CityMatCH TeleconferenceAugust 26, 2008

PPOR Level Two: Learning NetworkAddressing Statewide Disparities in Infant Mortality: Lessons

Learned from the Florida Black Infant Health Practice Initiative

Estrellita “Lo” Berry, MA Project Director/Principal Investigator

Central Hillsborough County Federal Healthy Start Project

The Central Hillsborough Healthy Start Project is supported in part by project H49MC00090 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and

Services Administration (HRSA), Department of Health and Human Services.

Definition: Community Engagement &

Mobilization

The process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people

Fawcett SB, Paine-Andrews A, Francisco VT, Schultz JA, Richter KP, Lewis RK, Williams EL, Harris KJ, Berkley JY, Fisher JL, Lopez CM. (1995). Using empowerment theory in collaborative partnership for community health and development. American Journal of Community Psychology, 23(5), 677-697.

Relevance of Community Engagement and Mobilization

• Encourage recipients of services to own the problem and hold themselves liable for good outcomes

• Promote culturally sensitive and sustainable interventions

• Expand current research focus to align methodologies with the realities of the lives of Blacks

• Foster the development of social networks long-term

• Influence re-examination of how providers construct/implement services

• Mobilize political and social will

Key Words

• Mobilize• Galvanize• Relationship• Investment• Trust• Respect• Credibility• Sustainability• Partnerships• Timing• Quantitative/Qualitative Research (CBPR)

Rules of Engagement

• Gather data from credible (re)sources• Collectively analyze data• Disseminate data in a culturally competent

fashion (avoid Cosby effect, WMWW effect)• Mobilize cohorts• Galvanize partners, cohorts, adversaries,

stakeholders, politicians, community-at-large• Claim success

Process and Procedures(Spoken & Unspoken)

• Use personal relationships• Call in favors• Court the adversaries• Embrace the “nay-sayers”• Deal with systemic/institutional racism• Openly discuss “What’s in it for me?”• Define primary and secondary gains• Honor history• Celebrate success

Infant Mortality Rate, 1991-2005 Hillsborough County, FL

(Data from Healthy Start Coalition of Hillsborough County)

Healthy People 2010 Goal 4.5Year County

Number Rate

WhiteNumber Rate

BlackNumber Rate

NonwhiteNumber Rate

2000 116 7.91 62 5.56 51 17.10 54 15.54

2001 125 8.41 71 6.29 52 17.63 54 15.09

2002 133 8.80 84 7.30 43 14.50 49 14.10

2003 137 9.00 81 7.00 15 17.00 55 15.30

2004 142 8.90 78 6.50 59 18.80 63 15.40

2005 149 8.90 65 5.20 71 22.70 83 20.10

Overview

• July 2007 FL Legislature passes HB1269(Florida Statute, Section 383.2162, Black Infant Health Practice

Initiative)• Review of infant mortality in FL counties with

average nonwhite IMR at least 1.75 greater than White IMR and at least 40 nonwhite infant deaths for urban counties, 5 for rural counties - 2003-2005

• Initiative implemented through collaborative between Department of Health, Federal Healthy Start consortia, State Healthy Start coalitions and Universities with public health expertise

• Collective findings and recommendations to legislature by January 1, 2010.

Governor Crist Signs HB 1269 in Tampa

Black Infant Health Practice Initiative (BIHPI)

• Champions: Senator Arthenia Joyner & Representative Betty Reed

• Conveners: Central Hillsborough Healthy Start, The Chiles Center, Healthy Start Coalition of Hillsborough County, Community Partners

• Partners:– FL Department of Health– Recipients of Funding: Six urban counties-

Hillsborough, Miami-Dade, Palm Beach, Duval, Orange & Broward-and two rural counties-Gadsden & Putnam

– USF College of Public Health & FAMU College of Public Health

BIHPI Steering Committee• Serves as a sub-unit of the practice

collaborative. • Includes representatives from USF, FAMU,

State Healthy Start Coalitions, Federal Healthy Start Consortia, CityMatCH, and the Florida Department of Health.

• Serves the purpose of combining the wisdom of all parties involved to guide the Department in carrying out the various activities of the Initiative.

• Meets twice a month via conference call to provide progress updates, plan future meetings, discuss sustainability options, and provide TA to collaborative members.

BIHPI’s Charge

• Produce and submit recommendations to the Legislature for sustainability– Fetal Infant Mortality Reviews (qualitative

assessment)– Perinatal Periods of Risk (quantitative

assessment)– Community Engagement and Mobilization

(inclusive and reflective)

BIHPI Statewide Achievements• Created website

http://www.healthystartcoalition.org/index.cfm/fuseaction/Research.Black_Infant

• Created Blackboard access (share literature reviews, sources of data, promising practices, etc.)

• Received Kellogg Grant (USF COPH, FAMU COPH)-capacity building for Black leadership

• Created White Paper for BIHPI (sustainability)• Established universal goals and objectives for all

partners• Enhanced working relationship with FL DOH and other

MCH stakeholders • Final Report of Recommendations and Findings due to

FLDOH 8/2008• Enhanced culturally competent “messaging”

Where We Go from Here

• Build upon concerted efforts to influence clinical practice and policy

• Strengthen and solidify local, state and national partnerships

• Sustain community-based health agenda that promote social justice and equity

• Eliminate the infant mortality and morbidity disparity in FL

Estrellita “Lo” Berry, MA Project Director/Principal Investigator

Central Hillsborough Healthy Start Project A program of The Lawton and Rhea Chiles Center

for Healthy Mothers and Babies

University of South Florida, College of Public Health, Tampa, FL

For more information:lberry@health.usf.edu

(813) 974-0312 (Phone)(813) 558-5044 (Fax)