Collaborative Improvement & Innovation Networks (CoIINs)

Collaborative Improvement and Innovation Networks (CoIINs) are multidisciplinary teams of federal, state, and local leaders working together to tackle a common problem.

CoIINs use technology to remove geographic barriers. Participants with a collective vision share ideas, best practices, and lessons learned. They track their progress toward similar benchmarks and shared goals. 

Participants self-organize, forge partnerships, and take coordinated action to address complex issues. They do this via structured collaborative learning, quality improvement, and innovative activities. 

What are characteristics of a successful CoIIN?

  • Together, they identify common aims and specific, measurable objectives to describe what they want to achieve;
  • Determine and use evidence-based strategies to show how they will accomplish these objectives; and
  • Use clear-cut metrics and share real-time data to reveal what’s working and determine if they achieved the aim(s).

Which CoIINs do we support?

The CoIINs we support address a range of topics across the lifespan. Each aligns with state Title V MCH Program priorities and other MCH issues of community-based organizations. 

These topics include:

  • Maternal health
  • Prenatal and infant/child oral health
  • Newborn screening
  • Infant mortality
  • Home visiting
  • Pediatric emergency care
  • Child safety
  • School-based health
  • Children’s healthy weight
  • Adolescent and young adult health
  • Environmental health

Maternal and Women’s Health

Home Visiting CoIIN

In September 2013, we launched the Home Visiting CoIIN through a three-year cooperative agreement with Education Development Center, Inc. (EDC)exit disclaimer icon

We work to achieve breakthrough improvements in select process and outcome measures. This includes benchmark areas legislatively mandated for the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) Program, while reducing or maintaining program costs.

A CoIIN allows us to spread information on learning and improvements more widely within participating organizations and to other MIECHV Program grantees and local agencies.

Ultimately, we want to identify evidence- and experience-based practices that result in significant change.

Family Engagement

Of families enrolled in home visiting:

84% are retained at three months; 71% at six months.

Perinatal and Infant Health

Infant Mortality CoIIN

Infant mortality refers to the death of a baby before his or her first birthday.

“The U.S infant mortality rate declined 15% from 2000 to 2015.” 1

The Infant Mortality CoIIN and its participating teams strive to reduce infant mortality in areas with high annual rates of, as well as disparities in, infant mortality and related perinatal outcomes.

Specific aims include:

  • Achieve measurable improvement as defined by the CoIIN teams during their three-year project period (FY2017 – FY2019)
  • Spur the development and/or discovery of innovations and new evidence to reduce infant mortality, as well as disparities in infant mortality and related perinatal outcomes
  • Support distribution of best practices to reduce infant mortality and disparities to stakeholders

Success in these areas will help ensure every baby reaches his or her first birthday and beyond.

Award Recipients include:

  • Association of Maternal & Child Health Programs (AMCHP)
    • CoIIN Team States: FL, IL, KY, MA, NC, NM, NV, OH, OR, RI, SC, TX, WI
    • CoIIN Team topic area/focus: social determinants of health
  • National Institute for Children’s Health Quality (NICHQ)
    • CoIIN Team States: AR, MS, NY, TN
    • CoIIN Team topic area/focus: Sudden Unexpected Infant Death
  • Project Concern International (PCI)
    • CoIIN Team States: AZ, CA, NM, TX
    • CoIIN Team topic area/focus: Early prenatal care & social determinants of health
  • University of North Carolina - Chapel Hill
    • CoIIN Team States: CA, DE, NC, OK
    • CoIIN Team topic area/focus: preconception health

Review the National Institute for Children’s Health Quality’s infant mortality prevention toolkit exit disclaimer icon. You'll have access to best practices, ideas, case studies, and key insights from participating state teams in the national phase of the Infant Mortality CoIIN from 2014 to 2017.

Healthy Start CoIIN

The Healthy Start (HS) CoIIN partners Healthy Start grantees to strengthen HS services and systems. This advances program goals to reduce infant mortality and improve birth outcomes.


  • Functions as an expert panel to the Division of Healthy Start and Perinatal Services (DHSPS) and the Healthy Start EPIC Center, the program's training and technical assistance provider.
  • Seeks to promote the implementation of standardized evidence-based and field-tested approaches to essential HS components such as risk assessment, case management, and participant engagement.
  • Promotes the use of standardized evidence-based approaches to core elements of the HS program.

What are specific objectives?

  • Promote communication among grantees, DHSPS and HS EPIC Center to ensure all grantees have a voice in setting the direction for HS;
  • Brainstorm and test opportunities to strengthen the program, especially related to standardizing components of the HS model;
  • Distribute lessons learned to the HS community; and
  • Promote HS as an effective and vital community-based resource in all communities to ensure the long-term success of HS.

