Saving Lives TogetherSeptember 2019

In this edition:

Greetings from the StaffUpcoming EventsField NotesKudos CornerData MattersResources for PreventionNew & Departing CoordinatorsNational Center Staff Out & AboutConnect with us!

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Greetings from the Staff

Dear Friends and Colleagues,

As many of you may know, we are a smallbut mighty crew at the National Center forFatality Review and Prevention. We havequite a variety of personal hobbies andinterests - knitting, fishing, hiking, bowling,piloting airplanes via virtual reality, and ofcourse, traveling. We do have one commonpassion among all of us though and that is ashared love for Broadway musicals! Manyof us have been fortunate to see Hamiltonthis year. Around the office or during staffmeetings, you might hear one of us toss outa favorite Hamilton quip like “Talk less;smile more,” “I want to be in the room whereit happens,” or “I’m not throwing away my shot.” But on a more serious note, thefinale song in Act 2 “Who Lives, Who Dies, Who Tells Your Story” often makes usthink about the important work we all do in fatality review. The National Center’svision for fatality review is to have an engaged, multidisciplinary community gathertogether to share a child’s story, one child at a time, to better understand the riskfactors and circumstances to prevent future deaths. Fatality review should include

the telling of the child’s life – not just the death – and come at it from an ecologicalperspective. The important work in drawing upon the lessons of an individualchild’s story helps to guarantee that individual child’s story lives on and shapes forthe better the lives of other children. Thank you for taking the time to continue totell the story of children whose own voices are now silenced. It is hard and attimes brutal work but so critical to prevention.

Warmly,

Heather DykstraSenior Data Analyst

Upcoming Events

Upcoming FIMR Regional Support Calls:Northern Region: October 15, 2019; 9:30-10:30 AM ESTMidwest Region: October 15, 2019; 11:00 AM-12:00 PM ESTWestern Region: October 16, 2019; 4:00-5:00 PM ESTSouthern Region: October 24, 2019: 11:00 AM- 12:00 PM ESTCentral Region: October 28, 2019; 11:00 AM-12:00 PM EST

Save the Date:WEBINAR: Using Fatality Review to

Understand DisastersThursday, October 31st, 2:00-3:00 PM EST

Registration information will be distributed soon through bothCDR and FIMR listservs.

Field Notes

Highlights from state and local programsFIMR teams celebrate Breastfeeding Awareness Month

Two FIMR sites celebrated BreastfeedingAwareness Month in August by sponsoringa public viewing of Chocolate Milk: TheDocumentary. Chocolate Milk is a digitalstorytelling project that shares videotestimonials from Black mothers who havestruggled and succeeded withbreastfeeding. The film is a production ofThe African American BreastfeedingProject, a multi-media initiative tonormalize breastfeeding by collectingpersonal narratives and creating an onlinedatabase of resources and groups servingAfrican American mothers across thecountry.Jene Yoder, the Maternal ChildHealth/First Steps/FIMR Coordinator fromthe Family Health Division of the ShawneeCounty Health Department in Topeka, KSparticipated with WIC in inviting thecommunity to view the documentary onAugust 7th. Katherine Campbell, FIMRcoordinator from the Mother & ChildHealth Coalition in Kansas City, MO,

sponsored a viewing of the film on August 14th, followed by a panel presentationon strategies for improving the breastfeeding rates among African Americanmothers. Fifty-nine people attended.Yoder identified that attendees enjoyed that the film highlighted both the strengthsand struggles of Black women in the various roles of giving birth, breastfeeding,and providing lactation services and midwifery care. Panelists focused on thefollowing questions:

How do we encourage women of color to choose lactation professions?How do we reach Black women to connect with them and promotebreastfeeding?

Fatality review teams regularly develop meaningful recommendations to addresshealth disparities, including disparate rates of breastfeeding--a known protectivefactor to support infant health and wellness.

CDR coordinators participate in regional meetings

The National Centerparticipated in a meetingin each of the 5 CDRregions over the summer,meeting a key objective oftheir cooperativeagreement with the HealthResources and ServicesAdministration. TheNortheast region met inBurlington, VT; the Mid-Atlantic region met in

Rehoboth Beach, DE; theSoutheast region met inAustin, TX, the Westregion met in Salt LakeCity, UT; and the Midwestregion met at the NationalCenter office in Okemos,MI.Meeting priorities wereidentified for each regionahead of time to ensurethat each region's meetingmet the needs of theparticipants. Attendees shared updatesfrom their state programs, engaged in shared problem solving, and providedinsights to help shape National Center programmatic support efforts. Federalpartners were able to join in 2 of the meetings.Participants identified the following as some of the helpful outcomes of themeetings:

Connections with other states--their issues and approachesLearned tips and tricks for assembling a strong state advisory boardResources for youth suicide preventionFeeling energized for upcoming panel meetings

The National Center hosts CDR regional meetings every other year.

