Category: Community Partners

Messages from Rebecca Shlafer, Warrior of the Minnesota Prison Doula Project

By: Amanda Wojan, MPH(c)

On September 27th Dr. Rebecca Shlafer, an Assistant Professor in the Division of General Pediatrics and Adolescent Health at the University of Minnesota, came to UIC to discuss her work implementing a prison doula project. Her lecture discussed the crucial nature of implementing policies that humanize incarcerated pregnant women throughout their pregnancy journeys. She discussed that prior to the implementation of this doula program in Minnesota, they lacked the resources and knowledge necessary to provide incarcerated pregnant women with what they needed to maintain their own health/the health of their babies. As Dr. Shlafer stated, the population of women in prison who are pregnant are a vulnerable group, potentially facing environmental risks, physical health issues, and issues related to mental health and substance misuse which in turn can lead to poor perinatal outcomes such as preterm and small for gestational age infants.1 Thus, focus on interventions that promote their health and well-being is of particular interest for public health professionals thinking in terms of lifecourse models. The long term health outcomes of these babies are dependent on both the prenatal and postnatal care that these women receive, as well as their ability to form important attachments with their babies early on.

The Minnesota Prison Doula Project implemented two core components into their programming: 1) a new moms informational group, and 2) one-on-one doula supports for all pregnant women in the prison. These components are meant to provide these mothers with the resources that they need to have a healthy and successful pregnancy, and to learn the skills necessary to form positive relationships with their babies. Dr. Shlafer mentioned that the doulas also provide emotional and social support to the woman post pregnancy when they are separated from their babies. They help the mothers establish healthy coping skills in this incredibly difficult separation process.

Doula support during childbirth is associated with better health outcomes for both the mother and the baby, including better APGAR scores, shorter first stage of labor, less medical interventions required during labor/delivery, and decreased c-sections.2 Doulas are not only helpful before, during, and directly after pregnancy, but they are also key players throughout the weeks postpartum in supporting the mother and baby in activities such as breastfeeding and forming healthy relationships. A key component of forming positive relationships between mother and baby is skin to skin contact. The benefits of skin to skin contact between mother and baby are invaluable: it helps to calm the baby by reducing stress levels in both mother and baby; it helps the mother’s milk to flow more easily; it boosts the baby’s immune system; it builds important neural connections in the baby’s brain via the smells, textures, and sounds that the baby experiences; it lowers the mother’s risk of a postpartum mood disorder; and ultimately it creates lasting connections and strong attachments between the mother and baby.3

This seemingly simple concept is something that can prove extremely challenging for women in prison. Many do not have access to their babies postpartum, as they are entered back into prison after their 48 hour stay in the hospital. This leaves them only their occasional visitations with family to have any human contact with their babies. This crucial issue proposes important next steps for groups that work with these vulnerable women. The implementation of doulas in state prisons is extremely beneficial, and the data show that it improves birthing outcomes. But what comes next? How can we support new mothers who are still in prison to have successful and positive relationships with their newborns? This falls heavily on policy, advocacy, and compassion stemming from the multidisciplinary team that works to promote the health outcomes of these women and children. Our work here is not done and this is of importance considering over the last two decades the number of women in prison in the US has dramatically increased and approximately 76% of incarcerated women are of childbearing age.4

Which leads me to a powerful quote from Dr. Shlafer’s presentation: “Research without advocacy is just a dusty journal on someone’s shelf. Advocacy without research is just a temper tantrum.”5

References:

1 Shlafer, R. J., Hellerstedt, W. L., Secor-Turner, M., Gerrity, E. and Baker, R. (2015), Doulas’ Perspectives about Providing Support to Incarcerated Women: A Feasibility Study. Public Health Nurs, 32: 316–326. doi:10.1111/phn.12137

2 BOlBOl-haGhiGhi, N., MaSOuMi, S. Z., & KaZeMi, F. (2016). Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial. Journal of clinical and diagnostic research: JCDR, 10(9), QC14.

