Category: MCH Leadership and Legacy Community of Practice

Early Childhood Justice: Moving Forward

On October 18th 2016, experts in housing, health and employment; students, and early childhood advocates met at Loyola University’s Sargent Shriver National Center on Poverty Law to discuss progress, explore new data on the race and poverty disparities of health, and develop a trajectory for future research in the field of early childhood health. This conference, titled, Justice from the Start: Exploring Racial Disparities in Access to Services for Babies and Toddlers, included keynote speaker Olivia Garden, Executive Director of Loyola’s Center for Law and Social Policy, and featured Dr. Aisha Ray, Professor Emeritus at Erikson Institute.

In Chicago, Hispanic children are two times as likely to be born into poverty, and among African American children, this statistic increases to three. The mission of Shriver Center is to “promote justice, and improve the quality of life and opportunities for upward mobility for those living in poverty.” To best identify and address the needs of our most disadvantaged communities, advocates must approach system change with the application of a “race lens.” As Olivia Golden presented: young children of color are the poorest population among children aged 0-3; and a child born poor, is more likely to become an adult who is poor.

A theme throughout the conference was the intersection of race and poverty and their impacts on health of young children and their families. Early exposure to poverty impacts the lives of children in many direct and indirect ways. Increased food or housing insecurity, a lack of health care services, racial discrimination, and limited proximity to early childhood centers compound the challenges faced by young children and their families. Those who are invested in the fight to break the cycle of poverty in Early Childhood to break the cycle of poverty: must prioritize racial justice. This approach will impact the lives and stability of parents, and as a result the health and wellbeing of their young children will be improved.

Participants explored the importance of structural racism and equity in the development of policies, services, and programs targeting the needs of infants and toddlers. In Chicago, across the United States, race remains a controversial subject, and racism as a barrier to health needs to be included in our nations dialogue of health equity. Structural and institutional factors, such as early childhood education centers or screening programs, influence childhood health outcomes; however, we need to recognize how we exclude the most at need when we frame future laws and policies. The following are examples of policies that impact health equity in Early Childhood:

  • Proximity of high quality, bi-lingual early childhood programs to the infants and toddlers most in need;
  • Policies which allow the expulsion or suspension of preschool-aged children;
  • Implicit bias and lower expectations of children and families of color;
  • Quality of programs or curricula used with children in poverty and of color.

Beyond recognizing the many challenges and barriers Early Childhood advocates face, participants had the opportunity to discuss areas where we can advocate. With an accumulation of research focusing on equity in early childhood, there is an increasing wealth of data that can be leveraged to strategize future steps. To reduce structural racialization and implicit bias, we can target different levels of change. Through personal and interpersonal change, individuals become more effective in relating to others and interpersonal conflict in reduced. Individuals and groups can collaborate to address structural and systemic inequities, such as biased hiring practices and promotion, policies, and a lack of inclusive institutional cultures. Participants then discussed how to address these systemic inequities. The following are some examples of proposed strategies:

  • Improve data collection to make up for inconsistent data
  • Focus on structural racism systemic inequality rather than personal prejudices
  • Broaden the representation of diverse individuals and communities most affected by early childhood policies and programs
  • Develop a highly qualified, culturally, racially, and linguistically diverse early childhood workforce.

We are tasked with the responsibility as professionals in early childhood to challenge these barriers to equity. With further research and a greater understanding of new data on race disparities in early childhood, advocates can ensure that all children have equal access to services, regardless of their race or poverty status.

Written by: Paula Satariano, MPH Candidate 2018 and Irving Harris Early Childhood Scholar


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


MCH Students Champion Human Milk Banking

1965420_823145687700167_1210488824_oThe Mothers’ Milk Bank of the Western Great Lakes, a non-profit donor human milk bank, was established in January 2011 with the mission to provide pasteurized donor human milk to premature and low-birth-weight babies in the Wisconsin and Illinois region. Our most fragile babies’ lives rely on human milk. Their sensitive and underdeveloped digestive systems have special feeding needs in which formula feeding may do more harm than good. Infant formula lacks the anti-infective and anti-inflammatory ingredients found in natural human milk that can help prevent intestinal conditions such as necrotizing enterocolitis (NEC) and other long-term health complications that are prevalent in premature babies. Several studies have shown that infants that are born premature who receive even partial human milk feedings leave the hospital earlier and are less likely to develop NEC. Donating breast milk gives lactating mothers an opportunity to use their excess milk supply to save a premature infant’s life, and is also seen as a bereavement strategy for grieving mothers who recently lost their infant.

