The National Preconception Health + Health Care Initiative                                                                                     August 2018
Whether the summer is still in full-swing or you're "back-to-school" and ready for fall, we hope your upcoming August is a good one. In this issue, you'll find resources, upcoming events, and learn more about the PCH IM CoIIN Chapel Hill team in a 'get to know you' format.   We'll be reaching out to feature your teams next! 
Save the Date!

Preconception Specific Measurement Webinar - August 2nd, 2-3pm ET - Hosted by Abt Associates, this is only for members of our Preconception CoIIN team. We will focus on the different tiers of measures for this project, including defining our uniform measures as well as assisting teams with the process of selecting their own measures. For details, email Katherine Bryant.
 
Leveraging Screening Tools to Advance Woman-Centered Care: Wisdom and Strategies from Federal Healthy Start - August 14th, 3-4pm ET -  
Join us for a PCH CoIIN Webinar about ways we can innovate the well-woman visit using an effective screening tool. This will be an honest conversation led by Faye Johnson, Deborah Frazier, Katherine Selchau, and Maria Reyes about connections, strengths, and challenges that Healthy Start sites and clinics may encounter in working together with the screening and referral process. Don't have Healthy Start in your state? Doesn't matter - there will lots of application to everyone working with community partners.  
 
IM CoIIN "Universal" TA Webinar on Measurement -  August 29th, 3:30-5pm ET. Hosted by Abt Associates, and open to all IM CoIIN team members. This webinar will be an opportunity to hear from other state teams about what they are considering for measures, as well as additional technical assistance based on the feedback received during the previous measurement sessions. For details, email IMCoIIN@abtassoc.com 
 
Looking ahead: 
January 17-18, 2019 -  Please hold this date for the 2019 Preconception IM CoIIN In-Person Meeting (Location TBA - somewhere fun and warm).
IM CoIIN DATA Team TA Webinar Resources

Understanding Human-Centered Design/Design Thinking  - Sarah has re-watched Part I, "What is Design Thinking?" several times and thinks it offers good insights into the "design mindset!" This webinar covered case studies and discussion about the HCD process. 
To supplement their presentations, click to view their Project Concern International's Ideation Toolkit. 

Systems Mapping for Beginners -  This session reviewed the purpose of developing systems maps and introduced various types of maps, and described who should participate and how to prepare for systems mapping. They also had an example of a systems mapping experience from a state CoIIN team.
Click to view the NICHQ's Systems Map Template (adapted from Quality Learning Australia) and Arkansas' CoIIN Systems Map referenced in the webinar.
Design Thinking Improves Performance & Care

The HCD Human-Centered Design Kaiser Permanente Compass
 
 
Dan Frayne shared this article, and we loved reading  how Kaiser Health uses human-centered design to  improve systems process, management  and the experience for their patients, staff, and stakeholders. 
Summer Nights & Bug Bites!
 
Summer nights, the bugs are biting! While Zika news coverage seems to have slowed down, it is important to keep these resources top of mind! 

The CDC has a great Zika virus resource for preconception health counselors and young adults. Check it out here. 
Prediabetes Awareness Campaign 2018
 
Before September 3rd, be sure to #ShowYourLoveToday and support the #CYL2PreventsType2 Prediabetes Awareness Campaign , launched by Black Women's Health Imperative. This work focuses on increasing awareness of prediabetes, and type 2 diabetes and how lifestyle changes can help anyone prevent or delay both prediabetes and type 2 diabetes! 
 
Get involved by using the #CYL2PreventsType2 hashtag & signing up for the DayCause (Similar to Thunderclap) before September 3rd. 
Preconception Health Bi-weekly Updates
Sign up for the  CDC's bi-weekly updates on preconception and interconception health by  emailing Cheryl Robbins  (ggf9@cdc.gov). A great resource for everything happening in the industry, across the country - and world!
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Stay connected! Follow along and join the conversation: 
T.A. Picks from the Center for Maternal and Infant Health PCH CoIIN Team
Learning About (and with) Sarah
Hello, Erin
Sarah Verbiest, DrPH, MSW, MPH, Exec Director, UNC CMIH. Sarah is the project Principal Investigator and the Oklahoma team coach.
 
What has been your go-to source for this project?    One of my key sources has been the  Health Care System Measures for Preconception Wellness  paper by Dan Frayne et al. As we think about how to improve care for women of reproductive age, this publication offers guidance on priority focus areas. The authors lay the foundation for health care systems to assess the preconception wellness of the women in the communities they serve. A key learning I've had so far from the PCC CoIIN process is how to better describe the difference between well woman care and preconception care. The webinar presented by Dr. Frayne on preconception screening informed my thinking. Further co nversations with him, illustrated with stories from his clinical experience, helped me to see that a woman's consideration of becoming pregnant should shift a provider's approach to counseling, medication, a nd care plan. The One Key Question TM  paired with patient-provider shared decision-making and respect has real potential to improve outcomes for women and their future families.
 
