Workgroup: Infant Mortality Coalition
The Infant Mortality Coalition is formed
to address infant health disparities and ultimately reduce inequities in infant mortality in Ingham
County. The overarching goal of the initiative is to keep mothers and infants
alive and well before, during and after birth. It also serves as the advisory group to the FIMR (Fetal and Infant Mortality Review) team.
The Infant Mortality Coalition meets on the 4th Thursday of
every month, usually from 1:30 - 3:30pm in the Sparrow Hospital RNICU Conference Room in Lansing.
For more information on this Coalition and the meetings contact Lisa Chambers at the Ingham County Health
Department:
LChambers@ingham.org
Lisa Chambers
Jump Start/MIOP/NAOP Coordinator
Ingham
County Health Dept
5303 S Cedar, Lansing
517-272-4122
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Infant Health Disparities/
Infant Mortality Coalition
Minutes Thursday May 28, 2009
Sparrow RNICU
Present: Debby Starnes (ICHD), Sarah
Bryant (ICHD), Jennifer Lawson (CAUW), Carol Buzzita (EPO), Ruby Rogers
(GLAAHI), Marcie Schwartz (ICHD0, Sandy Gellar (Sparrow), Evelyn Taylor
(Sparrow clinic)
- Welcome and introductions, All
- Approval of the April minute
deferred
- No other additions to the
agenda
- New business
- FIMR
findings/recommendations, Marcie Schwartz-. Will schedule meeting with director of Sparrow ED to
identify a process to share findings related to ED care of pregnant
women.
- Funding: Sarah Bryant reported that that due
funding cuts from the executive order from the Governor, not new mothers
will be added to the Interconception Care project (currently 20 mothers
enrolled). Will continue to use
already acquired resources and services will continue to be provided by
PHN. Funding for FIMR may
continue if Ingham receives a Healthy Start Grant.
- Old business (20 minutes)
- Work group updates
i.
Access
to Prenatal Care, Kathy Way No report
ii.
Smoking
Cessation, Tiffany Doolittle
House
Calls received second year grant form Legacy
- Community Updates
i.
Great
Start Collaborative, Ken Sperber No report
ii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant No report
iii.
Neighborhood
Network Centers
Working
to bring the Pastors “on-board” and encourage them to support pregnant mothers
to receive care.
iv.
Tomorrow’s
Child, Rachel Copeland No report
- Other announcements
- Shared minutes from Power of
WE coalition meeting.
- Future agenda items
i.
Common
screening tool for community
ii.
Development
of tool that Mothers carry to record visits to any health care provider
iii.
Plan
Fall Lunch and Learn- possibly have a personal “story” about how attitudes and
treatment effect mothers and their returning for care.—(front office staff)
Next meeting:
Thursday June 25, 2009
1:30-3:30pm Sparrow RNICU
Infant Health Disparities/Infant
Mortality Coalition
Thursday May 28,
2009-1:30pm
Infant Health Disparities/
Infant Mortality Coalition
AGENDA Thursday May 28, 2009
Sparrow RNICU
Welcome and introductions, All
- Agenda additions
- Approval of minutes for
April (if available)
New business- FIMR
findings/recommendations, Marcie Schwartz
- Potential impact budget cuts
- Future plans
Old business - Work group updates
i.
Access
to Prenatal Care, Kathy Way
ii.
Smoking
Cessation, Tiffany Doolittle
- Community Updates
i.
Great
Start Collaborative, Ken Sperber
ii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
iii.
Neighborhood
Network Centers
iv.
Tomorrow’s
Child, Rachel Copeland
- Other announcements
Next meeting: June 25, 2009
Infant Health Disparities/
Infant Mortality Coalition MINUTES Thursday April 23-1:30pm
Sparrow NICU
Present: Sandy
Geller (NICU), Tiffany Doolittle (ICHD), Ruby Brown (GLAAHI), Jennifer Lawson
(CAUW), Kathy Brandenburg (Tomorrow’s Child), Sheri McCluen (NWI), Debbie
Edokpolo (ICHD), Marcie (ICHD/FIMR), Lisa Chambers (ICHD), Rachel Copeland
(Tomorrow’s Child).
- Welcome and introductions, All
- Approval of 3/26/09 minutes-approved
with Kathy Brandenberg added to the list of meeting attendees.
- New business:
- Updates on April training
i.
Overall,
evaluations were very positive (see attached).
Seven attendees expressed interest in receiving additional information
focused on the work of the IM Coalition.
Discussion over seeing if they would be able to attend a meeting or at
least send information to this group.
ii.
Six
to seven different practices attended, though no representation from Ingham
practices. Discussion focused on
establishing a personal connection (either via phone or in person) with IRMC
practices for future trainings; as well as hosting at Dawe Auditorium next time
to see if that would impact attendance.
- Planning for future events
i.
Plan
events for Fall 09, Spring 10, and Fall 10.
Ideas included:
1.
FIMR
data presentation/updates
a.
Continue
with information dissemination, but provide more details
b.
Glean
ideas of where to take the findings
c.
Assessment
tool usage
2.
Focus
group session
a.
Brief
updates followed by three key questions
3.
Service
provider panel
a.
Incorporate
someone who can tell their story
ii.
Future
incorporation of other service providers who are impacted such as Medicaid,
dentists, Emergency Departments.
iii.
Need
to present as a community health issue by involving groups such as the Power of
We, Board of Health, Board of Commissioners, etc.
iv.
Discussion
of web presence (Facebook, website) Next meeting: Thursday May 28, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Coalition Minutes Thursday March 26-1:30pm
Sparrow RNICU
Present: Lisa Chambers (ICHD), Dawana Ben (NWI), Kevin Benson (ICHD
Resident), Jennifer Lawson (CAUW), Ken Sperber (GSC), Debbie Edokpolo (ICHD),
Marcie Schwartz (ICHD/FIMR), Rubie Zuchowski (ICHD), Kathy Way (ICHD), Rachel
Copeland (Tomorrow’s Child), Sarah Bryant (ICHD), Debby Starnes (ICHD), Ruby
Brown (GLAAHI), Sandy Geller (Sparrow), Sheri Eldred (March of Dimes); Katie,
Hallie, Lauren (MSU Nursing students).
- Welcome and introductions, All
- Approval of 2/26/09 minutes
- Agenda additions-none noted
- New business (90 minutes)
- Planning for April training
i.
Sponsorship
information should be acknowledged on print materials ii.
Include
information/contacts for persons interested in joining the IMC, along with a
one pager describing the purpose of the coalition
iii.
Other
logistical information (including budget, food, resource packets, information
tables, speakers, and evaluation) was discussed by the group.
- FIMR findings/recommendations,
Marcie Schwartz
i.
Discussion
of how we might approach the use of a psycho-social assessment tool at the
April training. Several were shared with
the group, and the recommendation was to include a question on the evaluation
asking practices about their use of such a tool.
- Old business (20 minutes)
- Work group updates
i.
Access
to Prenatal Care, Kathy Way-tabled
ii.
Smoking
Cessation, Tiffany Doolittle-tabled
- Community Updates
i.
Great
Start Collaborative, Ken Sperber
1.
Ken
shared that there was a proposed 2010 budget elimination for a number of
maternal/child issues, and discussed the potential impact of the economic
stimulus package.
2.
The
GSC recently submitted four mini-grants to the Community Foundation to expand
some of its initiatives (play and learn sites, literacy events, and
others).
3.
Lansing’s 150 year celebration is holding
a parade on May 16, and the GSC is looking to march to support of early
childhood issues.
ii.
March
of Dimes, Sheri Eldred
1.
Sheri
shared several MoD data updates that included decreases in preterm birth and
their 4 point plan to continue to address this issue.
2.
Community
grants-letters of intent due April 3; if selected full proposals will be due
September 2009.
3.
The
March of Dimes walk will be held on April 25 at Riverfront Park.
iii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
1.
Close
to 20 women are enrolled in the project.
2.
Sarah
introduced the MSU nursing students who worked on a project to introduce the IC
project into the WIC office.
iv.
Neighborhood
Network Centers
1.
Some
discussion over discrepancies in information shared with prenatal women
(alcohol use) and its impact on miscarriage and overall prenatal
education.
v.
Tomorrow’s
Child, Rachel Copeland
1.
Sudden
Unexplained Infant Death webcast available on project impact website (http://www.sidsprojectimpact.com/)
2.
Rachel
shared a new safe sleep DVD and solicited feedback from the group.
- Other announcements (10 minutes)
- The group decided to move
forward with holding an April meeting.
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday March 26-1:30pm
Sparrow RNICU
- Welcome and introductions, All
- Approval of 2/26/09 minutes
- Agenda additions
- New business (90 minutes)
- Planning for April training
i.
Update
on budget
ii.
Food
update
iii.
Resource
packet updates
iv.
Information
tables
v.
Speakers
update/talking points
vi.
Evaluation
- FIMR
findings/recommendations, Marcie Schwartz
- Old business (20 minutes)
- Work group updates
i.
Access
to Prenatal Care, Kathy Way
ii.
Smoking
Cessation, Tiffany Doolittle
- Community Updates
i.
Great
Start Collaborative, Ken Sperber
ii.
March
of Dimes, Sheri Eldred
iii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
iv.
Neighborhood
Network Centers
v.
Tomorrow’s
Child, Rachel Copeland
- Other announcements (10 minutes)
Next meeting: Thursday April 23, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative MINUTES Thursday February 26-1:30pm
Sparrow RNICU
Present: Ruby
Brown (GLAAHI), Jennifer Lawson
(CAUW), Debby Starnes (ICHD), Lisa Chambers (ICHD), Debbie Edokpolo (ICHD),
Sarah Bryant (ICHD), Marcie Schwartz (ICHD/FIMR), Ken Sperber (GSC), Carol
Buzzita (EPO), Tiffany Doolittle (ICHD), Sandy Gellar (Sparrow), Katie (MSU
nursing student), Jackie (MSU nursing student), Anne (U of M intern), Judy Dekun
(IRMC), Rachel Copeland (TC), Sheri Eldred (MoD).
Welcome and introductions, All
- Approval of 1/22/09 minutes
i.
Ruby
Brown’s name was changed to correct a typo listing her as Ruby Rogers.
- Agenda additions
i.
None
noted.
New business (90 minutes)
- Planning for April training
i.
Update
on budget
Secured
funding includes: $500 from the League
of Women Voters, $150 from Community Churches, and $100 from the Capital Area
United Way. Jennifer is also looking
into the possibility of additional funds from the Sparrow Foundation.
A draft of an invite was shared and the group provided feedback. Lisa will e-mail the mailing list to Sandy
so that the invitations can be sent out.
Lisa
will contact several catering options to plan for food
ii.
Resource
packet updates The
coalition will purchase folders to distribute at the event. The folders will contain the key pieces of
information that we want all participants to be able to take with them.
Additionally,
there will be information tables available for participants to collect
additional information from. Lisa will
contact individual agencies to determine their participation at the event.
iii.
Speakers
update/talking points
Draft
agenda:
12-12:15:
Registration and lunch
12:15-12:20:
Welcome, purpose (Sandy)
12:20-12:35: Dr.
Renee Canady, ICHD
12:35-12:50: Dr.
Ira Gewolb, Sparrow RNICU
12:50-1: Question
and Answer, visit info tables, evaluation, wrap up
A
‘running loop’ of Q + A focusing on infant mortality
information/statistics/medical access/enrollment with graphics was proposed to
run for the first 15 minutes while participants registered and got their
food. Lisa will work on and send to the
group for feedback.
Lisa
will work with Marcus Cheatham, the ICHD’s information officer to see how we
might get some media coverage for the event.
iv.
Evaluation
Tabled
until next meeting - FIMR
findings/recommendations, Marcie Schwartz
i.
Recommendations
are attached.
ii.
Additional
discussion focusing on benefits at DHS.
It was shared that when cash assistance and Medicaid are ‘batched’
together, it prolongs a client’s ability to receive benefits.
Old business (20 minutes)
A. Work group updates
i.
Access
to Prenatal Care, Kathy Way
Continued
discussion of implementing a mini-PRAMS study at area delivery hospitals,
particularly focusing on issues of access to care.
Include
access information/data in Renee’s talking points.
ii.
Smoking
Cessation, Tiffany Doolittle
Working
to complete a local prevention resource assessment looking at what kinds of
smoking cessation services and supports are available.
The
group is looking to do some outreach activities at sites such as bus stations
and homeless shelters.
B. Community Updates
i.
Great
Start Collaborative, Ken Sperber
1.
The
GSC is pursuing a fund mapping project looking at what funds are available for
families and young children in Ingham County.
ii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
1.
Sarah
reported that she has 17 women enrolled in the MDCH interconception care
project.
2.
MSU
students approached Sarah to get a better sense of the services that she
provides, as well as some of the larger issues impacting IM in Ingham County. They will work with several coalition
members to develop an ‘access to prenatal care’ video/clip.
iii.
Neighborhood
Network Centers
1.
No
report.
iv.
Tomorrow’s
Child, Rachel Copeland
1.
New
safe sleep DVD will be finalized and available soon.
2.
Looking
to do some promotional/media events focusing on safe sleep for Safe Sleep month
in September. Current ideas include a
display at the ICHD, and working with area newspapers to develop
articles/information pieces.
