Use of competency-based self-assessments and the MCH navigator for MCH workforce development: three states' experiences.

Workforce development is a priority across many state Maternal and Child Health (MCH) Title V programs. Three case studies were conducted to explore varied state implementations of MCH workforce development initiatives. Three states utilized the online MCH Navigator resource to support orientation and ongoing professional development for staff and other partners. Key informant interviews and surveys were utilized to gather staff feedback on practical aspects of the project and to ascertain lessons learned by state MCH leadership during project implementation. Staff impressions of the MCH Navigator were generally positive. Staff reported that Navigator modules were useful to their current work and that completion of the modules resulted in expanded knowledge in key MCH competency areas and contributed to their professional development. Many indicated that they would recommend use of the Navigator to colleagues. State leaders found that utilization of introductory training sessions or the Navigator's online orientation modules were helpful in acclimating staff to the Navigator, although some staff still experienced minor technical challenges. State leaders across all three sites reported the value of pre-existing tools on the Navigator site, including core competency self-assessments and orientation bundles; the leaders also noted that the Navigator represents a useful and thorough resource that can be integrated into state efforts to enhance professional development for MCH staff. The significant variation between the three states' implementations demonstrates the flexibility of the Navigator, highlighting its utility to meet state-specific needs.

Association of physical violence by an intimate partner around the time of pregnancy with inadequate gestational weight gain.

Intimate partner violence has been previously examined in relation to a variety of pregnancy, labor and delivery outcomes. We evaluated whether women who experienced physical violence by their intimate partners around the time of pregnancy were less likely to achieve weight gain according to the US Institute of Medicine (IOM) guidelines. A cross-sectional study was conducted using the 2000-2006 Oklahoma Pregnancy Risk Assessment Monitoring Survey (PRAMS) data for post-partum women, 20 years and older. Physical violence perpetrated by an intimate partner before and/or during pregnancy was prevalent in nearly 6.5% of women. Weight gain was adequate in 38.8%, deficient in 28.4% and excessive in 32.8% of these women, respectively. After adjusting for maternal age, marital status, education, pregnancy intention, stressful life events, third-trimester use of tobacco and alcohol and gestational age at delivery, physical violence by an intimate partner around the time of pregnancy was positively but non-significantly associated with excessive (but not deficient) gestational weight gain. After stratifying by age group, positive and significant associations between physical violence by an intimate partner around the time of pregnancy and inadequate gestational weight gain were observed only among women 35 years and older. With the exception of mothers ≥ 35 years of age, deficient and excessive gestational weight gains were not significantly related to experiences with physical violence by an intimate partner prior to delivery. Prospective cohort studies are needed to establish whether other forms of violence, including emotional and sexual abuse, can affect gestational weight gain and whether gestational weight gain can mediate the effect of physical, sexual and emotional abuse on pregnancy, labor and delivery outcomes.