2011 PASOs Community Benefit Report

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1 2011 PASOs Community Benefit Report

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3 Table of Contents Reflections from the Executive Director. 2 A Year of Achievements. 3 PASOs Program Overview. 4 PASO s Commitments Program Reports Journey to Best Practices. 18 Message from Program Evaluators. 20 Thanks to the PASOs Staff, Advisory Council and Volunteers for making this work happen! Central Leadership and Support PASOs Program Statewide Advisory Council Julie Smithwick-Leone, LMSW Margarita Franco, BA Lucy Willms, LMSW Cheri Sprankle, BS Program Leadership Mari Borghini, BSW Yajaira Benet-Smith Gabriel Cardona Ana Cossio, BA Romina McCandless, MPH Judith Rundbaken Andrea Pajón, NA, CCE Mercedes Van Leer, M.Ed. Evaluation support Myriam Torres, PhD Deborah Billings, PhD PASOs Volunteer of the Year 2012 Arti Patel, USC, Class of 2012 Megan Branham, LMSW Stephanie H. Caffee, RN, BSN Emmie Caplan, BA Sarah Covington-Kolb, MSW, MSPH Margarita Franco, BS Jennifer Greene, MD Carolyn Jenkins, MSN, RN-BC Jorge Leone Maria Martin, BSW Sebastian Naranjo Amy Nienhuis, LISW-CP Lyn Phillips, LCSW Amy Picklesimer, MD Jim Riddle Maria Smoak Anna Tecklenburg, MA Gregory Torrales Myriam E. Torres, PhD, MSPH Susan Watts, RN, MSN, CS Maria Yturria 2011 PASOs Community Benefit Report 1

4 Reflections from the Executive Director 2011 was a great year for PASOs one that was filled with growth, change, success and of course some challenges. The Puentes Project and PASOs for Parents really made traction in the Midlands area and are piloting projects that will begin to spread as the models are polished. The Charleston program now has many organizational partners and is speaking out as a voice for the Latino population in that area consistently. The Promotores Initiative is supporting community health worker teams in three focus areas. In 2011, PASOs coordinators taught over 300 classes, partnered with 150 organizations to improve access to quality care, and reached over 7000 people. We were honored to receive the designation from the Association of Maternal and Child Health Programs (AMCHP) as a promising practice model, and further honored to be chosen by that organization as the Promising Practice of the Year for In 2012, PASOs will be redefining our strategic plans, both for individual programs and our organization as a whole, to adapt to our changing environment and changing population and to focus on the strengths of the population and of PASOs. We will invest time and resources in becoming a stronger organization and stronger individual programs in order to affect the most change in the most effective manner. Since its inception in 2005, PASOs has grown quickly to meet challenges and fill gaps. Throughout all of this growth, we have not been perfect. However, I believe our greatest success is that everything we do, we try to do it in a very respectful and honorable way, and we are always looking to improve our work. We take the time to listen to the community s needs, talk with our supporters to get their ideas, reflect on our successes and failures, and change our methods when we need to do so. We also respect people from all walks of life, and try to treat all with the dignity that they deserve. We honor and appreciate the diverse cultures of our participants, and we believe in each person s ability to contribute to our society. I m proud of the organization that PASOs has become, not only for the work we do but the way that we do it. Julie Smithwick-Leone, LMSW PASOs staff members with Puentes Community Ambassadors at the semi-annual staff training in Columbia, SC PASOs Community Benefit Report

