Pernet Family Health ServiceJosiah Bote, Meghan Grimes, Pamela Lu and Lauren Veit

Umass Medical School

Introduction

Service Project

Discussion

Methods

References

Pernet Family Health Service offers a variety of intervention programs to help families in need in the Worcester Area. We were able to experience many of these services by shadowing Pernet Staff members over our two week clerkship.

•Maternal Child Heath Nursing Visits: Nurses provide home care, education and support to new mothers referred by local hospitals, physicians, or community agencies.

•Fathers and Family Group: Provides fathers with the opportunity to share their experiences and support their efforts to strengthen their connection with their children.

•Parent Aides (Family Support Program): Complements the support families receive from the Department of Children and Families. Home visitors help families with household management, parenting skills and access to community resources.

•Early Intervention: Provides family centered developmental services for children ages 0-3 who are experiencing or are at risk of developmental delay.

•Emergency Assistance: Provides emergency food and infant supplies including formula, food, cereal and diapers.

1. www.pernetfamilyhealth.org

2. Pernet Family Health Annual Report, 2011

3. Search” United State Census 2010, n.d. Web.26 Ocv 2012. http://2010.census.goc/2010census/popmap/ipmtext.php

4. “Worcester Household Income Status” CLResearch.com. N.p., n.d. Web. 26 Oct. 2012. http://www.clrsearch.com/Worcester_Demographics/MA/Household-Income

5. Preventing Child Maltreatment and Promoting Well-Being: A Network for Action 2012 Resource Guide. Washington D. C.: U.S. Department of Health and Human Services’ Children’s Bureau, 2012.

5. Acts of Omission: An Overview of Child Neglect. Washington D. C.: Child Welfare Information Gateway: Children's Bureau, 2012.

6. DePanfilis, Diane. Child Neglect: A Guide for Prevention, Assessment, and Intervention. Washington D. C.: U.S. Department of Health and Human Services, Administration for Children and Families, Office on Child Abuse and Neglect, Children's Bureau, 2006.

7. Barnes-Boyd, Cynthia, Kathleen Fordham Norr, and Karla W. Nacion. "Promoting Infant Health Through Home Visiting By a Nurse-Managed Community Worker Team."Public Health Nursing 18.4 (2001): 225-35.

Our Service Project focused on creating an evidence-based tool to help Pernet measure outcomes of Maternal Child Health home nursing visits. Our tool is based on a three-visit model as most insurance companies tend to reimburse three postpartum home visits. This user friendly checklist assesses maternal knowledge and education, family resources, social situations and future goals. The tool allows the nurse to track progress in maternal education while also providing Pernet with a systematic approach to data gathering and outcome assessment.

Pernet Family Health Services targets families marginalized by poverty including multicultural and ethnic minorities living in the Worcester area particularly at risk for:

Results

Each year, Pernet provides services to the residents of Worcester and its surrounding metropolitan areas. Below is the data on the number of people served through Pernet’s services in the year 2011: •The Early Intervention Program - served 210 children•Young Parents Support Program - provided home visits for over 175 families•The Computer lab - had an average of 40 people a week•The Homework Club - grew to over 40 participants•The Fathers and Family Program – served over 200 men•Food pantry - served 3,219 families and 10,235 individuals•Over 350 Thanksgiving baskets were donated to families and and 1300 Christmas gifts were donated to client and children families•The Nursing Program served 215 families in their homes (Prenatal and post-partum women and their babies)

Pernet promotes family stability and works with families who have an increased risk for child abuse and neglect. Research shows that child abuse and neglect has significant long term consequences for children. The areas primarily affected include:

•Health and physical development: malnourishment, impaired brain development, delays in growth or failure to thrive

•Intellectual and cognitive development: poor academic performance, delayed or impaired language development

•Emotional and psychological development: deficiencies in self-esteem, attachment or trust

•Social and behavioral development: interpersonal relationship problems, aggression, conduct disorders

The Nurse-Family Partnership is the organization on which the Maternal Child Health Program is based. A 15 year follow-up study showed:

•48% reduction in child abuse and neglect•59% reduction in arrests among children•72% fewer convictions of mothers•56% reduction in emergency room visits for accidents and poisonings •67% reduction in behavioral and intellectual problems among children

For Future Physicians:•Appreciating the role of community health services •Realizing that how patients present in the office is not necessarily indicative of their home environment•Appreciating that socioeconomic factors play a major role in health disparities including access to resources and health education•Understanding the community population that you serve •Obtaining a knowledge base of the community resources available for patient referral including private organizations like Pernet and Government programs like WIC, Food Stamps and Medicaid •Remembering that as a physician you can be an effective advocate for health policy reform

Other Observations•Many of the parents we worked with were limited in their capacities as parents by cognitive deficiencies making basic activities and daily scheduling difficult•Many of the subsidized housing options available for low income families are unclean and located in unsafe neighborhoods •Most of the parents that we worked with genuinely wanted to be good parents but lacked the resources or education in order to do so•We worked with many parents who grew up in poverty and were victims of abuse and or neglect•The Green Island area lacks the capacity to be a supportive and nurturing environment to its residents based on the disjointed layout of the neighborhood, the lack of nearby school, the plethora of abandoned buildings, the high frequency of absentee landlords and the lack of community center and community activities to draw residents together

The Pernet Family Health Service primarily serves the City of Worcester. Below are the family income, and population by race data for the city of Worcester:

In addressing these risk factors, Pernet and other similar agencies work to promote family stability and stronger communities thus preventing child abuse and neglect with the hopes of giving children the tools to lead successful lives.

Population Health Clerkship Team 22: Parenting and Family Stability