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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Accelerate with Evidence

MCH Best LogoThe first component of the MCH Evidence Center conceptual model requires us to accelerate strategies with evidence to ensure that they are meaningful and have the greatest potential to affect desired change. The strongest strategies rely on research that is unbiased, relevant to public health, and rooted in science, experience, and policy. They should show results that are statistically significant and lead to decisions that bring about change. Use this page to access specific approaches and tools that the Evidence Center uses to identify and adapt evidence-based/informed strategies through our Ready, Set, Go approach.

1. READY: Understand evidence through these introductory resources.

Video. Start here to learn about specific sources of evidence to use in developing strategies based on what works.

Resources. Dig deeper into where the MCH evidence base comes from and access our National Performance Measure (NPM) toolkits.

Summary: Understanding What Works

Overview of Evidence. The evidence base includes peer-reviewed findings, promising practices, and other state ESMs currently in use. Evidence-based/informed programs should be:

  • Agreed upon by expert consensus.
  • Based in science.
  • Clearly reflect actual experience.
  • Developed with the potential to influence policy.
  • Expressly address the needs of your community.

You can read more about how the MCH Evidence Center uses the Continuum Methodology to rate evidence (access information through the "Rating the Evidence" link).

Implementation Science: Adapting What Works

The need to base MCH programs on evidence-based/informed practices is well understood. The literature reinforces what we know: " Translation of evidence-based research to address macro-level issues [is] paramount to moving the field of MCH forward."1 Comments from recent applicants to the AMCHP Leadership Lab further illustrates this need:

"Implementing the transformation of my state’s MCH Block Grant will require strategic planning and an increased focus on and understanding of program evaluation and evidence-based strategies and creative thinking in how to apply these to long-standing and new partnerships with families, consumers and other stakeholders."

To accomplish this, the MCH Evidence Center utilizes implementation science to provide the public health workforce with a framework to translate evidence-based/informed practices into programs and policies that impact health outcomes. Implementation science "focuses on translation of interventions into practice and policy."2

In other words, MCH professionals need more than just access to research findings. With the dramatic increase in information currently available on the Internet, MCH professionals face information overload on a scale never before experienced. Title V professionals must sift through mountains of material to find what is useful, evidence-based/informed, and current. The ever-expanding evidence base is a growing issue that requires an implementation science-oriented response.3

This project provides practical tools to help Title V MCH programs translate academic evidence into actionable, results-oriented strategies that can become the foundation for State Action Plans.

To facilitate implementation science, the program offers:


1-2 Kroelinger CD, Rankin KM, Chambers, DA et al. 2104. Using the principles of complex systems thinking and implementation science to enhance maternal and child health program planning and delivery. Maternal and Child Health Journal 18(7):1560–1564.

3 Jacobs JA, Jones E, et al. Tools for Implementing an Evidence-Based Approach in Public Health Practice. Preventing Chronic Disease 9:110324.

NPM Evidence Toolkits: Digging Deeper

2. SET: Build programs with examples from the evidence base and the field.

Explore the Evidence - Decorative

Find evidence-based/informed strategies through the MCHbest database, promising practices through AMCHP's Innovation Hub, and field-generated resources from the MCH Digital Library.

Evidence-Based/Informed Strategies: Consult the MCHbest Database

MCH Best LogoAccess the MCHbest database: the Bank of Evidence-linked Strategies and Tools. The database aggregates sample evidence-based/informed ("evidence-linked") strategies that can be used as-is or adapted to develop Evidence-based or informed Strategy Measures (ESMs) for each of the MCH National Performance Measures (NPMs). Use the database along with the ESM Development Guide to work through the entire ESM process.

You can also access the full MCHbest database for advanced searches.

Promising Practices: Learn from AMCHP's Innovation Hub

MCH Library Databases: Access the Evidence Base Directly

Search the MCH Library databases on your own to find resources that can be used as models for adjusting current or developing new ESMs:

3. GO: Ensure strategies are effective and address the needs of all populations.

Tips: Review how to strengthen strategies to be meaningful, measurable, and moveable.

Effective ESMs measure strategies that draw from the evidence, advance NPM topic areas, and include:

Strategies that are meaningful. Consider if the ESM:

  • Is based on an evidence-based/informed strategy. Evidence can be based on peer-reviewed research or informed by emerging practices and expert opinion that there would be a positive, measurable, and expected result from the strategy.
  • Has a direct relationship to the NPM.
  • Is feasible relative to state priorities and funding.
  • Reflects the needs of your populations.
  • Has involved stakeholder input and/or buy-in.
  • Has potential for improvement over time.
  • Addresses disparities, gaps, or issues to improve health equity.

Activities that are measurable. Consider if the ESM:

  • Is quantifiable (count, percentages, rate) and specific (defined indicator, numerator, denominator). Note: Quantitative measures are better than qualitative “yes/no” measures to show improvement over time.
  • Is well-defined, specific, and captures relevant data needed to demonstrate change.
  • Has data sources that are available to measure and track the ESM over time.

Improvements that are moveable. Consider if the ESM:

  • Can show improvement over multiple assessments.
  • Is sensitive to change over time.
  • Is effective with multiple population groups, including vulnerable families and CYSHCN.

Ensuring Effectiveness: Adopting or adapting strategies to meet the needs of your populations

Not all strategies are effective for all population groups, and the evidence is often lacking in terms of using specific strategies to advance health equity.