5 A Year of Achievements PASOs was recognized nationally as A Promising Practice by the Association of Maternal & Child Health Programs (AMCHP). The award is a big step towards recognizing the dedication and commitment of people throughout South Carolina who are working with PASOs to serve the needs of Latino women and children. Margarita Franco was recognized as a Hero in the Field on September 29, 2011 by Healthy Start, Palmetto Health, and March of Dimes for her work on reducing infant mortality rates. Lucy Willms and Romina McCandless of PASOs presented a workshop entitled, Outreach Models that Work With Hard-to-Reach Populations, at the South Carolina Primary Health Care Association Network retreat. Lucy Willms and Margarita Franco on behalf of the PASOs Program received the Kathy Carson Promising Practice Award by CityMatch for their presentation of The role of advocacy in promoting reproductive health equity & social justice in the Latino population: A qualitative approach to understanding barriers and solutions. Julie Smithwick-Leone and Mariangeles Borghini presented at the 2011 CityMatch conference on A comprehensive training program for grassroots community leaders to forge social and reproductive justice in South Carolina. Margarita Franco and Julie Smithwick- Leone presented a poster about the Puentes Project at the American Public Health Association conference in Washington, DC. PASOs released two documentaries this year! Short films for the PASOs Program and the Puentes Project were produced by the talented Gustavo Montaña of At Dusk Media. They are available on the PASOs web site as well as YouTube: youtube.com/user/pasosprograms Lucy Willms and Julie Smithwick-Leone accepted the Promising Practice Award of 2011 from the Association of Maternal and Child Health Programs on behalf of PASOs dedicated staff, teams of community health workers, partners and volunteers PASOs Community Benefit Report 3

6 PASOs Program Overview Where is PASOs in South Carolina? PASOs Terminology Greenville, Richland, Lexington, Saluda, Newberry, Edgefield, Clarendon, Williamsburg, Charleston, Dorchester, Berkeley, Beaufort, and Jasper Counties. Spartanburg Greenville Cherokee South Carolina Counties with an Active PASOs Program York Pickens Oconee Chester Union Anderson Chesterfield Lancaster Marlboro Laurens PASOs: PASOs means steps in Spanish and is about helping families and communities be healthier step by step. Promotores/as: Grassroots leaders from within the Latino community equipped with skills to bring health information to their peers and neighbors and help others navigate health resources effectively. Fairfield Newberry Abbeville Richland Saluda Calhoun Horry Clarendon Aiken York Williamsburg Georgetown Pickens Orangeburg Barnwell Chester Union Anderson Chesterfield Lancaster Bamberg Fairfield Newberry Darlington Kershaw Dillon Colleton Hampton Abbeville Charleston Lee Greenwood Richland Saluda Lexington Florence Marion Beaufort Jasper Horry Sumter Active PASOs Program Edgefield Calhoun Clarendon Aiken Community Ambassadors: Leaders who facilitate access to resources and bring ideas for change from their communities to health service providers and decisionmakers. Berkeley Dorchester Marlboro Allendale Laurens McCormick Marion Sumter Edgefield Cherokee Florence Lexington McCormick Spartanburg Dillon Lee Greenwood Greenville Darlington Kershaw Williamsburg Advocacy: Amplifying the voice of the Latino population; ensuring that the Latino community s needs are considered and addressed when decisions and policies are made. Georgetown Orangeburg Barnwell Bamberg Berkeley Why is PASOs needed in SC? Dorchester Allendale Colleton T he Hampton Latino population in SC has increased 148% during , the largest increase of any state. During that time, the population of Latino children increased 192%. Charleston Beaufort Jasper Latino population in the US is younger, less insured, of lower socio-economic status and has higher fertility rates than other racial and ethnic groups. T he Health Resource Navigation: Assisting participants with understanding the complicated matrices of health care systems and community resources available to them. N ew Culturally Appropriate: Modified and adapted to fit a cultural framework. Languages, dialects, literacy levels, beliefs and cultural values are incorporated to ensure that it is appropriate for and acceptable to the target audience. immigrants and people whose first language is not English often face significant barriers when trying to access health information, medical services and community resources in an unfamiliar system. T he ability to access community resources is a key factor in diminishing the disparities that face Latino children and families T he Latino immigrant population has many strengths and healthy behaviors that can be supported and promoted. 4 Bridge Building: Facilitating communication between the Latino community and health care service providers so that services are delivered more effectively and in a culturally sensitive way. Assisting Latino families and health organizations learn more about each other PASOs Community Benefit Report PASOs Commitment to Education

