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K e l s e y P o r t e r

Nicol e Hu r s t Juli e Dahl e n. H E A L TH Y P E OPL E 2020 M A T ERNAL , IN F AN T AN D CHIL D HEA L T H. K e l s e y P o r t e r. LE A DIN G HE A L T H INDI C A T ORS & OBJECTIVES 28. • R educ e th e ra t e o f al l infan t death s (withi n 1 y ear )

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K e l s e y P o r t e r

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  1. Nicole Hurst JulieDahlen HEALTHYPEOPLE2020 MATERNAL,INFANTANDCHILDHEALTH KelseyPorter

  2. LEADINGHEALTHINDICATORS & OBJECTIVES28 •Reducetherateofallinfantdeaths(within1 year) •Reducetotalpretermbirths •Increaseabstinencefromcigarettesmoking amongpregnantwomen •Increasetheproportionofinfantswhoare breastfed

  3. LHI:REDUCETOTALPRETERMBIRTHS28 •Baseline:12.7percentoflivebirthswere pretermin2007 •Target:11.4percent

  4. THE12“P’S”OFPRETERMBIRTHS8 •Plurals •Perinatology •PPROM-Preterm •PriorPretermBirth PrematureRuptureof •Preeclampsia •PlacentalProblems •Poverty •Pressure •Pus Disease Membranes •Puffing •Parentage •Periodontal

  5. LHI:REDUCETHERATEOFALL INFANTDEATHS(WITHIN1YEAR)28 •Baseline:6.7infantdeathsper1,000livebirthsoccurredwithinfirstyearoflifein2006 •Target:6.0infantdeathsper1,000livebirths

  6. INFANTMORTALITY7 •Twoageperiods •Neonatal(birth-27days) •Postneonatal(28-364days) •Differentcausesofdeathineachperiod •2007-2011:U.S.IMRdeclinedapproximately 3%peryear •6.75to6.05per1,000livebirths

  7. NATIONALPROGRAMS26 •HRSAHealthyStartProgram •CommunityDriven •Service-focused •Effective •2006U.S.IMRwas6.7infantdeathsper1,000live births •Healthy Start Participants the IMR was 5.7 infant deaths per 1,000 live births. •2007U.S.roseto6.8infantdeathsper1,000live births •Healthy Start participants IMR dropped to 5.1 infant deaths per 1,000 live births.

  8. NATIONALPROGRAMS7 •TheCollaborativeImprovementofInnovation Network(CoIIN) •Strategyteamsfocuses: •Reducingelectivedeliveriesat<39weeksgestation •ExpandinginterconceptioncareinMedicaid •ReducingSIDS/SUID •Increasingsmokingcessationamongpregnant women •Expandingtheregionalizationofperinatalservicesto pregnantwomen

  9. WASHINGTONSTATEPROGRAMS10 •Centeringpregnancy® •Pregnantwomenmeetwithclinician •TakeownBP,weightandsetpersonalgoals •Meetwithinagroupofwomenwhoarethesame gestationalage •Discusshealthcareissuesofpregnancy •CenteringModel •Bettercare,Betterhealth,Lowercost

  10. WASHINGTONSTATEPROGRAMS26 •DSHSFirstSteps •Promoteshealthybirthoutcomes,increaseaccessto earlyprenatalcare,&reduceinfantmortality •Medicalservices •Familyplanning •Expeditedalcoholanddrugtreatmentservices •Enhancedservices •MaternitySupportServices(MSS) •InfantCaseManagement(ICM) •ChildbirthEducation(CBE)

  11. WHATCOMCOUNTYPROGRAMS •SeaMarCommunityHealth23 •FirstSteps: •MaternitySupportServices34 •Incomeeligiblepregnantwomen •Preventativehealthservicestoenhancemedical visits •Maternity cycle •Infant related •Linkage, advocacy, and referral services •Education, brief counseling, and interventions

  12. OBJECTIVE:ABSTINENCEFROM CIGARETTES28 •Baseline:89.6percentoffemalesreportedcigarette abstinenceforlivebirthsin2007 •Target:98.6percentabstaining

  13. SMOKINGANDPREGNANCY •Conceptiondifficulty5 •Miscarriage5 •In utero risks4 •IncreaseriskofSIDS4 •Increasepretermandlowbirthweightbabies4

  14. SECOND-HANDSMOKEEXPOSURE25 •Whyisthisrelevant? •45%ofwomenwhosmokequitduring pregnancy •52%ofwomenrelapseafterbirth •Negativeeffectsin babies

