MCH Leaders in the Southeast: Mississippi

Another one of our featured leaders from Mississippi is Juanita Graham, DNPc, MSN, RN, FRSPH. She is the Health Services Chief Nurse for the Mississippi State Department of Health. She serves in a nurse consultant role to the seven offices of Health Services and participates in a variety of activities including grant writing, continuing education for nurses, and research. She is currently a full time doctoral student at the University of Mississippi. Juanita has a significant leadership background representing several organizations. She has given dozens of presentations at the local, state, national, and international levels. She has published multiple infant mortality-related research articles. Her current research interests include assessing the relationship between maternal health and Mississippi birth outcomes. Juanita shared her thoughts about her work and why she is involved with Every Woman Southeast.

How long have you been in your current position?

I’ve served as Health Services Chief Nurse for the Mississippi State Department of Health since 2005. Only in the past few months my title has changed to Director, Program Development and Effectiveness.

What is your favorite thing/task/part of your work?

I really enjoy networking opportunities and working with other groups and partners at local, state, regional, and national levels who are interested in improving the health and welfare of families in the Southeastern U.S.

What is your biggest challenge?

Funding has always been the biggest challenge for Mississippi.

Why are you involved in Every Woman Southeast?

I’m very interested in improving Mississippi birth outcomes and reducing Mississippi infant mortality. Besides having several good friends from neighboring states who work with EWSE, I feel that improving the health of Mississippi infants begins with improving the health of women and participating in EWSE is one way to accomplish that.

If you had a million dollars what would you do with it? 

I believe that education and health literacy among Mississippians must be addressed if Mississippi is ever going to pull ourselves up from being the negative benchmark or worst case scenario to which other states compare themselves and measure progress. If I had a million dollars, I would devote it towards peer-based train-the-trainer health education and health literacy programs. $1 million is not nearly enough to solve Mississippi’s problems but if “each one could teach one”, perhaps we could improve some of our stats and indicators.

MCH Leaders in the Southeast: Mississippi

For May we are featuring Mississippi. One of our featured leaders is Connie Bish, MS, PhD, MPH, State MCH Epidemiologist. Connie was happy to answer a few questions about her work and why she is involved with Every Woman Southeast.

How long have you been in your current position?

I started my position as the CDC assigned State MCH Epidemiologist in October 2009.

What is your favorite thing/task/part of your work?

Seeing that “Ah ha” moment when folks comprehend that human life is not segmented into funding silos but rather human life is integrated not only within a person but within their family, their community, their state, their country. In addition to being a Nutrition/Chronic Disease and Reproductive Health Epidemiologist, I am trained in Animal Husbandry and Poultry Science – agriculture. In agriculture, we know that the genetic potential of the seed is influenced by its ancestral seed stock, AND, the fertility of the soil where it is planted, the abundance or scarcity of water (usually rain), the supplemental nutrition added to less fertile soils (fertilizer), the protection from deadly risks (e.g., bugs, weeds, predatory plants and animals (think Kudzu!) through herbicides, pesticides, fencing or just good rotation cropping. So I have always understood the influence across the lifecourse – that is how agriculturalists think. I get excited when people schooled in the segmentation of public health programs suddenly understand the breadth of influence on human health, and then start to work toward integration. So I guess I get excited when human health folks start thinking like farmers!!

What is your biggest challenge?

Lack of funding is big. However, a lack of willingness to try a change, embrace a new concept, even if it results in failure or less than optimal results, is a barrier/challenge that is much harder to get past. At least with a willingness to try, creative ideas might find money or find synergy or find partners for create Win Win situations. But nothing happens when there is no willingness to try – money or no money!

Why are you involved in Every Woman Southeast?

Mississippi women of reproductive age do not have the best health. There are areas of MS where 74% of women ages 18-44 are overweight or obese, compared to 50.5% for 46 U.S. states (minus, MS, LA, AR, TN: source unpublished BRFSS data that compares MS Delta to the non-Delta US states). Hearing what other states are doing with regard to preconception health will hopefully provide ideas and strategies to further incorporate preconception health awareness and counseling into health department programs and general population education.

If you had a million dollars what would you do with it?