7 PASOs Program Overview PASOs - MAKING A DIFFERENCE ONE STEP AT A TIME Vision A healthy South Carolina with a healthy Latino community. Mission PASOs helps the Latino community and service providers work together for strong and healthy families. We do this through education, support and grassroots leadership development. Values Health is more than the absence of disease it is a state of complete physical, mental and social well-being. Health care should respect the person s identity and individual needs. People must be participants in decisions that affect their health, not merely recipients of the health care process. The sharing of knowledge empowers individuals, families and organizations. Collaboration is essential in order to create a healthier and more just society. Program Goals: Latinos throughout South Carolina will be mobilized with the information they need to make healthy choices. Latinos in South Carolina will be connected with maternal, child and reproductive health resources they need and will have the necessary skills to navigate these resources in the future. Input and guidance from the Latino population will be considered and incorporated in decision-making processes affecting the maternal, child and reproductive health of families in South Carolina. PASOs will be an effective and efficient organization, and the PASOs model will become recognized as a best practice. PASOs Program Supporters This work would not be possible without the commitment and resources given to us by our funders. In particular, we extend our appreciation to the Arnold School of Public Health at the University of South Carolina for their support of the PASOs Program, along with the following major supporters and funding organizations: The Children s Trust of South Carolina The Duke Endowment Greenwood Genetic Center Greenville Hospital System The Knight Foundation Advised Fund of Central Carolina Community Foundation Lexington Medical Center The New Morning Foundation Palmetto Health Providence Hospitals The Robert Wood Johnson Foundation Local Funding Partnerships The Sisters of Charity Foundation The South Carolina Chapter of the March of Dimes University of South Carolina, Arnold School of Public Health 2011 PASOs Community Benefit Report 5

8 PASOs Commitments Commitment to Education PASOs provides empowerment-based education both in the classroom and out in the community. Program coordinators facilitate a 14-hour prenatal empowerment course for expectant mothers in counties across the state and a 15-hour early childhood parenting course in Richland and Lexington Counties. Program coordinators also facilitate topic-based health education workshops. All educational courses are evaluated to measure knowledge attainment and commitment to change behaviors. Feedback from satisfaction surveys is used to ensure the program s quality, relevance and effectiveness. In 2011, PASOs provided over 300 educational classes. We learned to make a list of our questions before we go to the doctor to get answers to our questions about her body and the baby. Before, we just went and let the doctor have all of the control. Sebastian, PASOs participant and Community Ambassador Prenatal Program Satisfaction and Effectiveness Survey 82% of participants learned something new in every class 78% of participants reported that the information was easy to understand, 21% reported sometimes easy, sometimes difficult, and 1% reported difficult 98% of participants learned something in the class that will change their behavior Most helpful topics include: all topics (27%), nutrition (13%), prenatal care (12%) and breastfeeding (11%) In South Carolina, many Hispanic women are very recent immigrants. The average amount of time they have lived in the United States is only 4 to 6 years, which is not a lot of time to have developed a strong community with resources and support. I see so many women with the traditional Latino cultural strengths, who want to be a good mother and place importance on children and family, but many don t know where to go to get help. There is tremendous need for information in the Latino community, and PASOs does a wonderful job meeting that need. Dr. Amy Picklesimer, Greenville Hospital System Participants in PASOs Prenatal Education Program learn about infant care and safety PASOs Community Benefit Report

9 PASOs Commitments Commitment to Outreach and Resource Navigation PASOs conducts outreach events each month to bring information about program offerings and community resources. All outreach events are held at places where the community regularly congregates, such as Latino businesses, clinics, and churches. PASOs sponsors outreach events in collaboration with partner organizations whenever possible. In ,511 culturally appropriate educational materials were distributed. 1,124 bottles of folic acid vitamins were given out to Latina women for free. 3,463 people were educated and supported at outreach events. Developing rapport with the community through outreach activities is the key to encouraging people to participate in the PASOs program. Ana Cossio, Saluda/Newberry/Edgefield Prenatal Program Coordinator Outreach Event Topics PASOs program activities The importance of prenatal care, folic acid and breastfeeding Preconception health resources and education HIV and STIs Car seats and crib safety Information about legislation, immigration status and recommendations Resources for domestic violence and sexual assaults Parent education workshops Community events that benefit families Resource Navigation and Individual Guidance All PASOs Counties, 2011 N=4, PASOs Community Benefit Report 7