Other announcements (10 minutes)
- March of Dimes grants are
available; letters of intent will be due in May 09.
- Expectant Parents
Organization is having their annual auction on March 25.
Next meeting: Thursday March 26, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative AGENDA February 26, 2009 1:30pmSparrow RNICU
- Welcome and introductions, All
- Approval of 1/22/09 minutes
- Agenda additions
- New business (90 minutes)
- Planning for April training
Update
on budget
i. plan
for food
ii.
Resource
packet updates
iii.
Speakers
update/talking points
iv.
Evaluation
v.
Finalized
mailing list
- FIMR
findings/recommendations, Marcie Schwartz
Old business (20 minutes)
- Work group updates
i.
Access
to Prenatal Care, Kathy Way
ii.
Smoking
Cessation, Tiffany Doolittle
- Community Updates
i.
Great
Start Collaborative, Ken Sperber
ii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
iii.
Neighborhood
Network Centers
iv.
Tomorrow’s
Child, Rachel Copeland
- Other announcements (10 minutes)
Next meeting: Thursday March 26, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative MINUTES Thursday January 22-1:30pmSparrow RNICU
Present: Anne
Stone (Sparrow), Debbie Edokpolo (ICHD), Debby Starnes (ICHD), Sarah Bryant
(ICHD), Jennifer Lawson (CAUW), Carol Buzzita (EPO), Ken Sperber (GSC), Ruby
Rogers (GLAAHI), Lisa Chambers (ICHD), Marcie Schwartz (ICHD), Kathy Way
(ICHD), Sandy Gellar (Sparrow), Ira Gewolb (Sparrow), Tiffany Doolittle (ICHD),
Claudia Blazen (CAMW), Judy Dekun (IRMC).
- Welcome and introductions, All
- The 12/11/08 minutes were
approved with the addition of Jennifer Lawson to the attendees.
- No other additions to the agenda
- New business (90 minutes)
- Planning for a community
event for office managers focusing on IM, All
I.
Logistics
1.
Events
are planned and reserved on 4/21 at Sparrow (Clark Conference Center) and 4/29
at Ingham Regional (Dawe Auditorium)
2.
Both
events roughly will run 11-1:30
3.
Costs
(food, copies, materials, other?)
a.
Projected
food costs around $500
4.
Funding
sources
a.
March
of Dimes funding not available due to budget cuts. Coalition members agreed to check with the following sources to
fund the event:
i.
League
of Women Voters (Debby)
ii.
Greater
Lansing Convention Bureau (Jennifer)
iii.
MDCH
(Lisa)
iv.
Area
churches (Ruby)
v.
Each
member was also asked to approach their own agency to look into the possibility
of contributing $100 for the events.
vi.
Need
to include list of sponsors on all promotional and event materials.
b.
If
funding not available, the group will make alternate arrangements for sharing
information (possibly a packet of information)
5.
Marketing
materials
a.
Work
group to develop save the date postcard/letter to send out to potential
attendees. Members included: Sandy, Lisa, and Sarah.
II.
Content/Message
1. Core
concepts:
a. Ingham
County data (Lisa will send out prior to the next meeting)
b. Local
resources
2. Dialogue
with participants: what else would be
helpful to you
3. Format
a. Proposed
speakers included Dr. Renee Canady to focus on the local data and efforts, and
Dr. Ira Gewolb to focus on the NICU experience
III.
Local
resources
1.
Focus
on looking at the gaps in existing resources in the community.
2.
Format
suggestions included both an information packet and resource tables for
participants to visit at the event.
Ideas included:
a.
Great
Start Collaborative
b.
Tomorrow’s
Child
c.
Early
On
d.
ICHD/FIMR/HMBB
e.
EPO
f.
Postpartum
Depression support groups
3.
Work
group to develop packet of materials includes:
Debby S, Debbie E, and Ken.
IV.
Evaluation
1.
Sandy
and Anne will work to develop a pre-post test
V.
Goals for February meeting
1.
Clarification of what to include
in a resource packet
2.
Evaluation
3.
Finalized mailing list
4.
Update on budget/plan for food
FIMR
findings/recommendations, Marcie Schwartz-No report
- Old business (20 minutes)
- Work group updates
i.
Access
to Prenatal Care, Kathy Way
1.
Kids
Count data shared that demonstrates a 127% worsening in access to prenatal care
in Ingham County between 2000 and 2006.
ii.
Smoking
Cessation, Tiffany Doolittle
1.
House
Calls has enrolled 60+ moms in home based smoking cessation efforts.
2.
Project
is working to bring more community players to the table. Ideas included bus stops/stations, domestic
violence and homeless shelters.
Community Updates
i.
Great
Start Collaborative, Ken Sperber
1.
Shared
information on the recent Kids Count press release
2.
Parent
education coalition working to do play and learn groups for specific
groups: teens, homeless families,
refugees, and those at Food Bank sites.
3.
Pediatric
medical home conference at Lansing Center on 2/13
4.
Maternal/perinatal
health conference-3/4
ii.
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
1.
Fourteen
moms enrolled in HMBB
2.
Commonalities
include: need to connect with a medical
home, working with moms to make them feel comfortable in a primary care
situation, transportation
iii.
Neighborhood
Network Centers
1.
No
report
iv.
Tomorrow’s
Child, Rachel Copeland
1.
Next
safe sleep meeting-2/9 at 9am
2.
Safe
sleep display at Coming together for children conference at LCC and Women’s
Expo at Lansing Center
- Other announcements (10 minutes)
- Information shared on MSU
students who are interested in working on the issue of IM and need a
community service project.
Next meeting:
Thursday February 26, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday January 22,
2009 1:30pm
Sparrow RNICU
Welcome
and introductions, All
Approval
of 12/11/08 minutes
Agenda
additions
New
business (90 minutes)
Planning
for a community event for office managers focusing on IM, All
Logistics
Dates
- April 21 (Tuesday) and April 29 (Wednesday)?
Locations
Costs
(food, copies, materials, other?) and funding sources
Marketing
materials
Content/Message
Core
concepts:
Dialogue
with participants:
Format?
Presenter (s) vs. round table
Local
resources
What
to include
Format
Evaluation
Pre-post
test
FIMR
findings/recommendations, Marcie Schwartz
Old
business (20 minutes)
Work
group updates
Access
to Prenatal Care, Kathy Way Smoking
Cessation, Tiffany Doolittle
Community
Updates
Great
Start Collaborative, Ken Sperber
MDCH
Grant updates, Lisa Chambers/Sarah Bryant
Neighborhood
Network Centers
Tomorrow’s
Child, Rachel Copeland
- Other
announcements (10 minutes)
Next
meeting: Thursday February 26, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative Meeting Minutes Thursday
December 11, 2008-1:30pmSparrow
RNICU
Present:
Lisa Chambers
(ICHD), Ruby Brown (GLAAHI), Jeanne Sullivan (Tomorrow’s Child),
Judy Dekum (IRMC), Kathy Way (ICHD), Dr. Ira Gewolb (Sparrow),
Tiffany Doolittle (ICHD), Debby Starnes (ICHD), Marci Schwartz
(ICHD-FIMR), Sheri Eldred (March of Dimes), Sandy Gellar (Sparrow)
Welcome
and introductions, All
The
minutes from 10/23/08 were approved.
There
were no additions to the agenda.
New
business (90 minutes)
Planning
for a community event focusing on IM, All (60 minutes)
Focus
on training for office managers
Judy
(IRMC) will check on Dahl Auditorium for both dates; need to do
the same for Sparrow
Looking
at existing tools (MIHP screener suggested) to determine how to
refer clients for services
Suggestion
made to develop brochure with pullout information; some concern
over keeping information up to date
There
was much discussion on local data, implications, and the nature of
disparities in Ingham County.
Developing
a dialogue with the audience (office managers) to determine what
they can do in reducing IM in Ingham County. Suggestions
included:
Early
recognition (of both pregnancy and preterm labor)
Transportation
Where
to refer for services
Messaging
of infant mortality, MSU students (10 minutes)
Power
point put together by MSU students shared with the group. The
group wanted to add some additional data, particularly local data
looking at the disparities in our community; as well as local
resources.
Healthy
Start grant submission (10 minutes)
ICHD
submitted the Healthy Start grant to focus local efforts on ways
to reduce IM and the disparities that exist in our community.
Efforts include: perinatal system mobilization, community based
organization, and direct service. Direct service will focus
broadly on women at risk for a negative pregnancy outcome as well
as those women who have already experienced a negative outcome
(prematurity and/or low birth weight).
Expected
to hear back from HRSA in June 2009.
FIMR
findings/recommendations, Marcie Schwartz (10 minutes)
Four
cases reviewed since last presentation. Findings included:
Providers
need knowledge about DHS resources
Need
for comprehensive psycho-social issues
Increased
cultural knowledge and translation services particularly for
refugees
Information
on connecting women to hospital with RNICU if experiencing
preterm labor
Need
for additional perinatologists in our community
Protocol
for post assessment of stillborns
Protocol
for pediatricians with positive pregnancy tests
Old
business (30 minutes)
Work
group updates
Access
to Prenatal Care, Kathy Way
Working
to develop a list of prenatal providers who accept Medicaid along
with a handout that could be used at a pregnancy test (including
local resources, the importance of prenatal care).
Still
in discussions to determine how the group might administer focus
group or hospital questionnaire (a mini PRAMS); looking to
complete by spring.
Smoking
Cessation, Tiffany Doolittle
Shared
information on the House Calls project through the American
Legacy Foundation which targets pregnant and parenting women who
are enrolled in home based services through the ICHD (Public
Health Advocates/Nurses).
Suggestion
made to look at March of Dime funding for continuation of
services. Expected release of information date in May 2009.
Community
Updates
Birth
to Five Coalition, Ken Sperber-no report
MDCH
Grant updates, Lisa Chambers-no report
Neighborhood
Network Centers-no report
Tomorrow’s
Child, Mary Adkins
Received
a HRSA grant to serve as a communication hub between local and
state services/programs. Will work with target 11 communities
through MDCH
Coalition
structure and purpose, All
Revised
draft purpose of Coalition-tabled
The
IMI 2008 WORK PLAN-tabled
Other
announcements (10 minutes)
No
other announcements
Next
Meeting January 22, 2009 1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative Meeting Minutes October 23, 2008
Present: Lisa Chambers (ICHD),
Marcie Schwartz (ICHD), Ruby Brown (GLAAHI), Carol Buzzita (EPO),
Sandy Gellar (Sparrow), Jennifer Lawson (CAUW), Lyndsey Soetgen
(Sparrow intern), Ken Sperber (GSC), Kathy Brandenberg (Tomorrow’s
Child), Jo, Sandra Enness (MSU student), Jo Mcglew (MSU Student)
Shannon Hurst (Sparrow intern), Janet Bowen (ICHD), DaWana (NWI)
Welcome and introductions
September minutes approved
No additions to the agenda
New business
Infant mortality messaging
MSU students approached the IMC
to see how they might approach some messaging concepts focusing on
infant mortality. Sandy E. and Jo attended the meeting in order
to follow up with the larger coalition members. Key points
included:
The need to define the
intervention strategy (early prenatal care or interconception
care), desired behavior change, target audience, potential
barriers, benefits, demographics, age, race, and timelines.
Develop a comprehensive
community picture of infant mortality and the work of the IMC.
Developing multiple media
strategies (brochures, video to use in DHS lobby to use with
different audiences to use in different kinds of media.
Incorporate a life course
perspective in messaging-for a message to be successful, it must
include more than one aspect
Ideas/next steps included:
Piloting interconception
messages at different sites (for example: a provider on the
North side, ICHD, a sole provider)
General community education and
awareness as a starting point, but what do I do about it.
Bring more people to the table
and raise awareness of the concern
Planning for a community event
Carol brought a list for OB
providers who deliver at Sparrow deliveries (24), still need
providers who deliver at IRMC (ICHD, IRMC-Meridian, Dewitt)
The group felt that office
manager and nurse managers should be the target for the community
event. Inviting two staff from each office, 60 attendees is
target
Do we want to host two events?
One at IRMC (work with Janet/Jodi to get auditorium availability)
and one at Sparrow.
Tentative dates include: April
21 (Tuesday) and April 29 (Wednesday)
Key components to share with
this group includes:
Data: rates of deaths, who’s
dying/when,
Reasons why IM occurs (Note:
include impact of stress-racism controversy-cite Dr. Lu’s
research)
Strategies that providers can
become engaged in/resources available in the community.
The group also felt it was
important for this to be a two-way conversation, so that we learn
from providers as well. Ideas shared included:
What are the gaps that you know
in the community?
What can we do to get you that
information?
Would you be willing to come
back in 6 months to talk about some solutions?
What happens to women who get
kicked out of a practice for missing appointments?
A workgroup format was suggested
to begin the process of planning the event. Activities should
include:
Identify relevant
print/resource materials/reference materials, including: 211,
current system and initiatives, other psycho- social issues that
impact a woman’s outcome on pregnancy.
Content/Messaging
Logistics
Assessment piece-opening
questions
Suggestion to develop a
pre-post test to best determine what providers know about infant
mortality using survey wizard.
Healthy Start grant
Currently being written to focus
work on reducing infant mortality/disparities in Ingham County.
