plan your work and work your plan: reframing our...
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PLAN YOUR WORK AND WORK YOUR PLAN: REFRAMING OUR APPROACH TO PRECONCEPTION HEALTH
Brenda Stubbs
Regional Program Coordinator
NC Preconception Health Campaign
September 2019
Jasmine Getrouw-Moore, MPA
NC Perinatal Health Strategic PlanAntonia S. Mead, PhD, MCHES
Jhonson C, Smith University
• This training was developed by the March of Dimes North Carolina
Preconception Health Campaign, under a contract and in collaboration
with the North Carolina Division of Public Health, Women’s Health
Branch.
• Special thanks to Dr. Antonia Mead, Johnson C. Smith University for her
partnership and contributions to today’s webinar.
• Wake AHEC for their support in providing continuing education credit for
this webinar
ACKNOWLEDGEMENTS
None of the presenters today, have any relationship with commercial
companies that could be perceived as a conflict of interest (within the past
12 months).
DISCLOSURES
• Obtaining continuing education credits:
If attending as a group, everyone must sign-in
on Wake AHEC Roster and email to:
Must be present for whole training
Complete evaluation up on receipt
• Questions
HOUSEKEEPING
Nursing: 1.5 Contact Hours
Wake Area Health Education Center (AHEC) Nursing Education is an approved provider of continuing nursing
education by the North Carolina Nurses Association, an accredited approver by the American Nurses
Credentialing Center’s Commission on Accreditation.
Wake AHEC CEU: Wake AHEC will provide 0.2 CEU to participants upon completion of this activity.
National Association of Social Workers (NASW)
NC AHEC is a 2019 NASW-NC approved provider of distance continuing education. This program has been
approved for 1.5 contact hours
A participant must attend 100% of the webinar to receive credit. Partial session credit will not be awarded.
Contact Hours: Wake AHEC will provide up to 1.5 Contact Hours to participants.
Wake AHEC is part of the North Carolina AHEC Program.
CREDITS
Plan Your Work and Work
Your Plan: Reframing Our
Approach to Preconception
Health
Jasmine Getrouw-Moore, MPA
October 2, 2019
Establishing Common Language
The Life Course Perspective
The Life Course Perspective offers a way of looking at health, not as disconnected stages unrelated to each other, but as an integrated continuum. This perspective suggests that the many facets of life contribute to health outcomes across the course of one’s life. It builds on public health and social science literature which highlight the influence of each stage of life on the next and shows how social, economic, and physical environments interact to have a profound impact on individual and community health.
Reference: City MatCH
Social Determinants of Health
Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.”
Health Equity
Reference: NC Office of Minority Health and Health Disparities North Carolina Equity Report 2018
The opportunity for everyone to have good health.
Examining Our Lives
Maslow’s Hierarchy of Needs
Biological and physiological needs- air, food, drink, shelter, warmth, etc.
Safety needs- protection from elements, security, order, law, stability
Love and belonging-friendship, intimacy, trust, etc.
Esteem Needs
Cognitive needs
Aesthetic needs
The Social Determinants of
Health
The Perinatal Health Strategic Plan• Framework is based on the
“12-Point Plan to Close the Black-White Gap in Birth Outcomes: A Life-Course Approach” developed by Lu, Kotelchuck, Hogan, Jones, Wright, and Haflon
• Broader focus encompassing infant mortality, maternal morbidity and mortality; and the health of women and men of childbearing age
• Data driven and focused on the best evidence available
• Infused throughout with issues of health equity and social determinants of health
The Perinatal Health Strategic Plan: Examining Our Communities
Goals and Points
Prioritizing Preconception Health
Goal 1 - Improving Health Care for Women and Men
• Point 2. Increase access to preconception health and health care to women and men
– Action Step 2B. Integrate preconception health (PCH) care and messages into primary care for women of reproductive age.
Prioritizing
Preconception Health
Goal 1 - Improving Health Care for
Women and Men
Point 3. Improve the quality of
maternal care (includes prenatal, labor,
delivery, and postpartum care)
Action Step 3B. Provide
evidence-based clinical
standards in prenatal care (e.g.,
early elective deliveries,
cesarean rate, 17-P, tobacco
cessation, hypertensive
disorders, gestational diabetes,
mental health, substance abuse,
intimate partner violence, etc.)