10 PASOs Commitments Commitment to Partnership and Advocacy PASOs relies on a committed network of community partners across the state to extend its outreach, share resources, and collaborate in shared causes. Through relationships with our partners, we facilitate access to care, networking, referrals, collaboration, and communication between community organizations and the population. Our collaboration has shown to improve services and access for Latino families through increased communication and mutual understanding. Working with partners has lots of advantages. They are experts in the services they provide, so instead of knowing it all, I just need to know who to ask. By meeting often and working together, we build a relationship which eases communication and provision of services. I provide the Hispanic perspective, but can also bring awareness about a gap in the services available. I would not be able to do all that I need to do, if it was not for the support, expertise, teaching and time spent with partners. - Yajaira Benet-Smith, Beaufort/Jasper Prenatal Program Coordinator In 2011, PASOs participated in 228 partnership meetings across the state. With the support of diverse stakeholders, program participants and community members, PASOs advocates to decision-makers for the health and safety of Latino families in our state. We educate individuals, organizations and law makers about the implications of policies on this population. PASOs also works with health and social service organizations to ensure that they make informed decisions that enable Latino families to access the services that they need and that will benefit them. This year, the passage of SB-20, the South Carolina Illegal Immigration and Reform Act, directly affected immigrant families, and PASOs was called upon to provide more family support and resource navigation. With the collaboration of dedicated partner agencies, PASOs educated decision-makers and communities about the potential negative effects that SB-20 could have on the maternal and child health of Latino families. PASOs continues to be a source of information to the community about their rights and the immigration policy changes which we recognize to be deeply intertwined with the health of immigrant families. PASOs Advisory Council members Emmie Craig and Stephanie Cooper-Lewter collaborate with Mari Borghini, Puentes Project Coordinator, to find creative solutions during the semi-annual staff training. Advocacy is not just about encouraging people to speak up when they have experienced a situation that limited their ability to obtain services. Instead, it is about taking that experience, and using it to help bring about changes that prevent the same situation from happening again. This type of advocacy takes collaboration from both the community and the professional sector, and requires trust and respect for and from both parties involved. - Romina McCandless, Charleston/Dorchester/Berkeley Program Coordinator PASOs Community Benefit Report

11 PASOs Commitments Commitment to Community Leadership Development As an organization that recognizes the strengths of the Latino immigrant population, PASOs is committed to supporting the development of leaders across SC who can advocate, educate and inspire those around them to create a more just and healthy society. Promotores are provided with the knowledge, training and skills that they need to educate their community, connect them to resources and advocate on their behalf. Through the Puentes Project, Promotores have received in-depth training to become Community Ambassadors who not only facilitate access to resources but also bring ideas for change from their communities to health service providers and decision-makers. These community leaders are becoming equipped with tools and information they need to make a difference in their communities. Puentes Community Ambassadors with their children at an outreach event in Columbia, SC. I m happy now that we have more access to things, and now the world is not so closed off to us, like it was before. Italia, Community Ambassador Program coordinators, Promotores, and Community Ambassadors serve as guides in helping the community access the health information and services they need PASOs Community Benefit Report 9

12 Program Reports PASOs Prenatal Program PASOs offers a prenatal education course in Spanish using a curriculum that is based on Latino cultural values. The interactive course consists of 14 hours of sharing and discussion on a range of subjects and resources related to perinatal health. Participants develop a network of support with each other and the program coordinator as they share their experiences and practice new skills. The course is evaluated through a pretest and posttest to measure gains in knowledge and participant satisfaction. Results from 556 participants in years are shown in the charts below. In the PASOs Prenatal Program, participants receive free, empowerment-based prenatal education and connection to health care services. Daily intake of folic acid to help prevent birth defects 100% 80% 60% 47% 84% Pretest 55% Posttest 92% 78% 99% 40% 20% 0% Knows correct time frame to take folic acid Knowledge of folic acid as prevention Daily intake of a multivitamin with folic acid PASOs Community Benefit Report

