should we transform folic acid programs into preconception health campaigns?
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Should we transform folic
acid programs into preconception
health campaigns? The North Carolina
experienceAmy Mullenix, MSW, MSPH
3rd National Preconception Health SummitJune 14, 2011
Tampa, FL
Acknowledgements• Preconception health leaders• N.C. Attorney General’s Office• N.C. Division of Public Health, Women’s Health
Branch• Sarah Verbiest at UNC Center for Maternal &
Infant Health• March of Dimes• The “fairy dust” team
• Continuous folic acid leadership and committee in NC since 1994
• Infusion of funding in 2004 from Vitagrant; housed at March of Dimes; additional funding from other sources
• Large, comprehensive statewide campaign since 2005
And now what?
2006• CDC releases preconception health
recommendations• NC Folic Acid Campaign begins to plan for end
of Vitagrant funding• Board discusses potential role of Folic Acid
Campaign in preconception health efforts• Campaign commissions inventory of past &
current preconception health activities
Looking Back Moving Forward• North Carolina’s Path
to Healthier Women and Babies
Folic Acid Full preconception health campaign
Multivitamins
Providing leadership / applying our
expertise statewide in preconceptio
n health
Adding some preconception
health messages
Possibilities of expansion
Considerations+
• Compelling need for a preconception health campaign in NC
• Documented success in addressing one preconception health risk
• Infrastructure in place• Impending loss of folic
acid funding
?• Narrow program focus
had achieved results (39% drop in NTDs)
• All programs evaluated for promotion of folic acid vs other preconception health risks/issues
• Loss of brand identity
2007• State begins preconception health planning
process• Folic acid campaign pauses its transition• Folic acid team provides leadership for state
process• 1 year process: 30+ organizations, needs
assessment, multiple workgroups, identification of priorities
• Release of State Plan in 2008
North Carolina Preconception Health Strategic Plan
2008• Campaign develops strong relationships with
potential collaborators in the NC preconception health “world” during state planning process
• As new preconception projects begin, Folic Acid Campaign is invited to contribute folic acid content, program expertise, etc.
• Campaign identifies portions of state plan relevant to its work & in light of its own strengths: health care provider education, lay health education, media & printed materials
2009• Campaign reaffirms desire to expand &
examines potential messages• Board approves the addition of healthy weight
to folic acid campaign, with reproductive life planning as third message.
• Reaffirms emphasis on folic acid promotion for Hispanic women
13
Opportunities• With additional funding, the Folic Acid
Campaign can continue & grow• Infrastructure & relationships already in place
– can add new message without extensive “building” phase
• Grants provide opportunities to implement innovative programs without “starting over” (hiring new staff, developing new relationships, etc.)
Why healthy weight?• Natural link between nutrition, folic acid &
weight• Health care providers consistently express
desire for training on this topic; health care provider education is our specialty
• Potential for funding
2010• Active involvement by Campaign staff in the
NC preconception health coalition• Review of evidence-based healthy weight
programs for women of childbearing age• Development of new healthy weight
curriculum & materials• Development & testing of high school
preconception health curriculum• Development of new logo & brand identity
2011• Healthy weight trainings for health care
providers, focusing first on public health providers (~500 trained YTD)
• Partnership with state (on federal grant) to develop provider trainings & resource guides for local communities on 5 topics: healthy weight, reproductive life planning, tobacco cessation, early entry into prenatal care, interconception medical home
• High school preconception health curriculum• New website, tagline, materials, etc.
Lessons learned• Current initiatives can be expanded within the
broad framework of preconception health• Collaborative, inclusive process can be time-
consuming but reduces “ownership issues” and results in broad support and partnerships
• Strategic planning improves focus• Traditional stop/start funding cycles maintain
silos in both preconception health care delivery & public health programs
• Multi-year, multi-partner projects can actively leverage resources to sustain & transform public health programs
Who has capacity to expand?• Folic acid councils• Healthy Start programs• State women’s health/interconception
programs or agencies• Adolescent health programs or agencies• Infant mortality coalitions• March of Dimes state chapters• State Office of Women’s Health• State Office of Minority Health
Questions to consider1. How do our strengths and programs align with
identified preconception health needs in our state?
2. Who are the partners that need to be at the table for effective transition to preconception health?
3. Which organization(s) in our state can provide: a high-functioning board, commitment, patience, leadership, & institutional support?
What’s next for you?
Thanks!
Questions…Thoughts…Ideas…
Amy Mullenixamullenix@marchofdimes.com 919.424.2158
EveryWomanNC.com
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