I have learned that a million dollars does not go far, so I would want to find a way to grow the money then use it to enhance education. I would want to find a way to have education be the most revered pursuit of all people, families, communities and the state. I would want the population to learn critical thinking skills that would help with the understanding that risk is inherent, but we all have the ability to choose lower risk options – if we know what they are and we feel empowered to make those lower risk chooses. I am pretty sure that 1 million dollars would not go far in the pursuit of increased education status for the population.

MCH Leaders in the Southeast: Florida

For April we are featuring the Sunshine State, Florida. One of our featured leaders is Annette Phelps, ARNP, MSN, Division Director for Family Health Services at Florida Department of Health. Annette was happy to answer a few questions about her work and why she is involved with Every Woman Southeast.

How long have you been in your current position?

I have served as Director of the Division of Family Health Services for the past 10 years. My experience in the central office related to family and community health spans over 20 years and prior to that I worked in a county health department and served as an ARNP there. I also worked as an ARNP in a VA Ambulatory Care Clinic and a College Student Health Service and as an SICU nurse.

What is your favorite thing/task/part of your work?

Every day brings new challenges and opportunities to better serve families. Whether it is prioritizing scarce resources, assessing the needs of our families, creating a new program or adapting or introducing a new program--it is all about the families we serve.

What is your biggest challenge?

Change is the biggest challenge. We want to be evidence based in our approaches but are hesitant to give up old habits and what we "think" in our heart works and also wonder what about the populations that the approaches were not tested on, or what about the strategies that have not yet been tested at the evidence level. Reconciling all of the needs with the best solutions is hard and planning and implementing new approaches or changed approaches takes time and diligence.

Why are you involved in/interested in Every Woman Southeast?

I learn so much from colleagues across the region. It helps with implementing changes to have knowledge of others in regard to challenges and ways around hurdles. The bright ideas and energy are infectious too.

If you had a million dollars what would you do with it? (besides move to the mountains or beach and retire)

It depends on what the source and purpose are. If it is for personal use it would go a long way toward retirement and some special interests for caring for moms and babies. If I had a million program dollars, I would invest in some evaluation activities to try and build the evidence base on some of our state programs.

To find out more about what is happening in Florida, visit everywomansoutheast.org/partners/florida.

Camellia Project Provides Education, Support to High-Risk Postpartum Moms

High-risk postpartum mothers are receiving inter-conceptional education and support through the Camellia Project, a pilot program funded by the March of Dimes, Florida Chapter, in northeast Florida.  The project provides curriculum-based group activities and individual support to mothers who have had a fetal or infant loss, or a baby hospitalized in the NICU.  It offers an inter-conceptional intervention for  addressing maternal risk factors that could impact a subsequent pregnancy in this high risk group.

Project interventions include:  1) initial support for mothers in the NICU, follow-up and engagement post-discharge; 2) facilitation of post-partum health care, including family planning; 3) provision of education and support through group activities; and 4) follow-up and linkage to other needed services in the community. The Camellia Project utilizes an adaptation of the inter-conceptional curriculum developed for the Magnolia Project, a successful federal Healthy Start initiative being implemented in the urban core of Jacksonville. Group activities include six sessions that focus on goal setting, chronic disease and associated risk factors, baby spacing and family planning; stress, and the benefits of healthy eating, multivitamin consumption and physical activity.

In two years, 180 women have been served by the project with 77 completing the intervention. Preliminary evaluation results indicate the project has successfully increased participant knowledge through the educational session and positively impacted their intent to adhere to five of eight healthy behaviors.  Based on one- and four-month follow-up, exercise, contraceptive use, healthy diet, reduced smoking and improved problem solving increased following participation in the program. Only two of the participants (2.6%) have become pregnant again within a year. Stress and depression were also lowered for participants after the group activities; however levels appear to increase at the one- and four-month follow-up.  The most important impact of the program has been increasing the social supports provided by the women themselves. Follow-up interviews with initial participants reveal that lasting friendships have been formed among group members. During the group activities, mothers provided support to one another, offering resources and guidance based on their own knowledge and experience.  The mothers are particularly appreciative  for the opportunity to interact with other mothers who understand what they are going through with  a baby in the NICU.

