Incorporating Preconception Health into Programming at a Local Health Department: Taking Steps to Make

Change Happen

Cheri Pies, MSW, DrPH

Padmini Parthasarathy, MPH

Family, Maternal and Child Health Programs

Overview

• Life Course Initiative

• Strategies

• Activities

• Staff survey

• Lessons learned

The Life Course Initiative

• Launched 15-year initiative in 2005

• Engaging FMCH and county staff, as well as community partners

• Improving reproductive potential

• Paradigm shift

• Changing the health of a generation

Strategies

• Education through interactive methods

• Carefully planned roll-out of our initiative

• Bring staff and partners in gradually

• Enable staff to each have their own “A-ha!” moment

12-Point Plan…

…to close the Black-White gap in birth outcomes (Lu, et al.)

1. Provide interconception care to women with prior adverse pregnancy outcomes

2. Increase access to preconception care for African American women

Activities to Date

• Series of staff meetings

• Life Course Fact Sheet

• Articles in County Department publications

Activities to Date, cont.

• Presentations community partners (initial overview; later in-depth)

• Asked staff strategic questions about current and future activities

• Worked with Clinic Services on Interconception Care/Gestational Diabetes project

The Life Course Game

Staff Survey

• Evaluated staff understanding of Life Course Perspective

• Gathered ideas from staff about incorporating the Life Course Perspective into their work

• Survey sent to 107 FMCH Programs staff

• 68 staff (64%) responded

Survey Results

Are you a manager or non-manager?

Response Percent Response Count

Yes 14% 8

No 86% 51

TOTAL 100% 59

In Your Own Words, How Would You Describe the Life Course

Perspective?

• A holistic approach

• A focus on future generations

• Begins in the womb

• Life Course Perspective looks at the impact of social, emotional, and physical stressors on a woman’s health across her lifespan

What are two concepts from the 12-Point Plan that you think relate

to your work?

1. Expand health care access over the life course (16)

2. Enhance service coordination and systems integration (15)

3. Support working mothers and families (10)

4. Provide interconception care to women with prior adverse pregnancy outcomes (9)

5. Improve quality of prenatal care (8)

6. Close the education gap (8)

Have you changed anything about your public health work as a result of learning about the Life Course

Perspective?

Response Percent Response Count

Yes 72% 46

No 28% 18

TOTAL 100% 64

How have you incorporated the Life Course Perspective

into your work? • I remember the importance of other

issues for clients such as lack of transportation

• Encourage women to take care of themselves

• Recognize and reinforce that health care providers are partners

• Focus on how we may influence our clients’ ability to improve their health and well-being throughout their life span

How have you incorporated the Life Course Perspective

into your work?

• Realizing that change will impact future generations has been a shift in thinking

• More aware of the importance of building youth resiliency

Any comments, questions or concerns about the Life Course

Initiative?

• I hadn’t thought about health in that way before. It also made me think about the importance of life experiences and stresses on future generations and how important it is to make sure everyone has access to health care and a method to create a supportive family network for them and their families so all can thrive.

Lessons Learned

• Start with staff where they are

• Recognize and acknowledge staff’s existing work on preconception care and build on this

• Utilize the imagination and experience of staff to project where they could go with future programming

Lessons Learned, cont.

• Lay the groundwork with higher level staff/management in our organization about the importance of preconception health

Making Change Happen

• Staff:– Think

differently– Act differently

• Financing

What will success look like?