3 Breastmilk, Every Ounce Counts. Retrieved from http://www.breastmilkcounts.com/breastfeeding-101/skin-to-skin/

4 Shlafer, R. J., Hellerstedt, W. L., Secor-Turner, M., Gerrity, E. and Baker, R. (2015), Doulas’ Perspectives about Providing Support to Incarcerated Women: A Feasibility Study. Public Health Nurs, 32: 316–326. doi:10.1111/phn.12137

5 Shlafer, R. (2017). Pregnant and parenting among incarcerated women: from research to advocacy. [PowerPoint slides]. Retrieved on September 27 2017.


The Fight Against Severe Maternal Morbidity in Brooklyn: Video

By: Janet Murphy from City Limits

Statistically speaking, during the time you’re watching the video segment below, three new New Yorkers will be born somewhere in the city—three of the 120,000 or so births that occur here in a typical year. Most of those babies and their mothers get through the process in good health. But some moms end up very sick. That’s a problem called severe maternal morbidity — and it has been getting worse.

From 2008 to 2012, it shot up 28 percent in New York. And city statistics indicate race, poverty, age, access to healthcare and even whether a patient really wanted to have a baby all have dramatic effects on the risks different women face. Neighborhoods also matter: Central Brooklyn is the epicenter of SMM in New York City.

Reducing maternal morbidity is a goal of city health officials educators and providers. On Thursday’s BkLive, I was joined by Dr. Deborah Kaplan, the Assistant Commissioner for the Bureau of Maternal, Infant and Reproductive Health at the city’s Department of Health and Mental Hygiene, and Dr. Monica Sweeney, a Clinical Professor at SUNY Downstate Medical Center, where she is Chair of the Department of Health Policy and Management and the Vice Dean for Global Engagement.

The effort to fight maternal morbidity is part of the effort to reduce the more serious, if smaller, problem of maternal mortality. The U.S. has one of the worst rates of maternal mortality in the developed world, and it has edged higher in recent years. Every year, New York hospitals lose around three dozens mothers. The impact of such a death, as Sweeney notes in the video, is broad and devastating.

View the video below:

To read the full article and more articles from City Limit, please click here.


Pediatric Environmental Health Specialty Units: Creating a Better Environment for Children

PEHSU LogoFor the past 15 years, Pediatric Environmental Health Specialty Units (PEHSUs) have been advocating in communities around the country to educate people about children’s environmental health.  As a branch of the Centers for Disease Control and Prevention (CDC) these centers employ health care professionals who are devoted to informing and assisting communities in understanding the role that the environment plays in childhood health outcomes. PEHSUs are committed to protecting this vulnerable age group from the harmful effects of environmental hazards and toxic substances, with a focus on reproductive health in an effort to prevent the detrimental effects of certain exposures very early in development.

The Great Lakes Center for Children’s Environmental Health at the University of Illinois at Chicago (UIC) is one of the PEHSUs that is responsible for providing services to Illinois, Indiana, Michigan, Ohio, Minnesota and Wisconsin (Region 5) along with a unit in Cincinnati, Ohio . The UIC center strives to:

  • Work with communities and parents to teach, support, and interpret results of environmental hazards
  • Provide clinical services for children with environmental health issues
  • Provide technical assistance to public health and environmental agencies on children’s environmental health issues
  • Train pediatricians, environmental and occupational medicine physicians, medical toxicologists, and other health professionals about children’s environmental health
  • Conduct research that helps prevent children’s environmental diseases

The center is under the direction of Dr. Susan Buchanan who focuses on environmental and occupational medicine, and is a Clinical Associate Professor as well as the Director of the Occupational Medicine Residency Program at UIC. Besides pediatric and reproductive environmental health, her research interests include health outcomes of minority, low-income, and immigrant workers. The center is also staffed by a variety of health care professionals including environmental/occupational physicians, pediatric/family physicians, medical toxicologists, pediatric health nurses, and industrial hygienists. The center recently added a reproductive health care professional which has greatly improved the outreach to pregnant women who are at risk for environmental exposures negatively affecting their unborn children.

