Transcript Preconception Health Planning in NC Sarah Verbiest, MSW, MPH Presentation Purpose  Describe NC planning efforts  Share some data  Share lessons learned so far.

Preconception Health
Planning in NC
Sarah Verbiest, MSW, MPH
Presentation Purpose

Describe NC
planning efforts
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Share some data
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Share lessons
learned so far
The “we” in welcome
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70+ colleagues in public health, research,
minority health, and medicine
Creating and enacting a new focus on
women’s wellness will take all of us!
Why do we care?
In North Carolina…
• 45th in the nation for high rates of infant
death
• One out of 7 babies is born preterm
• 3,000+ babies are born w/anomalies each year
• African American babies have a 2.5 fold
greater risk of death than Caucasian babies
• 45% of pregnancies are unplanned
Why do we care?
For women of reproductive age (18-44):
• 23.5% of women smoke
• 23.6% of women are uninsured (69.9% of Hispanics)
• 7.9% report binge drinking in the past month
• 6.1% of women have asthma
• 2.4% are diabetic, 3.4% have cardiac disease and
13.1% are hypertensive
• High numbers of Chlamydia cases (617.9/100,000)
Why do we care?
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28% of women of all ages don’t engage in physical
activity
24.8% of women 18-44 are obese (40% for African
American women)
23.4% have poor mental health
19% nonimmune to Rubella
African American women are disproportionately
affected by poor health
Women’s wellness care is highly fragmented
Planning Steps
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State Infant Mortality Collaborative (2004-06)
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CDC’s Recommendations for Preconception Health and
Health Care prompt a need to respond
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June 2006 the Folic Acid Council commissioned an
inventory of preconception services in NC.
The Booklet
 A tool to initiate
conversation & prompt
collaborative action
 Contents:
• Details about
preconception health
• Lists of challenges
• Specifics of 3 decades
of NC projects
• Next Step Ideas
Accomplishments
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Family Planning Medicaid Waiver
Folic Acid Campaign since 1994
School Curriculum
Worksite Health Promotion
Preconception Health Risk Appraisal
Eat Smart Move More / Healthy Women, Healthy
Weight
Free NC Quitline
Syphilis Elimination Project
Planning Steps
March 2007 Think Tank Meeting #1
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To initiate a focused, collaborative, comprehensive
process to create a state Preconception Action Plan
Review of Participants, Group Notes and Ideas
May 2007 Think Tank Meeting #2
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To collect diverse ideas and understand how
preconception fits into existing work
Planning Steps
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Looking under rocks – finding detailed data
about women of childbearing age in North
Carolina
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Quantitative – what indicators do we have? What
indicators do we need to gauge outcomes?
Qualitative – what have we learned about NC women
– what do we still need to know?
Partnerships
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There are many groups working on different
elements of preconception health. There are a
variety of products, perspectives and
approaches.
NC’s efforts will integrate preconception
messages as appropriate into the existing
public health and medical infrastructure.
What women say…
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Behavior Change: Awareness not enough to
change behaviors. Knowledge of family
history, family support and healthcare options
can lead to change.
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Stress: Emotional, physical and financial
stress negatively influence health. Need more
social support and networking.
What women say…
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Mental health issues, especially depression,
are significant. Lack of resources in
communities.
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Barriers to Health Care: Cost. Racism.
Lack of - access, trust/ respect, childcare, and
transportation.
What women say…
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Approach to Healthcare: Prefer holistic approach.
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Substance Use: Many women reported they knew
someone struggling with drug addiction.
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Most pregnancies are unplanned. Women are
concerned about becoming pregnant but don’t use
contraception. Inconvenient clinic hours and quality
of care problems with family planning services.
The Challenge
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Preconception health is multi-faceted and complex.
There are many elements and a broad target population.
Guiding Principles
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Focus on the whole woman – not only her
reproductive capacity
Consider the woman’s health needs and related
wellness recommendations within the context of
her family and community
Be careful that messages don’t imply that certain
groups of women should not become mothers
Be cognizant of health disparities and prioritize
programs with potential to close the gaps
Areas of Interest
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Adolescents
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Clinical practice – continuity of care
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Interconception Health
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Data & Research
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Integrating new messages
into current campaigns
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Policy & Advocacy
Themes
Include men & families
• Start early / young
• Use existing programs
to carry messages
• Build on public health
outreach into worksites,
private practice, and
communities
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Messaging
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Give consumers messages they want to hear –
not what we think they want to hear.
Use social marketing principles
Consistent messages
Concise and Clear
Keep Literacy Levels Low
In Spanish
The Website
www.mombaby.org
Resources
• National News
• Minutes
• Feedback
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Developing Core Plan for Review
Think Tank #3 August 2007
We commit to seeing the ideas through
to an action plan – and the action plan
through to funding and implementation.
Questions?