CLAY
POLK
CATAWBAROWAN
IREDELL
STANLY
DAVIDSON
RANDOLPH
MOORE
ANSON HOKE
CHATHAM
LEEHARNETT
ROBESONBLADEN
SAMPSON
COLUMBUS
BRUNSWICK
NEW
HANOVER
PENDER
AL
AM
AN
CE
CASWELLPERSON
WARREN
FRANKLIN
WAKE
NASH
JOHNSTON
WAYNE
DUPLIN
GREENE
LENOIR
PITT
JONES
ONSLOW CARTERET
PAMLICO
CRAVEN
HYDE
DARETYRRELL
BERTIE
MARTIN
HERTFORD
NORTHAMPTON GATES
HALIFAX
ROCKINGHAMSTOKESSURRY
FORSYTHGUILFORD
YADKIN
DAVIE
WILKES
GASTONCHEROKEE
SWAIN
MACON
GRAHAMJACKSON HENDERSON
RUTHERFORD
BUNCOMBE
MADISON
YANCEY
AVERY
CLEVELAND
LINCOLN
BURKE
UNION
CABARRUS
ASHE
WATAUGA
ALLEGHANY
CALDWELL
McDOWELL WILSON
VA
NC
E
CURRITUCK
BEAUFORT
NC Preconception Peer Educator Training Program
Active PPE Programs
1. Appalachian State University
2. East Carolina University
3. Fayetteville State University
4. Johnson C Smith University
5. Winston Salem State University
2019 - 2020
5 Basic PPE Trainings
4 – 5 Community Ambassador Trainings Targeting Active Programs
1 Spring Update for All PPEs
Targeted PPE Programs
1. Bennett College
2. Bladen Community College
3. Elizabeth City State University
4. NC A&T State University
5. NC Central University
6. Robeson Community College
7. Rockingham Community College
8. Shaw University
9. UNC-Chapel Hill
10. UNC-Greensboro
11. UNC-Pembroke
12. University of Mount Olive
13. Wingate University
Northeastern Region
TBD
Eastern Region
27 – 28 September, 2019 @ ECU
Southcentral Region
01 – 02 November, 2019 @ FSU
Triangle/Triad Region
15 – 16 November, 2019 @ NCCU
References and Helpful Resources
• NC Perinatal Health Strategic Plan
• NC Early Childhood Action Plan
• NC Social Determinants of Health by Regions
• Racial and Ethnic Health Disparities in North Carolina: Report Card 2010
• NC Health Equity Report 2018
• Healthy People 2020
• CityMatCH
North Carolina National
NC PRECONCEPTION HEALTH CAMPAIGN
Brenda Stubbs
Regional Program Coordinator
20
ABOUT US
• Originally established as NC Neural Tube Defects Task Force in 1994
• Renamed as the NC Folic Acid Council in 2000
• Became the NC Preconception Health Campaign in 2007
GOALS OF THE CAMPAIGN
• Initiative aimed at improving birth outcomes in NC by reaching out to women with important health messages before they become pregnant
• Work to reduce infant mortality, birth defects, premature birth, and chronic health conditions in women, while also aiming to decrease unintended pregnancies in NC
• Seeks to raise awareness and inspire positive action among the general public, health care professionals, and community agencies
HOW DO WE DO THIS?
• Manage the statewide multivitamin distribution program for health departments and safety-net providers to ensure that women have access to folic acid
• Conduct accredited, evidence-based trainings to healthcare providers in-person, at professional conferences and via webinars
• Train, educate and promote preconception health knowledge and behaviors among women and men of reproductive age
• Increase the public’s awareness about preconception health using media
WHY IS PRECONCEPTION HEALTH SO IMPORTANT?
Research shows that ONE-HALF of all infant mortality and morbidity are DIRECTLY RELATED to the health of the mother BEFORE she became pregnant!
*Mostly modifiable risks that we can help women change prior to becoming pregnant!
