Healthy Women Build Healthy Communities

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• Healthy Women Build Healthy Communities
• August 6, 2007
• Healthy Start Grantee Meeting
• Sabrina Matoff-Stepp, M.A.
• Director
• U.S. Department of Health and Human Services
• Health Resources and Services Administration
  (HRSA)
• Office of Womens Health

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HRSA Office of Womens Health (OWH) Mission

• HRSA OWH provides a cross-cutting focus to reduce
• sex and gender-based disparities and improve
  womens
• health and wellness in support of the Agencys
• mission to provide national leadership, program
• resources and services needed to improve access
  to
• culturally competent, quality health care.

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HRSA OWH Functions

• Serve in a leadership capacity on womens health
  and sex/gender-specific issues and policy.
• Coordinate and support disease prevention and
  health promotion activities at HRSA and with
  other HHS agencies.
• Serve as the liaison with other Federal womens
  health and private sector organizations.
• Support educational efforts on topics related to
  womens health and wellness.

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HHS Office on Womens Health Collaborations
National Womens Health Information
Center www.womenshealth.gov

• HHS Minority Womens Health Summit (August 23-26,
  2007)
• HHS Charting New Frontiers in Rural Womens
  Health (August 13-15, 2007)
• Quick Health Data Online online access to
  county level data by gender, race/ethnicity
  and age

2007 Womens Health Calendar Daybook
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Collaborations

• Womens Health USA Data Books
• Women and HIV/AIDS Quilt
• Individual and Systematic Response to Natural and
  Man-Made Disasters for Vulnerable Populations
• Evidence-based Report on Management of Eating
  Disorders http//www.ahrq.gov/clinic/tp/eatdistp.h
  tm
• Womens Health in Health Professions Curricula
  Reports
• Webcasts (www.mchcom.com)
• The Management of Eating Disorders July 2006
• Teen Dating Violence February 2006
• Human Trafficking April 2005
• GIS Maps of HRSA womens health investments

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Womens Health USA 2006
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HIV/AIDS Quilt- Recognizing Womens Strengths
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BFWHW Vision and Mission

• Vision Statement to achieve physical, mental,
  social, and spiritual health, Bright Futures for
  Womens Health and Wellness identifies
  opportunities for integrating prevention into
  self-care, culturally competent health care, and
  community action.
• Mission Statement The mission of the Bright
  Futures for Womens Health and Wellness
  Initiative is to plan, develop, implement, and
  evaluate a variety of culturally competent
  consumer, provider, and community-based products
  to increase awareness and use of preventive
  health services for all women across their
  lifespan.

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BFWHW Goals

• Increase the use of preventive services.
• Empower women to share in health care
  decision-making.
• Encourage women to practice prevention in their
  daily lives.
• Increase practitioner utilization of preventive
  health guidelines.
• Support community-wide health promotion.

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BFWHW Infrastructure

• Funding HRSA/Maternal and Child Health Bureau
• Coordination HRSA OWH and Division of Healthy
  Start and Perinatal Services
• Organization inclusive, lifespan approach
• Participants non-Federal and Federal experts
  (consumer and professional)
• Purpose Develop tools for adolescent young
  women and adult women, clinicians, and
  communities to promote health and wellness

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BFWHW Steering Committee

• Non-Federal Steering Committee- a hand-picked
  multi-disciplinary, geographically representative
  group, including both men and women committee
  members and consumer representatives
• Purpose- to provide overall guidance on both the
  processes and products of this initiative

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BFWHW Executive Management Committee

• Chaired by Peter van Dyck, M.D., M.P.H.,
  Associate Administrator for Maternal and Child
  Health
• Decision-making arm of BFWHW comprised of senior
  management and representatives from across HRSA
• Staff-level individuals selected by Bureau
  directors
• Includes BFWHW co-chairs and Wanda K. Jones,
  Dr.PH, Deputy Assistant Secretary for Womens
  Health, HHS

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Bright Futures for Womens Health and Wellness
(BFWHW), 2001-2002

• Named the Initiative Bright Futures for Womens
  Health and Wellness (take off from Bright
  Futures for Infants, Children and Adolescents)
• Developed an Initiative mission and vision
• Developed an Initiative Logic Model
• Reviewed U.S. Clinical Preventive and Community
  Services models for establishing evidence-based
  guidelines
• Discussed the importance of communication and
  evaluation components
• Agreed on the need for easy-to-use, culturally
  competent tools
• Agreed on lifespan approach
• Agreed on consumer, clinician, community target
  audience groups
• Domains
• Physical Activity and Healthy Eating
• Mental Health and Wellness
• Maternal Wellness

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Purpose of BFWHW Physical Activity Healthy
Eating Tools

• Develop tools to promote healthy physical
  activity and eating behaviors among women across
  the lifespan, according to the Dietary Guidelines
  for Americans 2005 encourage shared
  decision-making and goal-setting with primary
  care providers and involve community
  participation.

