A Child 4 TH Annual California Breastfeeding Summit Monique - - PowerPoint PPT Presentation

“It Takes A Village To Nurse A Child”

4TH Annual California Breastfeeding Summit Monique Sims-Harper, DrPH, MPH, RD, IBCLC January 30, 2014

Background

• The birth outcomes of African American

women are much poorer than for any other race.

• Formula fed infants are 1.5 times more

likely to die than if breastfed.

• African American infants are twice as likely

to die before their first birthday as other infants.

• African American mothers are 3 – 4 times

as likely to die from labor and delivery complications as other mothers.

Breastfeeding is…

Natural

Working with Families of Different

Cultures

Session Objectives

 Assess Topic Relevance  Define Culture  Define Cultural Representation in CCC WIC

 Employees, Clients

 List a personal cultural belief that can interfere with BF promotion  List 3 methods that assist in educating clients based on their needs

5

“If a medicine were developed that could prevent the deaths of a million or more children per year and greatly reduce childhood illness and disease…What if this medicine had no side effects…and if this miracle substance was also free

• f charge?”- Barbara Quick

Breast Milk

Surgeon General’s Call to Action

• n Breastfeeding
• Excess Health Risks Associated with Not Breastfeeding

– Acute Ear Infections – 100 – Diarrhea and vomiting -178 – Hospitalization for lower respiratory tract infection – 257

• Public Health must demonstrate leadership through:

– Accelerate the implementation of the Baby-Friendly Hospital Initiative – Establish partnerships for integrated and continuous follow-up care after discharge from the hospital

http://pediatrics.aappublications.org/content/early/2010/04/05/peds.2009-1616

Healthy People 2020 Objectives

MICH-21.1 Were ever breastfed (any breastfeeding) 81.9% MICH-21.2 Were breastfed at 6 months 60.5% MICH 21.3 Were breastfed at 1 year 34.1% MICH 21.4 Were breastfed exclusively through 3 months 44.3% MICH 21.5 Were breastfed exclusively through 6 months 23.7% MICH-22 Increase the proportion of employers that have worksite lactation support programs 38% MICH-23 Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life 10% MICH-24 Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies 8.1%

www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=26

• Hospital Exclusive

and any Breastfeeding Rates

• Between Hospital

Newborn Screening results and discharge data

• Discharge BF rates

and PP BF rates

• African-American

and White BF rates

Closing the Gaps

Continuum of Care

COPP Grant

• California Obesity Prevention Program (COPP)

– 15 Clinic Awardees Statewide – Develop and pilot criteria for a Breastfeeding Friendly HealthCare Provider certification. – Implement systems to provide and bill for breastfeeding support services and pumps

Clinic Improvements

• Staffing
• Scheduling
• Referrals
• Staff Education
• Billing & Reimbursement
• EMR

• State Law

2002(Frommer) Time & Place

• Federal Law 2010 ACA
• Pregnancy Disability

Regulations

• State Law 2012 (Allen)

Discrimination

Workplace Lactation Accommodation

Churches as Partners

• Allen Temple Baptist Church, Oakland, CA

Allen Temple Baptist Church

• Campus

–Sanctuary, AIDS housing, Credit Union, Senior housing, Gym, Library, Offices/Training Rooms, Family Life Center

• Services/Resources

–Food Distribution, Counseling, Head Start, Youth & Family Services, Media/Arts/Worship training, Scouts, Prison ministry, Social Services, Health services

Best Practice Model: Glide Memorial

• Comprehensive, integrated service

model

• High visibility in community
• Paid staff for all programs
• Large volunteer force
• Clear structure
• Local and global activities
• Working partnerships with CBOs

Common Faith – Health Activities

• Health screenings/referrals and trainings
• Health fairs
• Nutrition and exercise classes
• Health messages in church media and

pastoral sermons

• Surveys
• Distribution and development of health

materials (print, video, cookbooks)

Elements that Promote Success

• Partnerships/collaborations
• Positive health values shared
• Membership > 400 members
• Church Resource Availability
• Ministers with graduate education
• Church ownership
• Commitment of church leaders
• Organizational Structure/Accounting &

Documentation

Why Engage Faith-Based Organizations?

• Churches have a history of community involvement
• Representation of millions of Americans

– 60% of US citizens worship is important – 42% report church attendance nearly every week

• Faith based organizations influence social norms and

attitudes and encourage lifestyle and behaviors consistent with recommended Public Health practices.

• Faith institutions are stable, strategically placed and

accessible and culturally appropriate to their members.

• Churches have valuable resources – health

professionals in the congregation and have access to facilities.

Why Engage Faith-Based Organizations?

• Faith communities are service oriented

and a rich reservoir of volunteers

• Church space and facilities
• Vast administrative, media and

communications infrastructure

• Traditionally serve the underserved and

marginalized – address health disparities

• Have established programs targeting

women, men, youth and incarcerated populations.

Formative Research

• Literature Review
• Consultation with pre-existing community

collaborations

– Breastfeeding Coalition – Black Infant Health Program and Coalition – Solano County Health Disparities Coalition

• Focus Groups

– 16 focus groups

• Clergy, women, men and teens
• Results informed the intervention

A More Excellent Way Health Community Breastfeeding Program

Monique Sims,

DrPH, MPH, RD, IBCLC Chief Executive Officer, A More Excellent Way Health

What is “A More Excellent Way*”

• An organization that aims to promote

wellness and reduce health disparities.

• MEW engages health organizations, the

community, and particularly churches, to provide health education, information and resources.

*“A More Excellent Way” refers to I Corinthians 12:31

But covet earnestly the best gifts: and yet show I to you a more excellent way.

Collaborative Partners

• Collaborators

– African American Churches – WIC – Black Infant Health Program and Coalition – Breastfeeding Coalitions – AA Breastfeeding Cultural Outreach Task Force – Kaiser Permanente Women’s Health Department – La Clinica De La Raza

• Key Funders:

– Kaiser Permanente – Los Medanos Community Health Care District – First 5 Solano Children and Families Commission

Activities

• Church Leadership training on health

disparities in maternal child health, the importance of breastfeeding, and the MEW Intervention

• Church breastfeeding-friendly assessment

and improvement

• Peer Counselor Training (Six 4-hour

Saturday sessions)

• Community Baby Shower
• Monthly Peer Counselor continued training
• Mother-to-Mother monthly Support Group

Breastfeeding is…

Part of My Heritage

Community Baby Showers

• Recruitment Strategy
• Community Education
• Health Workshops for Pregnant mother,

father of baby, grandmother and siblings

• Health Fair Referrals and Linkages
• Breastfeeding Education to all Participants

Pilot Project: 2005-2006

• Randomized interventions and wait-listed

control group at one church

• Pre- and Post- intervention surveys
• Outcome measure: breastfeeding intention
• Result:

– Increase in breastfeeding intention and confidence in the Intervention Group

2006: Revival Center Ministry, Vallejo

2007: True Love Baptist Church, Fairfield

2008: Tabernacle of David, Vallejo

2009: St. Stephens CME Church, Fairfield

2012 Friendship Missionary Baptist Church

2013 MEW Expansion to Contra Costa County

Good Samaritan Church, Vallejo Solomon Temple Church, Pittsburg

Outcomes/Successes

• 9 churches have participated
• 201 participants attended SOME of the

Peer Counselor Training

• 93 Completed the Peer Counselor

Training

• 581 Contacts by Peer Counselors
• 9 Community Baby Showers serving over

900 pregnant African American women and expectant fathers

Questions / Discussion