The staff educates and consults with communities and parents on a wide variety of topics, including climate change, second-hand tobacco smoke, air/water/soil contamination, heavy metal exposures, pollutants, allergens, and pesticides, among many more. Annually, the center reaches 6000-7000 attendees at 75-100 presentations with additional consultation through 150-200 individual phone calls. Through their work they are creating a better environment for young children and their communities.

For more information about the Great Lakes Center for Children’s Environmental Health at UIC you can visit their website at http://www.uic.edu/sph/glakes/childrenshealth/.


MCH Student Practicum Experiences 2015

We were able to connect with two Center of Excellence (CoE) in Maternal in Child Health (MCH) Masters students who completed their field practicums over the summer. We asked them to share their experiences and tell us what coursework helped them prepare for the programs.  Read their stories below.

Student internship program. Picture of the student and her preceptorMCH Epidemiology (EPI) Student Participates in Graduate Student EPI Program (GSEP) in Oregon

I had the privilege of participating in the Graduate Student Epidemiology Program (GSEP) at the Health Authority in Portland, Oregon. The GSEP internship is managed by the U.S. Department of Health and Human Services’ Maternal and Child Health Bureau (MCHB) and allows students to partake in MCH Epidemiology projects in state, local or tribal government settings. This summer, I worked on two projects that allowed me to use my classroom knowledge in a real world setting.

My first project focused on an analysis of Oregon youth participating in the “Choking Game,” a strangulation activity in which adolescents cut off oxygen to the brain in order to achieve temporary euphoria. Oregon is the only state conducting statewide surveillance on Choking Game participation, and our research is the first to focus on children at highest risk of injury or death – youth who participate alone. My work consisted of a literature review, statistical analysis using STATA, and draft manuscript to be considered for publication in a national journal. I will also be presenting our findings at the 2015 APHA Annual Meeting.

My second project, a cost-benefit analysis of flu vaccines administered through School Based Health Centers (SBHC), pushed me to use my analytical skills in a new realm – business and finance. My analysis demonstrated the cost-effectiveness of SBHCs across Oregon and the financial formula spreadsheets I produced can be leveraged by other states to illustrate the importance of their own SBHCs.

Over the summer, it became evident that my UIC training had prepared me to tackle these projects in an efficient and capable manner. My epidemiology, biostatistics, and MCH courses provided not only the skills necessary to complete assigned tasks, but the knowledge to apply my skills to real-world research questions. In addition, I came away with the following lessons learned:

  1. Focus on the details, but never lose site of the big picture. Learning to review the data and understand how it made sense in the big picture helped me conceptualize my findings and bridge the gap between research and broader health policy.
  2. Collaboration is key. While the majority of my work was completed with my preceptor, it was necessary to seek additional insight and feedback from other subject matter experts. Effective communication and collaboration skills are essential for future public health professionals, and I saw firsthand the value of strong working relationships.
  3. Don’t be afraid to be wrong. At the beginning, I was often nervous that my approach was flawed and found myself wishing for a non-existent answer key. With the support of my mentor, I became more comfortable taking leaps, making guesses and learning to make mistakes, which helped me grow and become more confident in my abilities.

By Alexandra Ibrahim, CoE in MCH EPI student

 

Cindy San Miguel, CoE student with leadership award MCH Student Participates in MCH Paired Practica Program in Michigan

I completed the National MCH Workforce Development Center’s Paired Practica at the Michigan Department of Health and Human Services in the Children’s Special Health Care Services (CSHCS) division. The practicum focuses on developing the next generation of MCH professionals by pairing a graduate student from a Maternal Child Health Program with an undergraduate student from Howard University.

My mentee and I worked on a project for the CSHCS’s Family Center, a parent-driven unit providing emotional support and resources to families of children and youth with special health care needs. Acknowledging that technological advances have created new opportunities for communication, our project focused on:

  • How the division communicates with families today,
  • What families feel about the current communication, and
  • What families want to see in the future.