The grant is due in early December and Lisa shared the current
proposal, which includes: a Perinatal System Coordinator, a
Community Coordinator, and direct services to high risk women and
women who have experienced a negative pregnancy outcome.
FIMR findings
Major findings: DHS
problems-woman didn’t understand how to take time off to get
circlage; DHS reports time for bed rest for women who need it.
Discussion about impact of cultural issues this woman didn’t
know that she could ask questions from findings.
CAT recommendations: Invite
DHS to community event, and invite IMC to DHS meeting
Old business
The Ingham County Great Start
Collaborative is working on a fund mapping project to identify
funding streams for projects/initiatives that impact families and
young children.
Next meeting: December
11-1:30-3:30
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday August 28,
2008-1:30pm
Sparrow RNICU
Welcome and introductions, All (10
minutes)
a. Approval
of 7/24/08 minutes
Agenda
additions
New business (60 minutes)
a. Planning
for a community event focusing on IM, All
i.
Focus on training for office managers
FIMR
findings/recommendations, Marcie Schwartz
Old business (40 minutes)
Work
group updates
i.
Access to Prenatal Care, Kathy Way
ii.
Smoking Cessation, Tiffany Doolittle
Community
Updates
i.
Birth to Five Coalition, Ken Sperber
ii.
MDCH Grant updates, Lisa Chambers
iii.
Neighborhood Network Centers
iv.
Tomorrow’s Child, Mary Adkins
Coalition
structure and purpose, All
i.
Revised draft purpose of Coalition
ii.
The IMI 2008 WORK PLAN
Other announcements (10 minutes)
NOTE LOCATION CHANGE:
Next Meeting: September 25, 2008 1:30pm,
Capital Area MI Works-Lake Michigan room
(2110 S. Cedar Street)
Infant Health Disparities/
Infant Mortality Initiative MINUTES 7/24/08
Sparrow RNICU
Present: Debbie Edokpolo (ICHD), Kathy Way
(ICHD), Peggy Roberts (PoW), Marcie Schwartz (FIMR), Claudia Blazen (CAMW),
Jennifer Lawson (CAUW), Ken Sperber (GSC), Sandy Geller (Sparrow), Janet Bowen
(ICHD), Maria Zavala (NWI), Sheri Eldred (March of Dimes), Debby Starnes
(ICHD), Lisa Chambers (ICHD).
- Welcome and introductions, All (10
minutes)
- Approval
of 6/26/08 minutes
- Approval
of agenda/revised format
- New business (60 minutes)
- March
of Dimes resources, Sheri Eldred
i.
Focus of MoD is preconception through the child’s first year
of life, and targets all women of childbearing age.
ii.
Peri-stats section of the MoD webpage provides local data that
can be imported into presentations and resources.
iii.
Sheri shared a number of materials and resources with the
group. If anyone is interested in
ordering, contact Sheri at 699-4863 x10 or seldred@marchofdimes.com to see if
she may be able to get them at a reduced cost.
iv.
MoD has pregnancy tests available. Contact Sheri for more information.
v.
Community grants available in January of each year which may
be able to help with the planning of the sessions described below.
- Planning
for a community event focusing on IM, All
i.
Incorporating FIMR findings/recommendations, Marcie Schwartz
(please see attached).
ii.
Clarifying the message:
what is the take home message that we want the community to hear?
iii.
Process:
1.
Slogan
2.
Marketing (possible connection to MSU students)
3.
Education
a.
Community (network centers, faith based, etc.)
b.
Office managers (lunch)
c.
Physicians-OB/GYN providers (dinner)
4.
Content: TBD, but
include both a general overview of the data locally, and link to community
based resources. Also include
handouts/brochures, ordering information, websites.
5.
Next meeting will focus on plans for training for office
managers, through the connections that Sparrow has.
- Old business (40 minutes)
- Work
group updates
i.
Access to Prenatal Care, Kathy Way
1.
Working to develop resource list
2.
Planning focus groups for fall (women and providers) and will
tie those into/collaborate with the event above.
ii.
Smoking Cessation, Tiffany Doolittle
1.
Working to find a way to get women to ‘tell their story.’
- Coalition
structure and purpose, All-TABLED
i.
Revised draft purpose of Coalition
ii.
The IMI 2008 WORK PLAN
- Community
Updates
i.
Birth to Five Coalition, Ken Sperber
1.
League of Women Voters is looking to host five community
forums focusing on children and health issues.
They will be looking for community partners to participate in the
trainings.
ii.
FIMR Updates, Marcie Schwartz
1.
Tabled
iii.
MDCH Grant updates, Lisa Chambers
1.
Three clients enrolled in the interconception care project,
two additional clients pending.
iv.
Neighborhood Network Centers
1.
Maria reported that she reached out to the other Network
Center Outreach Coordinators to encourage them to attend the IMI meetings.
2.
The Northwest Initiative is hosting a family event on Friday
July 25, 2008.
v.
Tomorrow’s Child, Mary Adkins
1.
No report
- Other announcements (10 minutes)
- Community
baby shower on August 23 sponsored by DRM
- Baby
shower on August 11 at the ICHD sponsored by MSUE/WIC
- Home
visiting grant focusing on reducing child abuse and neglect not submitted
locally; state level agencies submitted.
- The
September meeting will take place at Capital Area Michigan Works
- Meeting
successes: plan of work, tangible
project to work on
- Meeting
challenges: need to streamline
time allocations to adequately reflect discussions
Next Meeting: August 28, 2008, 1:30pm,
Sparrow RNICU
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday July 24,
2008-1:30pm
Sparrow RNICU
- Welcome and introductions, All (10
minutes)
- Approval
of 6/26/08 minutes
- Approval
of agenda/revised format
- New business (60 minutes)
- March
of Dimes resources, Sheri Eldred
- Planning
for a community event focusing on IM, All
i.
Incorporating FIMR findings/recommendations, Marcie Schwartz
- Old business (40 minutes)
- Work
group updates
i.
Access to Prenatal Care, Kathy Way
ii. Smoking Cessation, Tiffany Doolittle
- Coalition
structure and purpose, All
i.
Revised draft purpose of Coalition
ii.
The IMI 2008 WORK PLAN
- Community
Updates
i.
Birth to Five Coalition, Ken Sperber
ii.
FIMR Updates, Marcie Schwartz
iii.
MDCH Grant updates, Lisa Chambers
iv.
Neighborhood Network Centers
v.
Tomorrow’s Child, Mary Adkins
- Other announcements (10 minutes)
Next Meeting: August 28, 2008 1:30pm, Sparrow RNICU -----------------------------------------------------------------------------------------------
Ingham County Infant Mortality Initiative Purpose
Draft
Infant mortality is a complex
issue confounded by a combination of medical and psycho-social factors which
impact our community’s youngest members in a measure that has long been seen as
a community’s overall wellbeing.
Common medical factors that influence infant mortality include
inadequate prenatal care, prematurity, low birth weight babies, substance use
including smoking during pregnancy, and other maternal complications including
sexually transmitted infections and the impact of periodontal disease. Psycho-social factors are sometimes more
difficult to track and include issues of housing, unemployment, education, and
neighborhood environments.
Michigan’s overall infant
mortality rate of 7.4% has continued to remain higher than the national
average. This picture is further
clouded by the differences among those rates, which result in a disparity that
is three times higher for African American babies. In Ingham County’s overall infant mortality rate of 7.1% is
comparable to the state’s rate; though further examination raises the
discrepancies described earlier. In
Ingham County, the African American infant mortality rate is 20.1%. When compared to the White infant mortality
rate of 4.3%, we notice that an African American baby is nearly five times as
likely to die before its first birthday when compared to a White baby (Michigan
Department of Community Health, 2007).
To address these issues, the Ingham County Infant
Mortality Initiative (IMI) began in 2005.
The group is made up of representatives of organizations throughout the
Capital Area who are dedicated to addressing increasing disparities of infant
mortality rates in our community. The
initiative does this by working to address issues that impact infant mortality,
including
Ø
Prevention of
prematurity and increased access to prenatal care;
Ø
Substance use, including
improving smoking cessation efforts;
Ø
Maternal complications
including sexually transmitted infections
An innovative and critical
component of the initiative is the incorporation of efforts to combat health
inequities in each of the focus areas described above. Since such broad disparities among rates of
infant mortality exist within Ingham County, efforts will be targeted towards
to African American women in our community, with the expectation that the
lessons learned will then be translated into efforts with additional
groups.
This initiative also works closely in partnership with
the Ingham County Great Start Collaborative/ Birth to Five Subcommittee and the
Safe Sleep Coalition to provide seamless services for women and families in
Ingham County. Additionally, the IMI
serves as the Community Action Team for the Ingham County FIMR (Fetal Infant
Mortality Review); providing guidance in implementing strategies aimed at
reducing fetal and infant losses.
The IMI functions to develop a culture of agency
collaboration and communication. Its
primary foci include:
1) Serving as a clearing house through information sharing
and dissemination
2) Avoid redundancy and programmatic overlap by
identifying gaps in services
3) Building inter-agency rapport and partnerships
4) Legislation information and advocacy
Infant Health Disparities/
Infant Mortality Initiative
Meeting Notes 6/26/08
Sparrow RNICU
Present: Ken Sperber (GSC), Sandy Geller (Sparrow), Marcie
Schwartz (ICHD/FIMR), Jennifer Lawson (CAUW), Sarah Bryant (ICHD/PHN), Ira
Gewolb (MSU), Tiffany Doolittle (ICHD/PHN), Jeanne Sullivan (Tomorrow’s Child),
Kathy Brandenberg (Tomorrow’s Child), Lisa Chambers (ICHD), Maria Zavala
(Northwest Community Initiative).
- Welcome and introductions, All (10
minutes)
- Approval
of 5/22/08 minutes
- Approval
of agenda
- Concluding discussion-coalition
structure and purpose, All (60 minutes)
- Revised
draft purpose of Coalition
i.
Please see attached
- The
IMI 2008 WORK PLAN
i.
Nominate co-chairs
1.
Sandy Geller, Sparrow RNIC, agreed to act as co-chair for the
IMI.
ii.
GOAL #4. Expand
NETWORKING by identifying and engaging with community entities that have a role
to play in eliminating infant health disparities in Ingham County.
1.
Following discussion of this item, the suggestion was made to
bring the groups described in the goal together in a community dialogue type of
event. Planning will begin at the July
meeting.
iii.
GOAL #5. Deepen the
general public’s understanding of the ways infant health disparities affect
families and the overall quality of life in our community. Motivate broad OWNERSHIP of the problem and
a COMMITMENT to take action to eliminate these infant health disparities.
1.
Tabled.
- Work group updates (10 minutes each)
- Access
to Prenatal Care, Kathy Way
i.
The group did not meet so there was no report.
- Smoking
Cessation, Tiffany Doolittle
i.
Tiffany shared a number of resources and information from a
training that she had recently attended.
These will be incorporated into intervention strategies focusing on
smoking cessation efforts.
ii.
The next meeting is scheduled for Thursday July 24 at 9am.
- Community Updates (20 minutes)
- Birth
to Five Coalition, Ken Sperber
i.
Finalizing grant opportunity through the Community Foundation
and Capital Area United Way.
ii.
Working on a grant opportunity focusing on home visitation to
prevent child abuse and neglect.
- FIMR
Updates, Marcie Schwartz
i.
New reporting format was shared and approved for the
group.
- MDCH
Grant updates, Sarah Bryant
i.
Plans have been finalized to move forward with a partnership
at the Sparrow RNICU.
ii.
Program overviews were shared with members.
iii.
The project currently has two clients enrolled, with up to
four additional women pending.
- Neighborhood
Network Centers
i.
No report.
- Tomorrow’s
Child, Mary Adkins
i.
Reminder about the TC grief/interconception care project which
can serve a very broad population.
ii.
Kristin Patmos left TC and her position is posted online.
iii.
The Safe Sleep Coalition is scheduled to meet in August and
plans to partner with the Literacy Coalition to host a booth at their annual
mall event.
- Announcements (10 minutes)
Next
Meeting: July 24, 2008-1:30 pm Sparrow
RNICU Conference
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday June 26, 2008-1:30pm
Sparrow RNICU
AGENDA
- Welcome and introductions, All (10
minutes)
- Approval
of 5/22/08 minutes
- Approval
of agenda
- Concluding discussion-coalition structure
and purpose, All (60 minutes)
- Revised
draft purpose of Coalition
- The
IMI 2008 WORK PLAN
i.
Nominate co-chairs
ii.
GOAL #4. Expand
NETWORKING by identifying and engaging with community entities that have a role
to play in eliminating infant health disparities in Ingham County.
iii.
GOAL #5. Deepen the
general public’s understanding of the ways infant health disparities affect
families and the overall quality of life in our community. Motivate broad OWNERSHIP of the problem and
a COMMITMENT to take action to eliminate these infant health disparities.
