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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 7: Injury Hospitilization

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Strategy. Partnerships to Scale Evidence-based Programs and Practices

Approach. Align and mobilize traditional and non-traditional partners to sustainably implement and widely spread child safety programs and strategies.

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Overview. Traditional partners may include those at federal, state and local governments while non-traditional partners might include those from schools, hospitals, law enforcement agencies, insurance companies, and the private sector.

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impertial experts and are consistent with zccepted theoretical frameworks. Further research is needed to confirm effects. See references for initial studies that support this strategy.

Target Audience. State/National.

Outcome. Injury Prevention and Safe Behaviors. Ten studies focused on motor vehicled related injuries for teen drivers. Of these, seven studies evaluated the effectiveness of a graduated driver license (GDL) program to reduce motor vehicle crashes among teen drivers. For detailed information on the outcomes of these studies, click this link to review the full report, beginning on page 59.

Examples from the Field. Access descriptions of ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

The Nebraska Department of Health and Human Servcies sustainably and widely spread graduated driver license (GDL) education to teen drivers, parents, and caregivers by leveraging partnerships with schools, driver education instructors, the Highway Safety Office, NE Patrol, etc. Updated information on GDL was put into the DMV Driver Manual and more than 7,000 education cards have been distributed amongs thier partners.

The Role of Title V. Title V agencies can take a systems approach to lead and manage the establishment and/or expansion of traditional and non-traditional partnerships to achieve results:

For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.

Sample ESMs. Using the approach “Align and mobilize traditional and non-traditional partners to sustainably implement and widely spread child safety programs and strategies,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of partners (traditional/non-traditional) participating in the distribution of education cards.
  • Number of schools actively engaging in promoting the graduated driver license (GDL) during teen driving coures.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of partners (traditional/non-traditional) participating in the distribution of education cards.
  • Percent of schools actively engaging in promoting the GDL during teen driving coures.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Rate of hospitlization of teen drivers with a GDL.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of teen drivers who do not report an accident or hospitalization after one year of the GDL.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


1 Children's Safety Network. Evidence-based and evidence-informed strategies for child and adolescent injury prevention. Education Development Center (2019).

2 Leonardo J.B., Spicer, S.S., Katradis, M., Allison, J., & Thomas, R. (2018). Buidling the Child Safety Innovation and Improvement Network: How does it work and what is it achieving? Injury Prevention, 1-6.


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.