Hello all,
 
This month's Preconception Newsletter is for all of PCHHC, not just our COIIN teams. However, we do have some CoIIN-specific information to share with all of you.
 
IM CoIIN Web Platform
 
All members of the team should have received an email from the IM CoIIN DATA Contractor with information about how to sign up for this space - which is a private and secure online platform to promote sharing and collaborative learning within our CoIIN Team and across the IM CoIIN. The platform will allow for exchange of information and resources, as well as a space for learning and improvement through data and shared measurement. Please make sure that you review the security slides (if you missed the July training webinars), the data security agreement, and respond back to the IM CoIIN team at IMCoIIN@abtassoc.com with the following statement:   I, <INSERT FIRST AND LAST NAME>, certify that on <ENTER DATE AND YEAR> I completed the IM CoIIN General Security Awareness Training. I have also read and agree to the Data Security Agreement.
 
Please make sure that you prioritize this training and the security requirements to sign up for this resource!
 
Save the Date!

Our second annual in-person Preconception CoIIN team meeting will take place January 17-18, 2019. More details , including location and the number of individuals that we can support to travel from each state will be available in the near future.
 
Technical Assistance
 
Is there any specific technical assistance that your site or state team would find beneficial? We can provide a range of support to your team, including project planning, communications assistance, and measurement tracking and development. Technical Assistance resources are available through UNC CMIH as the Preconception CoIIN backbone organization, as well as from the DATA Contractor. Please let us know how we can support you!
 
Webinars and Communications

We have heard that it is helpful to clarify the different communications and TA webinars you receive as part of this project. Below you will see the breakdown of different communications and sessions that you may see. We are working to streamline communications, develop recaps of any TA sessions, and highlighting key takeaways for your reference.  
 
Preconception CoIIN: There will occasionally be all state team members collaboration calls. These are not archived, and  the goal is to facilitate shared learning and collaboration across all four state teams. The frequency varies, but may be once per quarter.
 
We host Preconception CoIIN webinars in an effort to provide technical assistance on a variety of topics. These are optional, recorded, and we encourage teams to attend as needed/available. The frequency varies, but is generally once a month. We try to host our Preconception CoIIN webinars and all team calls on Friday afternoons, but this varies on occasion due to presenter schedules. We send a monthly newsletter to all of our Preconception CoIIN team members as well, with information related to our projects, topics in preconception health, and quality improvement.
 
The Preconception CoIIN Resources are archived and available on the Before and Beyond website.
 
DATA Contractor: Abt Associates & Population Health Improvement Partners (the IM CoIIN DATA contractor) hosts monthly technical assistance webinars focused on cross-cutting skills, knowledge and methods related to CoIIN (i.e., quality improvement, innovation, collaborative learning). These are for all IM CoIIN participants in the four different CoIIN Teams. These are optional, recorded, and we encourage teams to attend as needed/available. These take place on the last Wednesday of the month. You also receive emails from the IM CoIIN DATA contractor team ("IMCoIIN"). These include TA webinar save-the-dates, reminders, and a monthly newsletter with IM CoIIN-wide information. This information is for all IM CoIIN participants.
 
All of the calls and communications above are designed to provide support to the CoIIN teams as they plan for and implement their projects, facilitate shared learning and collaboration, with a goal of addressing the technical assistance needs of teams. We will do our best to streamline and not flood your inboxes. We know everyone is busy! If you are ever unsure about an email or announcement, please reach out to your team coach and we can clarify the intent.  If you have recommendations for other topics and/or methods of collaboration and learning, please let us know.
 
PCHHC: You likely also receive the emails for the PCHHC webinars. These are optional, not developed as part of the CoIIN project, and at an individual's discretion whether or not to attend. There is also a PCHHC newsletter that is released quarterly, and you may receive this as well. This is general information related to preconception health, not specific to our CoIIN. We do hope that you still find these webinars and the information in the newsletter beneficial!

All the best,
Preconception IM CoIIN/UNC CMIH Team
The National Preconception Health + Health Care Initiative                                                                                                                          September 2018
Communications Corner

Prediabetes Awareness Campaign 2018
Launched by Black Women's Health Imperative, the 
"Change Your Lifestyle, Change Your Life" project focuses on increasing awareness of prediabete s and type 2 diabetes as well as how lifestyle changes can help prevent or delay both! Get involved by using their social media toolkit & using the #CYL2PreventsType2 hashtag.  
 