- Work group updates (10 minutes each)
- Access
to Prenatal Care, Kathy Way
- Smoking
Cessation, Tiffany Doolittle
- Community Updates (20 minutes)
- Birth
to Five Coalition, Ken Sperber
- FIMR
Updates, Marcie Schwartz
- MDCH
Grant updates, Lisa Chambers
- Neighborhood
Network Centers
- Tomorrow’s
Child, Mary Adkins
- Announcements (10 minutes)
- Home
visitation to prevent child abuse and neglect grant opportunity
Next
Meeting: July 24, 2008
Infant Health Disparities/
Infant Mortality Initiative MINUTES Thursday May 22, 2008
Ingham County Health Department, Conference Room C
Present: Sarah
Bryant (ICHD/PHN), Debbie Edokpolo (ICHD/MIOP), Jeanne Sullivan (Tomorrow’s
Child), Janet Bowen (ICHD/PHN), Hollie Hammel (Allen Neighborhood Center),
Peggy Roberts (Power of We), Ken Sperber (Great Start Collaborative), Maria
Zavala (Northwest Initative), Ira Gewolb (Sparrow), Sandy Gellar (Sparrow),
Kathy Way (ICHD/WH), Lisa Chambers (ICHD/JS/MIOP).
- Welcome and introductions, All (10
minutes)
- Approval
of 4/24/08 minutes-the title of the document was changed to ‘minutes’ and
subsequently approved by the group.
- Approval
of agenda-the agenda was approved b the group
- Concluding discussion-coalition structure
and purpose, All (60 minutes)
- DRAFT-purpose
of Coalition
i.
There was discussion about adding additional data to this
statement, including (1) factors that impact infant mortality-including
medical, social, and post-natal; (2) demographic data about the issue in our
community; and (3) specific statistics about each of the target areas described
below.
ii.
Additional conversation about changing language of focus areas
to include: (1) prevention of
prematurity and improved access to prenatal care; (2) broadening to the impact
of substance abuse (from just smoking), and the inclusion of a new target to
include (3) sexually transmitted infections.
iii.
The purpose will be revised and brought back to the coalition
for further input.
- The
IMI 2008 WORK PLAN
i.
GOAL #2. Establish and
define the operating STRUCTURE for the Coalition, including clear roles and
responsibilities for the oversight body, leadership, member organizations, work
groups, and staffing.
1.
Two co-chairs will be identified at the June 2008 meeting.
2.
A reporting template will be established for the FIMR process
to share with the larger coalition.
3.
The remaining items under goal 2 will be adjusted for
completion status and shared at the next meeting.
ii.
GOAL #4. Expand
NETWORKING by identifying and engaging with community entities that have a role
to play in eliminating infant health disparities in Ingham County.
1.
Tabled until June
iii.
GOAL #5. Deepen the
general public’s understanding of the ways infant health disparities affect
families and the overall quality of life in our community. Motivate broad OWNERSHIP of the problem and
a COMMITMENT to take action to eliminate these infant health disparities.
1.
Tabled until June
- Work group updates (10 minutes each)
- Access
to Prenatal Care, Kathy Way
i.
There was discussion on getting additional data about the
number of providers trained in Ingham County.
This could include the number of:
deliveries, infant mortality rates among area counties, NICU beds,
perinataologists. This information will
be brought to the next full coalition meeting, along with information from the
2006 Black infant death certificates to glean the causes of death.
ii.
There were some additional thoughts about adding some
activities focusing on the impact of substance abuse, dental care, and
involving those providing direct service to this high risk group of women.
iii.
Objective three-Develop plan to increase access to care for
those who are uninsured-add language about the online Medicaid enrollment
system.
iv.
Objective four-Develop patient education strategies to convey
what is included in comprehensive prenatal care-look to March of Dimes
community grants for additional supports.
- Smoking
Cessation, Tiffany Doolittle
i.
There was discussion about the Legacy foundation grant, and
the supports that will be built in to the home based services already being
provided through the work of Public Health Nurses and home visiting
Advocates.
ii.
Additional thoughts about connecting to alternative education
sites to share information in a less threatening way.
- Community Updates (20 minutes)
- Birth
to Five Coalition, Ken Sperber
i.
Information about the Capital Area United Way-Community
Foundation grant and the services/supports that have been submitted for
approval.
- FIMR
Updates, Marcie Schwartz
i.
No report.
- MDCH
Grant updates, Lisa Chambers
i.
Forms and flyers have been developed for use with the
interconception care project.
- Neighborhood
Network Centers
i.
Maria Zavala (Northwest)-there has been a change in focus to
work with more prevention initiatives; canvassing continues
ii.
Hollie (Allen)-canvassing, some discussion about doing some
short presentations or surveys at their farmer’s market.
- Tomorrow’s
Child, Mary Adkins
i.
Discussion about their connection to the Refugee Coalition and
the impact that the group may have in looking at culturally appropriate
approaches to grief/loss.
- Announcements (10 minutes)
- A
Community Conversation about infant safe sleep: “Why aren’t you listening?” Tuesday June 10 in Detroit.
- Unnatural causes presentations
through the ICHD.
Next
Meeting: June 26, 2008-1:30pm
Sparrow
RNICU
Infant Health Disparities/
Infant Mortality Initiative AGENDA Thursday May 22,
2008
Ingham County Health
Department, Conference Room C
- Welcome and introductions, All (10
minutes)
- Approval
of 4/24/08 minutes
- Approval
of agenda
- Concluding discussion-coalition structure
and purpose, All (60 minutes)
- DRAFT-purpose
of Coalition
- The
IMI 2008 WORK PLAN
i.
GOAL #2. Establish and
define the operating STRUCTURE for the Coalition, including clear roles and
responsibilities for the oversight body, leadership, member organizations, work
groups, and staffing.
ii.
GOAL #4. Expand
NETWORKING by identifying and engaging with community entities that have a role
to play in eliminating infant health disparities in Ingham County.
iii.
GOAL #5. Deepen the
general public’s understanding of the ways infant health disparities affect
families and the overall quality of life in our community. Motivate broad OWNERSHIP of the problem and
a COMMITMENT to take action to eliminate these infant health disparities.
- Work group updates (10 minutes each)
- Access
to Prenatal Care, Kathy Way
- Smoking
Cessation, Tiffany Doolittle
- Community Updates (20 minutes)
- Birth
to Five Coalition, Ken Sperber
- FIMR
Updates, Marcie Schwartz
- MDCH
Grant updates, Lisa Chambers
- Neighborhood
Network Centers
- Tomorrow’s
Child, Mary Adkins
- Announcements (10 minutes)
- A
Community Conversation about infant safe sleep: “Why aren’t you listening?” Tuesday June 10 in Detroit.
Next Meeting: May 22, 2008-1-3pm Ingham
County Health Department, Conference Room C
Infant Health Disparities/
Infant Mortality Initiative AGENDA & NOTES Thursday April 24,
2008Ingham County Health
Department, Conference Room C
Present: Peggy Roberts, Power of
We; Sarah Bryant, PHN/ICHD, Sarah Brown, Resident; Ken Sperber, Great Start
Collaborative; Kristin Patmos, Tomorrow’s Child; Mary Adkins, Tomorrow’s Child;
Carol Buzzita, Expectant Parents Organization; Jeanne Sullivan, Tomorrow’s
Child; Kathy Brandenburg, Tomorrow’s Child; Debbie Edokpolo, MIOP/ICHD; Lisa
Chambers, ICHD; Amy Moore, Health Promotion/ICHD; Janet Bowen, PHN/ICHD;
Kimberly Fiero, PHN/ICHD, Yvonne Phillips, Mayor’s office/Great Start
Collaborative; Sandy Geller, Sparrow NICU.
- Welcome and introductions, All (10
minutes)
- Minutes
dated 3/27/08 were approved by the group.
- The agenda
was approved for today and as a format as a standing agenda. The one change noted was that Amy
Moore was speaking on behalf of Tiffany Doolittle for the smoking
cessation work group.
- Continued discussion-coalition structure
and purpose, All (45 minutes)
- Adjustments
to the IMI 2008 WORK PLAN
i.
There was discussion of the scope of the infant mortality
initiative-is the scope too narrow as written?
Should goals be re-written to broaden our work to include all groups?
ii.
There was some concern over the visual diagram that had been
drafted to display the various workgroups of the IMI. Many felt that the ‘silo’ visual didn’t adequately capture how
many of the different issues impacted each other (smoking, for example).
iii.
There was additional discussion about how the IMI relates or
collaborates with the Birth to Five Coalition in order to draw in the larger
early childhood community.
iv.
Representatives from the ICHD, IMI, Birth to Five, Tomorrow’s
Child, and the Power of We Consortium are meeting on May 9. The IMI will wait for feedback from that
meeting before moving forward.
- DRAFT-purpose
of Coalition
i.
Tabled for the next meeting.
- Meeting
time/date change?
i. Tabled for further discussion/clarification.
- Work group updates (10 minutes each)
- Access
to Prenatal Care, Kathy Way
i.
The group is looking to conduct additional focus groups to
hear from women and community based workers.
The group is planning to work with Renee and Doak to best facilitate the
process.
- Grief
support, Mary Adkins
i.
There was discussion about developing a series of trainings/
community conversations/ a speaker’s bureau focusing on grief.
ii.
There was additional discussion about the impact of language
and cultural beliefs in pregnancy.
Tomorrow’s Child is planning to send someone to the Immigrant and
Refugee Coalition, which meets the second Monday of each month at 9am at 801
South Waverly.
- MDCH
Grant updates, Lisa Chambers
i.
The grant has refocused its efforts to include those women who
have experienced a negative pregnancy outcome, including low birth weight and
preterm delivery.
ii.
The goal is to target 25 Black women who have experienced such
an event and work with them for up to two years to delay their next pregnancy.
iii.
Sarah Bryant is the Public Health Nurse working on the
project, along with a Maternal Infant Outreach Program (MIOP) Advocate.
- Safe
sleep, Carol Buzzita
i.
The group did not meet, and is now likely looking to move back
to its initial schedule of the fourth Monday of every month at 9am.
- Smoking
Cessation, Amy Moore
i.
The group felt that they needed clarification on the proposed
structure of the coalition and subseqent work groups. Additionally, as described earlier, there
needed to be clarification as to who the target population should be (Black
women or all smokers).
- Community Updates (10 minutes)
- Birth
to Five Coalition, Ken Sperber
i.
The Birth to Five Coalition/Great Start Collaborative has been
selected by the Capital Area United Way and Capital Region Foundation to
receive a grant aimed at improving school readiness.
ii.
Funding will be up to $225K each year for three years. If there are ideas to submit for funding
consideration, please contact Ken.
- FIMR
Updates, Marcie Schwartz
i.
Marcie was out ill, so there was no FIMR report.
- Neighborhood
Network Centers
i.
No report from the network centers.
- Tomorrow’s
Child, Mary Adkins
i.
Tomorrow’s Child will hold a statewide project focusing on
safe sleep in hospitals on April 29.
ii.
The Association of Infant Mortality Professionals will host a
training September 18-19 in Dearborn.
There will be a medical examiner panel, which will focus on how to
determine the cause of death.
iii.
Kathy shared that the women served through the Interconception
Project very much appreciated the grief services available through Tomorrow’s
Child.
- Announcements (5 minutes)
- Reducing
Infant Mortality in Michigan:
Lessons From the Field-May 5 at the Lansing Center
Next Meeting: May 22, 2008-1-3pm
Ingham
County Health Department, Conference Room C
Safe Sleep Coalition &
Infant Mortality Initiative
Joint Meeting Reminder 3/27/2008
JOINT MEETING SAFE SLEEP & INFANT
MORTALITY COALITIONS
on 3/27/08 from 1-3pm
at Ingham Human Services Bldg
5303 S Cedar Lansing, MI 48911
(Conf Rm C)
AGENDA Thursday March 27,
2008
- Welcome and introductions
- Safe Sleep Updates, Carol Buzzita
- MDCH Grant updates, Lisa Chambers
- Other grants updates
- FACT and Fatherhood
- Legacy Foundation
- Healthy Start
- March of Dimes
- FIMR Updates, Marcie Schwartz
- IMI 2008 ACTION PLAN, Doak Bloss
- Unnatural
Causes: PBS Health Disparities
documentary
- Reducing Infant Mortality In
Michigan: Lessons From the
Field-May 5
- Power
of We Presentation: March 28,
2008
- Other?
Next Meeting: April 24, 2008-1-3pm
Ingham
County Health Department, Conference Room C
Infant Health Disparities/
Infant Mortality Initiative
IMI Meeting Reminder 1/24/2008Our next Infant Mortality Meeting is scheduled for Thursday January 24 from 1-3pm in conference room C at the ICHD. At this meeting, we will finalize our plans for our work in 2008 and beyond. A reminder that our meetings will always take place on the fourth Thursday of each month from 1-3pm, and we are scheduled in Conference Room C at the ICHD for the rest of the year. Thanks,
Lisa
LChambers@ingham.org
Lisa Chambers, MSW
Jump Start/MIOP/NAOP Coordinator
Ingham County Health Department
5303 South Cedar
Lansing, MI 48911
Phone: 517.272.4122
Fax: 517.887.4384
Infant Health Disparities/
Infant Mortality Initiative
Please click on the link below to view the Powerpoint presentation focusing on the current Ingham County IM data that was presented at our last coalition meeting (on 11/27/07). ICHD Comprehensive Infant Mortality Strategy Planning
Infant Health Disparities/
Infant Mortality Coalition
Infant Mortality Initiative
Report on Planning
Work – September 27, 2007
BACKGROUND. The Infant Mortality Initiative is engaged in
a planning process to define its future work, based upon the five
recommendations generated in July.
