PLAN YOUR WORK AND WORK YOUR PLAN: REFRAMING OUR …everywomannc.org/wp-content/uploads/2019/10/MOD-NCPHC_Preco… · REFRAMING OUR APPROACH TO PRECONCEPTION HEALTH Brenda Stubbs

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:

[email protected]

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

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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

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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

Contact Information

• Dr. Antonia Mead, [email protected], 704-378-1236

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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