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Building State and Local Partnerships to Promote Preconception Health: The Florida Experience

Building State and Local Partnerships to Promote Preconception Health: The Florida Experience. Carol Brady, Executive Director, Northeast Florida Healthy Start Coalition, Inc. EveryWoman SE Webinar  November 4, 2010. Background & Overview. MCH in Florida: Key Stakeholders

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Building State and Local Partnerships to Promote Preconception Health: The Florida Experience

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  1. Building State and Local Partnerships to Promote Preconception Health: The Florida Experience Carol Brady, Executive Director, Northeast Florida Healthy Start Coalition, Inc. EveryWoman SE Webinar  November 4, 2010

  2. Background & Overview • MCH in Florida: Key Stakeholders • State & Local Collaborations in preconception health (PCH) • Perinatal Periods of Risk (PPOR) Practice Collaborative • Preconception Care (PCC) Community Initiatives (Title V) • VitaGrant Initiative • Black Infant Health Practice Initiative • Interconception Care (ICC) Pilots (MOD) • Lessons Learned

  3. MCH in Florida • State Healthy Start legislation • Created and funded 30 community-based non-profits focused on reducing infant mortality, promoting healthy child development • State agency leadership • Title V willing to “think outside box” • Strong March of Dimes • History of collaboration (state DOH, local MCH agencies) • Visionary

  4. MCH in Florida • Stakeholders: offer different strengths, resources, organizational structures, capacity • Allowed Florida to create, take advantage of opportunities in PCC • Highlight five examples of state-local partnerships

  5. PPOR Practice Collaborative • Recognition of need to move before and beyond pregnancy (2002) • Opportunity to “build a case” using Perinatal Periods of Risk (PPOR) • Proposal submitted to MOD to replicate national practice collaborative (CityMatCH) with coalitions and local health departments in seven largest counties

  6. PPOR Practice Collaborative • Teams met quarterly to analyze data, translate data into practice • DOH provided TA, along with other experts • Resulted in expansion of HS services to include interconception education and support, in addition to “traditional” case services during pregnancy • Link between PCC and disparities • Incorporated into state plan (Title V)

  7. PCC Community Initiatives • $3 million in “extra” Title V funding authorized in 2006 • DOH allocated funding to Healthy Start Coalitions (HSC) to develop and implement new CDC recommendations on PCC • Focus: community outreach & education, provider education & direct services • Streamlined RFP & funding process

  8. PCC Community Initiatives • Community Outreach • Movie theatre ads: raising awareness among young women • Faith-based partnerships • Collaborations (STEPS, Federal Qualified Health Centers (FQHC), Closing the Gap Grants, Zero Exposure, WIC)

  9. PCC Community Initiatives • Provider Education • Conferences, workshops, train-the- trainer • Web sites • Info sheets, brochures

  10. PCC Community Initiatives • Direct Services • Dental care to address periodontal infections: women identified in primary care, family planning clinics • Weight management, nutrition counseling to address obesity • Training, screening, education in private MD offices

  11. 2006 – 2008 VitaGrant Initiative • MOD funded and partnered with the Department of Health • Provided and distributed educational materials and multivitamins with folic acid to women of childbearing age statewide • Paid for staff outposted in state DOH • Knowledge increased from 3 – 92%; multivitamin consumption increased from 6 percent to 88%

  12. Black Infant Health Practice Initiative • Advocacy efforts (disparities) resulted in $1 million appropriation for BIHPI (Federal HS) • Implemented through DOH in eight counties with largest disparities in birth outcomes (urban, rural) in 2008-09 • Teams included state, federal HS, DOH and community representatives • Strategies: PPOR, FIMR and community engagement

  13. Black Infant Health Practice Initiative • Results underscored importance of preconception health on disparities • Aligned efforts in communities with state & federal Healthy Start initiatives • Strengthened advocacy around preconception health • Increased community awareness, engagement around issue

  14. ICC Pilots • MOD initiated “focused” funding in 2009 • Three community-based pilot projects currently funded to develop ICC model for mothers who have had a baby hospitalized in NICU • Multi-site evaluation • Potential for sustainability through HS

  15. Lessons Learned • State, local partnerships are more powerful than “top down” or “bottom up” alone. • Alliances between public, private and voluntary sectors provide the flexibility required for innovation. • Collaborative state, local initiatives can stretch limited resources. • Different perspectives – one goal

  16. Resources • EveryWoman Florida http://everywomanfl.com • Preconception Health Indicator Report http://everywomanfl.com/Pages/Healthcare_Providers/Preconception_Health_Indicator_Report.aspx • HS Standards & Guidelines – Chapter 21 ICC Education & Counseling http://www.doh.state.fl.us/family/mch/hs/hstraining/hstraining.html

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