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Physical Activity Healthy Eating

• Guide for Adolescent Young Women and Wallet Card
  (English)
• Guide for Adult Women and Reaching My Goal Tip
  Sheet Set (English and Spanish)
• Provider Training Materials
• Administrators Handbook
• PowerPoint Training Modules
• Counseling Support Tools
• Community Toolkit (English)
• Coming soon Rural Consumer Guides, Tip Sheets
  and Adolescent Bookmark!

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BFWHW Consumer Guides

• 4 main components
• Self-assessment
• Clinical Assessment/Conversation Starter
• Goal Setting
• Resources and Information

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Tools for Consumers

• Booklets that encourage a dialogue between female
  patients and their health care providers about
  physical activity and healthy eating.
• Includes patient self-assessment, tips for
  communication with health care providers, goal
  setting, and resources for more information.
• My Bright Future for Adult Women Guide and Tip
  Sheets
• Available in English and Spanish
• My Bright Future for Young Women Guide and Wallet
  Card
• Available in English

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Recommended Use in Clinical Setting
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Tools for Consumers

• Rural Adaptation
• The core BFWHW physical activity and healthy
  eating tools were used as the foundation to
  create tools tailored for adult and young women
  living in rural communities in the United States.
  Rural adult and young women face unique
  challenges to improving physical activity and
  healthy eating including geographic isolation and
  access, limited transportation, provider
  shortages and poverty.
• Adult Women Guide and Tip Sheets
• Young Women Guide and Bookmark

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Tools for Clinicians

• Administrators Handbook Training and
  Implementation of BFWHW Physical Activity and
  Healthy Eating Guides
• This Handbook describes the My Bright Future
  Physical Activity and Healthy Eating Guides and
  other patient and provider materials. It also
  contains information on how to train health care
  providers to implement the Guides in the clinical
  setting, using PowerPoint presentations, and
  counseling support tools for adult and young
  women patients.

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Tools for Communities

• Healthy Women Build Healthy Communities Toolkit
• Designed to help young and adult women who want
  to improve the health of their communities take
  action and plan activities and events promoting
  physical activity and healthy eating. The toolkit
  provides 10 Building Blocks to help women plan
  community activities.

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Intermediate Evaluation

• In June 2005, an intermediate exploratory
  assessment
• using the physical activity and healthy eating
• consumer tools was funded to identify
  characteristics
• of individuals (consumers and providers) who are
• more likely to use the tools, and to integrate
  them into
• primary care practice. Up to six sites will be
  included
• from Federally Qualified Health Centers,
  faith-based
• organizations, workplace wellness centers, and
  school-
• based health clinics.

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BFWWW Mental Health and Wellness Tools

• Extensive background work to define mental
  wellness from a positive perspective.
• Three concepts interwoven throughout family of
  tools
• Value yourself
• Develop sense of balance, meaning and purpose in
  life
• Connect to your community
• Tools
• Guide for Adolescent Young Women
• Guide for Adult Women
• Provider Booklet
• Exam or Waiting Room Flyer
• Community Idea Kit

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BFWHW Mental Health and Wellness Tools
Characteristics

• Gender-specific
• Evidence-based
• Wellness focused (vs. disease focused)
• Address mental wellness constructs and protective
  factors

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Evidence Base Delphi Study
Three-round, electronic survey of Mental Health
Expert Panel to identify and score search terms
for the literature review and environmental scan.
The following 21 terms received the highest
consensus scores

• Hardiness
• Mental Health
• High Positive Affect, Low Negative Affect
• Hope
• Meaningful Interpersonal Relationships
• Life Satisfaction
• Subjective Well-being
• Work
• Ego Strength
• Self-confidence

