Geraldine Oliva, M.D.,MPH 1 Jennifer Rienks, MS, Ph.d (c) 1 Virginia Smyly, MPH, CHES 2

1. SevenPrinciples for African American Infant Survival and Community Unity * Levels of Awareness of Disparities in African American Infant Mortality, SIDS Prevention Strategies and their Correlatesin 4 San Francisco Neighborhoods Geraldine Oliva, M.D.,MPH1 Jennifer Rienks, MS, Ph.d (c) 1 Virginia Smyly, MPH, CHES 2 Judith Hager Belfiori, MA, MPH, Linda Mack Burch, MPH 1 • University of California, San Francisco, Family Health Outcomes Project, 3333 California Street, Suite 365, San Francisco, CA 94118 • San Francisco Department of Public Health

2. Infant Mortality in San Francisco • In 2000 the SF African American infant mortality rate for was 9.2 almost three times the rate for whites and double that for other race/ethnic groups • This disparity has persisted for over 15 years • The preterm birth and low birthweight rates remained twice that of whites over the same time period UCSF Family Health Outcome ProjectAPHA 2004

3. SevenPrinciples Project Description Goal:To eliminate disparities in African American infant mortality rates in San Francisco and improve infant survival and the health of families and communities through increasing community protective factors and educating and supporting community members Philosophy:Project values and strategies derived from Karenga’s seven principles of Kwanza (Nguzo Saba) Funding:Centers for Disease Control REACH 2010 Initiative. UCSF Family Health Outcome ProjectAPHA 2004

4. SevenPrinciples Project Partners and Stakeholders • San Francisco Department of Public Health • Booker T. Washington Community Service Center • CA Health Education Employment and Dignity, Inc. • IT Bookman Community Center (Pilgrim) • Jelani House • Family Health Outcome Project, University of California, San Francisco UCSF Family Health Outcome ProjectAPHA 2004

5. Public Awareness Campaign Based on Nguza Saba Value Ujima(Collective Work and Responsibility)“To build and maintain our community together and make our brother’s and sister’s problems our problems and solve them together.” Description of Campaigns: • AA babies are 2 times more likely than white babies to die in the first year of life • Babies sleep best on their backs • Take action to stop AA babies from dieing UCSF Family Health Outcome ProjectAPHA 2004

6. Study Objectives 1) To assess the level awareness of racial disparities in infant mortality rates, associated risk factors and their correlates in African Americans residing in the 4 targeted San Francisco neighborhoods 2) To compare awareness levels before and after a 3-pronged public awareness campaign targeting those neighborhoods UCSF Family Health Outcome ProjectAPHA 2004

7. Results: Baseline Survey Demographics • 804 AAs aged 18-64 years old were surveyed. • 71 % of participants self define as AA only, 22% Black and 6.7% mixed AA and other. • 62.8% of respondents were female and 37.2% male. • 12% of respondents are between 18 to 25 years old, 16.3% are between 26-39, 31.5 % are between 40-54, and 40% are 55 to 64 years old. UCSF Family Health Outcome ProjectAPHA 2004

8. 70.0% 57.3% 60.0% 50.0% 40.0% 30.0% 24.4% 20.0% 8.2% 7.0% 10.0% 3.1% 0.0% Never heard Occasionally heard Often heard Repeatedly heard Not sure Results: Baseline Survey Have you heard that African American babies are 2-3 times likely to die? UCSF Family Health Outcome ProjectAPHA 2004

9. Results: Factors Associated with Disparity Awareness UCSF Family Health Outcome ProjectAPHA 2004

10. 94.5% 100.0% 94.1% 86.8% 90.0% 80.0% 69.7% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Put baby on back to sleep Avoid fluffy pillows Avoid secondhand smoke Get good prenatal care Results: Awareness of SIDS Risk Factors UCSF Family Health Outcome ProjectAPHA 2004

11. Results: Factors Associated with Awareness of Proper Infant Sleep Position UCSF Family Health Outcome ProjectAPHA 2004

12. Results: Awareness of Disparities after Campaigns Chi-square analysis reveal that at time 2 Bayview respondents are 4.1 times more likely to have ever heard IMR disparity than respondents from time 1 (OR = 4.1, CI 2.7-6.2, X2 = 45.1, p <.0001). UCSF Family Health Outcome ProjectAPHA 2004

13. SevenPrinciples Project – Evaluation The UCSF Family Health Outcomes Project (FHOP) acts as both a project partner and the project evaluator A model for participative evaluation is used with workgroup involvement from health care providers, community members & faith leaders The evaluation provides formative, monitoring & outcome data The evaluation data are used to both refine the interventions and to monitor their impact UCSF Family Health Outcome ProjectAPHA 2004

14. Conclusions SevenPrinciples is a culturally specific and creative project which has uniquely incorporated the Seven Principles of Kwanzaa into intervention strategies to engage San Francisco’s African American community in improving infant health and survival informing both national and local efforts. UCSF Family Health Outcome ProjectAPHA 2004