  Non-Judgemental Conversations and Care
Join us for a webinar about inclusive conversations, welcoming care, and relevant engagement with LGBTQIA+ populations.

Headed to Portland, OR on Sept. 12-14 for the 

Our friend from the CDC, Cheryl Robbins and team, will be presenting on 
Thursday, September 13 at 1:45 3:15 PM. Look for the session, " Using preconception health (PCH) and preconception care (PCC) indicators to improve pregnancy outcomes and women's health status." This session will detail the recent publications, including one from the Journal of Women's Health, " Making the Case: The Importance of Using 10 Key Preconception Indicators in Understanding the Health of Women of Reproductive Age. "
 
While you're there, keep an eye out for City Leader Chemyeeka Tumblin for #ShowYourLoveToday branded goodies, behind the scenes footage, real-time insights about the preconception health work being discussed at #CityMatCH. Follow her:  @PositivelyMeek.

Be sure to mark your calendar for the inaugural 
Black Maternal Health National Conference and Training Institute, Dec. 7-9, 2018 in Atlanta, GA! #BMHC18  The conference will be an assembly of researchers, advocates, policymakers, and other concerned stakeholders working to improve Black maternal health in the U.S. For details, reach out to BMMA Co-Directors Angela Doyinsola Aina, MPH and Elizabeth Dawes Gay, MPH at  info@blackmamasmatter.org.
Ambassador Spotlight 

"Currently there are no spaces for women who are over the age of 25, black and could become a mother at any moment in women's health circles. It's almost like we are forgotten about since we made it out of our teens without a baby.
 
Preconception health awareness should not begin and end with adolescents. 
 
I want to do my part in reducing low birth weight and premature babies as well as any related sickness or death of mothers. No one will talk to us about this so I will!" 
-Eilish Seeley. Follow Eilish: @agirl_fromthe_x.  T he world needs to hear her message & learn from her wisdom. 
Preconception IM CoIIN Update

Our HRSA MCHB Preconception IM CoIIN teams are in full-fledged human-centered design screening tool development! Here's a quick snapshot of all their happenings this summer.
 
The Oklahoma team has had numerous in-person and virtual meetings to explore screening tool development possibilities.  On August 9th, they hosted a full day design sprint with  seven partner sites representing different settings including, Federally  Qualified Health Centers, Healthy Start, and local health departments. 
The North Carolina team also held a human-centered design workshop in August. North Carolina  is working with three local clinical partners from across the state. L ocal partners are recruiting community members and consumers to work with them  in the design process.

The Delaware team is organizing four "Chat and Chew" events with consumers. This  focus group-style HCD session will help inform them of their consumers' priorities  for a screening tool and preventive clinic visit. Delaware is working with two large clinics  and is also supporting a statewide meeting in October to redesign their Healthy  Mothers, Healthy Babies initiative.
 
The California team will be working with two clinics representing the Northern and Southern areas of the state. One of their partners is a large system of managed care, which brings this unique perspective to the PCC CoIIN work.
 
Newsletters, webinars and other resources are all posted on BeforeandBeyond.org and are open access. Is your state interested in staying more closely connected to our CoIIN work? If yes, please email Suzanne Woodward
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: 
A Call to Action 
Nothing gets people's attention like name-dropping Beyonce, Serena, and pregnancy health complications in one sentence. This summer we've seen two A-list celebrities elevate significant problems in the US maternity care system. Their voices have opened the door for more women and men to share their experiences. As maternal and child health professionals, we can work to magnify the voices of people in our communities who have stories to tell. We must find ways to collaborate within public health sectors and other fields to improve health care and address injustices. The relevance of the PCHHC vision: That all women and men will achieve optimal health and wellness for them and any children they chose to have remains critically important in closing gaps in birth outcomes and advancing care for all. As described in an article below, policy changes are important, as are investments in programs and research to improve women's health and well-being. As you'll see in our September issue, there is great work underway to make real change. Likewise, there is a list of strategies awaiting resources to launch. Much work to be done - the time is now!
Preconception health is the meeting of two generations. 