• Connectedness
• Resiliency
• Coping Skills
• Family and Community Support
• Faith and Spiritual Life
• Optimism
• Self-efficacy
• Adaptability
• Self-esteem
• Positive Psychology
• Protective Factors for Wellness

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Evidence Base Key Findings

• Some studies suggest resiliency, hardiness, and
  optimism can be learned
• Coping skills are linked with health outcomes as
  early as mid-adolescence
• Meditations and aerobic exercise have been shown
  to increase well-being
• Happy people tend to
• Have high self-esteem, be optimistic, outgoing,
  agreeable
• Have close friendships or a satisfying marriage
• Have work and leisure that engage their skills
• Have a meaningful religious faith
• Exercise

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Draft Definition Core Elements
Elements of psychological wellness developed by
the Mental Health Expert Panel

• Identification with/or Connection with Community
• Meaningful, Rewarding and Supportive
  Relationships
• Meaningful and Rewarding Activities
• Sense of Balance, Meaning and Purpose in Life
• Healthy Emotional, Cognitive and Physical Habits
• Compassion for Others
• Ability to Adapt to Change and Cope Successfully
  with Adversity
• Meaningful Spiritual Beliefs and Practices
• Valuing and Appreciation of Self

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BFWHW Mental Health and Wellness, Primary Care
Clinic Flyer
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BFWHW Mental Health Wellness Adult Womens
Guide
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Maternal Wellness Tools

• Three Target Audiences
• Consumers reproductive age women, from pregnancy
  through one year after pregnancy (perinatal)
• Community individuals and organizations with
  whom perinatal women come into contact
• Healthcare Providers physicians, nurses,
  counselors and others providing care to perinatal
  women
• Draft Products
• Tailored to specific audiences
• Similar conceptual messages across products
• Anticipatory in nature

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Maternal Wellness Tools

• Evidence-based
• Address maternal emotional/mental wellness
  constructs
• Raise awareness of physical and psychosocial
  changes
• Present strategies to increase healthy adaptation
  to changes and reduce adverse outcomes
• Encourage conversations about perinatal emotional
  wellness

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BFWHW Logic Model Promotion Connections

• Advocacy within organization and professional
  associations
• Resource distribution
• Training materials with resource requests
• Journal articles, reports, and presentations

• Changes in awareness, attitudes, and practices
  related to preventive health for women across the
  lifespan
• Increased awareness of BFWHW at Federal, State
  and local levels, and among professional and
  consumer based organizations
• Policy and program initiatives integrating to
  BFWHW messages

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Promotion Dissemination Opportunities

• Raise awareness of BFWHW tools and support
  dissemination.
• Partner with BFWHW Steering Committee members to
  form strategic partnerships with public health
  organizations, educational, worksite,
  faith-based, and community groups to put BFWHW
  tools to use outside of Washington D.C.
• Outreach to underserved women through natural
  leaders in rural and border communities on the
  importance of preventive health and wellness.

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Promotion Dissemination Opportunities

• Consider adaptation of existing domains for
  specialized groups. Form partnerships to develop
  BFWHW tools focused on other preventive health
  issues.
• Conduct process, impact, and outcome evaluations.
• Continue to support health and wellness for all
  women, their families, and their communities.

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Lessons Learned

• Develop conceptual and theoretical framework for
  program planning.
• Develop a logic model (program goal(s), inputs,
  short-term, long-term outputs).
• Build evaluation into programs from the start
  (process, impact, outcome).
• Gather information from a variety of stakeholders
  (consumer, professional, community-based)
• Learn as much as you can about your target
  audience(s).
• Gain buy-in from your target audience(s).
• Develop partnerships.

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Lessons Learned (continued)

• Put together a steering committee, council, or
  board group to advise you.
• Have regular meetings and conference calls.
• Develop marketing, promotion, and dissemination
  plans early.
• Do what you do best let others do what they do
  best.
• Culturally competency includes more than just
  race/ethnic diversity.
• Use technology wisely.
• Allow extra time for reviews, clearances, and
  approvals.
• Take time to thank people who support your
  program.

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For More Information
A variety of BFWHW Tools and other
publications are available free of charge at the
HRSA Information Center 1-888-ASK-HRSA or
online at www.hrsa.gov/womenshealth HRSA
Office of Womens Health 5600 Fishers Lane,
18A-44 Rockville, Maryland 20857 [phone]
(office) [phone] (fax)