Pilot Project Leaders: Mirine Dye of Urban Health Partnerships

This month we’re featuring Mirine Dye, a Program Manager for Urban Health Partnerships and new member of the Every Woman Southeast Coalition.

How long have you been in your current position?

I joined Urban Health Partnerships (UHP) and our corporate arm Urban Health Solutions (UHS) in May of 2012. This EWSE grant project is my first venture with our non-profit arm, UHP.

What brought you to the organization and your current work?

The UHP Executive Director, Anamarie Garces, and I teamed up a few years ago to represent our graduate school of public health (Florida International University) in a Student Scholar Competition, which we placed third Campus wide. I then had the opportunity to put together a team to participate in the American Public Health Association Maternal Child Health Leadership Institute and felt Anamarie and I would be great team members. Our state project for Florida involved intersecting public health preparedness, epidemiology and maternal child health. We gained national recognition and remained in contact over the years. She reached out to me after forming her company and invited me to consider participating as a collaborator, and my grant funded position at the time was winding down so the timing was perfect. I came on board to assist with any projects that needed more staff, and was encouraged to seek grants in our areas of interest.

What are you most excited about for the Transportation Access Throughout the Life Course project?

I am most excited about the opportunity to creatively intersect two areas of public health, which usually do not get much attention together. Transportation and particularly active transportation (walking, biking, safe streets as well as public transportation) have been increasingly seen as not only a public health issue, but a public policy and urban planning focus. When we consider “access to care” usually the number of clinics or the number of providers and the cost is what comes to mind. We are looking at a broader view of access to care, meaning, how do women age 15-44 (and men) get to the clinics which are targeting them with reproductive and preconception care services? Miami-Dade has several areas of concern within this age group relating to reproductive health, and we want to see how do they access the services which are offered, and what improvements can be made. Are there plenty of bus routes or safe sidewalks? Are the areas shaded and comfortable for women and families in the Miami heat? What about bike routes for men and women to access the clinics easily? Are clinics and clients aware of these options? How easy is it to access information or plan your trip without a car? These are the questions we hope to answer with our project.

What do you anticipate will be the biggest challenge with this project?

I think we will have a couple of challenges; the first challenge being how can we engage our non-traditional health partners in this topic? We have reached out to our planners, engineers and transportation partners and we are at the beginning stages of the formation of the steering committee. I know we will have to sell them in the first meeting in order to ensure long-term participation and interest. The second challenge will be to create a marketing outreach campaign to translate our findings, and get the information into the hands of those who plan clinics and can influence street and transportation improvements.

Can you share any great books, articles, websites, etc, that would help people learn more about urban planning or transportation and the intersection with health?

Although I was not involved with this particular UHP project, I feel that the Broward Complete Streets Initiative was particularly influential in my recommendation to seek grant support for our Transportation Throughout the Life Course project. I would definitely recommend visiting the website BrowardCompleteStreets.org which then has other resources available as well. We have also set up a website for our project, and hope to list many references to help both transportation and maternal child health groups understand the significance of taking MCH out of a silo, and inserting MCH into the bigger picture of urban health and planning: Transportation4Families.org.

I am currently reading Making Places Healthy: Designing and Building for Health, Well-being and Sustainability, edited by Andrew Dannenberg, Howard Frumkin and Richard Jackson, and would recommend it for a practical, yet comprehensive, systems-level look at the built environment and health.

EWSE Meeting Reflections: Adaptive Leadership

By Carol Brady, Executive Director of the Northeast Florida Healthy Start Coalition, Inc.

What a great kick-off for the Kellogg grant and Every Woman Southeast! There are so many opportunities and synergies with other initiatives focusing on poor outcomes among women and children in our region -- ASTHO, AMCHP HRSA, CDC Consumer Work Group. Our leadership group will be an important vehicle for implementing strategies within and across our states. The concepts of “adaptive leadership” (loved Sterling Freeman, the meeting facilitator!) and “leading from the middle” really resonated with participants. We have momentum!

Check out some pictures from the meeting below!

Some EWSE coalition members take a tour of  UNC-Chapel Hill after the meeting on May 22.

One of the facilitated activities from Sterling Freeman.

Megan Lewis from RTI presenting an update from the National Initiative on Preconception Health and Health Care Consumer Work Group.

Lori Reeves (Florida) and Sarah Verbiest (North Carolina) lead a group brainstorming session.

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/.