The HS CoIIN successfully developed standardized screening tools that the 100 Healthy Start programs nationwide implemented in 2017.

Child Health

Child Safety CoIIN

Injuries are the leading cause of death for children and adolescents.

The Child Safety CoIIN – made up of federal partners, national organizations and states – aims to prevent child deaths, hospitalization and ER visits due to preventable injuries.

The consequences of these injuries impact the life of the child and members of their family, including:

  • lost time in school,
  • decreased academic achievement,
  • economic impacts due to missed work and medical expenses,
  • children who have long-term special health needs, and
  • emotional stress.

Each year:

  • 13,000 children die from preventable injuries
  • almost 300,000 are hospitalized, and
  • 8.9 million visit the emergency room for medical treatment.

But—this is a preventable issue. Over the past three decades, researchers and practitioners have successfully led efforts to generate an evidence base of effective interventions. To put them into practice on a national scale, takes a coordinated, collaborative effort, such as the CoIIN.

Early Childhood Comprehensive Systems Impact (ECCS Impact) CoIIN

The Early Childhood Comprehensive Systems Impact (ECCS Impact) grant program uses a Collaborative Innovation and Improvement Network (CoIIN) approach to enhance early childhood (EC) systems building and demonstrate improved outcomes in population-based children’s developmental health and family well-being indicators.

Additionally, these grants develop collective impact expertise, and implement and sustain efforts at the state, county and community levels.

How It Works

Grant recipients identify up to five place-based communities within their state or territory to participate in the Early Childhood Comprehensive Systems Collaborative Innovation and Improvement Network (ECCS CoIIN). At least one of the identified communities in each state receives state and/or tribal MIECHV services. 

ECCS CoIIN Coordination Center

The Early Childhood Comprehensive Systems Collaborative Innovation and Improvement Network Coordination Center (ECCS CoIIN CC) manages, coordinates, and executes the CoIIN process with the ECCS Impact recipients and communities and guides and facilitates three successive 18-month CoIIN cohorts of one to five place-based communities per participating ECCS Impact grantee. 

To improve results for families, the ECCS CoIIN CC uses the following approaches:

  • collaborative learning, 
  • identification of core indicators/benchmarks, 
  • implementation of coordinated strategies, 
  • rapid tests of change, and 
  • real-time date and collective impact principles.

The ECCS CoIIN CC will provide intensive, targeted assistance to the ECCS Impact recipients in providing support to their identified place-based communities.

School-based Health CoIIN

National level school-based health data would improve our understanding of the needs and gaps at the local and state level and allow us to collectively solve those potential issues.

“Currently, school-based health care is not tied to standardized performance measures at the national level.”

Through a cooperative agreement led by the School-Based Health Allianceexit disclaimer icon CoIIN participants, including individual School-Based Health Centers (SBHC), sponsoring organizations, and community- and state-level organizations, aim to:

  1. Build the capacity to document and report SBHC performance measures, and
  2. Identify best practices to increase sustainable business practices of SBHC programs.

Participants receive ongoing expert-led trainings, personalized coaching, and technical assistance to support and guide program improvement.

Adolescent and Young Adult Health

Adolescent and Young Adult Health (AYAH) CoIIN

Adolescence and young adulthood are crucial developmental periods – where behaviors can impact both immediate and ongoing health outcomes.

“ Nearly ¾ of adolescents (age 12-17) had a well-visit check-up in the past year. ”

The aims of the Adolescent and Young Adult Health (AYAH) CoIIN are to identify and implement evidence-based strategies to increase access to, and the quality of, preventive health care visits for adolescents and young adults. The collaborative network currently includes five states: New Mexico, Texas, Iowa, Mississippi, and Vermont.

Cross-Cutting/Life Course

Children’s Healthy Weight CoIIN

The Children’s Healthy Weight CoIIN (CHW-CoIIN) supports states in adopting and implementing evidence-based or evidence-informed policies and practices related to nutrition, physical activity, and breastfeeding.

The goal is to increase the proportion of children and young adults ages birth to 21 years, including those with special health care needs, who fall within a healthy weight range.

The CHW-CoIIN acts as a catalyst for programmatic and systems-level change. It accelerates improvement and innovation in integrating and translating evidence-based or evidence-informed strategies to support states in achieving National Performance Measures (NPMs) related to nutrition, physical activity and breastfeeding.

Date Last Reviewed:  March 2018