Kudos CornerYouth firearm suicide study published in Journal of BehavioralMedicine

"Firearm Suicide among Youth inthe United States, 2004-2015" waspublished in the Journal of BehavioralMedicine on August 1st. PatriciaSchnitzer, Heather Dykstra, TheodoreTrigylidas, and Richard Lichensteinwere contributing authors. The studyexamined child death review data in theNational Fatality Review-CaseReporting System (NFR-CRS) of

firearm suicide deaths of children ages 10-18 where the suicide-specific sectionin the case report tool was complete, providing rich contextual information foranalysis.Of the 1388 suicide deaths included in the sample, 36% of the children had talkedabout, threatened, or attempted suicide prior to their death; these cases werecategorized as at "greater risk" for suicide. The study concluded that firearmsused by children in this "greater risk" category were less likely to bestored in a locked location than firearms used by children who had notpreviously talked about, threatened or attempted suicide.Access to firearms is a significant preventable risk factor for youth suicide, andthis important study maximizes the use of CDR data to more effectively inform the

field of injury prevention professionals about levels of risk and exposure tounsecured firearms. Congratulations!

Indianapolis celebrates program milestones

The Marion County, IN HealthyBabies/Healthy Start Consortiacelebrated 25 years of theIndianapolis Healthy BabiesConsortium, 20 years of HealthyStart, and 15 continuous years ofFIMR operation. Over 100community leaders andstakeholders attended the eventon June 28th. Keynote speakersincluded (from left to right) YvonneBeasley; Dr. Haywood Brown; Dr.Thomas Ferrara; RosemaryFournier; Dr. Arthur James, and Dr. Virginia Crane. Congratulations on theseanniversaries, Marion County!

Data MattersData Tip: Please check your bookmarks for National FatalityReview Case Reporting System!

Please note that https://www.cdrdata.org hasbecome https://data.ncfrp.org. If you have the dataentry site bookmarked, please check to makesure it says https://data.ncfrp.org. If you are stillusing cdrdata.org, it will no longer work as ofFebruary 2020.

Data Quality Summary Reports coming in September

The National Center will release the 4thannual Data Quality Summary Reports inSeptember, featuring data on deaths thatoccurred in 2017 and are entered into theNational Fatality Review-Case ReportingSystem (NFR-CRS). This report, prepared foreach state that records 30 or more deathsoccurring during the report year, shows thepercent of missing and unknown data for theCDR priority variables for monitoring dataquality. This year the report has been updated,with input from the Data Quality Workgroup, inan effort to make it more user-friendly. Theseupdates include the addition of timeliness

variables as well as several new tables that display the data in various ways (e.g.,percent missing and unknown combined, or Core variables only.)Dawn Porter (pictured), Arkansas' Infant and Child Death Review ProgramCoordinator, has used her data quality summary to build data collection and dataentry capacity among her local coordinators. She has focused her training effortson the Core "High 5" and "Low 5" variables--the five variables for which there arethe highest and lowest rates of missing and unknown responses in the NationalFatality Review-Case Reporting System (NFR-CRS). Recognizing it takes asignificant investment of time and effort to help build data capacity, sheexpressed the value of doing so: "If you don't have the data, you can't makerecommendations because you don't know all the circumstances."The first Data Quality Summary Reports were provided for cases of fatalities thatoccurred in 2014 and were distributed in 2016.Arkansas has seen great success since beginning this focused work, includingsignificant decreases in the rates of missing data on specific Core variables (seeimage below). In 2014, 73% of the Arkansas' cases had missing data for thevariable assessing child's health insurance; two years later, it was only missing in1% of the cases. Porter is pleased, but still sees room for improvement. Lack ofinvestigations, or challenges accessing records still make it difficult for teams toget all the information they want. She continues to encourage teams to buildrelationships to break down barriers to effective data collection, recognizingquality data drives effective prevention.If your state program is interested in ways to improve your data quality, pleasecontact us at info@ncfrp.org; we are happy to help you consider ways to improvefatality review data to drive effective prevention.

Resources for PreventionNational Center releases Improving Racial Equity in FatalityReview

Fatality review methodologies offerunique strategies for analyses of

individual and community factorsthat significantly affect healthdisparities, including communitymembers' experiences of racism.Acknowledging this, the NationalCenter released Improving RacialEquity in Fatality Review inAugust. It is intended to provideguidance for fatality review teams:

On team composition and educationto new and existing teams to helpmembers understand implicit biasand other equity issues.On gathering the right records tohelp teams understandmothers'/families' experiences ofracism, the impacts of other socialdeterminants of health, and howthose experiences may haveimpacted maternal and child

outcomes.On ensuring that--once teams have their findings--they are making andimplementing meaningful recommendations that effectively addressdisparities and the social determinants of health.

The National Center is excited to help teams build capacity to address systemicracism and promote health equity through the fatality review process.