Jennifer Anderson, a current UIC Maternal and Child Health (MCH) student and Executive Director of the organization, has been growing and managing the extensive network of milk bank supporters and donor milk drop-off centers, or depots, in Wisconsin and Illinois. The organization’s outreach efforts have focused on raising awareness among physicians, nurses, and public health professionals, about ways to incorporate pasteurized donor milk as a standard feeding practice in hospital neonatal intensive care units.

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In January 2014, a group of UIC MCH classmates formed the Associate Board of the Mothers’ Milk Bank of the Western Great Lakes with the goal of increasing awareness among young professionals and garnering support with regard to the importance of human milk access. Since its inception, the Associate Board has hosted a screening of the documentary “Donor Milk” to bring awareness of the issue, held several fundraising events, and assisted with planning the Mother’s Milk Bank 2014 Race to Save Tiny Lives 5K Run/Walk. The funds raised have directly contributed to opening the milk processing facility in Northern Illinois.

This year, the Associate Board is actively pursuing the establishment of additional milk depots in order to make the donation process easier for mothers living within the city of Chicago. Members are also excited to be assisting with the Inaugural Human Milk Banking Conference, hosted by the Mothers’ Milk Bank of the Western Great Lakes, taking place in November 2015 at the NIU Hoffman Estates Conference Center.

10365315_966815979999803_1042634725965134391_oWe are always seeking new members who are dedicated to providing human milk to the most vulnerable infants in our region. To stay updated on our meetings and events, please follow us on Facebook and Twitter.

Written by Bree Medvedev, MPH in MCH Candidate, and Tamara Kozyckyj, MPH and Maternal and Child Health Program Alum


Janine Lewis, MCHP PhD Candidate, Receives 2015 Young MCH Professional Award from AMCHP

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Maternal and Child Health Program PhD Candidate and EverThrive Illinois Executive Director, Janine Lewis, receiving the 2015 Young MCH Professional Award for Region V at the AMCHP Annual Conference.

 


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


MCH Seminar–Self-Care: Practical Ways to Move from “Should” to “Good” Habits

On February 23, 2012 Nikki Lively a Clinical Social Worker in the Women’s Mental Health program in the Department of Psychiatry at the UIC Medical Center gave a presentation about self care.  The workshop covered key obstacles to healthy self-care, and provided tips and experiential exercises that participants could choose from to build their own customized “tool kit” for taking care of themselves physically, emotionally, and spiritually.

 

Click here  to download the powerpoint presentation and the handouts

Click here to download the audio recording of the workshop (please note that the first 40 minutes of the 90 minute presentation was not recorded. We apologize, but we experienced some technical difficulties)

 

Relevant Links:

 

“The operative word is “practice”.  Practicing self-care is not the path of least resistance; it is a conscious choice you make again, and again, and again…” ~ Nikki Lively

 


UIC MCHP Retreat Keynote Speaker: Dr. Stephen Bogdewic

This year at the UIC MCH Retreat the leadership training will be facilitated by Dr. Stephen Bogdewic, the Executive Associate Dean for Faculty Affairs & Professional Development at the Indiana University School of Medicine.  He is an innovative, thought leader. He is connected with the human spirit and our core desires to make an impact. He has taken what he teaches and implemented it in practice to help change the face of the Indiana University School of Medicine.

Learn more about Dr. Bogdewic by reading a couple articles that he wrote or listening to his radio show Sound Medicine.

