District of Columbia, five U.S. territories, and 11 tribes
Preconception Health and Health Care: Information for Health Professionals
www.cdc.gov/mmwr/preview/mmwrhtml/rr5506a1.htm
Information on evidence-based interventions that reduce the risks of adverse pregnancy outcomes
U.S. Food & Drug Administration (FDA)
Women’s Health Research Roadmap
www.fda.gov/science-research/womens-health-research/womens-health-research-roadmap
The Food & Drug Administration in conjunction with the Office of Women’s Health detail research priority areas for future investigation and quality improvement initiatives
Futures Without Violence
Addressing Intimate Partner Violence, Reproductive and Sexual Coercion
www.futureswithoutviolence.org/addressing-intimate-partner-violence
Guide that offers a discussion on the magnitude of IPV and reproductive coercion; overview of the health impact; guidelines for implementing routine assessment and intervention; policy implications and system responses; and provides validated assessment tools.
Health Cares about Intimate Partner Violence
www.futureswithoutviolence.org/health/hcadvday
Screening and counseling toolkit
Health Resources and Services Administration (HRSA)
Cervical Cancer Screening
www.hrsa.gov/sites/default/files/hrsa/owh/fccc-toolkit-build-provider-capacity.pdf
A guide for improving the HRSA cervical cancer screening measure including characteristics for success, implementation of the clinical quality measure, improvement strategies, and other supporting tools and information
Prenatal – First Trimester Care Access
www.poliklinika-harni.hr/images/uploads/252/prvo-tromjesecje-trudnoce.pdf
A guide for improving the HRSA prenatal measure (first-trimester care access) including characteristics for success, implementation and improvement strategies, and other supporting tools and information
Women’s Preventive Services Guidelines under the Affordable Care Act (ACA)
www.hrsa.gov/womensguidelines
Guidelines for women’s preventive health care required under the ACA including well-woman visits, screening for gestational diabetes, HIV, HPV, sexually transmitted infections, breastfeeding, and more
Healthy People 2020
Evidence-Based Resources for Cancer Screening
www.healthypeople.gov/2020/topics-objectives/topic/cancer
Resources for improving cancer screening rates including information on the use of client reminders, reducing barriers, one-on-one education, and other interventions
Intimate Partner Violence (IPV) Health Partners
Toolkit for Health Centers
ipvhealthpartners.org
Information for promoting domestic violence and health partnerships for domestic violence/sexual assault advocates, and for health centers
Maternal Mortality Review Information App (MMRIA)
Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017-2019
www.champsonline.org/assets/files/ToolsProducts/ClinicalResources/ClinicalDocs/MaternalMortalityReviewCommitteePregnancyRelatedDeathsData2017-2019.pdf
Data on 1,018 pregnancy-related deaths among residents of 36 states from 2017-2019.
Mother to Baby
Pregnancy Risk Line
www.mothertobaby.utah.gov/
An affiliate of the Organization of Teratology Information Specialists (OTIS), the Pregnancy Risk Line provides evidence-based information to parents and healthcare providers about medications and other exposures during pregnancy and breastfeeding
National Association of Community Health Centers (NACHC)
Did You Know? Engaging Community Partners can Improve Adolescent Access to Telehealth
www.nachc.org/wp-content/uploads/2022/08/TelehealthAccessPartnershipHandout6.17.22.pdf
A document outlining considerations and questions to ask when developing Telehealth opportunities.
Sample Policy and Procedure on Family Planning Services
www.dropbox.com/s/1gwbtya1usbo26p/FamilyPlanningPP062222.pdf
A sample policy and procedures outline for health centers regarding family planning services.