The Camellia Project is one of three demonstrations projects funded by the March of Dimes, Florida Chapter targeting a statewide priority to develop Comprehensive Inter-conception Health Services for High-risk Women. Women who have experienced a poor birth outcome are at highest risk of a poor outcome in their next pregnancy. The Florida chapter is also funding an evaluation of the demonstration projects to identify best practices for a model inter-conceptional intervention.  The Camellia Project is being implemented by the Northeast Florida Healthy Start Coalition, Inc. For more information visit: http://nefhealthystart.org/for-women/camelia-project/.

MCH Leaders in the Southeast: Florida

Another one of our featured leaders from Florida is Lori Reeves, MPH, Program Services Director at the Florida Chapter of the March of Dimes. Lori thoughts about her work and why she is involved with Every Woman Southeast are below.

How long have you been in your current position?

I have been in my current position as state program director for 12 years and with the March of Dimes for 17 years.

What is your favorite thing/task/part of your work?

I really enjoy working with partners on high-impact initiatives.

What is your biggest challenge?

Finding enough time!

Why are you involved in/interested in Every Woman Southeast?

I love the synergy of working with a passionate group of people that crosses state lines and disciplines on the common goal of improving health for women across the lifespan. I think there is great power in putting minds together to solve problems, and that with the brainpower and passion of leaders across the Southeast, we have a much greater chance to come up with effective solutions.

If you had a million dollars what would you do with it? (besides move to the mountains or beach and retire)

Well, that would depend on whether it was mine personally or mine for work! If it were for work, I would put it towards expanding our quality improvement efforts to include a stronger emphasis and post-partum and interconception care, in order to increase the number of women who complete a postpartum visit, improve the content of that visit, and develop a medical home that would keep women connected with providers before, during, and beyond pregnancies.

If it was for me personally, I think it would just pay for college for my kids, and if anything were left, I would put it in a retirement account. I might also consider replacing our 14 year-old car!

To find out more about what is happening in Florida, visit everywomansoutheast.org/partners/florida.To find out about the Florida Chapter of the March of Dimes, visit http://www.marchofdimes.com/florida/.

WISH Media Preference Survey Results

THANK YOU Every Woman Southeast (EWSE) VOLUNTEERS
Every Woman Southeast would like to thank all EWSE members who participated in the Women’s Integrated Systems for Health (WISH) media preference survey. The survey asked about how you receive, share, and find out about learning opportunities and professional training. Your responses will help the WISH team better serve you and your colleagues when advertising about new trainings and generating interest about new topics in women’s healthcare.

WHAT IS WISH?
The WISH project focuses on promoting and integrating the public health community to optimize mental and physical health among adolescents and women of reproductive age. The project has several components to build leadership capacity among public health, mental health, substance abuse, violence prevention and primary care in order to develop more holistic and integrated systems of care. Thank you for taking time to help us deliver better healthcare to women.

RESPONDENT DEMOGRAPHICS
About 70 health professionals completed the survey, the majority of whom identified as Public Health Nurses, Public Health Program Managers, Health Educators, Administrators, Social Workers, Physicians, Epidemiologists, Nurse Practitioners, and Nutritionists. Several respondents also work in the following fields: academia, health policy, midwifery, and community health advocacy.

MEDIA PREFERENCES AND SURVEY RESULTS
Below is a summary table of online mediums EWSE members use to receive information about educational opportunities. 95% of all EWSE respondents indicated that email alerts are a preferable way to receive information, followed by online newsletters and websites. 50% of respondents indicated that listserves are useful when receiving information about training and educational opportunities.

Several EWSE respondents also identified several professional organizations they use to find out about learning opportunities. The majority of EWSE follows indicated the following professional organizations: AMCHP (47%), HRSA (44%), APHA (40%), NACCHO (26%), CityMatCH (27%), and MCH Navigator (25%). Several participants also cited local health departments, CDC, March of Dimes, and ACOG as professional organizations they follow for training and educational information.

The chart below indicates how people share information about educational opportunities with peers and colleagues. 80% of EWSE survey respondents indicated that they used email alerts to share information, followed by websites (35%), listserves (31%), newsletters (30%), and Facebook (23%).