What has been your biggest opportunity?  I think one of the most important professional experiences for me this year was the invitation to speak about preconception health at HRSA's Global Maternal Mortality Summit in June.  I spent time with the CMIH team thinking about the key challenges and opportunities that preconception health offers and reshaped how I spoke about preconception. The presentation was recorded - I'd love feedback! I was excited that the organizers at HRSA dedicated an entire morning to preconception health. I'm looking forward to seeing where the work may go next!
 
What is one skill set you hope to gain during this CoIIN project? 
I hope to build my capacity to support Human Centered Design. There are so many potential applications for this approach. I've found myself saying "how might we" a fair bit after Rachel Berkowitz's workshop last December. I'm looking forward to hearing what comes from Oklahoma's August 9th meeting where they'll bring all their clinic partners together to do some design sprinting!
 
What is your well visit pet-peeve? Even though my children are 18 and 21 I still seem to end up making their dental and health care appointments. I wish that all providers had an option for online appointment scheduling. Getting around to making the calls  is hard.
 
What is on the top of your summer reading list?  This summer I'm working my way through two books. The first is  Emergent Strategy  by Adrianne Maree Brown. To quote the back of the book, "Emergent Strategy is a radical self-help, society-help and planet-help designed to shape the futures we want to live." It was recommended by Omisade Burney-Scott who is a most amazing activist and leader with Sister Song. The book is beautifully written and includes tools and exercises to use in practice. The other book is  Essentialism, The Disciplined Pursuit of Less  by Greg McKewon.This is more than just learning to say "no" rather urges a thoughtful process of discernment to identify where one can have the greatest impact and focus there. This has been an interesting read at this point in our preconception work as we  think about how to focus on specific points of care, conditions, and groups of women.
 
Erin McClain, MA, MPH, 
Assistant Director with UNC CMIH and a Tobacco Screening & Cessation Expert. She is the coach for Delaware & North Carolina. She has expertise in working with clinicians and clinics to improve the quality of practice.

What has been your go-to source for this project?  
Two sources I've turned to throughout this project and have sent others to are the PCHHC Clinical Measures Paper and the
While these QI tools are nothing fancy, I find that they are practical ways of looking at an issue in a clinic setting and figuring out all of the moving parts, allowing clinic staff to decide when and where to make changes and how to evaluate those changes.
 
What has been your favorite part of the CoIIN project?    
 I've really enjoyed the opportunity to share strategies I've learned in the last 13 years working on outpatient quality improvement initiatives, particularly around tobacco screening and counseling, reproductive life planning, and other MCH topics, as the states and their clinic partners work together to set their strategies.
 
What is on the top of your summer reading list?
I'm an ecumenical and voracious reader, and I've had an interesting summer of reading everything from fiction (including re-reading my favorite non-Anne, L.M .Montgomery books with my newly PEI-obsessed 12 year old daughter) to self-help, to travelogues, to independent magazines, to text books. There are two standouts that I'd highly recommend: Feminist Spaces: Gender and Geography in a Global Context by Ann Oberhauser, Jennifer Fluri, Risa Whitson, and
Panteha Abareshi illustration
Sharlene Mollett is a fascinating look at the intersections of place, space, gender, race/ethnicity, rurality, nationality, (dis)ability, and social justice.  

The web-series In Sickness, produced by BitchMedia, is a 15-part look at women and chronic illness, including invisible disabilities and chronic pain.  It is a vitally-important and engaging work of independent reporting -  check it out here
 
If you could change ONE thing about YOUR health care visit with YOUR provider, what would it be?
I'd love to have online access for scheduling and lab results.

Get to Know Katherine
What's Up, with Suzanne
Katherine Bryant, MA, MSPH, 
Project Director at UNC CMIH. Katherine is the California team coach.
 
What has been your go-to source for this project? 
The first place I always look for resources is the  Institute for Healthcare Improvement website. In their  resources  section, they share both written materials walking through processes, toolkits and templates, as well as brief videos to demonstrate how to use these tools or discuss improvement. I like the way that they present the information in a really digestable and engaging format.  

I also like to turn to my team members and other colleagues for their insights and recommendations when I am unsure of the best approach or a solution. I am a big advocate of sharing resources with one another, as it sparks thinking of how we might be able to modify a tool or process already in place for our work.  

What PCH IM CoIIN resources have you learned the most from and found most beneficial? 
I have personally learned a great deal about human-centered design throughout this process. I look back to the webinar hosted by our colleagues at Abt Associates on human-centered design,  The Field Guide to Human-Centered Design   by IDEO.org, as well as the  HCD resources   developed for our team by Rachel Berkowitz. I think that HCD is a great strategy to use, and I'm enjoying learning more about the process and how to apply it to my work.   
   
