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Preconception W.H.E.E.L.S

Preconception W.H.E.E.L.S. Rhonda Freeman, MPH Maternal, Child, and Adolescent Health Coordinator County of San Diego, Health and Human Services Agency Maternal, Child and Family Health Services . W orking to H elp E ducate and E mpower healthy L ife S tyles.

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Preconception W.H.E.E.L.S

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  1. Preconception W.H.E.E.L.S Rhonda Freeman, MPH Maternal, Child, and Adolescent Health Coordinator County of San Diego, Health and Human Services Agency Maternal, Child and Family Health Services Working to Help Educate and Empower healthyLife Styles 3rd National Summit on Preconception Health Tampa, FL June 12-14, 2011

  2. TIMING IS EVERYTHING!

  3. SAN DIEGO, CALIFORNIA Geography Population • Source: United States Census Bureau, American Community Survey 2009

  4. INFANT MORTALITY RATE, 2005-2008SAN DIEGO COUNTY RESIDENTS

  5. PERCENT OF LOW BIRTH WEIGHT BIRTHS, 2006-2009SAN DIEGO COUNTY RESIDENTS

  6. PECENT OF PRETERM BIRTHS, 2006-2009SAN DIEGO COUNTY RESIDENTS

  7. PERCENT OF BIRTHS WITH LATE OR NO PRENATAL CARE, 2007-2009, SAN DIEGO COUNTY RESIDENTS

  8. HISTORY County's Fetal Infant Mortality Review (FIMR) Program • Conducted Case Reviews • Convened Community Action Teams • Utilized Perinatal Periods of Risk (PPOR) Analysis • Focus on African American women

  9. FIMR FINDINGS

  10. FIMR FINDINGS

  11. A LIFE COURSE PERSPECTIVE: RACIAL AND ETHNIC DISPARITIES IN BIRTH OUTCOMES Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. MaternChild Health J. 2003;7:13-30.

  12. Organizations Community Environment Interpersonal THE FACTors OF LIFE Society/Public Policy Individual

  13. A CALL TO ACTION • Create an interactive user-friendly tool to increase knowledge and change behavior among women to take action to improve health and lifestyle choices • Build partnerships with organizations and providers in moving the concept of "waiting until pregnancy to think about being healthy is too late" to the forefront • Ensure resources are available for women to access and utilize • Improve maternal health and birth outcomes

  14. EXPANSION March of Dimes • Received Community Services Grant for Preconception Health Awareness Project • Expansion of wheels to other ethnic groups for women of childbearing age • Partner with non-clinical organizations

  15. METHODOLOGY • Data analysis and recommendations of local FIMR case review findings • Identification of clinics and organizations in high risk geographic areas • Solicit input from key community stakeholders

  16. KEY STRATEGIES • Strategy #1: Develop culturally and linguistically appropriate educational tools • Designed an eye-catching and interactive tool • African American, Spanish, and Multi-Cultural • Developed specialized messages • Translated into Spanish • Selected culturally appropriate images • Conducted focus groups • Created preconception toolkit

  17. PRECONCEPTION WHEEL Healthy Women Have Healthy Babies • Nutrition • Weight and Exercise • Stress Management • Family Planning • Medical and Dental Check-ups • Communicating with Your Healthcare Provider • Smoking, Alcohol, Drug Use and Environmental Exposure • Resources

  18. KEY STRATEGIES • Strategy #2: Identify and engage community participation • Utilize existing task force partners in promoting project • Establish relationships with community clinics and organizations • Outreach and recruit to non-traditional agencies • Develop distribution plan • Conduct educational trainings • Provide follow-up and technical assistance

  19. KEY STRATEGIES • Strategy #3: Develop evaluation process and tools • Create database for tracking project activities • Contact information • Organization profile • Material distribution • Administer surveys • Client • Staff • Conduct focus groups

  20. RESULTS • Project Period: March 2008 – November 2009 • Partners • Clinics – 18 • Organizations – 26 • Total surveys – 321 surveys completed • Focus groups - 8 conducted • Wheels – 8,000 distributed

  21. RESULTS Focus Groups • 59% reported using tips from the wheel • 77% learned something new Staff Survey • 91% stated it was easy to incorporate into their routine and facilitated healthy behavior discussions with clients Client Survey • 88% learned new information and wheel was easy-to-use • 83% would use the wheel more than once • Most helpful sections: • Eat right (63%) • Manage stress (52%) • Take care (52%) • Get moving (47%)

  22. CONCLUSIONS • Realistic time frames need to be set when developing new materials • Creating a tool with target population input is critical for acceptance • Routine follow-up is key in keeping partners motivated in delivering preconception messages • Partner buy-in is instrumental for sustainability of project • Tailor intervention to organization’s infrastructure

  23. FUTURE DIRECTION A Look Ahead… • Adapt wheel for other target populations • Incorporate preconception wheels into other settings • Institutionalize preconception education with existing partners • Serve as an example for other counties to replicate • Connect and integrate with other initiatives • A LIFETIME OF GOOD HEALTH

  24. THANK YOU • Community clinics and organizations • FIMR task force • County staff: • Sutida Jariangprasert, MPH • Shukri Adam, PHN • Cindy Tso, MPH • Amethyst Cureg, MD, MPH, FAAP Preconception Health Awareness Project funded by March of Dimes California Chapter

  25. CONTACT INFORMATION Rhonda Freeman, MPH Maternal, Child, and Adolescent Health Coordinator County of San Diego, Health and Human Services Agency Maternal, Child, and Family Health Services Phone: 619.542.4039 Email: Rhonda.freeman@sdcounty.ca.gov Website: www.sdmcfhs.org

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