National Maternal & Child Oral Health Resource Center
Bright Futures Toolbox: Health Professionals and Human Services Providers
www.mchoralhealth.org/pocket/index.php
Oral Health Pocket Guide for providers, education and training opportunities, and screening/risk assessments
Oral Health During Pregnancy: A National Consensus Statement
www.mchoralhealth.org/PDFs/OralHealthPregnancyConsensus.pdf
Provides guidance on oral health care for pregnant women for both prenatal care health professionals and oral health professionals, pharmacological considerations for pregnant women, and guidance for health professionals to share with pregnant women
The Henry J. Kaiser Family Foundation
Women and Health Care in the Early Years of the Affordable Care Act
www.kff.org/wp-content/uploads/2014/05/8590-women-and-health-care-in-the-early-years-of-the-affordable-care-act.pdf
Report with key findings from the 2013 Kaiser Women’s Health Survey including information on coverage, access, affordability, connections to providers, preventive services, and reproductive and sexual health services
U.S. Department of Health and Human Services, Office of Adolescent Health
Reproductive Health
www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/#.Urx_JXl3vIU
National and state data on adolescent reproductive health including birth rates by age and race/ethnicity and sexual behaviors, and information on adolescent and reproductive health topics
U.S. Department of Health and Human Services, Office of Refugee Resettlement
Identifying Potential Victims of Human Trafficking
www.acf.hhs.gov/archive/otip/resource/fact-sheet-identifying-victims-of-human-trafficking
A resource guide for health care providers as well as assessment tools and patient resources including posters and brochures
PATIENT EDUCATION
American Congress of Obstetricians and Gynecologists (ACOG)
Patient Education FAQs
www.acog.org/patient-resources/faqs
Guidelines for cervical cancer screening, family planning, information for teens, and other gynecologic problems
Patient Education
www.acog.org/store/products/patient-education
Fact sheets and FAQs on contraception, pregnancy, labor, delivery, postpartum care, and other women’s health issues
Bright Futures at Georgetown University
Family Materials
www.brightfutures.org/familymaterials.html
Materials for download including What to Expect and When to Seek Help developmental tools, anticipatory guidance cards, tip sheets, and other handouts in English and Spanish
Centers for Disease Control and Prevention (CDC)
Alcohol Use in Pregnancy
www.cdc.gov/ncbddd/fasd/alcohol-use.html
Questions and answers for patients about alcohol use in pregnancy and fetal alcohol spectrum disorders
Hear Her – Resources for American Indian and Alaska Native (AIAN) People
www.cdc.gov/HearHer/
The Hear Her Campaign was started in 2020 to prevent pregnancy-related deaths in AIAN communities by sharing messages about urgent warning signs and when to seek help.
Women’s Reproductive Health
www.cdc.gov/reproductivehealth/WomensRH/index.htm
Resources on women’s reproductive health including A-Z health topics, gynecologic cancers, immunization schedule, preconception care, healthy living, and more
CHAMPS
Patient Education Handouts
www.CHAMPSonline.org/Resources/ClinicalResources/PatientEdTools/PatientEdHandouts.html
Customizable handouts for download on Pap tests, child safety, vaginal discharge, and other health topics
Health Resources & Services Administration (HRSA)
National Maternal Mental Health Hotline
www.mchb.hrsa.gov/national-maternal-mental-health-hotline
Free, 24/7, mental health support before, during, and after pregnancy with culturally sensitive support and connection to local resources. Call or text 1-833-9-HELP4MOMS (1-833-943-5746) to connect with a counselor for English and Spanish-speaking clients.
Mayo Foundation for Medical Education and Research
Pregnancy Nutrition: Healthy-Eating Basics
www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20046955
Information on what foods pregnant women should eat and how much
Mother to Baby
Pregnancy Risk Line
www.mothertobaby.utah.gov/
An affiliate of the Organization of Teratology Information Specialists (OTIS), the Pregnancy Risk Line provides evidence-based information to parents and health care providers about medications and other exposures during pregnancy and breastfeeding
National Maternal and Child Oral Health Resources Center
Tips for Good Oral Health during Pregnancy
www.mchoralhealth.org/PDFs/OralHealthPregnancyHandout.pdf
Fact sheet including information about getting oral health care, eating healthy, and practicing good oral hygiene while pregnant
National Women’s Health Network
Cervical Cancer Prevention and Screening Fact Sheet
www.nwhn.org/cervical-cancer-prevention-and-screening
Includes information on the role of HPV in causing cancer, other risk factors, screening and early detection, what to do after an abnormal Pap test, and other resources
Policy Center for Maternal Mental Health
Maternal Mental Health Fact Sheet
www.issuelab.org/resources/42983/42983.pdf
A fact sheet about maternal mental health including prevalence and range of disorders, why it matters, detection and treatment, and risk factors.
OTHER ONLINE RESOURCES
CDC
Advancing Women’s Health and Safety
www.cdc.gov/women
HRSA
Women’s Health
www.hrsa.gov/about/organization/bureaus/owh/index.html
Maternal and Child Health Bureau (MCHB)
Maternal/Women’s Health
www.mchb.hrsa.gov/maternal-child-health-topics/maternal-and-womens-health
National Cervical Cancer Coalition
Cervical Cancer Awareness and Prevention
www.nccc-online.org
Power to Decide
One Key Question Initiative
www.powertodecide.org/one-key-question