13 Program Reports Knowledge related to healthy pregnancy 100% 80% 60% 40% 20% 0% Feels prepared to respond to preterm labor warning signs (posttest only) 80% 83% 6% States definition of preterm labor 50% Pretest 86% Recognizes signs of postpartum depression Posttest 77% 95% Names warning signs to monitor during pregnancy 84% 76% 22% 23% Knowledge of how to track baby's movements after 28 weeks Can identify foods with higher iron contents Knowledge and behaviors related to baby 77% 97% 43% 67% 50% Pretest 82% Posttest 16% 66% 57% 36% 38% 63% Can give safe sleep recommendations Understands shaken baby syndrome Understands car seat guidelines for infants Knows recommended guidelines for pregnancy spacing Plans to breastfeed Plans to breastfeed AND use infant only formula Knowledge and utilization of resources 100% 80% 60% 40% 20% 0% 86% 87% Reports good communication with providers 66% Receives WIC Supplemental Nutrition Program benefits Pretest 78% 79% 40% Posttest Names documents needed for Medicaid application 62% 94% Has chosen specific birth control method for use postpartum 69% 85% Plans to use birth control postpartum Find more information about PASOs Prenatal Program at PASOs Community Benefit Report 11

14 Program Reports The Puentes Project, Richland & Lexington Counties The Puentes Project builds upon the success of the PASOs Program and the participants desire to part of solutions. Puentes was established to construct bridges between the Latino community and the local health services providers through: Empowering Latino leaders with necessary skills to educate their peers, facilitate access to resources, and bring ideas for change from their communities to health service providers and decision-makers. Providing more capacity to local health care providers and policy-makers. The diverse team of Community Ambassadors was selected through an application process and brings a variety of backgrounds, skills and experiences. 34 Community Ambassadors from 7 different countries 29 females and 5 males 54% have experience as a community health educator/volunteer prior to involvement with Puentes Puentes Project Community Ambassadors share ideas at a monthly capacity-building training Puentes resource navigation and individual support by month, N= PASOs Community Benefit Report

15 Program Reports What do Community Ambassadors do? Participate in Puentes Committees Resources, Youth, Achievements and Events Attend weekly English classes and practice with a conversation partner Contribute to decision-making groups Assist peers with connecting to health services and community resources Provide educational sessions on reproductive health topics Puentes Project Training In Puentes, the Community Ambassadors receive the tools and training they need to educate their communities and work with health care providers. This year, they participated in a culturally appropriate, participatory training curriculum. Topics include: Leadership and communication skills Community resource navigation Human, immigrant, and gender rights Family planning and contraception Prenatal health and postpartum depression Gender-based violence STDs and HIV Teen pregnancy prevention Leadership in Action By participating in meetings and events with community organizations, Community Ambassadors serve as the voice of the Latino community and affect change on an organizational level. Examples of leadership activities include: Meeting with the Mexican Consul General to discuss effective services for the Latino community in SC Participating at the state Victims Rights Conference Facilitating workshops about immigrant rights Training as Benefit Bank counselors to help peers access benefits for which they are eligible Participating as PASOs representatives at health fairs, the Latin Festival in Columbia, and the Mexican mobile consulate Resource Navigation and Individual Support With their newly acquired information and skills, the Community Ambassadors are beginning to educate their peers on reproductive health topics, hold outreach events, and assist with resource navigation. Each month, the Community Ambassadors report the number of times they assist their peers in connecting to resources. See chart. Too many times, groups that don t have access to information get left out of the conversation. I believe that you train individuals within each community to be empowered, to be the next generation of leadership. Stephanie Cooper-Lewter, MSW, Sisters of Charity Foundation of South Carolina Find more information about Puentes at PASOs Community Benefit Report 13

