Crosswalk

MCH Jurisdictional Survey

Crosswalk of Survey Questions to National Outcome and Performance Measures*

*Other survey questions will be used as covariates or have been requested specifically by the jurisdictions

#	National Outcome Measure	Survey Questions
1	Percent of pregnant women who receive prenatal care beginning in the first trimester	AS1, AS2, NM1, VI11
4	Percent of low birth weight deliveries (<2,500 grams)	C2
6	Percent of early term births (37,38 weeks gestation)	C1
9.5	Sleep-related Sudden Unexpected Infant Death (SUID) rate per 100,000	GM13, GM14
13	Percent of children meeting the criteria developed for school readiness (DEVELOPMENTAL)	H3, I2, I3
14	Percent of children, ages 1 through 17, who have decayed teeth or cavities in the past year	B3
17.1	Percent of children with special health care needs (CSHCN), ages 0 through 17	A10, A11, A12, A13, A14, A21, A22, A23, A24, A25, A32, A33, A34, A35, A36, A43, A44, A45, A46, A47
17.2	Percent of children with special health care needs (CSHCN), ages 0 through 17, who receive care in a well-functioning system	D7, D8, D9, E3, E5, E6, AS4, MI18, MI19, PR3, PR4, PR5, PR6, PR7, PR8, PR9, PR10, VI4, VI5, VI6, VI7
17.3	Percent of children, ages 3 through 17, diagnosed with an autism spectrum disorder	B5, PR1, VI8
17.4	Percent of children, ages 3 through 17, diagnosed with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD)	B5
18	Percent of children, ages 3 through 17, with a mental/behavioral condition who receive treatment or counseling	A14, A25, A36, A47, D9
19	Percent of children, ages 0 through 17, in excellent or very good health	B1, B5, B6, B7, B9, B10, B11
20	Percent of children, ages 2 through 4, and adolescents, ages 10 through 17, who are obese (BMI at or above the 95th percentile)	D3, D4
21	Percent of children, ages 0 through 17, without health insurance	F1, F2, F3
24	Percent of women who experience postpartum depressive symptoms following a recent live birth	NM7, NM8, GM3,
25	Percent of children, ages 0 through 17, who were not able to obtain needed health care in the last year	D10, D11

*Other survey questions will be used as covariates or have been requested specifically by the jurisdictions

#	National Performance Measure	Survey Questions
1	Percent of women, ages 18 through 44, with a preventive medical visit in the past year	L1, NM11, NM12, MI2, MI3, MI4,
4	A)Percent of infants who are ever breastfed and B) Percent of infants breastfed exclusively through 6 months	C5, C6, MC3
5	A) Percent of infants placed to sleep on their backs, B) Percent of infants placed to sleep on a separate approved sleep surface, C) Percent of infants placed to sleep without soft objects or loose bedding	C4, GM13, GM14
6	Percent of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year	D5, D6, MC1, MI20, PA1, PR15
7	Rate of hospitalization for non-fatal injury per 100,000 children, ages 0 through 9; and rate of hospitalization for non-fatal injury per 100,000 children, ages 10 through 19	D12
8	8.1 Percent of children, ages 6 through 11, who are physically active at least 60 minutes per day; and percent of adolescents, ages 12 through 17, who are physically active at least 60 minutes per day	H8
9	Percent of adolescents, ages 12 through 17, who are bullied or who bully others	AS5, AS6, NM13, NM14, PA2, PA3, PR13, PR14
10	Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year	D1, VI1
11	Percent of children with and without special health care needs, ages 0 through 17, who have a medical home	E1, E2, E3, E4, E5, E6
12	Percent of adolescents with and without special health care needs, ages 12 through 17, who received services necessary to make transitions to adult health care	E7, E8, E9, E10
13.1	Percent of women who had a dental visit during pregnancy;	L4
13.2	Percent of children, ages 1 through 17, who had a preventive dental visit in the past year	B2, D9, D10
14.1	Percent of women who smoke during pregnancy; and	L7, L9, L10
14.2	Percent of children, ages 0 through 17, who live in households where someone smokes	J1, J2, L7, L9, L10
15	Percent of children, ages 0 through 17, who are continuously and adequately insured	F1, F2, F3, F4, F5, F6, G1, G2, G3, G4