1 / 60

Promising Practice: A Successful Infant Mortality Reduction Initiative

Promising Practice: A Successful Infant Mortality Reduction Initiative. CityMatCH Urban Maternal and Child Health Leadership Conference September 23, 2008. Shannon Brownlee, MPH Daniel Kruger, Ph.D. Our Problem. Genesee County REACH 2010 Project 9/08. Genesee County REACH 2010 Project 3/08.

zona
Download Presentation

Promising Practice: A Successful Infant Mortality Reduction Initiative

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Promising Practice: A Successful Infant Mortality Reduction Initiative CityMatCH Urban Maternal and Child Health Leadership Conference September 23, 2008 Shannon Brownlee, MPH Daniel Kruger, Ph.D.

  2. Our Problem Genesee County REACH 2010 Project 9/08

  3. Genesee County REACH 2010 Project 3/08

  4. REACH Partners • FACED • Flint Odyssey House/Health Awareness Center • Genesee County Community Action Resource Department • Genesee County • Health Department • U-M SPH/PRC • Genesys Regional Medical Center • Greater Flint Health Coalition • Hurley Medical Center • Mott Children’s Health Center • PRIDE • Priority Children • U-M Flint Genesee County REACH 2010 Project 9/08

  5. Our Community Action Plan Derives from two points of view: Bench Trench Genesee County REACH 2010 Project 9/08

  6. Bench Racial disparities in infant mortality have persisted despite at least 2 decades of applied contributions from the clinical, scientific laboratory and legislative arenas to reduce racial disparities. Two explanations: No single intervention is likely to eliminate racial disparities in infant mortality The period of pregnancy is simply too short to effectively address many risk factors important to infant health. Genesee County REACH 2010 Project 9/08

  7. Trench If you always do what you’ve always done, you’ll always get what you’ve always gotten. If you want something you’ve never had, you have got to do something you’ve never done. Genesee County REACH 2010 Project 9/08

  8. Community-based Partners • “Bench” • “Trench” Thinking Outside of the Box A Different Approach to Address Infant Mortality Genesee County REACH 2010 Project 9/08

  9. Socio-Ecological Model Genesee County REACH 2010 Project 9/08

  10. MATERNAL-INFANT HEALTH Enhancing the Babycare System Fostering Community Mobilization Reducing Racism Addressing Infant Mortality in Genesee County: Our Model

  11. Fostering Community Mobilization

  12. Community Dialogues Priority setting and problem-solving regarding infant mortality Two action groups organized Black Men for Social Change Women Taking Charge of Their Health Destiny Provide needed assistance to mothers Community empowerment & education Health fairs Genesee County REACH 2010 Project 9/08

  13. Community Media Campaign Radio spots TV commercial Posters, fans, T-shirts • Billboards Genesee County REACH 2010 Project 9/08

  14. Enhancing the Babycare System

  15. PRIDE Medical Services Committee • Provider seminars and community roundtables • Perinatal risk assessment tool • Perinatal morbidity and mortality reviews • Safe sleep campaign Genesee County REACH 2010 Project 9/08

  16. Maternal/Infant Health Advocates • Peer support • System navigation • Community “windshield” tours Genesee County REACH 2010 Project 9/08

  17. University “Cultural Competence in Health Care” Course Designed and offered at University of Michigan – Flint Specialized training for client advocates Enhance culturally competent practice Improve patient-provider communication Patients more likely to keep prenatal care appointments Genesee County REACH 2010 Project 9/08

  18. ReducingRacism

  19. Undoing Racism Workshops 2 ½ day facilitated event 24 workshops with over 880 participants People’s Institute, New Orleans, Louisiana Impact Attitudes and beliefs towards culture and racism Diffusion of impact Follow-up working groups of community residents Genesee County REACH 2010 Project 9/08

  20. African Culture Education Development Center History and culture lectures Middle Passage Experience Post-Traumatic Slavery Disorder Curriculum Genesee County REACH 2010 Project 9/08

  21. Healthy Eating Curriculum Afrocentric Peer Trainers Harambee (“pulling together”) celebrations Genesee County REACH 2010 Project 9/08

  22. SUCCESS!

  23. Annual Infant Mortality Rates by RaceGenesee County, MI 1999-2006 Source: Michigan Department of Community Health, Vital Records & Health Data Development Section.

  24. Infant Mortality Disparity Ratio*Genesee County, Michigan 1999-2006 *African American to White Disparity Ratios Source: Michigan Department of Community Health, Vital Records & Health Data Development Section.

  25. 3-Year Moving Average Infant Death RatesGenesee County and Michigan 1997-2006 Source: Michigan Department of Community Health, Vital Records & Health Data Development Section.

  26. REACH Evaluation

  27. Designed to assess: Process – Documentation of activities Outcomes – Changes in systems and individuals Impact – Changes in African American infant mortality rate and disparities with White infant mortality rate REACH Evaluation

  28. REACH 2010 Logic Model

  29. REACH 2010 Logic Model Process Evaluation Racism and Health Disparities Survey Vital Statistics

  30. Reduce/Undo Racism

  31. Enhance Baby Care System

  32. Mobilize Community

  33. Facilitating Policy Change Graph Represents Institutional Policy Changes

  34. Racism and Health Disparities Survey • Asses experiences of racism, responses to experiences of racism, perceptions of the health care system, relationships with partners, health and birth outcomes. • Telephone interviews were conducted by the Michigan Public Health Institute in April and May, 2007 • Respondents included REACH Program participants, randomly selected community members aged 18-45 in the REACH focus ZIP Codes in Genesee County, and randomly selected community members aged 18-45 in demographically similar ZIP Codes in neighboring Saginaw County. REACH 2010 Evaluation

  35. Descriptives of Survey Sample

  36. Descriptives of Survey Sample

  37. Attitudes, Beliefs, and Knowledge regarding Racism

  38. I believe that racism exists in our society today (Controlling for educational attainment)

  39. Even today Blacks feel the effects of slavery and segregation (Controlling for educational attainment)

  40. Experiences of racial discrimination

  41. Beliefs regarding racism in healthcare

  42. Blacks and Whites receive the same quality of health care (Controlling for educational attainment)

  43. Blacks and Whites are treated with the same level of dignity and respect (Controlling for educational attainment)

  44. Vital Statistics Analyses Genesee County REACH Part 1: Perinatal Health Behaviors Data Source: Michigan Department of Community Health’s vital statistics

  45. Month of Pregnancy when African American Mothers entered Prenatal CareBy County

  46. Number of Prenatal Health CareVisits by African American MothersBy County

  47. Kessner Index for adequacy of African American pre-natal care(lower scores indicate greater adequacy)

  48. Vital Statistics Analyses Genesee County REACH Part 2: Perinatal Health Outcomes Data Source: Michigan Department of Community Health’s vital statistics

  49. Percent of births that are premature among African American Infants

More Related