16 Program Reports PASOs for Parents, Richland & Lexington Counties According to the Pew Research Center, more Latino children are living in poverty 6.1 million in 2010 than children of any other racial or ethnic group. Since poverty puts families at greater risk for child neglect and maltreatment, PASOs for Parents is providing much needed support at a crucial time. PASOs for Parents is a parent education course in Spanish for Latino families in Lexington and Richland Counties. The goal of PASOs for Parents is to prevent first-time incidences of child abuse and neglect by providing parents with tools to be effective caregivers and build healthy relationships with their children. PASOs for Parents is unique to South Carolina because it serves a growing population of parents who are often unable to access traditional parenting resources due to language barriers, cultural differences, lower levels of education and social isolation. To support the success of Latino children in our state, PASOs focuses on connecting families to health, education and violence prevention resources, as well as networkbuilding among parents with same-aged children. Our curriculum is the evidence-based, educational intervention called Nurturing Parenting (Crianza con Cariño in Spanish). Mercedes Van Leer, PASOs for Parents Program Coordinator, shares interactive parenting techniques with class participants. Just as technology is always changing and getting better, we as parents have to change the ways that we raise our children. You have to learn to leave behind spanking and use words instead. Ondina, PASOs for Parents graduate PASOs for Parents in 2011 Number of program participants: 108 Number of classes held: PASOs Community Benefit Report

17 Program Reports Protective Factors Survey The Protective Factors Survey is a pre-post evaluation tool developed by the Friends National Resource Center for Child Abuse Prevention. The PASOs for Parents program adapted this survey so that it is culturally relevant. The lower scores in Concrete Supports resulted in program strengthening Protective Factors Survey, N= % 86% 84% 78% 81% 82% 80% 76% 72% 69% 72% 59% 60% 40% 20% 0% Pretest Posttest Parenting Abilities Survey The Parenting Abilities Survey measures participants change in knowledge through a pretest and posttest on the five constructs of the Nurturing Parenting Curriculum. The survey was adapted from 2011 Parenting Abilities Survey, N=33 100% 97% 97% 85% 84% 83% 80% 79% 79% 64% 60% 58% 55% 40% 20% 0% curriculum materials to complement the Protective Factors Survey. Pretest Posttest I love to hear the parents talk about their successes in the PASOs for Parents Program. They say they are more affectionate, give more praise, and spend more time together. They have learned to use positive forms of discipline, make family rules and focus on collaboration with their children. Mercedes Van Leer, PASOs for Parents Program Coordinator Find more information about PASOs for Parents at PASOs Community Benefit Report 15

18 Program Reports Hispanic Folic Acid Project Raising awareness and providing resources for birth defect prevention Greenwood Genetic Center and PASOs initiated a partnership in 2009 to expand outreach and education efforts about folic acid to the Latino population, which is at higher risk for neural tube defects (NTDs) and orofacial clefts. The program works in partnership with the SC Birth Defects Prevention Program to raise awareness about these defects and how folic acid helps to prevent them. Program coordinators and peer health educators throughout the state provide education on folic acid through workshops, outreach events, and prenatal classes. Program efforts are further concentrated in Greenville County, where the Latino population is the largest and where, at the time of the program s inception, there were alarming numbers of Latino children born with NTDs. Greenwood Genetic Center reports that in 2011, only one incidence of a Hispanic baby born with a NTD was reported a testament to the success of this partnership. NTDs are severe defects of the brain and spine. Most of these defects are preventable by taking 0.4 mg per day of folic acid. But these problems occur very early in pregnancy, often before a woman knows that she is expecting. So, folic acid needs to be taken both before and during pregnancy. Jane Dean, RN, Statewide Coordinator of the SC Birth Defects Prevention Program at Greenwood Genetic Center Through the Hispanic Folic Acid Project, Latina women receive free bottles of folic acid multivitamins and information on preventing NTD s to increase their chances of having healthy, happy babies. The majority of women I talk with do not know the importance of taking folic acid before pregnancy and do not begin taking folic acid until their first prenatal appointment. Health care providers often prescribe vitamins with folic acid, but they do not have the time to explain the vitamin s importance in a way that makes sense to the Latino patient. That s where I step in. Andrea Pajón, Greenville County Prenatal Program Coordinator Hispanic Folic Acid Program Results In Greenville County, PASOs held 129 outreach events, distributed 350 bottles of folic acid to Latina women of child-bearing age, and appeared 30 times in local media. The coordinator provided 204 individual educational sessions with women in the Greenville Hospital OB/GYN Clinic. Of the women who received education and multivitamins, 63% were pregnant and 82% continued to take their multivitamins at 3 months later. In all of PASOs Programs across the state, 1008 bottles of folic acid were distributed, along with 896 culturally appropriate educational materials. Our numbers indicate that our efforts are truly impacting the lives of Latina women and their families PASOs Community Benefit Report

