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PCHHC Newsletter
May 2015
Women's Health   

Harriet Beecher once said that "women are the real architects of society." Charles Malik noted that "the fastest way to change society is to mobilize the women of the world." While these quotes are inspiring, we know that in order to have the energy needed to change the world, girls and women need to be healthy and well across their life course.  May brings many opportunities to focus on women and the foundational role they have in society. From Mother's Day to Women's Health Week, we all can do something to celebrate and care for the women and girls in our lives. As Archbishop Desmond Tutu said, "Men and boys, we show our manhood through the way we treat our women. Our wives, our sisters, our mothers." 

This month's newsletter highlights several key resources across the life span that allow us to maximize women's wellness, from a call for papers on postpartum health, to tobacco cessation training, health tips, a policy brief and a highlight of some great community programs. We encourage everyone to join forces with us and the Office on Women's Health to raise the volume May 10-16th and beyond.
Office on Women's Health National Women's Health Week Resources
National Women's Health Week is May 10-16, 2015.  The US DHHS Office on Women's Health has put together a series of consumer-oriented and provider and agency resources to promote women's wellness.  Explore the links below to:
The Show Your Love campaign from CDC and the National PCHHC Initiative has variety of tools and resources for providers and consumers.  For providers and program planners, there is an American Journal of Health Promotion supplement that contains the latest research and strategies for promoting preconception health: Effective Strategies for Promoting Preconception Health-From Research to Practice.  For consumers, there are tools, such as checklists in English and Spanish for women  who desire pregnancy in the next  year and those who are not planning to become pregnant.  There are also website buttons, talking points, and e-cards available that contain messaging for planners and non-planners.  


The Association of Maternal Child Health Programs (AMCHP) has released a new brief titled Opportunities and Strategies for Improving Preconception Health through Health Reform.   Through this report, AMCHP details the provisions of the Affordable Care Act that have the potential to facilitate state activities to improve preconception health and, ultimately, improve birth outcomes.  They provide state-level examples of successful initiatives to improve preconception care, including building and strengthening state and community partnerships, improving access to and quality of primary care for women, financing preconception care services, and using data to improve programs and inform policy change.  The brief is available here. 

The Reproductive Health Group of the Ontario Public Health Association has released a position paper on preconception health,  SHIFT - Enhancing the Health of Ontarians: A Call to Action for Preconception Health Promotion and Care.  The paper provides the rationale for broadening the window of reproductive health practices to include preconception health, by providing a summary of current evidence, promising interventions, and existing gaps and opportunities. It concludes with advocating for a comprehensive approach to mobilize this shift.  Access the full paper or read the executive summary
State Snapshot: Prioritization of Preconception Health in Omaha, Nebraska 

An interview with Mary A. Balluff, Division Chief, Community Health and Nutrition, Douglas Co. Health Dept. 

By now we realize that enhancing a woman's health before planning and conceiving a pregnancy reduces the risk of adverse health effects for both herself and her baby. But optimizing women's health before and between pregnancies is an ongoing process that requires the full participation of all segments of the public health and health care systems. In Omaha, Nebraska the Douglas County Health Department has prioritized preconception health to not only increase positive birth outcomes, but to also promote the health of all of its county's women, infants and children.


Mary A. Balluff, Chief of the Community Health and Nutrition Services Division within the Douglas County Health Department, has worked for many years to improve maternal and infant health in her locale. One of these areas of improvement involves sexually transmitted infections (STIs). In 2004, Omaha's rates of STIs reached epidemic levels, and the area has since continued to exhibit some of the highest rates of STIs in the nation. With a $2.5 billion investment from the Sherwood Foundation, the Division is initiating a media campaign to urge appropriate prevention methods and testing. This campaign will eventually transform into one focusing on teen pregnancy - another area of concern.