Earlier decisions that were reached include the following:
- The name of the collaborative is
changed to “The Infant Mortality Initiative,” because the prior name
(Infant Health Disparities Coalition) was derived from the state grant and
did not reflect the real focus of the group.
- The
IMI is a collaborative of the Power
of We Consortium. Its work is
complementary to the work of another PWC collaborative, the Birth to Five Subcommittee (which
is also known as the Great Start Collaborative). Because the IMI focuses on infant mortality explicitly and
the Birth to Five Subcommittee on early child development, the two
collaboratives should not be redundant or duplicative.
- As
issues are surfaced by the IMI that require policy or community action that is beyond the scope of the IMI
to effect, they should be brought to the PWC. The IMI should also regularly look for opportunities to
convene community members and organizations to raise awareness of infant
mortality concerns through the PWC.
- The
IMI should have two co-chairs,
ideally one with a “community” orientation and one with and
institutional/agency affiliation; and the latter should not necessarily “default”
to ICHD. Co-chairs should act as
facilitators of the group’s work, striving for forward motion as defined
by the priorities of the action plan.
- Two standing items should appear on
all meeting agendas: a report
on the IHD grant, and the provision of information from the FIMR. Once the current planning process is
complete, qualitative discussion on FIMR information should be a major
part of the regular meetings.
- A template for meeting minutes should
be developed, one that clearly identifies decisions reached on tasks to be
completed (who/what/by when).
- The
IMI will not have standing subcommittees, but rather will work through task-oriented, time-limited work
groups to advance specific action steps as they are defined.
- ICHD
will explore whether clerical
support can be donated to support the initiative’s work.
There are three areas of work that need to be addressed in
the planning process:
Ø What
specific issues/actions should the IMI prioritize in the coming year?
Ø How
should the IMI expand its networking and communication with other groups whose
work relate to infant mortality?
Ø How
should the IMI deepen public understanding of infant mortality?
DISCUSSION OF
PRIORITY ACTIONS
As a step toward determining the issues the IMI might focus
on in the coming year, Renee Canady presented information from focus groups
held in 2005 under the direction of Public Sector Consultants, which were used
to inform the original plan as part of the state grant. Participants discussed this information in
“open dialogue” format. At the October
meeting, it will engage in a more structured dialogue to determine an
appropriate priority focus for action.
The following points were made:
- Ingham
County focus group participants were hesitant to acknowledge racism as a
problem in accessing services (unlike participants in other Michigan
cities). However, they also spoke
of being ignored, minimized, or not getting their questions answered. Important issues that emerged in Ingham
County were bias based on the absence of fathers; class bias (reflected in
differences in treatment based on insurance/coverage type); bias against
teenage parents; fear of Child Protection Services and distrust of DHS and
other systems.
- The
idea of “planning” pregnancy was understood in many different ways by
focus group participants, i.e. planning for conception, planning for
pregnancy, and planning for motherhood.
Fatalism and resignation were common themes, and it was clear that
the participants did not share the conventional understanding of
“planning” as used by providers and health educators.
- Concluding
impressions of the focus groups were that we need to:
- Better
understand the relationship between women’s perceptions and health
institution goals;
- Understand
our role in advocacy;
- Validate
women’s experiences; and
- Change
practice to better reflect the context of care as suitable to all
patients (including under-represented, at-risk populations).
- It
was noted that the drop in infant mortality in 2006 coincides with the
first year of the Safe Sleep campaign.
- Regarding
the discussion of different care for different types of insurance
coverage, it was noted that this would also usually involve seeing a
different provider (one who takes Medicaid or IHP). Many ICHD patients plainly distinguish
between coming to the health department and “seeing a real doctor,”
despite messages to the contrary.
It was noted that many patients in Women’s Health are seen by
residents, and that there are more support services available to women
going to Child Health.
- Regarding
the confusion about “planning,” members of the group noted that:
- Condoms
were seen as expensive by many, and that lots of women don’t have access
to other forms of birth control.
- Taboos
in education confuse the issue, i.e. being able to talk about
reproduction but not sex in school; abstinence-only messages.
- For
girls under 16, there is often no connection made between having sex and
making babies. Also for younger
girls, a common presentation is “I don’t plan to have sex,” but the
desire for a relationship is
strong, and leads them to sexual activity.
- An
aspect of the “culture of poverty” is that young women and girls don’t
recognize that control is an
option. When social workers or
nurses try to empower them to communicate with their provider, the patient
can get discouraged by the provider’s attitude. (Example: a woman phoned
her provider because her baby would not stop crying and was repeatedly
told “That’s what babies do.”)
Empowering patients requires that we work with providers as well.
- Addressing
the absence/presence of fathers, members of the group noted the following:
- The
presence of a father can improve the power dynamic between patient and
provider.
- The
father’s involvement may be negative or even hazardous if the woman is in
an abusive relationship with the father.
Rather than assuming positive involvement of the father, it’s
important to ask women, “Who in your life is making you feel safe?”
- In
the focus groups and in the literature, there is evidence of differing
relational patterns by race. For
example, the involvement of the mother’s mother is seen as a stressor for
white women, and a positive influence for black women.
Asked to sum up what this conversation implied about
strategies of reducing disparities in infant mortality in Ingham County,
participants suggested the following:
- We
need to work with providers as well as patients: providing knowledge and background while validating concerns
on both sides.
- By
“providers,” we mean doctors, nurses, and all levels of health center
staff. Agency staff don’t
necessarily understand the clients we serve and the issues they face.
- We
need to understand issues of generational poverty and what it means to
function in a world defined by that experience: how do we break the cycle?
(Activities, educational/support tools)
- We
need to help clients “problem-solve,” moving from “do for” to “do with”
and “cheer on.”
Asked what we could do to pursue these strategies,
participants suggested:
- Bring
more people to the table. Outline
what each organization does related to their involvement with the Infant
Mortality Initiative. Organize the
available resources in the community.
- Prioritize
tasks. (Example: the Tobacco Task Force prioritized
reducing smoking during pregnancy.)
NEXT MEETING
At the October 25 meeting, we will attempt to narrow down
the possible focus for action, based on the September conversation and any
other information members bring to the table.
If time allows, we will also brainstorm strategies for expanded
networking and increased public understanding of infant mortality disparities.
Infant Health Disparities/
Infant Mortality Coalition
AGENDA Thursday August
23, 2007, 1-3pm
Ingham County MSU
Extension Conference Room
- Welcome and introductions
- Project updates
- Grant updates and training
opportunities, Lisa Chambers
- FIMR Updates, Marcie Schwartz
- Thoughts about the Coalition from a
state and local perspective, Dr. Canady
- The future of the Coalition, a
continuing conversation
facilitated by Doak Bloss
- Set next meeting date
- Other?
Infant Health Disparities Coalition (IHDC)
8/23/07 Meeting Reminder
Our next meeting will take place on Thursday August 23 from 1-3pm. We will again meet in the MSU Extension Conference Room, located at the Human Services Building (5303 South Cedar). At that time, we will continue our facilitated discussion with Doak Bloss.
Please contact me with any questions.
Thanks,
Lisa
Lisa Chambers, MSW
Jump Start/MIOP/NAOP Coordinator
Ingham County Health Department
5303 South Cedar
Lansing, MI 48911
Phone: 517.272.4122
Fax: 517.887.4384
Infant Health Disparities Coalition (IHDC)
AGENDA Monday July 30, 2007Conference Room
C-Ingham County Health Department
Welcome and introductions
Project updates Renee Canady-Deputy Health Officer,
Nursing and Special Services
Marcie Schwartz, FIMR Coordinator
The
Status of Young Children in Ingham County-Report to the Community on the
well-being of Ingham County’s young children and their families-2007
The Birth to Five Ingham Great Start Collaborative
The future of the Coalition-Doak Bloss
Other?
Infant Health Disparities Coalition (IHDC)
Infant Health Disparities Coalition
Report on Planning Session – June 28, 2007
On June 28, 2007, members of the the Infant Health
Disparities Coalition (also referred to as “the collaborative” in this report) met
to assess the group’s progress since the creation of the 2006 Implementation
plan, and begin a process of considering ways to re-energize the
collaborative’s work. The overall Focus
Question to be answered by the session was “What do we need to do to improve this
collaborative’s effectiveness in reducing disparities in infant mortality in
Ingham County?”
Process: The session began with a review of the
five major goals of the 2006 plan, and the strategies and action steps related
to each goal. As these were presented,
participants identified actions that had been taken. The facilitator then asked participants a series of “summary
questions” intended to organize the information the group needed to consider in
answering the Focus Question. Finally,
participants brainstormed their individual answers to the Focus Question,
shared these answers in small groups, and clustered the group answers on an
adhesive board. The clusters thus
formed were translated by the facilitator into the five recommendations found at
the end of the report. These will be
further refined at the group’s next meeting, July 30, 1:00 to 3:00 p.m.
I. REVIEW AND ASSESSMENT OF PLAN ACTIVITY
Plan Goal: To keep
mothers and infants alive and well before, during, and after birth, and to reduce
disparities in survival among population groups.
Objective 1: Public Awareness and Outreach
Strategy
1: Increase community awareness
Actions:
1)
Develop public
education messages about the rates of infant mortality, focusing on the
disparity between African American and white infants; increase community
ownership of the issue.
2)
Develop a specific
message that deglamorizes having a baby at a young age.
3)
Bring residents,
health care, providers, and agency staff together, provide information about
issues and current services; train neighborhood based facilitators to lead
dialogues within the community.
Strategy
2: Educate young men and women about healthy pregnancies and infant health
Actions:
1)
Work with local
media and community based news outlets to inform young mothers and fathers
about resources available.
2)
Design outreach
activities through neighborhood centers and associations and faith-based
organizations.
3)
Strengthen and
expand delivery of the “Safe Sleep” message, making the message clear and consistent.
What has been done:
- Neighborhood
centers and community groups have used some grant funding and Title V
dollars to provide information about issues and current services. They
produced newsletters with educational messages, and designed an implemented
outreach strategies.
- Daylong
training was provided to professionals, paraprofessionals, and
neighborhood/community/faith groups working with young mothers.
- The Birth
to Five Committee reports data to the community on health outcomes; one
part of their report addresses infant mortality.
Other Comments
- Regarding
“deglamorization”: Pregnancy rate
among 15- to 19-year olds is higher for Ingham County than for the state
as a whole.
- Public
awareness and education has been a topic of discussion at many of the
coalition’s meetings.
Objective 2: Address underlying causes of infant mortality
Strategy
1: Focus on social, economic, and
environmental conditions.
Actions:
1)
Establish FIMR in
Ingham County, focusing on deaths due to prematurity and post-neonatal deaths;
use findings to refine and strengthen actions.
2) Strengthen death scene
investigation and child death review process.
3) The Power of We Consortium
should educate the public on the connection between infant health and survival
and the social, economic, and environmental conditions within the community.
4) The consortium should
receive regular briefings on the findings and recommendations of FIMR. Incorporate actions into broader strategies,
and include this information in community briefings.
Strategy
2: Address internalized oppression and racism through a coordinated initiative
among all neighborhood network centers.
1)
Expand role of
community outreach workers to engage neighborhood residents in peer outreach to
young families and provide avenues for resident advocacy with institutions and
providers.
2)
Implement group
prenatal care models facilitated by nurse midwives, emphasizing empowerment of
women.
What has been
done:
- Useful
information is coming to light at the FIMRs; this may soon be ready to
share with a wider audience.
- Guidelines
are being revised for death scene investigation, with the hope that they
will be adopted by more counties, thereby unifying the process for
Protective Services, nurses, law enforcement, etc.
- Power
of We Consortium (PWC) was consulted in review of targets.
Other Comments
- Repeatedly
acknowledged the difficulties of tracking down information on infant
deaths; contradictory records; inability to locate mothers for follow-up.
- No
real attempt to identify the lessons or forge new strategies through PWC.
- “Expanding
the role of community outreach workers” is a promising and frequently
proposed idea, but it can’t really be accomplished without supplying the
resources needed to do it.
Objective 3: Build continuum of supports at the neighborhood level.
Strategy
1: Start work to build the entire
continuum, beginning with prior to pregnancy and after newborns come home.
Actions:
1)
Improve health of
women prior to pregnancy by educating children (both girls and boys) about
nutrition, exercise, and the risks associated with sex.
2) Improve health of women
prior to pregnancy by educating women of childbearing age about preconception
health and maternal health.
3) Improve infant health through
outreach connecting parents to resources and supports.
Strategy
2: Deliver and expand programs and services in neighborhoods, both universal
(outreach to all new parents) and targeted, continuing one-on-one support in
high-risk areas/populations.
1
Increase home
visitation, using peer outreach workers.
2)
Educate about
healthy pregnancy and infant health and screen for risks, e.g., deploy a
“mobile Pre/Postnatal Health Van.”
3)
Increase
alternatives for young women.
What has been
done:
- Expectant
Parents Organization went to neighborhood groups to provide sessions on a
variety of topics, such as kinship care.
- Neighborhood
health teams continue to incorporate IHP and other resources into their
canvassing and other contacts.
- Physicians
Health Plan involved itself with neighborhood centers, health fairs,
schools, and other community outreach points. It also provided incentives for Well Child visits.
