It Takes A Village To Nurse A Child. 4 TH Annual California Breastfeeding Summit Monique Sims-Harper, DrPH, MPH, RD, IBCLC January 30, 2014

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1 It Takes A Village To Nurse A Child 4 TH Annual California Breastfeeding Summit Monique Sims-Harper, DrPH, MPH, RD, IBCLC January 30, 2014

3 Background The birth outcomes of African American women are much poorer than for any other race. Formula fed infants are 1.5 times more likely to die than if breastfed. African American infants are twice as likely to die before their first birthday as other infants. African American mothers are 3 4 times as likely to die from labor and delivery complications as other mothers.

4 Breastfeeding is Natural

Employees, Clients List a personal cultural belief that can interfere with

5 Working with Families of Different Cultures Session Objectives Assess Topic Relevance Define Culture Define Cultural Representation in CCC WIC Employees, Clients List a personal cultural belief that can interfere with BF promotion List 3 methods that assist in educating clients based on their needs 5

6 Breast Milk If a medicine were developed that could prevent the deaths of a million or more children per year and greatly reduce childhood illness and disease What if this medicine had no side effects and if this miracle substance was also free of charge? - Barbara Quick

8 Surgeon General s Call to Action on Breastfeeding Excess Health Risks Associated with Not Breastfeeding Acute Ear Infections 100 Diarrhea and vomiting -178 Hospitalization for lower respiratory tract infection 257 Public Health must demonstrate leadership through: Accelerate the implementation of the Baby-Friendly Hospital Initiative Establish partnerships for integrated and continuous follow-up care after discharge from the hospital

9 Healthy People 2020 Objectives MICH-21.1 Were ever breastfed (any breastfeeding) 81.9% MICH-21.2 Were breastfed at 6 months 60.5% MICH 21.3 Were breastfed at 1 year 34.1% MICH 21.4 Were breastfed exclusively through 3 months 44.3% MICH 21.5 Were breastfed exclusively through 6 months 23.7% MICH-22 MICH-23 MICH-24 Increase the proportion of employers that have worksite lactation support programs 38% Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life 10% Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies 8.1%

11 Closing the Gaps Hospital Exclusive and any Breastfeeding Rates Between Hospital Newborn Screening results and discharge data Discharge BF rates and PP BF rates African-American and White BF rates

12 Continuum of Care

13 COPP Grant California Obesity Prevention Program (COPP) 15 Clinic Awardees Statewide Develop and pilot criteria for a Breastfeeding Friendly HealthCare Provider certification. Implement systems to provide and bill for breastfeeding support services and pumps

14 Clinic Improvements Staffing Scheduling Referrals Staff Education Billing & Reimbursement EMR

15 Workplace Lactation Accommodation State Law 2002(Frommer) Time & Place Federal Law 2010 ACA Pregnancy Disability Regulations State Law 2012 (Allen) Discrimination

16 Churches as Partners Allen Temple Baptist Church, Oakland, CA

17 Allen Temple Baptist Church Campus Sanctuary, AIDS housing, Credit Union, Senior housing, Gym, Library, Offices/Training Rooms, Family Life Center Services/Resources Food Distribution, Counseling, Head Start, Youth & Family Services, Media/Arts/Worship training, Scouts, Prison ministry, Social Services, Health services

18 Best Practice Model: Glide Memorial Comprehensive, integrated service model High visibility in community Paid staff for all programs Large volunteer force Clear structure Local and global activities Working partnerships with CBOs

19 Common Faith Health Activities Health screenings/referrals and trainings Health fairs Nutrition and exercise classes Health messages in church media and pastoral sermons Surveys Distribution and development of health materials (print, video, cookbooks)

20 Elements that Promote Success Partnerships/collaborations Positive health values shared Membership > 400 members Church Resource Availability Ministers with graduate education Church ownership Commitment of church leaders Organizational Structure/Accounting & Documentation

21 Why Engage Faith-Based Organizations? Churches have a history of community involvement Representation of millions of Americans 60% of US citizens worship is important 42% report church attendance nearly every week Faith based organizations influence social norms and attitudes and encourage lifestyle and behaviors consistent with recommended Public Health practices. Faith institutions are stable, strategically placed and accessible and culturally appropriate to their members. Churches have valuable resources health professionals in the congregation and have access to facilities.

22 Why Engage Faith-Based Organizations? Faith communities are service oriented and a rich reservoir of volunteers Church space and facilities Vast administrative, media and communications infrastructure Traditionally serve the underserved and marginalized address health disparities Have established programs targeting women, men, youth and incarcerated populations.

23 Formative Research Literature Review Consultation with pre-existing community collaborations Breastfeeding Coalition Black Infant Health Program and Coalition Solano County Health Disparities Coalition Focus Groups 16 focus groups Clergy, women, men and teens Results informed the intervention

24 A More Excellent Way Health Community Breastfeeding Program Monique Sims, DrPH, MPH, RD, IBCLC Chief Executive Officer, A More Excellent Way Health

25 What is A More Excellent Way* An organization that aims to promote wellness and reduce health disparities. MEW engages health organizations, the community, and particularly churches, to provide health education, information and resources. * A More Excellent Way refers to I Corinthians 12:31 But covet earnestly the best gifts: and yet show I to you a more excellent way.

26 Collaborative Partners Collaborators African American Churches WIC Black Infant Health Program and Coalition Breastfeeding Coalitions AA Breastfeeding Cultural Outreach Task Force Kaiser Permanente Women s Health Department La Clinica De La Raza Key Funders: Kaiser Permanente Los Medanos Community Health Care District First 5 Solano Children and Families Commission

27 Activities Church Leadership training on health disparities in maternal child health, the importance of breastfeeding, and the MEW Intervention Church breastfeeding-friendly assessment and improvement Peer Counselor Training (Six 4-hour Saturday sessions) Community Baby Shower Monthly Peer Counselor continued training Mother-to-Mother monthly Support Group

28 Breastfeeding is Part of My Heritage

29 Community Baby Showers Recruitment Strategy Community Education Health Workshops for Pregnant mother, father of baby, grandmother and siblings Health Fair Referrals and Linkages Breastfeeding Education to all Participants

30 Pilot Project: Randomized interventions and wait-listed control group at one church Pre- and Post- intervention surveys Outcome measure: breastfeeding intention Result: Increase in breastfeeding intention and confidence in the Intervention Group

31 2006: Revival Center Ministry, Vallejo

32 2007: True Love Baptist Church, Fairfield

33 2008: Tabernacle of David, Vallejo

34 2009: St. Stephens CME Church, Fairfield

35 2012 Friendship Missionary Baptist Church

36 2013 MEW Expansion to Contra Costa County Solomon Temple Church, Pittsburg Good Samaritan Church, Vallejo

37 Outcomes/Successes 9 churches have participated 201 participants attended SOME of the Peer Counselor Training 93 Completed the Peer Counselor Training 581 Contacts by Peer Counselors 9 Community Baby Showers serving over 900 pregnant African American women and expectant fathers

38 Questions / Discussion

The Power of Peer Groups. Laurie Haessly, MA, RD, IBCLC Breastfeeding Coordinator County of Riverside Department of Public Health

The Power of Peer Groups. Laurie Haessly, MA, RD, IBCLC Breastfeeding Coordinator County of Riverside Department of Public Health The Power of Peer Groups Laurie Haessly, MA, RD, IBCLC Breastfeeding Coordinator County of Riverside Department of Public Health Breastfeeding Peer Counseling in WIC Special Project Funded by State WIC