 

 


A Space for Learning, Growing, and Feeling Inspired

Participants discussing “Commitment” within MCH Leadership during a group activity

As a volunteer, I had the opportunity to participate in the Maternal and Child Health National Leadership Retreat this summer.  The theme was “Leadership, Legacy, and Community” and throughout the three-day retreat, it became very clear how this truly prospers.  There was an intentional focus on intergenerational connections, especially in learning from one another in our leadership and practice, discussing the current issues we face in government, in academia, and in the field, and from this, passing down the torch of the maternal and child health profession—with integrity, enthusiasm, and sincere trust.

This was extremely unique and unlike any other conference, workshop, or retreat I had been to before.  The theme of community also took shape, not only in the daytime group activities, but in the evening social gatherings.  I remember sitting around a small wooden table with key MCH leaders (such as Dr. Arden Handler and Amy Fine) eating refreshments and hearing invigorating stories, over and over, about their past successes in public health policy and even how they happily landed themselves in MCH leadership.  This was inspiring to me and also a helpful guide, in knowing that I’m only beginning this journey.

Along with this, the retreat had a focus on building a “Community of Practice” and emphasized collaboration and genuine exchange across the “different lands,” as we called it, within MCH work (i.e. government officials; faculty and staff in academia; students in academia; practitioners in the field).  Everyone had something to contribute to the overall community and would help to improve the health and wellbeing of maternal and child health populations, just in a variety of ways.

In conjunction with building a community of practice, there was a particular focus on discussing the life-course perspective throughout the seminars.  I think it was valuable to tie in this perspective because we are at a pivotal moment in maternal and child health—with rising health care costs, increasing health disparities, and overwhelming amounts of chronic disease.  Through discussions of this perspective, it became obvious that this could help frame our necessity to expand services, adjust programming to critical time periods throughout the life-course, and thus enhance the health potential of communities throughout the U.S. and improve overall health equity.

Mike Fraser, speaking about MCH advocacy

One of my favorite lectures during the retreat was by Michael Fraser (Executive Director of the Association of Maternal and Child Health Programs).  With humor and charm, he spoke quite clearly about the need for us, as public health leaders, to advocate for MCH populations within our daily work.  Especially in a time of budget-cuts and high unemployment, we each have a part to play in the policy-making process.  Fraser described advocacy as a combination of education and “urging action.” It wasn’t something scary, overwhelming, or just what the policymakers do.   It is within our leadership competencies and our public heath agenda.  It requires a deliberate investment with our time, our money, and our voices.

Overall, the retreat was a wonderful experience for me as a graduate student still in training.  It helped me to reflect on my own leadership skills and how I can contribute to the overall success and future of maternal and child health field.

by Jessica Barnes, 2nd Year MCH-MPH Student

 

If you would like to view pictures from the 2011 retreat click here.

 

 


Top Ten List: Ten Most Significant Achievements in Maternal and Child Health, 2001-2010

Number 10
Newborn Screening
Expansion of blood-sample based newborn screening from a handful to more than 29 conditions in almost every state.

Development of universal newborn hearing screening with diagnosis and intervention.  This is not a job completely done, but a dramatic change from beginning to end of the decade.

 

Number 9
Folic Acid-Preventable Neural Tube Defects
Worldwide progress occurred in preventing anencephaly and spina bifida through fortification of food sources with folic acid.

More work remains – experts estimate that 20% are now prevented.  Experts differ as to whether additional cases in the US could be prevented with increased levels of folic acid fortification.

 

Number 8
Mental Health in MCH
The decade brought greater recognition of mental health issues in children.  Even more dramatic was the emerging awareness of the importance of maternal mental health, especially perinatal mood disorders and postpartum depression.

 

Number 7
Child Lead Exposure
The decade saw continued reduction in the proportion of infants and young children with elevated blood lead levels, and intervention programs became more focused through the use of enhanced databases and geographic information systems analyses.

 

Number 6
MCH Epidemiology
MCH epidemiology was an established field in 2001, but this decade saw it placed firmly in the pantheon of public health, with dedicated MCHEPI positions in almost every state.  The annual MCH Epidemiology Conference grew to 500 annual participants, and the annual MCH Epidemiology awards developed considerable prestige.