What is your favorite public health campaign? This one always caught my eye on the subway in NYC. The bright colors, distinct font, and use of visuals particularly stand out to me.    
 
What is on the top of your summer reading list? I am currently reading The Immortal Life of Henrietta Lacks. The brief description on the cover of the book describes it as the "...story of the collision between ethics, race, and medicine; of scientific discovery and faith healing; and of a daughter consumed with questions about the mother she never knew."  This is such a powerful story and I am so grateful it was recommended to me.  
Related image
 
Who is your "health hero" if you had to nominate one person who is catalyzing the public health world? I've always admired Paul Farmer, MD PhD,  
and the work that he has done through  Partners in Health.
 
  Home
 
If you could cha nge ONE thing about YOUR health care visit with YOUR provider, what would it be?
For my provider to spend less time looking at their computer to go through a checklist and taking notes and more time directly engaging with me during the visit. I know that there is only so much time and a lot of work to do, but it can truly feel dismissive as the patient in the room.  
 

Suzanne Woodward is the Communications Manager at UNC CMIH and provides CoIIN public relations support. 
 
 
What has been your go-to source for this project? 
The resource I've loved the most is  CityMatCh's Well Woman Project hub - if you haven't taken a look at their  well-women toolkit, do it now. I joined the  CityMatCH Reproductive Justice Action Group, and really enjoyed their webinar,  "Looking at Public Health Campaigns Through a Reproductive Justice Lens". We examined the effectiveness of campaigns and reviewed the importance of message and campaign testing materials before your "go-live." I thought there were great case studies and discussion about when, how, and why to get various audiences' feedback. As health professionals and communicators, we can't assume our messages and images are impactful or relevant to any community, even our own. I think consumer feedback is especially needed in the CoIIN process so we can create something valuable and truly enhance the well visit. What I have learned from marketing: If you aren't LEARNING something about your community during the HCD/focus group process, you're probably doing something wrong.
   
Dr. Diana Ramos has taken the lead as our clinical spokesperson. This one was a favorite of mine. I always learn A LOT listening to her responses to reporter questions. She is always  talking about preconception health topics. If you haven't read some of her articles, they're all saved here
Dr. Ramos is great to  cite or repurpose on social media!
 
What are you most excited to accomplish by the end of this "planning phase?"
I am excited to have a hand in "innovating" the well visit process. Health appointments tend to be a dreaded process, so finding ways to make it a beneficial and valuable visit is great. I hope we can create a tool that allows a young person to feel understood, heard, and insightful so they can have open conversations with their provider and staff. 
 
What is your favorite public health campaign?
I really love all the communications work from the National Sexual Violence Resource Center, especially their  Sexual Assault Awareness Month (#SAAM) toolkit. Their #SAAM toolkit has such clean, engaging content for all to use, with a lot of variations and literacy levels. They include graphics and guides for community leaders, coaches, teachers, health professionals, parents, young adults - #SAAM is something everyone can and should be engaging in, so I love that they make it easy to get involved. 
CharityWater is a great case study for innovative ways non-profits can story-tell and collaborate with partners from all sorts of sectors.  Here's a short(ish) video about how they established this model. 
 
What is your well visit pet-peeve?
The wasted time in the waiting room.
  
(Professional) words to live by?
" Don't come with a problem, come with a solution." Mantra for life in general! It's okay to be completely wrong, but I always appreciate when someone makes the effort to create a *possible* solution to the problem.
Virtual PCH CoIIN Meeting Takeaways

We virtually gathered on June 15th for our Mid-Year All State & Team Meeting. Click to view the meeting slides.  Here are some highlights of lessons learned so far: 
  • Dedicated team time is essential to keep momentum. 
  • Human Centered Design can be easy to overthink, but HCD will unpack a new way of thinking that can offer a new result. 
  • The KEY to doing the well woman visit differently lies in HCD! 
  • We can switch to a "report out" structure for the next all state team call.
  • Start "where the clinic is" when it comes to recruiting.
  • Balancing patience with the process and timelines is important!
Happenings in each state: 
North Carolina has an upcoming i n-person meeting that will take place in August. They are working with three local clinical partners from across the state. The local partners are recruiting community members and consumers to work with them in the design process. 

Delaware is arranging four "Chat and Chew" events in August with consumers. This focus group-style HCD session will help inform them of their consumers' priorities for a screening tool and clinic visit. Delaware is working with two large clinics and is also supporting a statewide meeting in October on redesigning their Healthy Mothers, Healthy Babies initiative .

California holds calls twice a month to keep their core team aligned and on-track. They will be working with two clinics, one being Sutter Health, a large system of care.  

Oklahoma is proud to share they had three conference calls and one face-to-face meeting so far. They have an upcoming in-person meeting on August 9th with their seven clinic partners representing many different settings including, Federally  Qualified Health Centers, Healthy Start sites, and local health departments. Congrats to the OK team for being quoted in The Oklahoman about infant mortality work being done!