Member states were asked to answer the following question:
What are you doing related to health promotion and prevention across the lifespan?
Administrator, Lifespan Health Services Unit
Nebraska Department of Health and Human Services
In 2007, the Lifespan Health Services Unit, Nebraska Department of Health and Human Services, initiated a strategy development process for two of the state’s MCH priorities: overweight among children and women of child bearing age, and preterm birth/low birth weight. Using the Family Health Outcomes Project’s planning methodology, stakeholder work groups developed logic models for both priorities. This planning process and the logic models resulted in several preconception health strategies within a life course framework.
Subsequently, the Lifespan Health Services Unit integrated the life course framework into its work. An RFP was issued for MCH community-based services that incorporated the work groups’ logic models, resulting in a number of preconception health projects that reach adolescents and young adults. Three of the projects enhance preconception health services within Title X/Family Planning clinics. A fourth project integrates a life course model of preconception health into medical education.
The logic models were also key to the preparation of a successful application for the First Time Motherhood/New Parents Initiative grant. Nebraska’s project, now in its second year, has as its target audience young women, ages 16 to 25. Market research with this audience is currently being used to develop a campaign with original music as the “hook” to connect this group of Millennials to positive and empowering health messages. For more details on this project, which is undergoing a transformation from “Building Bridges” to “Tune My Life,” visit here.
Dr. Linda Jones-Hicks, D.O. FACOP, FAAP
Director, MCCH (Maternal Child Community Health) Family Health Services
New Jersey Department of Health & Senior Services
In New Jersey, the issue of preconceptual health has been a priority for several years. As a result, several statewide collaborative steps have been taken to provide education and information through Family Planning agencies, to expand the Department of Education’s core curriculum on health and physical education, and under the direction of the Department of Health and Senior Services, Division of Family Health Services, a Statewide Prenatal Task Force was created which addressed additional recommendations. These initiatives have created the framework by which New Jersey addresses preconceptual health to stress health before and during pregnancy.
The Family Planning program has clinic sites on some college campuses. These sites provide preconceptual health counseling and family planning services. New clients are provided information about prenatal vitamins, the role of folic acid, the importance of cessation of smoking, decreasing alcohol use and avoiding stress.
The Department of Education (DOE) developed Core Curriculum Content Standards which mandate comprehensive health and physical education. The Department of Health and Senior Services collaborated with the DOE to help students develop an understanding of how the physical, emotional and social aspects of human relationships and sexuality support a healthy, active lifestyle. Additionally, students learn medically accurate information about contraception, including abstinence and the skills needed to reduce or eliminate sexually transmitted diseases, HIV/AIDS and unintended pregnancies. The comprehensive health and physical education core standards have three strands: Relationship, Sexuality and Pregnancy/Parenting, each with a prescribed set of indicators, that build upon the knowledge and skills gained in preceding grades, beginning with Grades 7, 8, and culminating in Grade 12.
In 2008, Health and Senior Services Commissioner, Heather Howard convened a Prenatal Task Force. The Task Force's Final Report increased public awareness of the importance of preconception health, improved knowledge (by professionals and the community at large) of risks and behaviors that impact preconception health. The Task Force Report stressed the importance of entering planned pregnancy in optimal health and in obtaining proper first trimester prenatal care.
Recommendations for policies to promote family planning as a priority are important not only because they reduce unintended pregnancies but also because they can improve the initiation of early prenatal care which promotes better health outcomes for both mother and babies throughout life.
RI’s Preconception Health Efforts for Adolescents and Young Adults
Ana Novais, MA
Division of Community, Family Health & Equity
Rhode Island Department of Health
Rosemary Reilly-Chammat, Ed.D.
Adolescent Health Manager
Perinatal and Early Childhood Team
Division of Community, Family Health and Equity
Rhode Island Department of Health
Rhode Island approaches preconception health within the context of prevention and social determinants of health. Rigorous laws and policies on tobacco use and nutrition have created a strong foundation for efforts to support preconception health among young people in schools and the community. Further environmental changes, such as safe walkways, promote physical activity. Injury prevention program supports school and community based initiatives on suicide prevention and teen dating violence. The Title X program includes the Women’s Health Screening and Referral Program to identify at risk women including teens, who have a negative pregnancy test. When risks are identified, such as tobacco use, the woman is referred to tobacco cessation services.
Access to health care is another key area. Adolescent well child visits serve as an important indicator of care. In 2008, Rhode Island health plans reported an average of 60 percent of enrolled adolescents with well care visits. While this number meets the United States benchmark of 59.6 percent, improving access will serve to improve preconception health. To that end, Rhode Island’s newest endeavor is the development of adolescent medical homes where a myriad of providers coordinate comprehensive services and care for teens in their geographic area. If you are interested in more detail of any of these efforts, please contact Ana Novais or Rosemary Reilly-Chammat.
Sam Cooper, MSW, LMSW
Title V MCH Director
Texas Department of State Health Services
The Texas Department of State Health Services (DSHS) is launching the Texas Healthy Adolescent Initiative (THAI) to improve the overall health and well-being of Texas adolescents, age 10 to 18 years. THAI provides funding for Local Community Leadership Groups (LCLG) to conduct a needs assessment and develop a strategic plan for their community to address adolescent health through a comprehensive youth development approach. To help ensure a comprehensive approach, LCLG members have a variety of expertise including adolescent health and mental health, school advisory councils, community resource coordinating groups, juvenile justice, faith-based services, sports and recreation and parents of adolescents.
THAI strives to incorporate evidence-based youth development principles throughout all levels of interaction with youth in each community. THAI grant recipients will incorporate strategies such as involving families, strengthening academic skills and opportunities for youth and family members and school-to-work programs. Strategies may also include mentoring programs, referrals to health and mental health services and activities that enhance self-esteem. By putting these strategies into place, local communities should improve protective factors such as future orientation and reduce risk taking behaviors among youth.
DSHS is also producing the “Get Fit Kit,” a toolkit for school nurses to use with adolescents who are identified as overweight or obese through the state’s physical assessment test. This toolkit was developed in response to school nurses that voiced the need for a resource tailored for them about nutrition and physical activity specifically for adolescents. The toolkit includes lessons for students on MyPyramid, portion control, physical activity and BMI, fast food and snacking, reading nutrition labels and diabetes. There is also an interactive GetFitKit.org website to complement the toolkit that provides access to the lesson information for both students and nurses. There are interactive games and quizzes, including a pretest and posttest to help evaluate whether students are learning key messages from the toolkit.
Linda Hale, RN BSN EMT
Chief, Family Health Section
Bureau of Community Health Promotion
Division of Public Health
Wisconsin Department of Health Services
Wisconsin is working to bring a preconception health focus to many of our programs:
As part of the First Time Motherhood New Parents Initiative grant a social marketing campaign The Journey of a Lifetime was launched in October, targeting African American teens and young adults in the southeastern region of the state. This multi-media campaign consists of the key message – a lifetime of maternal health and stress control is the best recipe for a healthy baby. For more information, visit here.
As part of a statewide MCH contract the Infant Death Center of WI has developed the Take Control brochures series. These multi racial and ethnic brochures include messages on taking control of your body, health, environment, habits, and mental health. The brochures are available online to all of our partners.
The Family Planning and Reproductive Health Program partnered with Prenatal Care Coordination to implement Women’s Health Now and Beyond..Pregnancy. This initiative is targeting all women during pregnancy to introduce a post-partum contraceptive plan and intervention in the third trimester, and preconception messages on women’s health and a reproductive life plan during the third trimester and following delivery. To view some of the materials for this initiative, visit here.