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Benchmarks

REDCap

Children's First

OCAP

Maternal and newborn health

Measure

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Question

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Question

Prenatal Care

Prenatal and Postnatal Medical Care

Did you get prenatal care as early as you wanted?

Maternal Health Assessment

HA7

How many weeks pregnant were you when you began getting prenatal care for this pregnancy?

Primary Caregiver Enrollment Form

How many weeks pregnant were you when you began getting prenatal care for this pregnancy?

How many weeks pregnant were you when you began getting prenatal care for this pregnancy

Pregnancy & Birth Summary

PB3

How many prenatal care visits did you have during your pregnancy?

Pregnancy & Identified Child Form

How many prenatal care visits did the mother have during pregnancy?

How many prenatal care visits did you have during your pregnancy?

Parental alcohol, tobacco, drug use

Alcohol Use Disorders Identification Test (AUDIT)

Health Habits

HH5

Do you now smoke cigarettes every day, some days, or not at all?

Primary Caregiver Wellness Form

Do you know smoke cigarettes every day, some days, or not at all?

Drug Abuse Screening Test, 10 item version (DAST-10)

HH6

In the last 48 hours, how many cigarettes have you smoked?

Cigarette Usage Questionnaire (CUQ)

In the last 48 hours, how many cigarettes have you smoked?

HH9

Considering all types of alcoholic beverages, how many times during the past 30 days did you have four or more drinks on one occasion?

How many alcoholic drinks do you have in an average week?

Currently, how many days per week do you smoke?

HH10

Over the past 14 days, on how many different days did you use alcohol?

How often do you use marijuana, cocaine, narcotics, or other recreational drugs?

On the days that you do smoke, how many cigarettes do you consume?

HH11

Over the past 14 days, when you used alcohol, how many drinks did you usually have per day?

HH12

Over the past 14 days, on how many different days did you use marijuana?

HH13

Over the past 14 days, when you used marijuana, how many pipes or joints did you usually smoke per day?

HH14

Over the past 14 days, on how many different days did you use cocaine?

HH15

Over the past 14 days, when you used cocaine how many times per day did you usually use it?

HH16

Over the past 14 days, on how many different days did you use methamphetamine?

HH17

Over the past 14 days, when you used methamphetamine, how many times per day did you usually use it?

HH18

Have you ever used methamphetamine?

HH19

Over the past 14 days, on how many different days did you use other street drugs?

HH20

Over the past 14 days, when you used street drugs, how many times per day did you usually use it?

HH21

How many times in the last year have you used an illegal drug or used a prescription medication for nonmedical reasons?

Pre-conception care

Prenatal and Postnatal Medical Care

Have you received education on pre-pregnancy/in-between pregnancy care topics such as the importance of folic acid?

Demographics Update

DM26

Have you received education on preconception/inter-conception care topics, such as the importance of folic acid; the harmful effects of alcohol, smoking, and illegal drugs; medical check-ups?

Primary Caregiver Renewal Form

Have you received education on preconception/inter-conception care topics, such as the importance of folic acid; the harmful effects of alcohol, smoking, and illegal drugs; medical check-ups?

Have you received education on pre-pregnancy/in-between pregnancy care topics such as the harmful effects of alcohol, smoking, and illegal drugs, or medical check-ups?

Interbirth intervals

Demographics

Date of birth of your youngest child-10th child

Demographics Update

DM30

Have you been pregnant since you had (index child)?

Primary Caregiver Renewal Form

Have you been pregnant since you had (identified) child?

Maternal depressive symptoms

Center for Epidemiology Studies Depression Short-Form (CESD-SF)

Edinburgh Postnatal Depression Scale

All

Total Score

Edinburgh Postnatal Depression Scale

All

Total Score

Edinburgh Postnatal Depression Scale

Breastfeeding

Healthcare Questions

Has your child ever had breast milk?

Infant Health Care

HC14

Have you ever breastfed or pumped breast milk for your baby?

Identified Child Health Form

Did you ever breastfeed or pump breast milk to feed the baby after delivery?

Does your child continue to get breast milk?

HC15

Does your baby currently get breast milk?

How old was your baby when s/he stopped getting breast milk?

HC16

How old was your baby when s/he stopped getting breast milk?

Until what age was our baby fed exclusively breast milk?

HC17

Until what age was our baby fed exclusively breast milk?

Well-child visits

Healthcare Questions

What is your child's immunization (shots) status?