Other Comments
- Incentives
are definitely helpful in the engagement process with the target
population; example, coupons for diapers in exchange for participating in
post partum assessment.
- These
efforts are focused only in the Lansing area; there are no similar
resources (health outreach teams) in the rural parts of the county.
- The
plan doesn’t address smoking cessation, which has been the focus of much
of our efforts. Ingham regularly
ranks smoking cessation as a high priority issue in preventing infant
mortality.
- The
risk of domestic violence during pregnancy is another important issue that
is not explicitly addressed.
Objective 4: High quality health care.
Strategy: Reduce barriers (“red tape,” lack of
respect, and judgmental treatment).
Actions:
1)
Convene groups of
teen parents, new parents, and African American women at the neighborhood level
to review and evaluate existing programs that educate health providers: provide suggestions for improving those
programs.
2) Provide cultural competency,
self-awareness, and sensitivity training and supervision for health care
providers and front-line staff.
3) Health care providers and
organizations conduct a joint review and improve the process by which they work
together to provide services to expectant and new parents: provider follow-up on quality of care; peer
interviews on quality of care, with findings given to providers.
What has been
done:
- Focus
groups were held in 2005 as part of the initial plan development process.
- ICHD’s
Social Justice Project examined racism, classism, and gender
discrimination as underlying causes of health disparity and outlined a
plan for addressing these. Project
is in the process of developing internal capacity to do trainings on
multiculturalism and root causes of health inequity.
- Public
Health Nurses and Women’s Health Services have liaison relationship. High risk prenatal cases are
assessed. Hospitals also call for
prenatal intakes and outreach.
- Changes
in practice: One public health
nurse’s job (J. Bowen) changed to be more responsive to needs of high-risk
cases. ICHD pays for services that are not reimbursable. At IRMC, every person who has a baby on
a weekday gets a visit from the ICHD nurse.
- Cultural
competency session incorporated into daylong training for professionals,
paraprofessionals, and neighborhood groups.
Other comments:
- Recent
“REACH US” grant application submitted by ICHD would provide roles for
Greater Lansing African American Health Institute and Lansing Latino
Health Alliance in assessing and improving cultural competency within
health institutions such as ICHD, hospitals, and colleges.
Objective 5: Strengthen the role of fathers.
Strategy:
Promote volunteerism and enhance the role and responsibilities of
fathers.
Actions:
1)
Neighborhood centers
convene groups of new fathers to find more effective ways of helping them
prepare for fatherhood and strengthening their roles as caretakers.
2) Neighborhood centers, BCFI,
GLAAHI, Cristo Rey work together to construct and provide volunteer and
mentoring programs for young fathers.
3) Increase community awareness
of existing father’s groups and send the message that it is OK for men to
nurture and support others.
What has been
done:
- Baker
Donora had fathers group for some time.
- Barry
Kaufman from CMH continues to work with fathers support groups lasting 6 –
8 weeks.
- Presentation
on fathers’ programs was incorporated into the 2006 daylong training.
NOTE: The following,
sixth objective was inadvertently left out of the trigger exercise by the
facilitator. It is provided here, with the facilitator’s comments only.
Objective 6: Establish oversight and monitor progress by the Power of We
Consortium.
Strategy 1:
Oversee the implementation of the action plan
Actions:
1)
Adopt the goal and
incorporate in regular reports to the community.
2) Incorporate strategies and actions underway in regular briefings
to the community.
3) Review progress monthly.
4) Use website to inform the
community about the issue and actions underway in the community.
Strategy 2: Monitor progress on
objectives.
1)
Select measures to
monitor objectives
2)
Assess overall
progress in September 2006
Strategy 3:
Set targets for reducing infant mortality rates.
1)
Initiative proposes
targets for reducing overall rate and the disparity between rates.
2)
Consortium continues
to use the overall rate of infant mortality as an indicator of community
well-being, informs the community of the targets that have been set to help
reach the goal and progress toward achieving the targets.
What has been
done:
- PWC
did adopt goal and plan, and receive periodic updates on progress. PWC also adopted targets recommended by
the initiative, which will be used in the next edition of the indicators
report.
- Website
has not been used to inform the community, except through the indicators
report.
II. “SUMMARY QUESTIONS” RESPONSES
The following comments were made in response to “Summary
Questions” asked by the facilitator.
General Observations
- The
needs haven’t changed much since the plan was created.
- The
plan’s approach is comprehensive, embracing many facets of the
problem. No one entity could be
expected to do all that the plan entails.
- Each
objective has multiple targeted activities; the plan perhaps isn’t as
“systematic” as it could be in its approach.
- The
plan represents a snapshot of conditions as they existed in 2005, which
hasn’t been revisited since. The
process to produce the plan was a distinct activity, not part of a
cohesive flow of inquiry by the community.
- There
is no clear feedback or communication mechanism attached the plan, other
than occasional contact with the PWC.
- Health
care providers are a “missing player.”
There are no activities in place that address cultural competency
issues with providers. Could
Ingham Medical Society have a role to play in providing this
connection? Community Mental
Health?
- Membership
in the coalition is not broad, and may need to be expanded to accomplish
all the things in the plan.
- Remember,
some of the responsibilities of oversight and awareness fall to the PWC.
Things that Frustrate
- We
haven’t kept up with plan by regularly revisiting it, or tracking our activities
within it. The grant functions
have primarily driven activity of the coalition.
- We
haven’t really connected our activity to “the big picture,” for example,
the economic issues underlying infant mortality and low birth weight. Other collaboratives deal with “other”
issues that are in fact integral to infant mortality; i.e. Birth-to Five,
Substance Abuse.
Things that Gratify
- A lot
is being done.
- We
come together regularly, sharing and exploring ideas for improvement.
Challenges
- We
know the problem, but need to find a way to trigger action by
others—preferably more comprehensive, systemic action. We need a hook, a way to empower the community to pursue a different
approach.
- In
moving from general infant mortality to disparities in infant mortality, there is a sense that the
urgency of the issue gets “softened.”
The target-setting group helped to reveal the impact on overall
infant mortality that would be achieved by reducing disparities, but it is
a challenging message to convey.
- Cultural
competency needs to be addressed at an institutional level. Structural racism needs to be
confronted through a social justice approach.
- It’s
been challenging to move beyond the focus that the funding dictates to
deal with the wider issues.
Opportunities
- May
be ready to achieve greater communication about what is going on, and a
more collaborative approach through sharing of resources.
- We
need to explore the real barriers that contribute to disparity. For example, on paper everyone may have
access to care, but are there different obstacles for different groups, in
the form of attitudes, distrust, etc.?
- Different
geographic neighborhoods have access to different resources for pregnant
women. Perhaps we could find ways
to work together to expand availability across the neighborhood centers.
- In
providing an update to the Power of We Consortium on the plan, we have an
opportunity to strengthen and deepen key strategies.
- Faith-based
groups represent an opportunity for new outreach, education, access.
Envisioning Success (if
we succeed, what will be true?)
- An
updated plan, with a more structural, systemic approach to the problem.
- Data
showing infant mortality disparities in decline.
- New
strategies for contacting the people we don’t reach now.
- We
know people who know people who can help us attack the problem.
- Documentation
of greater number of African Americans accessing services, and receiving
quality services.
- The
whole community sees this as an issue the whole community must take
responsibility for.
- A
larger coalition, with a steering committee and various subcommittees and
work groups.
III. RECOMMENDATIONS
Participants generated five “clusters” of answers to the
Focus Question (What do we need to do to
improve this collaborative’s effectiveness in reducing disparities in infant
mortality in Ingham County?). These
clusters have been used to formulate five draft recommendations for review at
the July 30 meeting. It should be noted
that the last of these recommendation, “Specific Strategies and Issues,”
contains a number of discreet strategies that the collaborative may want to
pursue (addressing structural racism, supportive role models, father
involvement, smoking cessation, etc.)
The five recommendations are
- STRUCTURE: Establish and define the operating structure for the
Coalition, including clear roles and responsibilities for the oversight
body, leadership, member organizations, work groups, and staffing.
- PLANNING: Revise the 2006 Implementation Plan to reflect the real work
being done, and create a feasible approach to reducing infant mortality
disparities over time.
- EXPANDED NETWORKING: Identify and engage with all community
entities that have a role to play in eliminating infant health disparities
in Ingham County.
- PUBLIC AWARENESS AND OWNERSHIP: Develop new ways to make infant health
disparity relevant to the community at large, motivating broad ownership
of the problem and creating the community will to take action.
- SPECIFIC STRATEGIES AND ISSUES: Identify and prioritize specific
actions the Coalition will concentrate on to reduce infant mortality among
African Americans in Ingham County.
The recommendations are provided in greater detail on the
following pages. On July 30, the
coalition members will attempt to refine and validate them, and determine next
steps implementation.
1. STRUCTURE:
Establish and define the operating structure for the Coalition,
including clear roles and responsibilities for the oversight body, leadership,
member organizations, work groups, and staffing.
In its first two years of operation, the Coalition’s work
has largely been driven by the parameters of the grant from the state. However, the implementation plan that was
developed in 2006 is far more encompassing, and there is a desire by the
participants in the Coalition to take a more comprehensive approach to
eliminating disparities in infant mortality.
In order to do that, a new organizational structure needs to be defined
and implemented. Within the structure,
clear roles and responsibilities also need to be defined. Issues that need to be resolved for each
component of a new structure include:
·
OVERSIGHT: The
Coalition is a community collaborative of the Power of We Consortium
(PWC). As such, the PWC has oversight
over the Coalition’s work, and should serve as a vehicle for disseminating
information, facilitating policy change, and blending resources. The Coalition needs to think through how it
can best utilize and communicate with the PWC in pursuing its strategies.
·
LEADERSHIP: The
Coalition originally had designated Co-chairs, but for some time now has been
coordinated by Health Department staff without officially assigning leadership
roles. The Coalition should consider
what leadership arrangement will best serve the goal of making the Coalition a
broad-based, community collaborative that can effectively pursue strategies to
eliminate disparities in infant mortality.
·
COMMITTEES or WORK GROUPS: How should the work of the Coalition be carried out? It may be advisable to organize the
membership into committees or work groups addressing specific issues or a specific
core functions. Such groups would move
work forward between Coalition meetings, and perhaps meet more frequently than
the entire Coalition.
·
STAFFING:
Dedicated staff would greatly help move the Coalition’s work
forward. The Coalition should seek
funding for Coalition staff; in the absence of funding, the possibility of
getting a member organization to contribute support staff time should be
pursued.
·
COMMUNICATION:
The Coalition should establish or pursue a mechanism for facilitating
ongoing communication between its members, and with other community entities
that are involved in eliminating infant health disparities.
2. PLANNING:
Revise the 2006 Implementation Plan to reflect the real work being done,
and create a feasible approach to reducing infant mortality disparities over
time.
The original Implementation Plan was created without a clear
understanding of the resources that would be available to carry the work
forward. The Coalition now has a better
sense of the need to work with existing capacities, combining resources and
linking services where feasible. The
current facilitated dialogue process should therefore be used to create a new
plan of action, one that more clearly defines goals, roles, responsibilities,
and expectations. This plan should then
be taken to the Power of We Consortium for validation and buy-in, with an
understanding that the collaborative will seek additional resources whenever
possible but in the absence of additional funding will work with the limited,
existing capacity of participating organizations. Appropriate linkages should also be made to other PWC
collaboratives, such as those that address early child development and
substance abuse.
Action steps:
·
Articulate an Action Plan based on the findings from
the current dialogue process. Include in the plan recommendations for new
structure, expanded communication and networking, public awareness and
ownership, and responses to specific health and social factors contributing to disparities
in infant mortality.
·
Present and seek approval of the plan from the Power of
We Consortium. Achieve clear buy-in to
the PWC’s role in disseminating information and working toward positive policy
changes.
·
Assign work tasks to committees or work groups.
3. EXPANDED NETWORKING: Identify and engage with all community
entities that have a role to play in eliminating infant health disparities in
Ingham County.
Clearly the full array of stakeholders, service providers,
and people of influence who could transform our community’s approach to
reducing infant health disparities are not immediately engaged in the Coalition
as it is currently configured. While it
may not be necessary to convince all such entities to become regular, active
participants in the Coalition, we should use the current planning process to
invite new members into the Coalition, and identify ways to maintain networking
ties with those that are interested but unable to commit to membership. To identify the entities that should be
approached to join in this network, Coalition members should engage in a
brainstorming activity that teases out the health and social factors that
contribute to infant mortality disparity.
Action steps:
·
Identify through brainstorming all stakeholder groups
that have a role to play in eliminating infant health disparities.
·
Strategically select specific entities to participate
in the Coalition’s planning process, and invite to join the process.
·
Devise other means for engaging with additional stakeholders
once the plan is adopted by the PWC, possibly through a “community awareness /
update” event.
·
Construct ongoing mechanisms or avenues for regular
communication between all entities that are involved in reducing infant health
disparities, regardless of their official membership in the Coalition.
4. PUBLIC AWARENESS AND OWNERSHIP: Develop new ways to make infant health
disparity relevant to the community at large, motivating broad ownership of the
problem and creating the community will to take action.