19 Program Reports Promotores Initiative Based on the success of the Puentes Project in Richland and Lexington Counties, the Promotores Initiative has begun to expand to all PASOs Program sites. In order to increase PASOs ability to reach the Latino population with information and resources, new teams of Promotores are being created in five counties. The Promotores will spread culturally appropriate health messages in their communities and assist their peers in navigating the health care system. They will also provide information about the changes brought about by the Patient Protection and Affordable Care Act. Program Goals: To train at least 12 Promotores in each PASOs site, for a total of 60 new Promotores Of those who are trained, 80% of the Promotores will be active and will receive continual support from the team and the program coordinator By the end of 2013, the new teams of Promotores will have assisted 5,000 people to navigate the health care system I think that this Initiative is powerful for both the Promotores and for the community. The Promotores bring all of their knowledge and leadership potential to their team and to their community. In return, the community receives the information and support that is needed to make healthy decisions. Margarita Franco, Director of Community Leadership Development Margarita Franco, Director of Community Leadership Development, with Andrea Pajon, PASOs Program Coordinator Greenville County, and a graduate of the Promotores Initiative. Promotores participate in a 24-hour training program in order to bring information and resources to their communities PASOs Community Benefit Report 17

20 Journey to Best Practices Preconception Health Promotion Strategy Preconception health promotion is recommended to all populations in their childbearing years; however, research indicates a great need for preconception health promotion among Latinos in South Carolina. PASOs is incorporating a PCH outreach and education strategy into its program model using research, program best practices and community input. The strategy includes an interactive preconception health workshop for men and women, community approved outreach materials, free folic acid vitamins, and mass media campaigns. Preconception Health Strategy Priorities Folic Acid in preventing neural tube defects (NTDs) Reproductive anatomy Family planning and pregnancy spacing Access to health care services Nutrition and exercise Preconception Health Strategy Components Culturally appropriate messages Community outreach Health education workshops Promotores and Community Ambassadors Partnership with Greenwood Genetic Center for folic acid promotion We are working hard to be able to measure change, to see if people feel that they are learning something, and to see if they are able to put that knowledge into practice. We are trying to measure at every level. Myriam Torres, PhD, USC Consortium for Immigration Studies Culturally Appropriate Outreach Materials Initiative PASOs program coordinators collaborated with the Puentes Resources Commission to assess the educational materials distributed at outreach events for cultural appropriateness. The team evaluated the materials for relevant images, culturally appropriate messages, and adequate literacy levels. Thanks to this team s efforts, the Latino community is receiving more effective educational materials at outreach events. Advocacy/Resource Navigation Qualitative Study The quantitative data collected in PASOs prenatal program surveys demonstrate consistent gains in knowledge of perinatal health and available resources. Qualitative data has been collected to better understand how the program is successful in helping participants overcome barriers to receiving health information and services. We are also demonstrating how change can occur with the collaboration of participants on both organizational and policy levels. The preliminary analysis shows that personal relationships, cultural knowledge, and status as a trustworthy source of information are significant to PASOs success. With the trust of the community, PASOs is able to act with and on behalf of the participants to overcome obstacles to accessing the system. We are excited to share the results of our in-depth study in the coming months PASOs Community Benefit Report