Utilizing personal interviews and the Fetal Infant Mortality Review (FIMR) process, Mary and her staff have realized that intervening during pregnancy is too little too late. These data revealed that women are going into pregnancy both uninformed and unprepared, so the Division asked "How can we make sure women are ready for pregnancy?" To answer this question, the Division focused its attention on adolescents. Though the surrounding community was concerned that any program addressing adolescent preconception health would highlight discussions about sex, the community agreed that implementing Wyman's Teen Outreach Program (TOP) was an acceptable approach to take. The evidence-based nature of the TOP Program exposes youth to 10 key developmental assets that relate to preconception health through three areas: 1) educational peer group meetings, 2) positive adult guidance and support, and 3) community service learning. Through this program, Omaha's highest-risk low-income adolescents are learning to develop life goals, understand their decision-making processes, and ultimately delay parenthood.


The final area of focus involves postpartum women. FIMR data indicate that many women, especially women who have lost their infant, miss their six-week postpartum visit. To address this issue, the Division is in the process of initiating two projects, both within the WIC program. The first of these is a survey designed for WIC-enrolled women to assess why they are missing their postpartum visits. With an understanding of the underlying reasons, WIC staff should be better able to service these women and encourage proper postnatal health. Still, when a woman does arrive for her final postpartum visit, the final WIC visit in particular, the topic of discussion is often focused on the baby. There is little dialogue about her health or the issues that are most important or pressing for her. The second WIC project addresses this dearth with a survey of two WIC sites that inquires about women's specific postpartum needs. These results should promote among WIC staff an understanding of the information that is most wanted and needed by postpartum mothers.


Overall, optimizing women's health requires a multifaceted approach - much like the one Mary and her staff are implementing within the Douglas County Health Department. With a focus on STIs, adolescents and postpartum women, the Division is developing new ways to think about maternal and infant health in Omaha's highest-risk communities. For more information about the Fetal and Infant Mortality Review (FIMR) process within the Douglas County Health Department, view their 2013 annual report.  

About the Newsletter  
Thanks for reading!  Is your organization doing exciting work to promote preconception health? We would love to feature you in an upcoming newsletter.  Email us for details.    
This e-newsletter is archived.  Find back issues of the newsletter and more information about improving preconception health and health care here.

The Maternal and Child Health Journal is soliciting manuscript submissions for an upcoming themed issue focusing on postpartum health and wellness. Papers on any aspect of postpartum health are welcome, including policy briefs, original research, program implementation, commentaries, perspectives in practices, evaluation, and lit reviews. Deadline is 10/15/15.  Click here for more information about manuscript submissions.
WHO Commission on Ending Childhood Obesity has released an interim report for comment through June 5th 2015. Acknowledging that a life course approach must be part of reducing the risk of childhood obesity, the report highlights the preconception period as a key time for intervention.
Webinars on Tobacco Cessation for Women
Women and Tobacco: Why Gender Matters, will be presented by the Tobacco Free College Campus Initiative on May 20, 2015 at 2pm EST. Click here to register.

Tobacco Cessation for Pregnant Women and Mothers: What Clinicians Should Know was presented by the Smoking Cessation Leadership Center on Apr 22, 2015.  Access the archived webinar here.

Free Preconception Health App Available
Kids Connected By Design, an organization working on improving birth outcomes in St. Lucie County, FL, has launched an app called Preconception Health Now!  - a free interactive, self-guided smartphone application designed for anyone of reproductive age. Using the app, an individual can self-score her own health and wellness competency while expanding her knowledge in nine key areas. Each of the nine sections is layered with related questions and answers, links and automatic phone options to additional information.  See the Kids Connected by Design website for more information.


Sign Up for Bi-Weekly Preconception Updates to Your In-Box 

To receive a bi-weekly media and literature update on preconception and interconception health through a listserv, please email Cheryl Robbins.
Do you work on issues related to preconception health? 
Please email us - we would love to know about your work!
We have postcards and website banners that we would love to share with you to get the word out.  Email us if you would like us to send you these resources for your website or your next meeting/conference.