Well Child Summary

WV6

Were immunizations given at this well-child visit?

Home Visitation Form

HV15

Immunizations currently up to date?

Do you take your child to get recommended routine check-ups, well-child care, even when he or she is not sick?

WV9

Are the immunizations for this child up to date?

HV16

Most recent medical well child check-up?

Most of the time, where does your child go for care when he or she is sick?

WV10

Has this child had the recommended number of well-child visits?

Identified Child Health Form

Where do you usually take your child for routine check-ups?

Infant Health Care

HC2

Where do you usually take your child for routine check-ups?

Maternal and child insurance status

Healthcare Questions

Does your child currently have any type of health insurance (for example, private insurance from your employer or purchased directly, government programs like Medicaid/SoonerCare, or programs that help pay medical bills)?

Demographics Update Form

DM35

Do you currently have health insurance that covers your health expenses (other than Medicaid)?

Identified Child Health Form

Does your child currently have health insurance?

What type of insurance do you have?

DM36

Does your child currently have health insurance?

Primary Caregiver Renewal Form

Do you have health care insurance that covers your health expenses?

Infant Health Care

HC1

Does your child currently have health insurance?

Child injuries, child abuse, neglect or maltreatment

ER visits child

Injuries and Violence

In the past 6 months, how many times have you taken your child to the hospital emergency room/urgent care center?

Infant Health Care: 6, 12, & 18 months

HC10a

At 6 months: Since your baby was born, how many times have you taken your baby to a hospital emergency room/urgent care center for an injury or because you were concerned the baby swallowed something harmful?

Identified Child Health Form

In the past 6 months, how many times have you taken your child to the hospital emergency room/urgent care center?

HC10b

At 12 months: Since your baby was 6 months old, how many times have you taken your baby to a hospital emergency room/urgent care center for an injury or because you were concerned the baby swallowed something harmful?

HC10c

At 18 months: Since your baby was 12 months old, how many times have you taken your baby to a hospital emergency room/urgent care center for an injury or because you were concerned the baby swallowed something harmful?

HC11

For each use of the emergency room/urgent care services, categorize as injury, ingestion, or illness.

ER visits mom

Injuries and Violence

In the past 6 months, how many times have you visited a hospital emergency room/urgent care center to receive care/treatment for yourself?

Demographics Update Form

DM37

In the past 6 months, have you obtained care at the hospital emergency room for any reason?

Primary Caregiver Wellness Form

In the past six months, how many times have you visited a hospital emergency room/urgent care center to receive care/treatment for yourself?

DM38

In the past 6 months, have you obtained care at an urgent care center for any reason?

Training in prevention of child injuries

Injuries and Violence

Has information or training been provided to you on how to prevent child injuries?

Home Visit Encounter Form

HV10

Was parental education provided regarding prevention of child injuries?

Home Visitation Log

HV7

Was parental education provided regarding prevention of child injuries?

Incidence of child injuries requiring medical treatment

Injuries and Violence

In the past 6 months, how many times have you taken your child to the hospital emergency room/urgent care center?

Infant Health Care: 6, 12, & 18 months

HC10a

Identified Child Health Form

How many of those visits were for injuries or accidents?

HC10b

HC10c

HC11

For each use of the emergency room/urgent care services, categorize as injury, ingestion, or illness.

Reported/Suspected maltreatment

Child Maltreatment Outcomes from DHS Administrative Data Systems

DHS Administrative Data Systems

Substantiated maltreatment

Child Maltreatment Outcomes from DHS Administrative Data Systems

DHS Administrative Data Systems

Demographics

First time victims of maltreatment

Child Maltreatment Outcomes from DHS Administrative Data Systems

DHS Administrative Data Systems

Other

Brief Child Abuse Potential Inventory (BCAP)

Conflict Tactics Scale – Parent-Child Version (CTS-PC)

School readiness and achievement

Parent support for learning/development

Home Observation for Measurement of the Environment-Short Form (HOME-SF)

Child Well-Being Scales

Child Well-Being Scale

Parent knowledge of child development

Parents Opinion Questionnaire

Child Well-Being Scales

Child Well-Being Scale

Parent child relationship

Conflict Tactics Scale - Parent - Child Version (CTS-PC)

Child Well-Being Scales

Parent emotional well-being, stress scale

Center for Epidemiology Studies Depression Short-Form (CESD-SF)

