Workgroup: Infant Infant Mortality Initiative The Infant Mortality Initiative is a coalition 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 Initiative meets on the 4th Thursday of every month, usually from 1-3pm in the Ingham Human Services Building 5303 S Cedar in Lansing in the ICHD Conference Room C. For more information on this Initiative 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         GSC Website Navigation   GSC, Birth to Five homepage   GSC Agenda and Minutes   GSC Workgroups   GSC Training   GSC Members   GSC Meeting Calendars   Other Resources

Infant Health Disparities/
 Infant Mortality Initiative 

 AGENDA Thursday August 28, 2008-1:30pm

 Sparrow RNICU

1. Welcome and introductions, All (10 minutes)

          a. Approval of 7/24/08 minutes 

2. Agenda additions                       

2. New business (60 minutes)

         a. Planning for a community event focusing on IM, All
                 i.      Focus on training for office managers

2. FIMR findings/recommendations, Marcie Schwartz

3. Old business (40 minutes)
   

1. Work group updates
    i.      Access to Prenatal Care, Kathy Way
   ii.      Smoking Cessation, Tiffany Doolittle

2. 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

3. Coalition structure and purpose, All

                i.      Revised draft purpose of Coalition
               ii.      The IMI 2008 WORK PLAN

4. 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). 

1. Welcome and introductions, All (10 minutes)
1. Approval of 6/26/08 minutes
2. Approval of agenda/revised format                       

2. New business (60 minutes)
1. 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.  

2. 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. 

3. Old business (40 minutes)
1. 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.’

2. Coalition structure and purpose, All-TABLED

                    i.      Revised draft purpose of Coalition
                    ii.      The IMI 2008 WORK PLAN 

3. 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
 

4. Other announcements (10 minutes)
1. Community baby shower on August 23 sponsored by DRM
2. Baby shower on August 11 at the ICHD sponsored by MSUE/WIC
3. Home visiting grant focusing on reducing child abuse and neglect not submitted locally; state level agencies submitted. 
4. The September meeting will take place at Capital Area Michigan Works
5. Meeting successes:  plan of work, tangible project to work on
6. 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

1. Welcome and introductions, All (10 minutes) 

1. Approval of 6/26/08 minutes 

2. Approval of agenda/revised format                       

2. New business (60 minutes) 

1. March of Dimes resources, Sheri Eldred 

2. Planning for a community event focusing on IM, All

  i.      Incorporating FIMR findings/recommendations, Marcie Schwartz

3. Old business (40 minutes) 

1. Work group updates

                  i.      Access to Prenatal Care, Kathy Way
                  ii.     Smoking Cessation, Tiffany Doolittle 

2. Coalition structure and purpose, All

                 i.      Revised draft purpose of Coalition
                 ii.      The IMI 2008 WORK PLAN

3. 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 

4. 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). 

1. Welcome and introductions, All (10 minutes)
1. Approval of 5/22/08 minutes
2. Approval of agenda

2. Concluding discussion-coalition structure and purpose, All (60 minutes)
1. Revised draft purpose of Coalition

                                                               i.      Please see attached

2. 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.

3. Work group updates (10 minutes each)
1. Access to Prenatal Care, Kathy Way

                                                               i.      The group did not meet so there was no report.

2. 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.

4. Community Updates (20 minutes)
1. 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.

2. FIMR Updates, Marcie Schwartz

                                                               i.      New reporting format was shared and approved for the group. 

3. 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. 

4. Neighborhood Network Centers

                                                               i.      No report.

5. 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. 

5. 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

1. Welcome and introductions, All (10 minutes)
1. Approval of 5/22/08 minutes
2. Approval of agenda

2. Concluding discussion-coalition structure and purpose, All (60 minutes)
1. Revised draft purpose of Coalition
2. 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.

3. Work group updates (10 minutes each)
1. Access to Prenatal Care, Kathy Way
2. Smoking Cessation, Tiffany Doolittle

4. Community Updates (20 minutes)
1. Birth to Five Coalition, Ken Sperber
2. FIMR Updates, Marcie Schwartz
3. MDCH Grant updates, Lisa Chambers
4. Neighborhood Network Centers
5. Tomorrow’s Child, Mary Adkins

5. Announcements (10 minutes)
1. 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). 

1. Welcome and introductions, All (10 minutes)
1. Approval of 4/24/08 minutes-the title of the document was changed to ‘minutes’ and subsequently approved by the group. 
2. Approval of agenda-the agenda was approved b the group

2. Concluding discussion-coalition structure and purpose, All (60 minutes)
1. 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. 