National Center promotes video training module series forfatality review

The National Center isexcited to highlight aseries of video modulescreated to support thework of FIMR and CDRteams. All under one hourin length, the 13 modulesare available on theNational Center website.Half of the modules arefocused on fatality reviewprocess topics such as:CDR 101; FIMR 101;National Fatality Review-Case Reporting System; and Maternal Interviews.The other half focus on best practice topics such as: Building, Maintaining, andSustaining FIMR Teams; Collaborating Across Review Systems; andPartnering for Prevention.The modules were designed to support the work of fatality review teams, leaders,and their partners. They are ideal to include as part of an onboarding process fornew coordinators or team members, when rolling out a newly-adopted processsuch as maternal interviews, or joining the National Fatality Review-CaseReporting System. Click here to access the module series. Happy viewing!

Violence prevention resource released

The CDC Division of ViolencePrevention released Select, Adapt,Evaluate! How to Use EssentialElements to Inform YourPrevention Approaches in August.The tool helps state and localpartner with the implementation ofprevention approaches based onthe best available evidence.Because each community andstate is unique, practitioners must decide how to balance the benefits of certainprevention programs with the reality of their local contexts. This tool wasdeveloped to support this important decision-making process. Select, Adapt, andEvaluate! explains how evidence-informed approaches work and suggests waysto effectively select, deliver, adapt, and evaluate evidence-based programs, orpromising or emerging approaches.To see it in action, join CDC and Prevent Connect for a web conferenceon Wednesday, September 18, 2019 at 11:00 AM Pacific/2:00 PM Eastern.Register for the web conference here.

New & Departing Coordinators

WELCOMEMackenzie Gress, Amanda Rouse,and Blair Tomsheck; MontanaFICMMRAshley Sturm; Palm Beach, FLFICMMRSandra Despagne; Palm Beach, FLFIMRColleen Wilburn; Interim State CFRCoordinator, MarylandDebbie Walpole; Interim State FIMRCoordinator, MarylandTiffany James; San Antonio, TXFIMRAnya Monroe; Tallahassee, FL

FAREWELLJoey Thurgood; Utah statecoordinatorSheree Keitt; State FIMRcoordinator, MarylandMaura Dwyer, State CFRcoordinator, MarylandMonica Koenig; Yolo County, CAFIMRJennifer Miller; Sedgwick County, KSFIMRJorge Rodriguez; San Antonio, TXFIMRViolet Hyatt; Maine MFIMRcoordinator

FIMR Stefanie Schelling, and YvonneOlen; Montana FICMMRColleen Nester, Howard County, MDFIMRSandra Despagne; Broward County,FL FIMR

We rely on state and local coordinators to let us know of arriving or departing

coordinators, and we appreciate it when you let us know. Thank you!

National Center Staff Out & AboutWorking with programs is the best part of our job.

Rosemary Fournier presented atthe CDC's 2019 HIV SurveillanceTechnical Assistance Meeting inAtlanta, GA on June 12th; herpresentation was FIMR/HIV 101:A Systems-Level Tool for Endingthe Epidemic among Pregnantand Postpartum Women andtheir Infants.Abby Collier, Heather Dykstra,and Patricia Schnitzer joined thestate CDR coordinators from the

West Region in Salt Lake City June 16th and 17th.Abby went to Nome, AK on June 24th to support collaboration between thestate health department and local tribes.Susanna Joy participated in the Domestic Violence Fatality Review Summitin Flagstaff, AZ June 25th-26th.Rosemary attended and presented at the June 28th celebration of theIndianapolis, IN FIMR, Healthy Start and Healthy Babies Consortia Rosemary participated in the March of Dimes Equity in Action: Movingfrom Theory to Practice Summit July 8th in Orlando.Abby exhibited at the National Association of City and County HealthOfficials In Orlando, FL July 8th-11th.Rosemary and the Florida Department of Health conducted a community ofpractice day and bereavement training for Florida FIMR coordinators onJuly 9th. Heather and Abby presented and exhibited at PREVCON--The Safe KidsWorldwide Childhood Injury Prevention Convention--July 17th-20th.Susanna presented at the Florida Child Abuse Death Review Summit inOrlando July 18th and 19th.She presented on Writing Recommendations.Patricia Schnitzer joined her to remotely present on Data Quality.All National Center staff participated in the Mid-West Regional Meeting July25th and 26th in Okemos, MI at the National Center offices.On July 31st, Abby met with the Casey Family Programs and select NativeAmerican tribes to build capacity related to CDR.Abby joined the Arizona CDR coordinators and met with the Navajo Nationand the states whose borders intersect the reservation August 5th-7th.All National Center Staff participated in the NCFRP in-person Steering

Committee meeting in Rockville, MD, on August 13th. Susanna presented and facilitated at the Local CDR Team Coordinator'sMeeting in Alabama on August 18th and 19th in Montgomery.Susanna participated in the Alabama State Child Death Review Summit onAugust 22nd and 23rd in Montgomery.Abby participated in an Overdose Fatality Review meeting of nationalstakeholders in Washington, D.C. August 27th and 28th.

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One Stop Shop

The National Center is your one stop shopfor all things related to your FIMR and CDRprograms. Questions? Concerns? Anexciting idea? We would love to hear fromyou!

Contact the NationalCenter

National Center for Fatality Review and Prevention800- 656-2434 | 2436 Jolly Rd., Suite 120 Okemos, MI 48864 | ncfrp.org