The facts about disparities in infant mortality and infant
health are striking; however, the facts alone often fail to illuminate a
pathway to positive action or coherent community strategies for reducing these
disparities. To do this, it is
important to provide contextual information through narrative or supplemental
data on social inequities that create the conditions for poor health. A committee or work group should be assigned
the task of creating new strategies for increasing public understanding of the
phenomenon of infant health disparities, why they have persisted, and the
importance of eliminating them.
The reasons for increasing public awareness and ownership
are threefold: to create new avenues
for communication and action by the general public; to influence policy-makers
whose actions can impact policy and programming; and to garner additional
public and private resources to fight infant mortality.
Action steps:
·
Create a Public Awareness Committee or Work Group
within the Coalition.
·
Develop strategies for deepening public understanding.
·
Seek additional funding or expertise as needed to
implement strategies.
5. SPECIFIC STRATEGIES AND ISSUES: Identify and prioritize specific actions the
Coalition will concentrate on to reduce infant mortality among African
Americans in Ingham County.
While much of the Coalition’s focus is on the “big picture”
of infant health disparities, it must also explore opportunities to prevent
infant mortality through more targeted actions. A number of possible targeted issues and actions have been
proposed by the members of the committee, including the following:
o Reduce
smoking before, during, and after pregnancy
o Reduce
substance abuse before, during, and after pregnancy
o Increase
father involvement
o Increase
access to doulas or supportive role models before, during, and after pregnancy
o Increase
access to pre-natal care
o Increase
community awareness of existing resources and how to access them effectively
o Reduce
teen pregnancy
o Provide
Safe sleep education
o Identify
and confront structural racism at both the institutional and interpersonal
levels
In order to maximize its effectiveness and energy, the
Coalition should select a small number of priorities, with clear, achievable,
and time-limited indicators or benchmarks, and organize committees or work
groups around these priorities.
Staying mindful of the Coalition’s networking function, it is also
important to acknowledge and remain linked to other community efforts led by
other community stakeholder groups, and to avoid unnecessary duplication of
effort.
Action steps:
·
Determine a small number of specific goals to pursue
within a given time frame, and criteria for selecting them.
·
Prioritize goals and assign responsibility to
committees or work groups, with specific benchmarks for action or outcomes
within a specified time frame.
Infant Health Disparities Coalition (IHDC)
A reminder for the next Infant Health Disparities/Infant Mortality meeting scheduled for Thursday June 28 from 1-3pm. We will again meet in the Ingham County MSU Extension Conference room.
Doak Bloss will facilitate the meeting that day, and we plan to discuss the coalition's goals and objectives, and determine those actions that we need to put in place to get there. It is important that we get a broad representation from the community so that different perspectives are heard.
I look forward to seeing you all next week. Please let me know if you have any questions prior to the meeting.
Thanks,
Lisa
Lisa Chambers, MSW
Jump Start/MIOP/NAOP Coordinator
Ingham County Health Department
5303 South Cedar
Lansing, MI 48911
Phone: 517.272.4122
Fax: 517.887.4384
Infant Health Disparities Coalition (IHDC)
AGENDA Thursday March 22 - 1pm MSU Extension
Conference Room
- Welcome and introductions
- MDCH update
- Work First Presentation by Tekea
Jackson and Mary Welling-Bonney
- Target setting workgroup update-Maria
Zavala
- Other?
Next Meeting: Thursday May 27, 2007 1-3pm
Location TBD
Infant Health Disparities Coalition (IHDC) Meeting MINUTES Thursday March 22,
2007
Ingham County MSU
Extension Conference Room
- Welcome and introductions
- Present: Lisa Chambers, Chuck Goeke, Debbie
Edokpolo, Nancy Hayward, Mary Welling Bonny, Tekea Jackson, Ken Sperber,
Janet Bowen, Eldon Liggon, Peggy Roberts, Debby Starnes, Connie McQuaid,
Barb Artis, Monica Kwasnik, Jerin Messerrol, Doak Bloss, Jeanne Sullivan,
Pete Vargas, Natasha Davidson, Dean Sienko, Carol Buzzitta, and Maria
Zavala.
- MDCH update
- We have
received approval from MDCH to proceed with our grant proposal. The grant funds focus on the
interconception period and target African American women. The project will track 50 women who
have experienced either a fetal or an infant loss, and will provide case
management services and grief support for up to two years. Additional funding has been allocated
to FIMR, a portion of the smoking cessation coordinator’s position, and
several community partners.
- Community Presentations
- At our
last meeting, we talked about how we might better link with the services
and programs offered by DHS and Work First. Thanks to Tekea Jackson (JET Coordinator), Mary
Welling-Bonney (Successful Parent), and Jerlynn Messeroll (Ingham County
DHS) for their willingness to share information with us.
- When a
family applies to DHS for a cash grant, a referral is made to Work First,
where individuals must attend a week long orientation.
- Work
First (WF) has now transitioned to the JET program (Jobs, Education, and
Training). Instead of solely
focusing on obtaining a job as WF did, JET also provides life skill
information, education and training, and other supports that individuals
need to be employed (some transportation assistance, clothing); and the
program supports individuals in becoming more self sufficient.
- If an
individual is noncompliant with the JET program, they receive a
sanction. The first time, their
cash grant is closed for 90 days, the second time it is closed for another
90 days, and the third time it is closed for a year. Tekea reported that they do all that
they can to ensure that families remain in compliance.
- For
pregnant women in the JET program; doctor or hospital visits, WIC,
counseling, and other appointments can be included in their weekly program
requirements.
- Those
women who are more than seven months pregnant enter the Successful Parent
program. They receive supportive
services, such as education and training; a link to other community
services (Shared Pregnancy, EFNEP); and other issues that they may face
(DV, mental health issues).
- Doak
facilitated the follow up discussion about those things that we could do
to develop a relationship that would benefit the women that we are both
working with. We talked about
linking the services that coalition members provide to the women served at
Successful Parent, connecting to the network centers, providing
information/linking with the smoking cessation program. Follow up information will be shared at
the next meeting.
- Target setting workgroup update-Maria
Zavala
·
Lisa shared that she was approached by Melany Mack, in
order for the target setting work group to move forward. Lisa shared that we first needed to revisit
the recommendations that were developed last fall and get support from the
coalition. The recommendations would
then be taken to the Power of We Consortium for larger community support, and
shared in the community data book (to be released later this year).
·
Maria had chaired the group last year, and presented to
the group. The recommendations included:
1.
The Ingham County Health Disparities Coalition
recommends to the Power of We Consortium that the Community be engaged in a
comprehensive, coordinated effort to reduce the African American infant
mortality rate in Ingham County to no more than 10 per 1,000 live births by
2020, while reducing the overall infant mortality rate to no more than 5.5 by
2020.
2.
To reach this target by 2020, the African American
infant mortality rate must be reduced by an average of 0.4 percent per year.
·
There was discussion about the appropriateness of some
of the language, and questions about how the recommendations were
calculated.
·
The group was not able to come to a consensus
recommendation. But because the
recommendations are to be included in the data book, the target setting work
group will reconvene to clarify the recommendations, e-mail them out to the
larger coalition, and get support prior to the next PoW meeting (4/20). Maria will coordinate setting the meeting up.
- Updates
·
No updates were shared due to time constraints.
- Other?
- Mary
Welling Bonney asked to be added to the mailing list for involvement in
future meetings. If anyone is
interested in contacting her before then, her e-mail is MWellingBonney@camw.net.
- To
access the In-touch database, visit:
http://www.referweb.net/lansing
- Focus
of next meeting will be on determining overall coalition objectives and
functions, so that there is a clear purpose to the work we do.
Infant Health Disparities Coalition (IHDC)
AGENDA Thursday January
25 - 1pm MSU Extension
Conference Room
- Welcome and introductions
- FIMR update
- 2007 MDCH proposed plan-update
- First quarter report
- Role of the coalition-discussion
- Meeting changes
- Other
Infant Health Disparities Coalition (IHDC)
MINUTES - Ingham County Infant
Mortality Initiative - January 25, 2007
- Welcome and Introductions
Present: Lisa Chambers, Maria Zavala, Chuck Goeke,
Kristin Patmos, Ken Sperber, Peggy Roberts, Janet Bowen, Rachel Copeland, Eldon
Liggon, Doak Bloss, Debbie Edokpolo, Lisa Hale, Barbara Artis, Jeanne Sullivan,
Carol Buzzita, Natasha Davidson, Sophia Hines, Sandy Gellar, Chuck Steinberg,
Monica Kwaznick
- Role of the Coalition
The Coalition serves two purposes. First, they are the advisory committee to the Infant Mortality
Initiative proposal submitted to MDCH.
Second, they are the Community Action Team for the FIMR, which puts
actions in place that are raised during the reviews that take place at FIMR.
- FIMR Update
- Jeanne
shared that there were 12 deaths in 2006 (there had been 21 in 2005). She continues to face challenges in
getting the interviews.
Suggestions were made to connect to WIC and to outreach
workers. Common issues facing
these women include: depression,
substance use, poverty, and 1/3 were pregnant again.
- There
was discussion about Work First and the requirements placed on the
individuals in that system.
Effective February 1, the JET (Jobs Employment and Training)
program is in place, which puts additional parameters on clients (i.e. if
they were non compliant before JET, their cash assistance would be cut off
for 30 days; now it’s 90 days without those benefits).
- The
idea of having a “life coach” was raised for those women who had
experienced a loss. Janet shared
that the Refugee Coalition was working on a similar concept.
- The
following action steps were
proposed prior to the next meeting:
- Set
up a small group meeting among members of the coalition and
representatives from DHS and WF to discuss some of our issues.
- Invite
them to the next larger coalition meeting to share their information and
answer questions from the group.
- Connect
with Mary Wellington of Successful Parents, a group for pregnant women at
WF.
- MDCH proposed plan-update
- After
our last full coalition meeting, a group from the ICHD met with
representatives from MDCH who asked us to revise our plan. We have adapted it to include case
management services for those women who have experienced either a fetal or
an infant loss. We plan to provide
both interconception care services, as well as grief support (funded, in
part, by a grant that Tomorrow’s Child received from the March of Dimes). We plan to utilize the neighborhood
network centers and GLAAHI to spread the word about this project and to
refer those women who have experienced a loss. We also plan to work with EPO to hold educational sessions
at each of those area sites.
- The
revised plan was submitted to MDCH on 1/29/07, and they plan on providing
us feedback later this week.
- The
plan will be sent to the group once we receive final approval from
MDCH.
- First quarter report
- The
first quarter report was submitted to MDCH on 1/16/07. It provided an overview of our planning
and organizing during the first quarter.
Contact Lisa if you’d like to review a copy.
- Proposed meeting changes
- Because
the focus of the grant has changed to include a specific targeted group
and intervention, it was proposed that the group move from meeting monthly
to quarterly. There was some
discussion on the rationale of that idea, and it was decided, instead,
that the group would meet on an every other month basis.
- Other
- Super
Saturday was held 1/27 and focused on the Earned Income Tax Credit. Contact Maria Zavala for more
information.
Next
Meeting: March 22-1pm
Meeting
location TBD
|
Workgroup:Infant Health Disparities Coalition (IHDC)
Infant Health Disparities
Initiative
Summary
of Focus Groups on
Preconception and Interconception Care
On November 2
and November 14, 2006, staff from
various units of the health department were facilitated in two focus group
sessions. The overall Focus Question to
be answered by the sessions is “What do we need to do to improve the health
of African American women of child-bearing age before and between
pregnancies?”
In the first
session, participants were asked to share information about what the health
department does now to improve women’s health before, during, after, and between
pregnancies, and what more they would do if they could. In the second session, participants were
asked a number of questions meant to summarize what they had been hearing and
saying about ways to accomplish the goal of improved health for African American
women. They then engaged in a structured
process to answer the Focus Question.
These answers are framed in the form of Recommendations in this
report.
The first
section of this report shows the discussion points made in the first session,
grouped under the headings that were used to track comments; however, many of
the discussion points relate to more than one heading.
The second
section of this report shows the recommendations that were developed in the
second session.
I. OPEN DIALOGUE
Please note
also that many of the points below were the result of more than one
participant’s contribution, and that none necessarily reflect the will of the
entire group.
Before
Pregnancy
- The data on pregnancy, mortality, and morbidity rates tell one
story, and can lead us to talk more about nutrition and smoking and other
aspects of a woman’s health. But in the
personal stories of the women in question, what we hear is the need to set goals
for oneself, and strategies for achieving those goals. What women need more than information about
nutrition is a reason to eat
well. This is more likely to be
established if she can develop a personal connection with someone who can help
her set goals and support her in working toward them.
- The way we talk about
“goals” is critical. If we talk to women
as though we already believe they have goals, they will engage much more quickly
than if we assume that they do not. If,
instead of asking “Are you going to school now?”, we ask “Where are you going to
school?”, it sends the message that we assume they have a fundamental belief in
their own value. This is very
important. Otherwise, we can send the
message that we’re assuming they have a deficit that only we know how to
fix. It can also be effective to refer
back to an earlier stage in life, i.e. “When you were a little girl, what did
you want to do with your life?”
- Time, resources, and the push to increase productivity get in the
way of having the conversations we need to have with young women, to help them
see their worth and care about maintaining their health. A kind of “production line” social work can
result, where you have to focus your energy on only those with the greatest
needs. In the past, we were more able to
engage and explore with patients in the health centers; now you almost have to
be careful what doors you open in interviewing patients, because you know you
may not have the time to address the concerns that emerge. More and more, concerns about productivity
drive the way we serve our clients.