Child Well-Being Scales

Brief Child Abuse Potential Inventory (BCAP)

Demographic Information

Adverse Childhood Experiences Scale

Attachment Style Questionnaire

Child language literacy

Ages and Stages questionnaire (ASQ-3)

Ages and Stages Questionnaire

Home Visit Form

Communication and Symbolic Behavior Scales-Developmental Profile (CSBS DP)

The Modified Checklist for Autism in Toddlers (M-CHAT)

Autism Spectrum Rating Scales (ASRS) Short Form (2-5 Years)

Child general cognitive skills

Ages and Stages questionnaire (ASQ-3)

Ages and Stages Questionnaire

Home Visit Form

Child approach to learning/attention

Ages and Stages Questionnaire: Social Emotional : (ASQ-SE)

Ages and Stages Questionnaire

Home Visit Form

Child social emotional behavior

Ages and Stages Questionnaire: Social Emotional : (ASQ-SE)

Ages and Stages Questionnaire

Home Visit Form

Child Behavior Checklist for Ages 6-18 (CBCL)

Plays with own sex parts in public

Plays with own sex parts too much

Sexual Problems (describe)

Thinks about sex too much

110

Wishes to be of opposite sex

Communication and Symbolic Behavior Scales-Developmental Profile (CSBS DP)

The Modified Checklist for Autism in Toddlers (M-CHAT)

Autism Spectrum Rating Scales (ASRS) Short Form (2-5 Years)

Child physical health and development

Ages and Stages questionnaire (ASQ-3)

Ages and Stages questionnaire

Home Visit Form

Crime and domestic violence

Domestic violence

Conflict Tactics Scale CTC2 (Victimization & Perpetration)

Relationship Assessment - Intake

Relationship Assessment Form

Conflict and Problem Solving with Others

Relationship Assessment - 12 weeks

Acceptance Scale

Relationship Assessment - 36 weeks

Domestic violence services

Injuries and Violence Questions

Service Utilization Form

Intimate Partner Violence

Service Utilization Form

Number of families receiving safety plan

Injuries and Violence Questions

Home Visit Encounter Form

HV11

Was an Intimate Partner Violence safety plan discussed, completed or reviewed today?

Home Visitation Form

HV8

Was an Intimate Partner Violence safety plan discussed, completed or reviewed today?

Family economic self-sufficiency

Household benefits

Demographic's Form

What is your annual house income (including salaries, alimony, child support, SSI, AFDC, illegal and legal)?

Demographics Form

DM20

Which of the following categories best describes your total yearly household income and types of benefits you receive?

Primary Caregiver Enrollment Form

Annual Household income

Social Provisions Scale (SPS)

Family Resources Scale-Revised (FRS)

Employment of adult members

Demographic's Form

What is your work status?

Demographics Form

DM16

Are you currently working?

Primary Caregiver Enrollment Form

Employment

Education of Adult members

Demographic's Form

What is the highest level of education that you have achieved?

Demographics Form

DM10

Have you completed high school or a GED?

Primary Caregiver Enrollment Form

What is the highest level of school you have completed?

DM11

Have you completed education other than high school/GED?

Are you currently enrolled in any kind of school, vocational or educational program?

DM12

Are you currently enrolled in any kind of school, vocational or educational program?

Health Insurance status

HealthCare Questionnaire

Demographics Update Form

DM26

Do you currently have health insurance that covers your health expenses (other than Medicaid)?

Identified Child Health Form

Does your child currently have health insurance?

What type of insurance do you have?

Primary Caregiver Renewal Form

Do you have health care insurance that covers your health expenses?

Coordination and referrals for other community resources and support

Families identified for necessary services

Service Utilization Form

Personal Interview

Required services and received referral

Service Utilization Form

Formal agreements with service agencies

Administrative Files

Agencies which HV has contact

Administrative Files

Referrals by HV of services

Administrative Files

Other

Risk Assessment

Consideration of Future Consequences

Numeracy Scale

Cognitive Reflection Test

Rational/Experiential Multimodal Inventory

Child Abuse and Neglect Prototype Vignettes

Autism

The Modified Checklist for Autism in Toddlers (M-CHAT)

Autism Spectrum Rating Scales (ASRS) Short Form (2-5 years)

Communication and Symbolic Behavior Scales-Developmental Profile (CSBS)

Service Utilization

Service Utilization Questionnaire