preconception health planning in nc sarah verbiest, msw, mph
Post on 25-Dec-2015
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The “we” in welcome
• 70+ colleagues in public health, research, minority health, and medicine
Creating and enacting a new focus on women’s wellness will take all of us!
Why do we care?
In North Carolina…• 45th in the nation for high rates of infant
death • One out of 7 babies is born preterm• 3,000+ babies are born w/anomalies each
year• African American babies have a 2.5 fold
greater risk of death than Caucasian babies
• 45% of pregnancies are unplanned
Why do we care?
For women of reproductive age (18-44):• 23.5% of women smoke • 23.6% of women are uninsured (69.9% of
Hispanics)• 7.9% report binge drinking in the past month• 6.1% of women have asthma• 2.4% are diabetic, 3.4% have cardiac disease
and 13.1% are hypertensive• High numbers of Chlamydia cases
(617.9/100,000)
Why do we care?
• 28% of women of all ages don’t engage in physical activity
• 24.8% of women 18-44 are obese (40% for African American women)
• 23.4% have poor mental health• 19% nonimmune to Rubella• African American women are
disproportionately affected by poor health
• Women’s wellness care is highly fragmented
Planning Steps
• State Infant Mortality Collaborative (2004-06)
• CDC’s Recommendations for Preconception Health and Health Care prompt a need to respond
• June 2006 the Folic Acid Council commissioned an inventory of preconception services in NC.
The Booklet
A tool to initiate conversation & prompt collaborative action
Contents:• Details about
preconception health
• Lists of challenges• Specifics of 3
decades of NC projects
• Next Step Ideas
Accomplishments
Family Planning Medicaid Waiver Folic Acid Campaign since 1994 School Curriculum Worksite Health Promotion Preconception Health Risk Appraisal Eat Smart Move More / Healthy Women,
Healthy Weight Free NC Quitline Syphilis Elimination Project
Planning Steps
March 2007 Think Tank Meeting #1• To initiate a focused, collaborative,
comprehensive process to create a state Preconception Action Plan
• Review of Participants, Group Notes and Ideas
May 2007 Think Tank Meeting #2• To collect diverse ideas and understand
how preconception fits into existing work
Planning Steps
• Looking under rocks – finding detailed data about women of childbearing age in North Carolina• Quantitative – what indicators do we
have? What indicators do we need to gauge outcomes?
• Qualitative – what have we learned about NC women – what do we still need to know?
Partnerships
• There are many groups working on different elements of preconception health. There are a variety of products, perspectives and approaches.
• NC’s efforts will integrate preconception messages as appropriate into the existing public health and medical infrastructure.
What women say…
• Behavior Change: Awareness not enough to change behaviors. Knowledge of family history, family support and healthcare options can lead to change.
• Stress: Emotional, physical and financial stress negatively influence health. Need more social support and networking.
What women say…
• Mental health issues, especially depression, are significant. Lack of resources in communities.
• Barriers to Health Care: Cost. Racism. Lack of - access, trust/ respect, childcare, and transportation.
What women say…
• Approach to Healthcare: Prefer holistic approach.
• Substance Use: Many women reported
they knew someone struggling with drug addiction.
• Most pregnancies are unplanned. Women are concerned about becoming pregnant but don’t use contraception. Inconvenient clinic hours and quality of care problems with family planning services.
The Challenge
• Preconception health is multi-faceted and complex. There are many elements and a broad target population.
Guiding Principles
• Focus on the whole woman – not only her reproductive capacity
• Consider the woman’s health needs and related wellness recommendations within the context of her family and community
• Be careful that messages don’t imply that certain groups of women should not become mothers
• Be cognizant of health disparities and prioritize programs with potential to close the gaps
Areas of Interest
• Adolescents• Clinical practice – continuity of care• Interconception Health• Data & Research• Integrating new messages
into current campaigns• Policy & Advocacy
Themes
• Include men & families
• Start early / young• Use existing
programs to carry messages
• Build on public health outreach into worksites, private practice, and communities
Messaging
Give consumers messages they want to hear – not what we think they want to hear.
Use social marketing principles Consistent messages Concise and Clear Keep Literacy Levels Low In Spanish
Developing Core Plan for Review Think Tank #3 August 2007
We commit to seeing the ideas through to an action plan –
and the action plan through to funding and implementation.
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