StirFried Strategies for Womens Health

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Stir-Fried Strategies for Womens Health

• Jennifer Opalek, R.N., M.S.N., M.P.H. and
• Jane Bambace, M.Ed.
• St. Petersburg, Florida

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Part 1 Utilizing PPOR Results to Develop
Strategic Interventions

• Pinellas County PPOR analysis
• conducted during 1998-2000.

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Local Results. . .
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Feto-Infant Mortality All Births, Pinellas
County, 1998-00
291 Feto-Infant Deaths
29,085 Fetal Deaths Live Births
Overall Rate 10.0
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Feto-Infant Mortality Black Race, Pinellas
County, 1998-00
82 Feto-Infant Deaths
4,569 Fetal Deaths Live Births
Overall Rate 17.9
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Excess Feto-Infant Mortality Pinellas County
1998-00
Florida DOH Reference
Excess
All Races
2.4
4.7
2.3
1.6
0.9
1.0
0.7
0.5
0.6
2.3
1.4
1.6
_

10.0
5.8
4.2
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Phase 2 Analysis Findings

• Kitagawa Over HALF of excess feto-infant
  mortality is due to the LARGE NUMBER of VLBW
  births

• Risk Factors Examined included

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Leading Prevention Strategy

• Provide preconceptional and interconceptional
  care to women of reproductive age

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Program Map
Input
Activities
Outputs
Results
Physician Referral for High Score
Care Coordination
Improved Access to Healthcare for WCBA
Fewer LBW and VLBW Births
Interconceptional Care
Early Entry into Prenatal Care
Fewer Premature Births
Physician Referral for Other Factors
Community Consortium Building
Repeat Births at Least 2 years after Last
Lower Fetal and Infant Mortality
Family Planning
Social Agency Referral for Other Factors
Fewer Women Smokers
Improved Womens Health
Identify stress and mental health issues
Improved Maternal Nutrition
Outreach
Education on Womens Health Issues
Fewer GU Infections during Pregnancy
Pregnancy Testing
Counseling/Referrals
Improved Mental Health during Pregnancy/Postpartum
Self Referral
Peer Support Groups
PPOR Findings
Targeted Outreach
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Mapping revealed addressing Maternal Health was
vital to reducing the poor birth outcomes
experienced in Pinellas County
Preconceptional Health Healthy Behaviors Perinat
al Care Before Pregnancy
Maternal Health/ Prematurity
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4 Opportunities
Screening Tool for Women
Healthy Start Home Visiting
Linkage to Existing Health Programs
Community Health Education
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Pre/Interconceptional Current and Future
Activities
1-on-1 Education

Chronic Disease and Obesity Prevention Programs
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What About Mom
Beauty Talk
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Womens Health Questionnaire
While You Wait
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Part 2 Integrating Interconceptional
Education and Counseling into Healthy Start A
Best Practice

• Pinellas County Home Visiting Program for
  Pregnant Women and Infants

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Why develop another Healthy Start Enhanced
Service?

• More than 50 of pregnancies are unplanned.
• Untreated/Unmanaged Chronic Health
• conditions prior to pregnancy may increase risk
  of poor birth outcomes.
  
• Healthy Start participants need correct
• information about their personal health.

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Including Interconceptional Education and
Counseling in Pinellas County

• Primary Goals X 2
• Ensure Annual Well-Woman Visit
• Achieve Baby Spacing

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Interconceptional Care

• Interconceptional Care is what
• we know as Womens Health
• which includes family planning, healthy
  lifestyles, and medical
  
• care of any health problems.

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Interconceptional Education and Counseling 1.
Assesses the womens current health status using
a Womens Health Questionnaire.
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Interconceptional Education and Counseling 2.
provides activities that educate and inform the
Healthy Start woman about specific topics related
to Womens Health.
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Interconceptional Education and CounselingTopics
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10 Brochures to prompt discussions in each risk
factor topic area.
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Interconceptional Education and Counseling 3.
Uses a Risk Reduction Approach.
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Risk Reduction Approach Frequent and routine
assessment of progress is made during home
visiting.
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Care Coordinator/Home Visitor

• Focus on linking mother to an
• on-going medical home.
• Heavy emphasis on baby spacing and step by step
  risk reduction.

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Health Statistics

• Facts about Womens Health

Leading Causes of Death Pinellas County 2002 H
eart Disease 3,345 Pneumonia/Influenza
254 Cancer 2,683 Liver Dise
ase 132 Stroke
728 SIDS/HIV 65
Emphysema 739 Suicide
154 Accidents 423
Homicide 59
Diabetes Mellitus 296
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Routine Health Maintenance and Family Planning
for Women

• Health status screening and physical activity
• Physical exam, including STD screening
• Dietary/nutritional assessment
• Screening for tobacco, alcohol and other drugs
• Screening for domestic violence

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Documentation in Healthy Start Records
Establish separate record for woman and baby.

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MEASUREABLE RESULTS

• New Encounter Code 8013
• Information Given
• Referral Made
• Services Received

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Low Birthweight accounts for 10 percent of all
health care costs for children.Hospital stays
for newborns typically averaged 4,300 in 2001.
For LBW, the costs were 58,000.
Cost Savings
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Promotion of womens health needs should be a
collaborative approach within the medical
community and community-at-large.
What else is there to know?
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Statewide agency support was gained through the
efforts of Floridas Perinatal Periods of Risk
Practice Collaborative model.A new chapter has
been added to the HS Standards and Guidelines.
What barriers might be experienced?
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Women are concerned less for themselves when the
baby is born and often forget to pay attention to
their own needs. Interconceptional education and
counseling is an opportunity to focus on the
health needs of the entire family.
Remaining Advice?
34
jane_bambace_at_doh.state.fl.usjennifer_opalek_at_doh.
state.fl.us
Additional Information