Healthy Weight in Women of Reproductive Age

Action Learning Collaborative

Purpose of the Women’s Health Partnership

• Identify and promote unique state and local MCH roles and opportunities to ensure and improve women’s health before and between pregnancies.

Lifecourse Framework“Pregnancy outcomes are shaped by social,

psychological, behavioral, environmental, and biological forces that may occur at many stages in a woman’s life.”

Association of Maternal and Child Health Programs and

CityMatch’s Women’s Health Partnership. 2006

“Some of the most powerful influences on pregnancy outcome are related to influences on women’s health that occur long before pregnancy begins.”

Misra and Grason. Women’s Health Issues 2006

Initial Goal of WHP

• Develop state and local partnerships to promote healthy weight among women of reproductive age to improve maternal health and birth outcomes.

Rationale

• Obesity in pregnancy linked to maternal and infant morbidity and mortality

• Research and best practice information and guidelines are available

• Obesity impacts a large number of women and thus our efforts could affect a large number of pregnancies

• Identified as a priority by both agencies’ member base

Adverse Outcomes Associated with Maternal Obesity

• Infertility• Pregnancy, labor & delivery

complications• Fetal, neonatal death• Birth weight/prematurity• Birth defects• Gestational diabetes• Decreased breastfeeding• Childhood obesity

RFA for ALC, Summer 2006Team composition:• State Title V/MCH director• MCH leadership from local health

department• Data/analytic specialist• Professional from an existing community-

based health initiative• Nutrition and/or physical activity and/or

chronic disease professional

ALC Teams Selected• Los Angeles County, CA• Sonoma County, CA• Maricopa County, AZ• Salt Lake Valley, UT• Douglas County, NE• Minneapolis, MN• Boston, MA• Duval, Leon & Orange Counties, FL

HW ALC Activities• Kick off October 2006 • 1st on site meeting, December 2006 in

Atlanta, GA• 2nd on site meeting, June 2007, in Salt Lake

City, UT• All ALC technical assistance calls

• Lifecourse Framework, RE-AIM, Focus Groups, peer exchange

• 3rd on site meeting, February 2008, in Washington, D.C.

HW ALC Next Steps• Teams continue to implement, monitor

and evaluate their selected strategies

• Evaluation (within teams and of the ALC overall)

• Dissemination & Recommendations

Team Strategies

Maricopa County, AZ

Conducted a Nutrition Environmental Measures Survey in food stores in the South Phoenix area to address accessibility, quality and cost of healthy foods.

Contact: Donna Thompson, RD, MPHOffice of Nutrition Services; Maricopa Dept. Of Public HealthDonnaThompson@mail.maricopa.govORMargaret Tate, MS, RDArizona Department of Health Servicestatem@azdhs.gov

Los Angeles County, CA

Integrating with existing programs via communication tools & strategies for consumers and providers, worksite wellness, and leadership development.

Contact:

Cynthia Harding, MPHLos Angeles County Public Health, MCAHcharding@ph.lacounty.govOR

Suzanne Haydu, MPH, RD California Department of Public Health/MCAH Suzanne.Haydu@cadph.gov

Sonoma County, CA•Promotores de Salud and health providers support behavior change to increase healthy eating and active living;•Families eat a “balanced plate” including more vegetables;•Engage youth to increase daily physical activity.Contact:

Rebecca Munger, RN, PHN, CNMSonoma County, Department of Health Services, MCAHrmunger@sonoma-county.org OR

Suzanne Haydu, MPH, RD California Department of Public Health/ MCAHSuzanne.Haydu@cadph.gov

Duval/Leon/Orange Counties, FL

Developing statewide curriculum of best practices for healthy weight in postpartum women. Contact:

Helen Jackson, PhDDivision of Community Nutrition Services, Duval Co Health Depthelen_jackson@doh.state.fl.us OR

Laura Levine, BSNFlorida Department of Health, Infant, Maternal,and Reproductive Healthlaura_levine@doh.state.fl.us

Boston, MADevelop a community-informed report on healthy weight in reproductive aged women, focusing on black and Latina women, drawing from: a review of existing data, examination of promising practices and programs and key informant interviews and focus groups with women from the target communities.Contact:Kathy Cunningham, MEd, RD, LDNBoston Steps, Community Initiatives Bureau; Boston Public Health Commissionkcunningham@bphc.orgORKarin Downs, RN, MPHDivision of Perinatal Health, Early Childhood; MA Dept of Public Healthkarin.downs@state.ma.us

Minneapolis, MNAddressing healthy weight in women of childbearing age through partnerhips: local health dept., state health dept., Univ. of Minnesota, Healthy Start & STEPS.Strategies:•Presentations to professional groups•Materials (research brief for professionals and one page fact sheet for general public)•Develop new partnerships•Develop logic model for intervention pilot with post-partum women at local clinics•Seek resourcesContact:Megan Ellingson, MHA; MCH Initiatives; Minneapolis Dept of Health and Family Supportmegan.ellingson@ci.minneapolis.mn.us

Douglas County, NE

Expanding an existing preconception pilot project to a brief intervention and referral to a social support group tailored to help young women achieve & maintain a healthy weight.

Contact:Mary Balluff, MS, RD, LMNTCommunity Health and Nutrition; Douglas County Health DeptMary.balluff@douglascounty-ne.gov ORJennifer Severe-OforahLifespan Health Services; Nebraska Dept of Health and Human ServicesJennifer.severeoforah@dhhs.ne.gov

Salt Lake City, UTGathering information from WIC professionals and participants to determine the best way to integrate weight & reproductive health into WIC activities. Implementation of the Bright Futures for Women’s Health and Wellness Program (HRSA) into 3 Salt Lake County clinics.

Contact:Audrey Stevenson, MSN, FNP, MPHFamily Health Services; Salt Lake Valley Health Departmentastevenson@slco.org ORLois Bloebaum, BSN, MPAReproductive Health Program; Utah Department of Healthlbloebaum@utah.gov