Promising Practice: Men in MCH

CityMatCH Conference 2008

September 20-23, 2008

Albuquerque, NM

Healthy Start, Inc.Pittsburgh/Allegheny County, PA

Michael Caliguiri, M.S.Field Manager

Benjamin DavisProgram Specialist

Healthy Start, Inc.  is supported in part by Project No. CFDA #93.926E from the Healthy Start Initiative, Division of Perinatal Systems & Women’s Health, Maternal & Child Health Bureau, Health Resources & Services Administration, and Department of Health & Human Services.

The Problems (Pittsburgh/ Allegheny County) African American (AA) infants dies at

almost 4 times the rate of whites while representing just over 10% of the total births*

80% of AA births are to unmarried women [almost 40% for whites]*

2xs as many LBW for African American as for Whites*

Teen birth rate (15-17yrs) for AA is 8 times higher than Whites (45/ 5.6)*

*PA Dept. of Health EPIQMS (2003-05)

The Mission

The mission of Healthy Start, Inc. is to focus primarily on the reduction of infant mortality and low birth weight babies in Southwestern Pennsylvania in such a way as to make valuable use of its resources, preserve its flexibility and continue to offer seamless services with the intent of improving the quality of life of infants, toddlers, youths, siblings, parents, and grandparents.

The Purpose To create and coordinate a

comprehensive system that ensures infants are born healthy into homes where they will be nurtured and valued.

To demonstrate innovative ways to reduce infant mortality in some of the areas with the highest infant mortality rate in the country.

Men Need What Women Need – Comprehensive Teams and Services

Care Coordination - Outreach Workers Health Screening & Education - Nurses Depression Screening & Referral -

PHQ-9 Assessment Tool by Pfizer, Inc. Targeted Case Management – CACs Program Evaluation – MIS Indigenous Personnel – HR

Successful Program Strategies

Indigenous Employees Holistic in Approach Community-Based & Culturally Sensitive Multi-Disciplinary Speak to Male-Specific Topics Collaborative Across Systems Outcomes-Oriented

IMPACTS (-)…

“Children who live absent their biological fathers are, on average, at least 2 to 3 times more likely to be poor, to use drugs, to experience educational, health, emotional and behavioral problems, to be victims of child abuse, and to engage in criminal behavior.”

IMPACTS (+)…

“Children with involved, loving fathers are significantly more likely to do well in school, have healthy self-esteem, exhibit empathy and pro-social behavior, and avoid high-risk behaviors such as drug use, truancy, and criminal activity.” –

-NFI; Father Facts, 4th Ed.

Male Initiative Program (MIP)

The purpose is to inform male partners and spouses of how influential they are to the outcome of a pregnancy and the ongoing health and well-being of their babies. 

Fathers/ male caregivers receive identical services to those of enrolled women, while individualizing plans to meet male-specific needs.

Core Services for Men: The Basics Male Friendly Language, Literature &

Materials Male Role Models & Examples Male Staff Activities & Events Flexible Schedule Skill Enhancement & Support

Depression Screening & Referral for Men• PHQ-9 (Pfizer) Self Assessment Tool• Specialized Training for Outreach Workers (Lay/

Non-Professional) on: Counseling Techniques of Dialectical Behavioral

Therapy (DBT) Where to Turn for Community Services and

Referral Procedures Administering and Scoring the PHQ-9

Depression Screening & Referral for Men Referral System

Community based SWHealth Start, Inc. SW

*DBT developed Marsha Linehan, M.D., Univ. of Washington

*DBT Training Developed in Conjunction with University of Pittsburgh, Western Psychiatric Institute & Clinic, Katherine Wisner, M.D

Build a Referral Network for Men! Local Health Providers Employment & Training Housing Authorities – City/County Local/ State Health Department Mental Health/ D&A Treatment Centers and

Systems Family Planning Child Protection Services

Evaluation

Participant Information Management System (PIMS)

Referral & Enrollment Database Case Management Forms

Life Skills Groups

“FAMILY” Focus NightMonthly education forums for fathers/ male Monthly education forums for fathers/ male

caregivers as well as mothers, children, and caregivers as well as mothers, children, and support personssupport persons

Promotes peer to peer (man to man) Promotes peer to peer (man to man) learning and discoverylearning and discovery

Increases empathy and understanding Increases empathy and understanding specific to gender roles and responsibilitiesspecific to gender roles and responsibilities

Life Skills Groups

Interactive Health Learning Mechanisms Roundtable Discussions

Building Blocks for Programs

Provide economic, social, and emotional support for parents

Use screenings, assessments, and evaluations to monitor well-being and plan next steps

Build on strengths of participants Educate staff and advocate for further

research

Linkage Across Services

Promoting Responsible Fatherhood Grantee 2006-2011Three Primary Components

1. Case Management/ Care Coordination for Fathers/ Male Caregivers

2. Healthy Marriage/ Cooperative Parenting Counseling

3. Domestic Violence Counseling and Education

Responsible Fatherhood Projected Impacts• Increase case management/ care

coordination service capacity by 350• Expand eligibility and scope of

participants• Strengthen parental involvement for 300

couples• Decrease in parental conflict via

Prevention (education) and Intervention (counseling)

Challenges

Literacy Mentality

ParentingEmploymentDepression

Advocacy Sustainability

Strategic Sustainability Planning o Should be a written document with specific

steps and outcomeso Include evaluation as part of planning (# of

months/ years)o Identify resources large and small and of

various systems (local/ federal; philanthropic)

o Assure that outcomes meet the mission of the funding sources you approach

o Sustainability is just as much collaboration and partnership as much as financial

Sustainability Evaluation(s)o Quantitative & Qualitative assessments to

determine impact of male-based programs on MHC outcomes (see poster display!)

o National Healthy Start Association Dad’s Matter Cohort (Ken Scarborough)

o National Responsible Fatherhood Clearinghouse

o Low/ No Cost strategies, tools, approacheso Timely submission of grant and other

required reportso Knowledge Dissemination across systems

Sustainability Successes Grantee for federal PRF/HM Community Development Block Grant (5K) –

marketing Department of Community & Economic

Development (30K) – personnel Heinz Foundation – non-federal match and

commitment to child health and development outcomes

DV, FQHC, Faith-based Partnerships (collaborative agreement + financial)

Family Support/ Head Start Center in-kind support and shared program capacity

Lessons Learned Strengthening entire families, especially

fathers, are proven strategies associated with childhood success.

Healthy Start has shown that local communities can, with support, develop and implement innovative approaches to reducing infant mortality

For more information about us,call the Healthy Start, Inc. Helpline at:

(412) 247-1000 or

(724) 425-1799or

visit our website at:www.healthystartpittsburgh.org

Healthy Start, Inc.

Healthy Start, Inc.  is supported in part by Project No. CFDA #93.926E from the Healthy Start Initiative, Division of Perinatal Systems & Women’s Health, Maternal & Child Health Bureau, Health Resources & Services Administration, and Department of Health & Human Services.