We designed the entire analysis, from conducting a literature review, to gathering data and reporting final results. Twenty-eight families were recruited and administered a mixed methods survey (multiple choice and open-ended questions). We also created a database documenting the social media presence of the 45 Local Health Departments. Our findings were then presented to division leader, who are now working to implement our recommendations. I was surprised at how much I relied on my coursework throughout the summer. I had not worked with this population before, so I returned to lectures from my MCH courses to better understand the issues facing parents of children with special healthcare needs. The spring MCH Systems course (CHSC 511) was particularly helpful in preparing for the practicum. One of my other projects was to track the monthly budget for an epilepsy grant, and I used my budgeting slides from the spring Integrated Core course.

While it is difficult to narrow down, the top three things I learned this summer were:

  1. Mentorship is incredibly important. My practicum reminded me of the value of having a good support system. A lot of us will end up in leadership positions, and the experience of mentoring another student helped me prepare for future leadership roles.
  2. Care coordination is essential. We acknowledge care coordination as an issue in our courses, but working with families who have children with really complicated medical issues, allowed me to understand the burden families face when coordinating the multitude of services for their children.
  3. Remember to humanize our communities. Each individual makes up the community, and individual stories are indicative of what is happening at the broader population level. It was heartbreaking to see families’ day-to-day struggles, but also encouraging to know that when we do good public health work, we can improve families’ everyday lives.

By Cindy San Miguel, CoE in MCH student


Attending the 2015 Association of Maternal and Child Health Programs (AMCHP) Annual Conference

3304ce9In January 2015, I had the privilege of attending the 2015 Association of Maternal and Child Health Programs (AMCHP) Annual Conference in Washington, D.C. The conference, titled “United to Build Healthier Communities,” was an opportunity for me to network, learn, and go to Capitol Hill to advocate for the MCH Title V Block Grant.

On Saturday, I began the conference by attending a skills building session focused on community economic development strategies. This session emphasized collaborations, partnerships, and constituency building in expanding our MCH work to focus on economic development as a social determinant. At this session, a group of us from different sectors in Illinois brainstormed different ways in which economic barriers perpetuate inequities for Illinois families.

Other sessions that I attended focused on early childhood, MCH leadership, collaboration in policy and advocacy, systems thinking, and MCH 2015 policy issues. Since the conference brought together leaders from non-profits, universities, and state and local MCH programs, these sessions created rich discussions because of the various expertise and viewpoints. Often, these sessions were interactive and collaborative and I appreciated learning from the leaders of the sessions as well as the attendees.

Monday was the most rewarding day for me at the conference. After attending a session on 2015 MCH policy and discussing the funding needs of MCH programs, I went to Capitol Hill to advocate for Title V along with Dr. Arden Handler, Illinois Title V Director Dr. Brenda Jones, and LEND trainee Ryan Murphy. We visited both Illinois Senator Dick Durbin’s and Senator Mark Kirk’s offices and met with their health aids. We shared information on the importance of the MCH Title V Block Grant and the impactful work happening in Illinois. In addition, we provided resources on UIC SPH’s MCHP program, the LEND program, and other Block Grant specific programs. It was a pleasure to attend this hill visit that Dr. Handler organizes annually. In Dr. Handler’s Advocacy and Policy course, I learned about strategic ways to advocate to a legislator, and this was a prime opportunity for me to practice with a pro!

Throughout this conference, I took advantage of the opportunity of being around so many MCH professionals by networking. AMCHP encourages state programs to learn from their regional peers and the region V (IL, WI, MI, MN, OH, IN) lunch was a chance for us to meet with and learn from these other Title V programs. However, by far, the highlight of my networking efforts was meeting Dr. Michael Lu, Associate Administrator of MCHB! He was a pleasure to speak with and was encouraging of my upcoming step into the MCH workforce. Overall, this conference was a huge success; I tackled my first lobbying experience, made some promising connections, and gained a deeper understanding of the network of Title V programs and the future directions of the Block Grant. I am thankful to UIC SPH MCHP for providing me the opportunity to attend this conference!