  15. NATIONALPROGRAMS • •Standardizedpregnancy-specificcessation1 • intervention • Lacking integration • AmericanCollegeofObstetriciansand • Gynecologists • •‘AcliniciansGuidetoHelping • PregnantWomenStopSmoking’

  16. NATIONALPROGRAMS •5A’s1 •Ask •Advise •Assess •Assist •Arrange •AffordableCareAct27 •PreventativeServices

  17. WASHINGTONSTATEPROGRAMS 3MainHealthGoals31 •ReduceSmokingAmongAdults •PreventSmokingInitiationAmongYouth •ReduceSmokingAmongPregnantWomen •ReduceRelapseAmongPostpartumWomen

  18. WASHINGTONSTATEPROGRAMS •TobaccoControlStrategies31 •CessationPrograms •5A’s •Telephonecounseling •Traininghealthcareproviders •PublicEducationandAwareness •CommunityBasedPrograms •SchoolBasedPrograms •Comprehensive

  19. WASHINGTONSTATEPROGRAMS32 • •AffordableCareAct • •Uninsured • •EnrolledinWAAppleHealth • Medicaid • •Individualplan-WAHealthBenefitExchange • •EmployedBasedInsurancePlan • •Medicare

  20. WHATCOMCOUNTYPROGRAMS30 •SmokingandPregnancy •Prevention Programs •4maingoals •Cessation Resources •AccesstoInformation

  21. OBJECTIVE:INCREASETHEPROPORTION OFINFANTSWHOAREBREASTFED28 •Baseline:74.0percentofinfantsbornin 2006wereeverbreastfed,asreportedin 2007–09 •Target:81.9percent

  22. THEBENEFITSOFBREASTFEEDING35 •Mothers •Infants •Society

  23. CDC:GUIDETOSTRATEGIESTOSUPPORT BREASTFEEDINGMOTHERSANDBABIES12 •Maternitycare •Supportinthe practices workplace •Professional •Socialmarketing education •Addressingthe •Accessto marketingofinfant professionaland formula peersupport

  24. MATERNITYCAREPRACTICES • •Baby-FriendlyUSAHospital • Initiative6 • BreastfeedingCoalitionof • Washington:WADOH’s NutritionandPhysical ActivityProgram20

  25. PROFESSIONALEDUCATION •Increaseindurationofbreastfeeding15 •Incentivesforcontinuingeducationcredits(CE)12 •Staffbreastfeedingtrainingandeducationscores byMaternityPracticesinInfantNutritionandCare (mPINC)15: •31/100forPeaceHealthSt.JosephChildbirth Center •43/100forWashingtonstate

  26. MARKETINGOFINFANTFORMULA •Whatcom County MaternityCarePractices Assessment15 •88%ofpatientsreceived formula-containinggiftbag •WHO’s“theCode”has guidelinesformarketing and distribution of breastfeedingsubstitutes12 •WICdistributes>½ infant formula used in the U.S.14

  27. PEERSUPPORTPROGRAMS •LaLecheLeaguemother-to-mothersupport35 •Localmeetingsandclasses •2011USDA/WICLoving SupportThrough Peer Counseling:A Journey Together12

  28. CULTURALRELEVANCY13 BreastfeedingAmong MinorityWomen: Moving from Risk Factorsto Interventions StudybyDonnaJ. ChapmanandRafael Perez-Escamilla

  29. AFRICANAMERICANS13 •Highestgapbetween HP2020goaland currentbreastfeeding rates •AfricanAmerican Breastfeeding Network(since2008) •AfricanAmerican BreastfeedingAlliance

  30. HISPANICS •Hispanic women meetingHP2020goal of81.9%13 •PuertoRicanHispanicsandnon-PuertoRican Hispanics50%gap13 •Breastfeeding:A MagicalBondofLove (WICHispanic Breastfeedingand PromotionProject)18

  31. SUPPORTFORBREASTFEEDINGIN THEWORKPLACE •AffordableCareAct2 •Supplies •Counseling •Breaktime •Departmentof Health and Human Services:Business Casefor Breastfeeding29

  32. DONORBANKS •AAPsupportsuseof donormilk2 •EatsonFeets15 •Milkdonorbanks15 •11donorbanksin USA;nonein Washington. •Freescreeningfor transmittable diseases

  33. THANKYOU QUESTIONS?

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