“OPPORTUNISTIC” CARE
Preconception care is for every woman of reproductive age every time she is seen, whether or not she is planning to become pregnant
• 54% of pregnancies in NC are unplanned
Every Woman, Every Time!
https://www.guttmacher.org/sites/default/files/factsheet/nc_18.pdf 25
Moos, MK. Connecting the Dots: Health Status Before Pregnancy and Pregnancy Outcomes. 2011
* *
FROM LINEAR CARE…
…TO A CIRCLE OF CARE
27
Opportunistic
preconception
health care
Improved
preconception
health
Early
prenatal
care
Healthy
outcomes
Transition to
medical home
STRATEGIES TO PROMOTE PRECONCEPTION HEALTH AND THE CIRCLE OF CARE IN YOUR COMMUNITY
• Practice Collective Impact: collaborate with other groups and
agencies that address women’s health across the life span
Infant Mortality Reduction Coalitions
Healthy Moms, Healthy Babies coalitions
Perinatal health groups and coalitions
Youth Programs
Mental Health and Wellness
• Create a county-wide referral list and a standard referral process
STRATEGIES TO PROMOTE PRECONCEPTION HEALTH AND THE CIRCLE OF CARE IN YOUR COMMUNITY CONT.
• Utilize state-wide resources to help patients/clients address high-
risk behaviors
• Utilize NCPCH Campaign as a resource for training, education and materials!
PROVIDER TRAININGS OFFERED
• Folic Acid, Multivitamins and Prevention of Neural Tube Defects.
• Healthy Weight Matters
• Reproductive Life Planning Counseling (5As)
• The 5As of Tobacco Cessation
• Encouraging Mental Wellness Across the Life Span
• Healthy Babies are Worth the Wait
• Cultural Diversity: Working with Latinxs in NC
*Free CEUs are provided for most trainings
WEBINAR SERIES FOR PROVIDERS
31
COMMUNITY EDUCATION
32
Clinical settings
Middle and High Schools
Community Based Organizations
Health Fairs
Places of Worship
Bridal Showers
Wedding Fairs
COMMUNITY AMBASSADORS & PROMOTORAS
Community Ambassadors & Promotoras
are trained volunteers and natural leaders
who…
o provide health education to their peers
o deliver multivitamins to women of child-
bearing age
o distribute educational material
o expand reach to community
33
PEER EDUCATION THEORY
● Sharing information and education through peer relationships with people who are “equals” and share a common experience and an element of trust
● Peer educator acts as facilitator/mentor rather than teacher
● Peer educators can reach wider audiences through non-traditional settings
34
MIDDLE AND HIGH SCHOOL CURRICULUM
FREE EDUCATIONAL MATERIALS
WEBSITES & SOCIAL MEDIA
English and Spanish
PSAS AND PAID MEDIA
TV PSA
Radio PSA
Learning About the
Preconception Peer
Educator Program
Antonia S. Mead, PhD, MCHES
Professor, Health Education
Department Chair, Health & Human Performance Department
Faculty Liaison, Smith Institute Center of Excellence in Minority Health & Family Wellness
What is the PPE program?
• May 2007, the Office of Minority Health (OMH), of the Department
of Health and Human Services launched A Healthy Baby Begins with You to raise awareness about infant mortality
• Focus on the African American community
• Created the Preconception Peer Educators (PPE) get message out to
target college age students
PPE Program Background
• Preconception Peer Educator program started in 2007 by
the Office of Minority.
• Pilot Locations: Fisk University, Spellman College, Morgan State
University, & University of Pennsylvania School of Nursing
• Goals of the Program
• “Reach the college-age population with targeted health messages
emphasizing preconception health and healthcare.
• Train minority college students as peer educators.
• Arm the peer educators with materials, activities and exercises to
train their peers in college and in the community at large.”
Courtesy of DHHS Office of Minority Health
PPE Program Background
• Over 1,500 Preconception Peer trained
• Locations include Maryland, Delaware, Louisiana, New York, Tennessee, Pennsylvania, Mississippi, Virginia, Georgia, California, Massachusetts, Kansas, Texas, Florida, Ohio, North Carolina, and New Jersey.
• Must complete training addressing 8 topics. Certification of completion from OMH.