Written by Joanna Tess, UIC Maternal and Child Health MPH Candidate


Alumna Success Story–Jessica Bushar Providing Access to Crucial Health Information for Mothers

Jessica_Bushar_picture

Jessica Bushar, MPH
Research Director Text4baby
National Healthy Mothers Healthy Babies Coalition

Jessica Bushar earned a Master of Public Health in Maternal and Child Health Epidemiology at UIC in 2010 and was a recipient of an award from Irving Harris Foundation. Following her graduation from UIC, Jessica was a Principal Research Analyst at NORC at the University of Chicago. In 2012, she began working at the National Healthy Mothers Healthy Babies Coalition (HMHB) where she now holds the position of Research Director of Text4baby.

Jessica is passionate about her work on Text4baby, which partners with more than 1,200 local, state, and national partners to improve the health of mothers and babies by providing timely, vital health and safety information to mothers by via text message. The Text4baby program has reached over 800,000 pregnant women and new moms and provided them with over 116 million text messages. As the Research Director, Jessica spends much of her time at HMHB working with partners and staff to evaluate Text4baby’s impact and facilitate research informed quality improvement.

Jessica believes her degree in Maternal and Child Health Epidemiology from UIC helped improve her qualitative research skills and gain the competencies needed to make her a well-rounded researcher – skills that have made it possible for her to excel at her position as Research Director of Text4baby. Jessica’s research is implemented in real time to make a widespread positive impact on the lives of moms and babies through easy to access, crucial health information.

Written by Cristina Turino, UIC Research Assistant and UIC MCH MPH Candidate


Practicum Experience 2014: Chicago Department of Public Health

IMG_7584 (4)So far, our time at the Women and Children’s Health Division at the Chicago Department of Public Health (CDPH) has been very translational to what we learned in our first year at the University of Illinois at Chicago, School of Public Health (UIC SPH).  We are conducting a Community Health Needs Assessment for the MCH population in Chicago under the guidance of CDPH Assistant Commissioner, Susan Hossli. To start, we gathered quantitative data in the form of vital statistics; this included infant mortality rates, low birth weight percentages, preterm deliveries, and teenage pregnancy rates for Chicago and the 77 community areas. We used the data to identify 18 community areas that have the poorest outcomes and we designated them as “Hot Spots.” These community areas are located on both the South and West Sides of Chicago.

After we compiled quantitative data for Chicago and the Hot Spots, we created a demographic picture of each neighborhood, which included socioeconomic status, overall health, education attainment, insurance, income, housing, poverty, crime, food access, and educational resources. These topics touched on what we learned in the Determinants of Population Health class, a new introductory class in the pilot core (IPHS 494). We learned that health is not only affected by biological factors, but also where you live, learn, play, work, pray, and age. It is also pivotal to understand that factors affecting health run the entire life course, as well as transcend generations.

Following the quantitative data, we prepared a systems analysis for each community area. The systems assessment analyzes the available resources in one’s neighborhood; this includes, but is not limited to Healthy Start programs, FQHCs, Healthy Families, Better Birth Outcomes, family case management, hospitals, clinics, birthing hospitals, WIC, family planning, behavioral health programs, and dental programs. This process was very informative because we gained a holistic view of the healthcare environment in the Hot Spot community areas.

We took Community Health Assessment (CHSC 431) in Spring 2014, and it was the perfect primer for this practicum. The knowledge, skills and tools we gained in that class proved essential for our success in this practicum. In CHSC 431, we learned the basics of a community health assessment: what it is, how the process works, where to find the appropriate and credible data, how to identify priority issues, how to obtain and analyze qualitative data, and then how to disseminate the information to community groups and key stakeholders. Another useful class prior to this practicum was MCH Delivery Systems: Services, Programs, and Policies (CHSC 511). In this course, we were introduced to the concept of what a health care delivery system is. We learned about the service delivery system for women, infants, children, and children with special health care needs. Our cumulative project over the semester was to synthesize and analyze the MCH delivery system for various states.

For a holistic view on the health status of Women and Children in Chicago, it is necessary to have a mixed-methods approach for data acquisition. Quantitative data is important to provide a snapshot of the health status, but qualitative data provides a full narrative of the gaps in access to a healthy life. We are currently scheduling focus groups on the West and South Sides of Chicago with consumers, service providers, and community based organizations. The focus groups will complete the needs assessment, and then a Strategic Plan for the City of Chicago will be formulated based on the data and gaps in services found in the needs assessment.

