Conference Abstract Compendium Examples from the ... - CityMatCH

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2009 CityMatCH Urban MCH Leadership ConferenceRe-designing the Black Infant Health Program in California: Positive leadership formaximum impactPRIMARY CONTACT:Reggie Caldwell, LCSWHealth Equity ResearcherCalifornia Department of Public Health1615 Capitol AvenuePO Box 997420Sacramento, CA, 95899-7420Phone: (916) 650-0373Fax: (916) 650-0304Email: reggie.caldwell@cdph.ca.govCATEGORYInfant mortality and morbidityRacial and ethnic health disparitiesFOCUSProgram Policy FocusISSUECO-PRESENTER(S)/AUTHOR(S):Laurel Cima, laurel.cima@cdph.ca.gov (Author)The California Department of Public Health, Maternal, Child and Adolescent Health (CDPH/MCAH)Division places a high priority on addressing the persistent poor pregnancy outcomes thatdisproportionately impact African-Americans. Infant mortality rates have declined in California, yetAfrican-American infants are more than twice as likely to die as white infants and African-Americanwomen have more than triple the risk of pregnancy-related death compared to other racial/ethnic groups.California’s Black Infant Health (BIH) Program was established in 1989 to reduce high infant mortalityrates among African-Americans in the state. Under CDPH/MCAH’s leadership, BIH is undergoing astrategic re-development to maximize its impact.SETTINGBIH provides community-based, culturally-sensitive health promotion and support services to pregnantand parenting African-American women at risk of adverse birth outcomes in 17 local health jurisdictionswhere over 90% of all California African-American births occur. Between 1997-2007, BIH served 28,330women and 19,791 infants. Compared to the population of African-American women in California, mostBIH clients are at high risk, medically and psychosocially. Data suggest that BIH may be improving birthoutcomes by decreasing the number of very low birth weight infants and shifting them into the mid-lowbirth weight category, yet it has not had an impact on the Black-White disparity in pregnancy outcomes.PROJECTBecause of the lack of progress in reducing infant and maternal health disparities CDPH/MCAH engagedthe University of California San Francisco, Center on Social Disparities in Health to conduct anassessment of BIH with the goal of re-designing the program for maximum effectiveness. The assessment22
2009 CityMatCH Urban MCH Leadership Conferencerevealed that the current model was based on outdated research and that BIH was implemented differentlyacross the 17 sites. The revised BIH program intervention features a standardized, evidence-based modelthat builds upon current program strengths, latest research/science, and best practices. CDPH/MCAH isleading the program revision in partnership with UCSF and local MCAH/BIH staff.ACCOMPLISHMENTS/RESULTSWith leadership from CDPH/MCAH, the workgroup has developed a revised model that:• Engages African-Americans to learn about poor birth outcomes in their community by focusing on thelife course perspective and the social determinants of health, an approach that resonates with thispopulation• Provides services to pregnant and parenting African American women.BARRIERSConducting major program revision is a lengthy process and keeping the partners fully engaged has beena challenge especially since participation in the revision process is additional to their current work.Change is difficult—sites are committed to their current program model, and the proposed revisions havecreated apprehension for some providers. Common concerns revolve around staffing, funding andwhether the clients will be appropriately served.LESSONS LEARNEDCDPH/MCAH’s leadership has created a clear sense of direction and purpose within the BIH community.MCAH has worked diligently to fully engage BIH staff and stakeholders as partners in the revisionprocess by listening to their concerns, initiating open discussions about race and health and fostering anenvironment where participants feel they are creating a program that will help to reduce the Black-Whitegap in pregnancy outcomes.23
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