2. 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

3. Work group updates (10 minutes each)
1. 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. 

2. 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. 

4. Community Updates (20 minutes)
1. 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.

2. FIMR Updates, Marcie Schwartz

                i.      No report. 

3. MDCH Grant updates, Lisa Chambers

                 i.      Forms and flyers have been developed for use with the interconception care project.

4. 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.

5. 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. 

5. Announcements (10 minutes)
1. A Community Conversation about infant safe sleep:  “Why aren’t you listening?”  Tuesday June 10 in Detroit.
2. 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

1. Welcome and introductions, All (10 minutes)
1. Approval of 4/24/08 minutes
2. Approval of agenda                       

2. Concluding discussion-coalition structure and purpose, All (60 minutes)
1. DRAFT-purpose of Coalition
2. 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.

3. Work group updates (10 minutes each)
1. Access to Prenatal Care, Kathy Way
2. Smoking Cessation, Tiffany Doolittle 

4. Community Updates (20 minutes)
1. Birth to Five Coalition, Ken Sperber
2. FIMR Updates, Marcie Schwartz
3. MDCH Grant updates, Lisa Chambers
4. Neighborhood Network Centers
5. Tomorrow’s Child, Mary Adkins 

5. Announcements (10 minutes)
1. 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, 2008

Ingham 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.

1. Welcome and introductions, All (10 minutes)
1. Minutes dated 3/27/08 were approved by the group.
2. 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. 

2. Continued discussion-coalition structure and purpose, All (45 minutes)
1. 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.

2. DRAFT-purpose of Coalition

                i.      Tabled for the next meeting. 

3. Meeting time/date change?

                 i.     Tabled for further discussion/clarification. 

3. Work group updates (10 minutes each)
1. 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. 

2. 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. 

3. 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. 

4. 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.

5. 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).
 

4. Community Updates (10 minutes)
1. 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. 

2. FIMR Updates, Marcie Schwartz

                 i.      Marcie was out ill, so there was no FIMR report.

3. Neighborhood Network Centers

                i.      No report from the network centers.

4. 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. 

5. Announcements (5 minutes)
1. Reducing Infant Mortality in Michigan: 
   Lessons From the Field-May 5 at the Lansing Center

 
Next Meeting: May 22, 2008-1-3pm

Safe Sleep Coalition &
 Infant Mortality Initiative

Joint Meeting Reminder 3/27/2008

AGENDA Thursday March 27, 2008

1. Welcome and introductions

2. Safe Sleep Updates, Carol Buzzita 

3. MDCH Grant updates, Lisa Chambers 

4. Other grants updates
1. FACT and Fatherhood
2. Legacy Foundation
3. Healthy Start
4. March of Dimes 

5. FIMR Updates, Marcie Schwartz 

6. IMI 2008 ACTION PLAN, Doak Bloss 

7. Unnatural Causes:  PBS Health Disparities documentary 

8. Reducing Infant Mortality In Michigan:  Lessons From the Field-May 5 

9. Power of We Presentation:  March 28, 2008 

10. Other?
    
    

    Next Meeting: April 24, 2008-1-3pm
    Ingham County Health Department, Conference Room C
    
    

Infant Health Disparities/
 Infant Mortality Initiative

IMI Meeting Reminder 1/24/2008

Our 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

1. Welcome and introductions

2. Project updates
1. Grant updates and training opportunities, Lisa Chambers
2. FIMR Updates, Marcie Schwartz

3. Thoughts about the Coalition from a state and local perspective, Dr. Canady

4. The future of the Coalition, a continuing conversation
   facilitated by Doak Bloss

5. Set next meeting date

6. 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, 2007

1. Welcome and introductions

2. Project updates

1. Renee Canady-Deputy Health Officer, Nursing and Special Services

2. Marcie Schwartz, FIMR Coordinator

3. 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

4. The future of the Coalition-Doak Bloss

5. 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.

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.

What has been done: 

• FIMR was established.

• 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.

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.

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. 

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.

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