This practicum has been a learning opportunity since we have seen our coursework play out in a practical setting. It is exciting to see our work with the needs assessment play such a large role for the Department of Public Health. This project was undertaken with the hopes of influencing future programming and decision making within the city for healthy mothers and babies.

By Joanna Tess and Dan Weiss, UIC MCHP Students

 


Save the Children Event at UIC: Uniting for Maternal and Child Health

The University of Illinois at Chicago (UIC), Maternal and Child Health Program (MCHP) partnered with Save the Children, UIC’s Global Health Initiative, The University of Chicago’s Global Health Initiative, and Northwestern University Feinberg School of Medicine’s Center for Global Health to host a seminar at UIC on October 14th.  This was part of a three part lecture series where each university hosted an event that addressed various topics related to maternal and child health.

The keynote speaker was Steven Wall, MD, MPH, MSW, Senior Advisor, Save the Children, who discussed a report that was recently released by Save the Children entitled, “Surviving the First Day: State of the World’s Mothers 2013”.

Then the seminar focused on connecting the global to the local, and there were brief presentations by the following stakeholders:

  • Brenda Jones, DHSc, MSN, APN-BC, Deputy Director, Office of Women’s Health, Illinois Department of Public Health
  • Janine Lewis, MPH, Executive Director, EverThrive Illinois
  • Rosemary White Traut, PhD, RN, FAAN, Professor, Department of Women, Children and Family Health Science, UIC College of Nursing

The MCHP would like thank all our partners for such a great event!  It was a pleasure working with all of you and we look forward to working with you in the future!

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MCH Seminar–Shattering Families: How Mass Incarceration Harms Parents and Children

On March 12, 2013, the Maternal and Child Health (MCH) Training program at University of Illinois at Chicago (UIC) hosted the seminar “Shattering Families: How Mass Incarceration Harms Parents and Children.” This seminar featured two speakers: Gail Smith, Senior Policy Director at Chicago Legal Advocacy for Incarcerated Mothers (CLAIM), and a Visible Voices speaker. Visible Voices is a group composed of formerly incarcerated women who speak out and share their experiences with others. A diverse crowd of individuals from within and beyond the UIC School of Public Health assembled to hear these two speakers discuss issues related to the mass incarceration of all women and, in particular, of mothers.

Ms. Smith presented information on the scale of this issue, outlining the dramatic rise of incarceration in the United States over the past 40 years and how rates in this country are much higher than those in other developed nations. The female prison population grew by 832% between 1977 and 2007. About 80% of these women are incarcerated for non-violent offenses, and 80-85% of all incarcerated women are mothers. Ms. Smith outlined how this leads to several unique issues for the children of these women. For example, if a mother is her child’s sole caregiver, the child will be transitioned into the care of another family member or the foster care system. The latter is of particular concern since the Adoption and Safe Families Act of 1997 allows for termination of parental rights if any child is in foster care for 15 of the 22 previous months. She then discussed how everyone impacted by the criminal justice system would benefit from a restorative justice approach, which focuses on healing rather than punishing. The Visible Voices speaker then put a face to all of these statistics as she shared a powerful, personal account of her experiences with the criminal justice system and how her incarceration directly impacted her sons.

For more information on this issue and to learn how to become involved, please visit CLAIM’s website: http://www.claim-il.org/.

 

This blog entry was written by MCHP student, Nicole Gonzalez who also organized this event.

 

 


Want to Know More About MCH?

The students in the University of Washington Maternal and Child Health
(MCH) Program and in other MCH schools of public health training
programs nationwide created a visual narrative of the public health work
and research they are doing in their communities. The presentation was done with the help of Charlotte Noble and the University of South Florida MCH Program.

You can view the presentation here.  If you are interested in engaging in work that improves the health and well-being of women, men, children, and families then you will enjoy this presentation – it may even give you ideas about how you can make a difference!

The stories help illustrate how MCH makes a difference in the lives of
women and children.