Translating findings to practice: Visualizing relationships between fiscal crisis cuts and maternal child health (MCH) outcomes

Background: Washington State's declining revenues have forced difficult programmatic decisions. Local health department (LHD) budgets have been particularly hard hit, with some of the largest cuts made to MCH services. This project explores: 1) predictive relationships between recent cuts and MCH outcomes, and 2) characteristics of visual displays preferred by practice/policy-stakeholders. Methods: A sample of nine public health leaders were interviewed regarding their perceptions of the impact of LHD cuts on MCH services and outcomes. Interview notes and recordings were examined for themes related to potential research questions and theorized linkages. Questions and linkages are being explored through secondary data analysis (e.g. pooled time series regression) using 2005-2010 linked individual-level birth records (n>400,000) and budget data from Washington's 35 LHDs. Visual displays of findings are being developed for stakeholder review to maximize ease of interpretability and utility in translating new evidence to practice. Results: Interviewees believe LHD cuts are having negative health impacts on MCH clients. Datasets reflecting MCH outcomes (e.g. prenatal care timing, birth weight) and LHD/MCH funding data are being linked and analyzed during winter/spring 2012. Visual displays will continue to be iteratively developed with and for stakeholders. Final results will be presented at APHA-SA. Conclusions: Extensive LHD budget cuts are perceived to be negatively impacting the health of mothers and children in Washington State. Preliminary findings substantiate perceptions of decreased funding as well as worsening MCH outcomes. Use of visual displays designed with stakeholder input is anticipated to support decision-making thereby speeding translation of findings to practice.