Life Sized Life Course Game in South Dakota

Last week I had the wonderful opportunity to give a life course workshop in Pierre, South Dakota for over 230 members of the Department of Public Health. My host, Barb Hemmelmen, is a very creative woman and kind host. We tried very hard to find enough games for such a large crowd. When that didn't work, she and her 11 & 13 year old daughters made a life size board. The first hour of the workshop was a complete review of the life course theory with some examples and resources. I'm working on scripting that slide set and will make it available to Every Woman Southeast partners soon. After a break, we played the game as a group - talking about it a bit as we went. Everyone in the audience had a copy of the full board in front of them and their 'assignement' to a particular piece and what that color piece represented. When players landed on the red cards Barb read their fate. I read the green cards. Playing the game with real people was fun and brought laughter and definitely moans when people landed on certain places or received certain risk cards. When we were done with the game we asked people in the audience to get into groups of 3-4 and talk about a series of questions. We then heard back from different groups and closed with a brainstorming session for next steps for South Dakota. While we still recommend playing this game in small groups, the life sized version worked very well in this large group setting. I think we can expect to see great things coming from South Dakota!

Here is a picture of one part of the game. You can see the red and green squares.

Here is another view. We laid it out so the players walked across the front of the room.

These are the wonderful "game pieces" - all supervisors from the South Dakota Dept of Public Health.
Barb - the designer and mastermind is in the blue jacket.

The "death scene" of the game - finding out everyone's fate.

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.

EWSE Meeting Reflections: Meeting of the Minds!

By Monica Murphy, MPH, Public Health Prevention Specialist, Metro Public Health Department

Attending the EWSE Regional Meeting May 22-23, 2012, was a great experience. It was truly “a meeting of the minds!” Representatives from each of the 9 member states were in attendance and full of energy and enthusiasm. The two day meeting was jammed packed with discussions about the vision, identity and direction of EWSE and the much anticipated launching of the W.K. Kellogg grant. Everyone at the table shared their expertise, practical wisdom, and hopes for the grant project and the overall work of EWSE.

As a new EWSE team member from Nashville, TN, this meeting was an opportunity to get an in-depth understanding of the mission and goals of EWSE and to be a part of the strategic planning process as the collaborative prepares to move into a new phase. As an emerging public health leader, I have learned that improving the health of our communities is not a one man or woman job. The work that we do in our communities and states will not reach its full potential nor have maximum impact without the vision for new approaches that include collaboration, systems thinking, and adaptive leadership strategies. The EWSE collaborative is one example of a multi-state effort to improve the health of all women in the Southeast regardless of race, place, or circumstance.

EWSE Meeting Reflections: A Student's Perspective

By Jessye Brick, Graduate Student at the UNC School of Public Health

I chose to study public health because I was shocked that the United States, despite having higher health expenditures, lags behind most other developed countries in birth outcomes. Throughout my first year of courses we frequently discussed why this may be and how the lifecourse model offers a new way of understanding and responding to the determinants of health. When Sarah first told me about Every Woman Southeast, I was eager to see how public health leaders were implementing the model. I believe that preconception health is one of the keys to promoting women’s health and it was incredibly exciting to have the opportunity to take part in this groundbreaking event.

The first thing that struck me was the wealth of diversity among the participants as far as age and experience. I loved hearing about everyone’s work and interest in Every Woman Southeast. As I saw nurses work with epidemiologists and nonprofit organizations work with government employees, I thought “this is what public health is all about!” Every participant was committed to learning from one another and that included me! I was encouraged to participate in every session and many people were interested in my opinions and career goals. The group was full of lifelong learners who continuously strive to improve their efforts. They recognized and embraced the fact that doing so may require them to move out of their comfort zone at times.

The existing programs in each state and the variety of ways that states have attempted to improve preconception health care also impressed me. South Carolina recently held a video competition for college students to develop preconception health materials while Florida is developing a request for proposals to improve the quality of the postpartum visit. Despite different focuses and approaches, many states identified similar challenges, including a disconnect between stakeholders fueled by competition for limited funds. It quickly became clear why a group like Every Woman Southeast is necessary. By working together we can learn from each other’s successes and failures, while developing new approaches to overcoming common barriers.

Rethinking Mother's Day

Another Mother's Day has come and gone. I realize this may not sound very nice, but ever since I became a mother 15 years ago I have disliked this celebration. The hype and fuss can create expectations unmet. Every year I have dreams of a beautiful day sleeping in, resting and just enjoying my kids who are behaving well maybe along with a perfect gift that symbolizes their love for me. This has never happened. And really, that is OK! After all, the journey of mothering is amazing, challenging, messy and complicated. A single day is inadequate to mark it. Looking back to the origins of Mother's Day is pretty interesting. It started back with the early Egyptians who celebrated the goddess Isis as the Mother of the pharaohs. The Greeks and the Romans celebrated other Mother deities until it became a more Christian celebration with the focus on the "Mother Church". The day had a true renaissance in America in 1870 with Julia Ward Howe's Mothers Day proclamation. She called women to action for peace. At the end of the proclamation she said, "In the name of womanhood and humanity, I earnestly ask That a general congress of women without limit of nationality May be appointed and held at some place deemed most convenient And at the earliest period consistent with its objects To promote the alliance of the different nationalities, The amicable settlement of international questions, The great and general interests of peace." Julia tried hard to change July 4th to Mother's Day to no avail. Later Anna Jarvis campaigned very hard in 1908, using all her powers of advocacy with many groups to make this day official. Mother's Day is celebrated around the world. In the US Mother's Day, however, has become very commercialized. 96% of Americans participate in Mother's Day shopping spending over $16 billion each year. So, let's think about this. What would happen if on Mother's Day, women from around the state, country and world got together to discuss the problems that threaten our children and communities? What if we invested that $16 billion in programs to support mothers and their children in our country? What if this day grew to symbolize our national commitment to girls and women? What if women used this as a rallying cry for the change that we want to see in the world? I think that it is time to take back Mother's Day. We have 364 days to get ready for next year. I this would be a much better way to honor women. What do you think? PS As a side note, I do LOVE honoring my own mother who I cherish and appreciate all of the days of the year.

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.