 

Number 5
Immunizations
The decade saw the development or implementation of numerous vaccines.  Several additions to the required schedule for infants and children have resulted in significant reduction in morbidity (i.e. rotavirus, Hepatitis B), while the pneumococcal vaccine has led to a dramatic decline in invasive pneumococcal infection in young children.

 

Number 4
Prematurity Prevention
It’s been said that what goes around comes around, and that seems to be true.  Although there is increasing recognition of the social determinants of preterm birth, at least, 30-40 years after first being introduced we remembered that progesterone is useful for prevention of some preterm births.

Now if we could only figure out how to offer it as a quality product for a reasonable price . . .

 

Number 3
Quality Improvement
The decade saw an emerging focus on quality improvement in obstetrics and newborn care, spurred initially by the Vermont-Oxford Network, then by the Joint Commission and ACOG, and more recently AHRQ’s initiation of safety and quality indicators for pregnant women.

There is much more work to be done, including a focus on quality in prenatal care.

 

Number 2
Universal Access to Prenatal Care?
Okay, we didn’t achieve this, but we did get expanded access to health insurance, especially for infants and children and to some extent for women in pregnancy. We  also saw the emergence of new models of care such as Centering Pregnancy.    And the Affordable Care Act was passed in 2010, though few of its provisions had been implemented by the end of that year.

 

Number 1
Well-Woman Care
Beginning in mid-decade, putting preconception and interconception care on the map, and maternal health in general into the framework of well-woman care.

There is still a great deal of work to do, but a promising start occurred in the past decade.

But Just Like Women’s Work, MCH is Never Done…Here’s a partial list of remaining challenges:

  • Advancing maternal age
  • Limited progress on increasing pregnancy intervals
  • Half of all pregnancies are still unplanned
  • Few women know about or receive preconception/interconception care
  • We’ve made very slow progress on Baby Friendly Hospitals, almost none on the Mother Friendly Hospital initiative
  • Data integration is occurring, but the pace is glacial (both in clinical and public health settings)
  • Federal and state budget cuts are leading to dismantling of some publicly funded programs
  • Malpractice and defensive medicine practices
  • Regionalized systems of care losing ground
  • High-risk infant follow-up no longer occurs except for lucky infants who enter EI immediately or are enrolled   clinical trials
  • Public apprehensiveness to child vaccines
  • And many more . . .

By Russell Kirby, Ph.D., M.S., Professor, University of South Florida, College of Public Health, Community and Family Health

Dr. Kirby also serves on the UIC MCHP National Retreat Planning Committee.

Inspired by “Ten Great Public Health Achievements—United States, 2001-2010”, MMWR 2011, May 11;60,19: 619-623.

With apologies to David Letterman, and thanks for editorial assistance to Elizabeth Kirby and for their insights to the following contributors:

  • Godfrey Oakley, Emory University
  • Judith Vessey, Boston College
  • Kate Kvale, Wisconsin Department of Health Services
  • Mark Walker, University of Ottawa
  • Arden Handler, University of Illinois-Chicago
  • Lisa Korst, University of Southern California

Click here if you would like to read some of Dr. Kirby’s other Top 10 Lists.

 

 

 


CoP Learning Agenda: Leading Across the Generations

The Learning Agenda Item that was ranked as the #1 priority is Leading Across the Generations.  Below is the information we collected about this item.  What are you already doing in this area and what ideas do you have to move us forward with this agenda item?!  This is actually the small group discussion that had the largest number of participants and most diverse group of people!  I started with an action step that we actively try to do here at UIC with all of our MCH events.  What other ideas do you have or what are you currently doing?

Leading Across GenerationsWhat are the critical conversations we need to have to successfully pass the knowledge to the next generation and have fun at the same time?  [Energy of youth + Wisdom of elders ensuring sustainability]

  • Embracing and leveraging generational differences in the workplace.
  • Filling the talent gap.
  • Creating opportunities for leadership and mentorship.
  • Providing space and empowerment for younger colleagues.
  • Recruiting tomorrow’s leaders.
  • Early retirements/brain drain.

ACTION*:

  1. Have meetings/conferences in which all generations are invited and encouraged to interact as colleagues/equals.