During
Pregnancy
- Many young women, if employed at all, are working very low-paying
jobs in places like fast food restaurants, and have little aspiration to advance
to something better. Poverty is an
assumption, a way of life. Young women
need really great role models to change this assumption, by opening their minds
to the idea of getting back into school.
Most young moms are open to talking about their babies and how to help
them be healthy, but when you ask the question, “What are you doing for
yourself?” they respond with blank stares, as though their own health wasn’t an
issue.
- There are institutional barriers to young women wanting to improve
their lives through education and employment.
For example, Ross has a policy that doesn’t allow any absences—an
impossibility for some young mothers.
Work First also has many barriers.
- WIC has no requirement that women have a doctor in order to receive
assistance, and many do not. This is not
a bad policy in itself; however, we could be doing more to connect Women’s
Health Services to those woman who are not receiving regular health care
services. It is believed that this may
be a very large population of women we could be reaching.
- The support that you build around a pregnant women is very
important, i.e. nutrition education, social work assistance, transportation,
etc. We tend to “cover all the bases” in
terms of service delivery—family planning, pregnancy tests, etc.—but we don’t
necessarily connect women to other resources that could help to build a support
network around them.
- There are a number of very young mothers, many in the rural part of
the county, who have many children very fast, by multiple fathers who are not
involved in their children’s lives. Some
also lack the support of their own parents.
A critical message that they need to hear is that change can still
happen—their lives are not set forever because of having children. They needs support in finishing high school,
and emotional support through support groups.
- Several participants told individual stories of young women who had
succeeded in improving their lives against enormous odds, and also of women who
had not. They were asked what resources
or “ingredients” were likely to encourage success. Responses included time, personal attention,
and role models. Unfortunately, time is
very hard to find, with “numbers” the number one priority in delivering
care. When you have to do education in
ten minutes, how much effective personal support can you give?
After and Between
Pregnancies
- In some cases, young women who are seeing obstetricians outside of
ICHD’s health centers may run out of Medicaid-funded birth control and not
realize that ICHD can help them. One
thing that we could do is send materials to other practices in the area and try
to coordinate collaboration with ICHD to help these women.
- One participant recounted being on welfare as a young mother for
eleven years, and how the system has grown much more punitive and less
supportive since then. In the last year
of her education at MSU, she learned that her benefits would be taken away if
she continued; with the support of a great public health nurse who treated her
like an individual, however, she finished her degree. We need to validate women in their strengths
and their choices, whereas today the system judges women either directly or
implicitly. One of the things that we
need to acknowledge is that, as part of a bureaucratic system, some women will
find it hard to trust us.
- Today, to go to college, young moms are expected to work 40 hours a
week and afford child care as well. We
need a full service center, with child care, job support, and education support.
A new resource, the Women’s Center of Lansing, represents a new kind of thinking
and an important new resource. It will
have two job counselors on site, and an array of creative programming, e.g. free
yoga classes, car maintenance, a clothing bank, assistance with resumes and
interviews. Ideally, we would support
more creative approaches like this.
- We might benefit from doing a “FIMR” with the mothers of living
babies as well. By interviewing them a
year after the birth of the baby, we might be able to find out what exactly
impacted their choices, behaviors, and progress in improving their lives. Even women with very low maternal skills can
be very articulate about what they needed during and after
pregnancy.
- As public health workers, we have a lot of work to do to understand
the implications of race in how we
communicate and connect to those we serve.
Above all, we need to be able to meet people where they are, and to do
that we can to break through assumptions about being a bureaucracy, assumptions
about race and class differences, assumptions that we will judge. One participant told of feeling a great
barrier with a client, and the simple question “You don’t want to be here, do
you?” opened up the relationship.
Authentic acknowledgment of the difficult relationship can sometimes help
make the connection we need to make.
- In assessing the teen parent program, one finding was that
participants loved the goal-setting aspects of the program. Goals were valued because they helped teens
organize their lives.
- MIHP forms that are filled out in Women’s Health and Child Health
show a very different attitude between women who are pregnant and women who have
become a parent. While pregnant, they
tend to be revealing and earnest about such things as drug use, relationships,
etc., whereas in Child Health there is a much more defensive attitude (“Why are
you asking me all these questions?”)
Jeanne Sullivan validated this shift, saying that the different medical
charts on women during and after pregnancy show a very different
picture.
II. RECOMMENDATIONS
Ten
recommendations were developed. Four of
these were designated as catalytic, meaning that if they were accomplished they
would help to achieve most or all of the other recommendations as well. These four are presented first.
The catalytic
recommendations address:
- Collaboration and coordination
- A Listening, Strengths-based Approach
- Best Practices
- Prevention
The other seven
recommendation address:
- Work Force Diversity
- Grassroots Connection
- Employment
- Education and Life Skills
- Housing and Basic Needs
- Community Involvement in Decision-Making
Catalytic
Recommendations
- COLLABORATION AND
COORDINATION: Eliminate institutional
barriers to needed services by creating new mechanisms for teamwork, interagency
advocacy, and access to health care.
·
Within ICHD, create a team involving all units that work
with the target population (PHN, MIOP, WIC, MIHP, Willow). Also build alliances between this team and 1)
neighborhood groups, and 2) providers.
·
Create an ICHD liaison to advocate and identify barriers to
care within other systems, particularly DHS, mental health, and substance abuse
services.
·
Identify barriers to health care for this population,
including pharmacy and primary health care (bureaucracy, hours of operation,
limitation on number of visits, etc.) and communicate to community health
centers, Ingham Health Plan Corporation, etc.
- A LISTENING,
STRENGTHS-BASED APPROACH: Ensure that
all ICHD employees approach each woman free of judgment, with an earnest
commitment to understanding her story, beliefs, concerns, fears, and
dreams.
·
Clearly articulate that this approach is an expectation of
all ICHD employees working with the target population:
ü
Every woman has strengths and resources, and these are
important to apply to the work of ensuring the health of herself and her
child.
ü In
our work, an important step is engaging authentically with the women we serve
and helping them see their own strengths and resources.
ü For
many women, role models who have succeeded in overcoming similar challenges are
a valuable asset.
·
Provide professional development opportunities to employees
to help them apply this approach, and develop other skills as well (problem
solving, language, etc.)
·
Seek ways to help other systems of care adopt this approach
in their work.
- BEST PRACTICES: Gather
information on our clientele and strategies that have been applied elsewhere, to
create a comprehensive plan for improving services to those women who are
hardest to reach.
·
Survey women in the community about their needs, the
availability or services, and the current satisfaction with what is
available.
·
Research programs that have been effective
elsewhere.
·
Apply these findings to our own services and how they are
provided.
·
Formulate a plan that implements strategies to reach the
hardest to reach, i.e. those who might traditionally be characterized as
“non-compliant” or “low-functioning.”
- PREVENTION: Include prevention efforts in the continuum
of response to the target population, and strengthen early education efforts to
women.
·
Prevent early pregnancy through family planning and
prevention messages.
·
Educate girls and young women early about the importance of
maintaining general health, and prenatal and postnatal care.
Other (Non-catalytic)
Recommendations
- DIVERSE WORK FORCE: As an organization, ICHD should work toward
becoming a role model for other providers by 1) adopting policies that value
women, pregnancy, and parenting, and 2) actively striving to maintain a work
force that reflects the racial and ethnic diversity of the population we
serve.
- GRASSROOTS
CONNECTION: Develop a continuum of
supports to grassroots neighborhood and faith groups on how to support the
health of young women and girls before, during, and after pregnancy; and enlist
these grassroots partners as community
advocates.
- EMPLOYMENT: Through partnerships with local businesses
and other economic stakeholders, create more jobs that provide a living wage,
better job opportunities for young women of color, and work conditions and
policies that are respectful of the health needs of young parents and
children.
- EDUCATION AND LIFE
SKILLS: Increase and improve high school
completion programs by including social supports such as transportation and
child care; and incorporate life skills training (budgeting, home maintenance,
parenting) into these programs.
- HOUSING AND BASIC
NEEDS: Improve access to safe,
affordable housing, adequate maintenance programs, and other basic
needs.
10. COMMUNITY INVOLVEMENT IN
DECISION-MAKING: Encourage community
partners to be proactive in the legislative process, and processes that set
policies determining access to health care and others social
resources.
*********************************** |
|
Workgroup:Infant Health Disparities Coalition (IHDC)
Preconception and
Interconception Care:
Ingham County Health
Department
DRAFT
Program Overview
The Ingham County Health Department
(ICHD) will work within its various departments and beyond to begin to build a
targeted intervention to examine and address the maternal health of our
community. Specific collaborators on the
project will include Women’s Health Services, WIC, Public Health Nursing (MIHP),
and the Maternal Infant Outreach Program (MIOP).
Through the Infant Mortality
Initiative, we plan to identify a core group of 50 African American teens, who
have not parented before. We will identify these women from their
provider (Women’s Health) and will screen them, utilizing the following
questions, to determine their risk factors for LBW or preterm delivery.
- Was your pregnancy
planned?
- When was your last
pregnancy?
- What was your birth control method
prior to getting pregnant?
- What are your birth control plans
after delivery?
- Are you currently smoking
cigarettes?
- Do others smoke around you inside
your home?
- Do you drink
alcohol?
- Have you missed any of your
prenatal appointments?
- Do you regularly take your prenatal
vitamins?
- Do you eat healthy foods
regularly?
- Have you had a fetal or infant
death?
If the women are identified to be
at risk for preterm or low birth weight births, we will refer them to either
MIHP or MIOP, where they will receive additional information and support. Referrals will also be made with the Health
Department (through WIC or Child Health, for example) as well as other community
agencies. After delivery, we will work
to track these women for two years. To encourage their participation in the two
year process; diapers, formula, developmentally appropriate toys and books,
and/or health and safety items will be given to families at specific points of
their involvement with the process.
Outreach efforts will be
coordinated through other community partners.
We will work with the Greater Lansing African American Health Institute
(GLAAHI)/ Advent House and our neighborhood outreach centers to provide support
groups and information for our target population of pregnant, teen mothers who
have not parented before. Information
will also be shared on a number of topics related to preventing Infant Health
Disparities in Ingham County.
Additionally, we plan to
collaborate with Willow Teen Plaza, an initiative developed to address the
health needs of Ingham County adolescents, particularly needs related to
pregnancy prevention and infant mortality. Willow Plaza Services strives to
improve the overall health status of Ingham County adolescents through community
awareness, direct services and health promotion activities. At Willow we would be able to work within
existing groups to strengthen our message of preconception care with specific
strategies the teens can implement.
Finally, in order to get a more
complete picture of why infants are dying in our community, we plan to provide
support for a FIMR Coordinator. This
person will look at specific cases of infant deaths in Ingham County; and bring
them to the FIMR team, who will work to develop strategies and recommendations
to address issues surrounding infant mortality.
Through all of these initiatives,
we plan to work more collaboratively with the Birth to Five subcommittee of the
Power of We Consortium (our county’s mulit-purpose collaborative body). Members of the Birth to Five subcommittee
represent those agencies in our community that are committed to working with
families; and could be used to disseminate information developed through the
Infant Mortality Initiative.
Data collection
Both the results of the
questionnaires and the specific education shared with each of the women will be
contained in their charts. Additionally,
all referrals to outside agencies or services can be obtained
there.
Because smoking has been shown to
be correlated with low birth weight babies, it is an area that warrants
additional education. Those women that
are identified to be smokers in the questionnaire will be automatically referred
to the smoking cessation program at the ICHD.
There, if they choose to participate in the intervention, they will
receive intensive support through education and
counseling.
Evaluation
We will work with Public Sector
Consultants to provide evaluation services for our project. Prior to any sort of intervention, we will
work with PSC to specify those activities, timelines, and any other objective
that we determine we want to track.
Minimally, they will track data for the four objectives listed
below.
|
|
Indicator |
Objective |
Tool |
|
1. |
Pregnancy
intendedness |
At least **% of subsequent
pregnancies are planned. |
Self
report |
|
2. |
Pregnancy
interval |
At least **% of mothers will wait
18 months or more until their next delivery. |
Record review at Women’s
Health |
|
3. |
Length of gestation of next
pregnancy |
At least **% of women involved in
the intervention will deliver at 37 weeks or
later. |
Record review at Women’s
Health |
|
4. |
Birth weight of next
baby |
At least **% of subsequent births
will weigh more than 5 lbs. 8 oz. |
Record review at Women’s
Health |
**Note: Actual objectives will be obtained prior to
our proposal submission, as baseline data needs to be obtained from Women’s
Health.
Following data collection,
information will be shared with MDCH to provide information for evaluation of
the process and outcomes.
Staff Training
Staff at Women’s Health will be
trained in how to administer the brief 11 question survey. We will then need to ensure regular and
ongoing communication exists between Women’s Health and the MIHP/MIOP that will
be conducting the home visits and ongoing education. MIHP/MIOP staff have already been trained to
deliver health information, and are well connected within the community to refer
to other providers and supports. We
have, however, requested additional funding for other training needs as well as
new or updated curricula to use with our target population.
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Brief Overview