21 Journey to Best Practice Cost-Benefit Study PASOs is conducting a cost-benefit study to determine the number of dollars that it saves the health care system through prevention education and resource navigation successes. In a climate of scarce resources, we are endeavoring to show that the funds that are spent on the PASOs Program are valuable and serve the community in the most effective way possible. A full report will be forthcoming in Did you know? One case of Neural Tube Defects costs $52,415 in the first year alone (Centers for Disease Control). The social cost of losing a child due to a shaken baby syndrome is $3,200,000 (Goodman, Villarreal & Jones, 2011). Breastfeeding prevents many early infant and childhood illnesses that cost an average of $200,000 per case (United States Breastfeeding Committee). Care for a premature infant costs $51,600 over its lifetime (The Institute of Medicine). Prenatal Health Education Outcomes Study A follow-up survey is being conducted with prenatal program graduates to evaluate medium term program outcomes. The purpose of the follow up study is to discover what information was retained and which health behaviors were implemented upon the birth of the participant s child. We are investigating whether PASOs participants learned new information that influenced them to have healthier pregnancies, better deliveries and safer newborn care. The questions focus on premature birth, hospital delivery experience, breastfeeding, folic acid intake, newborn care, family planning, postpartum depression, and ability to access resources. We are administering this survey via telephone to 20% of participants who graduated the prenatal program in 2011 and look forward to presenting our findings in the coming year. Through PASOs, we are actually going out into the community and working within our target population to see what they need. Right now, it s really important because money is tight, and we need to focus on the services that are going to give us the biggest bang for our buck. This is just a wonderful opportunity to provide the best services we can with the little money that we have. - Jane Key, MPA, SC Department of Health and Environmental Control We are grateful for the milestones that we have reached in 2011, and we look forward to many more successes in 2012! 2011 PASOs Community Benefit Report 19

22 Message from the Program Evaluators The 2011 data from all PASOs Programs are showing very positive trends. The Prenatal Program data indicates that the participants are continuing to demonstrate strong knowledge gains in health behaviors, resource utilization and infant care. One noteworthy trend is the increase (10% since 2009) that we are seeing in pregnant women starting prenatal care during the first trimester of pregnancy. Another bright spot is that the majority of women who come to the prenatal course planning to combine bottle feeding with breastfeeding decide to breastfeed exclusively upon graduation. Also, we are very pleased to see that 94% of women completing the course are able to name the method of contraception they will use after giving birth. We are hopeful that the postpartum follow-up study will demonstrate retained information and positive health behaviors. The number of individual support interventions conducted this year is impressive. This year, we have seen an increase in number of interventions concerning legal concerns, legal documents, and connection to material resources, which likely reflects the economic recession and the immigration reform legislation. Since PASOs believes in the holistic nature of health, we recognize that helping individuals connect to resources they need immediately impacts their health both in the short term and long term. We expect the number of interventions to greatly increase in the coming years as new teams of Promotores begin to use their skills as systems navigators. With the addition of the PASOs for Parents Program and the Puentes Project this year, and the continuation of the Hispanic Folic Acid Project, PASOs has much to be proud of in terms of creating impact. PASOs for Parents participants are showing gains in knowledge of parenting and child development. Across the state, we are seeing a decrease in the number of Latino babies born with NTDs, due in part to PASOs folic acid education efforts. And lastly, a new generation of grassroots leaders is strengthening their voice, educating their community, and improving the health and wellbeing of our society as a whole. PASOs is now entering a time of growth and change. Through our emphasis on continuous and comprehensive evaluation, we will be able to make informed decisions about how to adapt our programs and how to use our resources effectively. While there is still much work to be done, PASOs is demonstrating many positive results in improving the maternal, child and reproductive health of Latinos in our state. We, as the evaluation team, are committed to measuring our efforts in order to show the full impact of our work in the community. With many new evaluation projects underway, we look forward to a very productive Dr. Myriam Torres, Dr. Deborah Billings Lucy Willms PASOs Community Benefit Report

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24 PASOS Programs Devine Street, Columbia, SC (803)