• Health disparities and minority health; infant mortality; African American health status and its impact on infant mortality; preconception health; research on infant mortality and prematurity; preconception care; HIV, STDs and preconception health; male involvement.
Courtesy of DHHS Office of Minority Health
PPE Program Background (cont’d)
• Two tier process
• 1st certificate (Certificate of Completion) is for individuals who
have participated in the basic training that focuses on
preconception health and infant mortality prevention.
• 2nd certificate (Certificate of Recognition) is given after the
individual has participated in required activities and OMH
webinars. These individuals are certified as a Preconception Peer
Educator.
Courtesy of US DHHS Office of Minority Health
North Carolina Involvement• North Carolina Division of Public Health
• 2007 North Carolina Preconception Health Strategic Plan
• Pregnancy Medical Home
• Healthy Start /Baby Love Plus
• Young Moms Connect
• 18 Schools PPE trained since 2010 (5 currently active)
• March of Dimes North Carolina Preconception Health Campaign
• 2006 Folic Acid Campaign
• 2010 Preconception Health included in campaign. Healthy Before Pregnancy curriculum created.
Courtesy of Everywomansoutheast.org
2019-2020 NC Preconception Peer Educator Trainings
5 Basic PPE Trainings
4 – 5 Community Ambassador Trainings Targeting Active Programs
1 Spring Update for All PPEs
CLAY
POLK
CATAWBAROWAN
IREDELL
STANLY
DAVIDSO
N RANDOLPH
MOORE
ANSON HOKE
CHATHAM
LEEHARNETT
ROBESONBLADEN
SAMPSON
COLUMBUS
BRUNSWICK
NEW
HANOVER
PENDER
ALA
MA
NC
E
CASWELLPERSON
WARREN
FRANKLIN
WAKE
NASH
JOHNSTO
N
WAYNE
DUPLIN
GREENE
LENOIR
PITT
JONES
ONSLOW CARTERET
PAMLICO
CRAVEN
HYDE
DARETYRREL
L
BERTIE
MARTIN
HERTFORD
NORTHAMPTON GATES
HALIFAX
ROCKINGHAMSTOKESSURRY
FORSYTHGUILFORD
YADKIN
DAVIE
WILKES
GASTONCHEROKEE
SWAIN
MACON
GRAHAMJACKSO
N
HENDERSON
RUTHERFORD
BUNCOMBE
MADISONYANCEY
AVERY
CLEVELAN
D
LINCOLN
BURKE
UNION
CABARRUS
ASHE
WATAUGA
ALLEGHANY
CALDWELL
McDOWELL WILSON
VA
NC
E
CURRITUCK
BEAUFORT
Northeastern Region
TBD
Eastern Region
27 – 28 September, 2019 @ ECU
Southcentral Region
01 – 02 November, 2019 @ FSU
Triangle/Triad Region
15 – 16 November, 2019 @ NCCU
School Commitment
• Advisor responsible for guiding the students in the
development; implementation and monitoring of their
work plan and will also help to connect them with local
community organizations and health departments
• Training on campus
• Commit to at least 2 activities per semester
(campus/community)
JCSU Past Approaches to Educating
Community
Three Phases of Conception
Infant Mortality Fact Yards during Infant Mortality Awareness Month
Crisis in the Crib Viewing & Discussion
Program partnerships with Residence Life, Athletics
Off campus presentations at local churches and schools
Preconception Through the Arts
Homecoming giveaways (personal protection equipment)
Successes & Challenges
Successes
• Student-led initiative
• Additional organization for student involvement
• Attendees learned valuable information
• Primary prevention to multiple generations
• State support
Challenges
• Student-led initiative
• Vague topic to some
• Comprehension of the message
• Funding
• Program conflicts on campus
• Time commitment
QUESTIONS?
This Photo by Unknown author is licensed under CC BY-NC.
OUR TEAM!
Brenda Stubbs, Triad Regional Coordinator
Danielle Little, Eastern Regional Coordinator
Fiorella Horna, Latina Sana Campaign Coordinator
Rocío Anderson, State Director
Kelli McNair,Communication Coordinator
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