addressing perinatal substance use, intimate partner violence & mood disorder screening in a...
TRANSCRIPT
Addressing Perinatal Substance Use, Intimate Partner Violence & Mood Disorder Screening
in a CPSP SettingUsing a Collective Impact Model
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
CityMatCH
• What is CityMatCH?• How your program might benefit?
http://www.citymatch.org/
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
CityMatCH Practice Collaborative to Prevent Substance Exposed Pregnancies
• Funded by CDC - National Center on Birth Defects and Developmental Disabilities
• Increase awareness of risks among health care providers
• Increase capacity to deliver screening & brief intervention services to women of reproductive age
• Six Teams: Baltimore, Dayton, Tampa, Denver, Portland, Sonoma
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Sonoma County Selected 3 Strategies
1. Screening & brief intervention of women seeking reproductive health services at 4 clinical sites
2. Decrease unintended pregnancy among women at high risk for continued use
3. Development of a community plan to address prescription drug misuse among women of reproductive age
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Adverse Childhood Experiences
• Context is key to successfully addressing perinatal substance us, IPV & mood disorder
http://www.cdc.gov/violenceprevention/acestudy/http://www.acesconnection.com/
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Collective Impact
• Public Health as the backbone organization in the collective impact process
• http://www.fsg.org/OurApproach/CollectiveImpact.aspx• http://www.ssireview.org/articles/entry/collective_impact
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Collective impact provide a structure for cross-sector leaders to forge a common agenda for solving a specific social problem
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Plan-Do-Study-Act
• Process matters – buy-in from team essential to success
• http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx• https://innovations.ahrq.gov/qualitytools/plan-do-study-act-pdsa-cycle
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Bundling Evidence Based Tools
• Preventing missed screening opportunities
• http://www.citymatch.org/sites/default/files/documents/bookpages/PESP%20final%20report.pdf
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
• Women screened for risky ETOH - 59% experienced DV/SA• Physically abused women - >7x risk of ETOH in pregnancy• Women with IPV - 20-38% have symptoms of depression• Teens in physically abusive relationships - 3-5x risk of pregnancy
Source: Family Violence Prevention Fund
Substance Use
Depressive
Disorders
Intimate Partner
Violence
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Local Pilot Results
70% of women screened for 1 or more areas• 20% ETOH - one third were < 21 yrs• 20% depressive disorder• 6% intimate partner violence• 18% marijuana• 42% of non-pregnant women reported using either
tobacco or marijuana • < ¼ providers assessed birth control
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SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Learnings
Marijuana, prevalence of IPV, and access to services for mood disorder
http://www.cdph.ca.gov/DATA/SURVEYS/Pages/default.aspxhttp://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
24,874 women - over a 7 year period of time …
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
The U.S. Surgeon General reported that smoking during pregnancy is responsible for 10% of all perinatal deaths. National Partnership to Help Pregnant Smokers Quit
Tobacco
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Partners Matter!
http://www.naccho.org/topics/environmental/pullingtogether/sectiontwo.cfm
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Sustainability
• Fit within CPSP! • Billable opportunities – demonstrated need
for behavioral health staff!
• http://www.cdph.ca.gov/programs/NutiritionandPhysicalActivity/Pages/MO-NUPA-SystemsandEnvironmentalChange.aspx
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Leveraging Data
• Leverage data to drive program change and resources
http://www.cdph.ca.gov/data/pages/default.aspx
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Pregnant women in Sonoma County don’t smoke & drink … right?
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
FAS and the Brain
A B C
MRI of the corpus callosum of A. a 14-year-old with a normal corpus callosum; B. a 12-year-old with FAS and a thin corpus callosum; C. a 14-year-old with FAS and agenesis (absence due to abnormal
development) of the corpus callosum.Source: Mattson, S.N.; Jernigan, T.L.; and Riley, E.P. 1994. MRI and prenatal alcohol exposure: Images provide insight into FAS. Alcohol Health & Research World 18(1):49–52.
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Ongoing …
• Printing, quality assurance …
SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTHSONOMA COUNTY DEPARTMENT OF HEALTH SERVICES PUBLIC HEALTH
Thank You!
Next ….
SBIRT Implementation ….