Once the evidence has been considered for what works generally,, it is important to understand if a specific strategy will work for targeted populations, especially those most affected by health disparities. Implementation science helps to translate the science into programs and policies that impact health outcomes in light of multiple social determinants. In finding strategies to meet needs, we have the ability to adopt and/or adapt what works.

ADOPT Strategies to Meet Needs

In choosing to adopt an existing strategy based on existing science and practice, we should consider:2

Is the study sample or population similar to our target audience?

  • ​Geography
  • Demographic characteristics
  • Culture, values, and preference
  • Health status
  • Other characteristics of interest 

Do we have the resources needed to implement?

  • ​Workforce capacity
  • Money
  • Time
  • Leadership 

Does our organization and the broader environment support the strategy? ​

  • Political support
  • Financial and legal support
  • Champions for intervention
  • Community norms and partnerships
  • Title V priority and jurisdiction
  • Favorable environment for change​​

Implementation Tool. The Hexagon Tool (National Implementation Research Network) provides a systematic approach to evaluation effectiveness of a strategy based on six fit and feasibility factors.

Note. Looking at the evidence may not be sufficient to identify next steps if through this process we identify that the proposed strategy(s) does not:

  • Fit local context
  • Present sufficient evidence
  • Offer enough information about implementation and plans for replication
  • Have the ability to be modified for immediate use or for varied stakeholders

If this is the case, we recommend using the Science-Based Intervention Approach below to adapt strategies to fit the needs of your populations.

ADAPT Strategies to Meet Needs

Not all strategies are effective for all populations. To adapt strategies to meet needs, we should consider:2

What about the existing strategy works? If we understand the key ingredients of a strategy, we can replicate and/or adapt the effective components. Looking at a strategy through a health behavior theory identifies key ingredients. Here are several to consider:

How does it work? Being specific about the underlying mechanisms can help us increase the impact. Developing a logic model with program actions, targets, outcomes, and moderators allows you track the process from action to outcome.

For whom does it work, and for whom does it not work? When we know who is and is not responding, we can make targeted adaptations to improve outcomes. Think about the program life cycle:

  • Precision. Understand what a strategy entails so you can go beyond “does it work,” to “what about it works” and “for whom does it work.”
  • Fast-cycle iteration. Incorporate new ideas as you go – what is working and what is not working.
  • Shared learning. Create a mechanism to share learning about success and failures.
  • Co-creation. Bring together multiple parties to create a mutually valued outcome.

In what contexts does it work? By evaluating the context in which a strategy is implemented, we can adapt it for other settings. The best way to ensure that a strategy is effective is to conduct a robust evaluation. The MCH Navigator’s Evaluation Spotlight provides trainings and resources related to the steps and standards for effective program evaluation.



1 Jacobs JA, Jones E, Gabella BA, Spring B, Brownson RC. Tools for implementing an evidence-based approach in public health practicePrev Chronic Dis. 2012;9:110324.
2 Adapted from IDEAS Impact Framework, Center on the Developing Child, Harvard University. 6Hayden J. Introduction to Health Behavior Theory, Second Edition. Burlington, MA: Jones & Bartlett Learning. 2014.

Need more help? Request technical assistance (TA).

We are eager to talk with you further about your ESMs. We provide TA that is customized to your needs and the time you have.

Addressing complex, systems-based issues is strengthened by a team approach. We collaborate with Evidence-Based Decision Making team of the National MCH Workforce Development Center to identify, develop, measure, and improve your ESMs.

We also collaborate with the Association of Maternal and Child Health Programs (AMCHP) to ensure that you have access to promising practices and tools from other Title V programs across the country. Finally, we coordinate with a wide array of MCHB-funded topical TA centers to make sure you have access to cutting-edge knowledge and resources from the experts.

SMARTIE TA: An Equity-Centric Approach to Our Work

Specifically, we provide SMARTIE TA that leads to:

  • Sharp, Specific, and Systems-based ESMs. We help sharpen ESM goals to more fully advance NPM topics and utilize systems to sustain these strategies.
  • Measurable and Meaningful ESMs. We ensure that your ESMs are measurable and in line with related projects in other states and jurisdictions.
  • Actionable, Achievable, and Aligned ESMs. We ensure that your ESMs inform your actions, are aligned with your needs assessment, and flow from your State Action Plan.
  • Relevant and Research-based ESMs. We connect your ESMs with the published evidence, emerging promising practices, and what other states are currently doing.
  • Translatable, Targeted, and Time-phased ESMs. We engage your team in developing sustained approaches to address specific needs of your populations, including Children and Youth with Special Health Care Needs (CYSHCN).
  • Inclusive and Integrated ESMs. We encourage you to work with all population groups as decision makers in every step of the process to ensure a meaningful partnership draws on the strengths of your communities.
  • Equitable ESMs. We continually ask the tough questions to address disparities, gaps, and issues of equity.

Read about our TA iin our brochure | Read about how our TA promotes implementation science

How To Request TA: Three Easy Ways

It’s easy to connect with us. We work closely with regional project officers to provide the most appropriate assistance. You can:

  • Email us at with specific questions or to set up a time to talk. We’ll get right back with you to get the process started.
  • Use our online form to choose from several different types of TA.
  • Talk with your regional project officer who will contact us to arrange for TA, either for your group individually or as part of a group Title V programs.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.