Too many women die in childbirth because of unstable chronic conditions  prior to pregnancy. Looking deeper: this reaches many aspects of care, including health provider bias, health system mistrust, inadequate access to services, inequitable policies/systems, and a limited understanding about the importance of health prior to conception, to name a few implications. Preconception health has an important role in reducing maternal mortality and morbidity.

The PCHHC Initiative was pleased to see preconception and interconception health prominently featured internationally this summer.  Dr. Verbiest spoke at the #HRSAMaternalMortality Summit, and called for us to look internationally at the work being done to advance health outcomes prior to pregnancy. In her p resentation, she cited the  World Health Organization preconception health guide  and the  The Lancet 2018 3-part series on preconception health .
 

Dr. Verbiest challenged us to consider how we might  talk about preconception health as part of the feminist and reproductive justice equation. Are there ways we can partner across sectors to take advantage of resources and technology to truly innovate our health care and system?  Here are a few strategies PCHHC shared as part of a larger preconception health blueprint:


Investing in America's Mothers 

In the words of a public health partner in Scotland,  " It is one thing to refrain from initiating public health and clinical actions when credible evidence and understanding are sparse or contradictory. But, it is quite another to have had so much certainty for so long, and yet fail to act."  Dr. Jonathan and his co-authors commented about the 'price of passivity' in  Failures in reproductive health policy: overcoming the consequences and causes of inaction , " Our aspiration is that the analysis, examples and recommendations we present will become a catalyst for all of us -- individually and collectively -- to take the steps available to us that will lead to positive action. We think there are underemployed opportunities here to make a meaningful and lasting difference internationally." 

Catalyzing Change in Maternal Health: Over the past couple of weeks, we've seen progress within the U.S.from some policy leaders: Senator Kamala Harris (D-CA) and 13 colleagues introduced the Maternal Care Access and Reducing Emergencies (CARE) Act , an effort to address implicit bias, end preventable maternal mortality and morbidity, and reduce racial disparities in maternal health outcomes through evidence-based quality improvements with two new grant programs. 
 
According to the CDC, Black mothers are 243% more likely to die from pregnancy or delivery complications than a white woman. As Senator Harris put it, " This is in America, not a developing nation . " Too many w omen of color experience life-threatening health care disparities - including barriers to health visits and racial bias and stereotypes.  As our partner and friend, Dr. Joia Crear-Perry, founder of the National Birth Equity Collaborative, states, "Race is not the risk factor--Racism is."

From a statement given by Monica Simpson, Executive Director of SisterSong:   "Black women in this country are facing a public health crisis.... This is an issue of access to quality healthcare, which can impede the management of chronic health conditions and the identification of other risk factors, but we must acknowledge that this is also caused by pervasive and systemic racism and discrimination in our healthcare system ...  We know that the very survival of Black mothers depends on lawmakers being willing to step up and take real and concrete action, but this conversation needs to be bigger than survival... Real change demands a multi-pronged approach. We need to close the gaps in the ability to afford preventative and prenatal health services and pushes for standardized protocols for care... There is a history of women of color doing birth work that we believe we can build on to make a positive difference not only in health outcomes, but also the experience of Black women in childbirth. We also need to look at how we can expand access to services within our communities. Transportation is a huge barrier to services. We also want to look at how to make sure there are more Black health providers to increase not just access, but also the quality and cultural competence of the care that women of color are receiving.  We urge decision-makers to look at the health of Black mamas and their children with a longer term vision that extends beyond birth... The health of our communities demands that we be holistic in our efforts to truly embrace and empower healthy Black mamas, healthy children and healthier communities." Read the full statement here
 
This is an important step forward.  We applaud Senator Harris' leadership and taking positive action, and would like to  invite conversation about how we can also extend the work in our preconception care efforts. Preconception health care is an essential component to reduce the poor outcomes that can affect two generations.
The Business Case for Racial Equity
 
...If that doesn't spark some emotion, let's talk numbers:

Altarum released a report called, "The Business Case for Racial Equity" and projected that by 2050, the US stands to gain $8 trillion in GDP by eliminating racial disparities in health, education, incarceration and employment. 
 
"To improve health outcomes - improve housing, education, employment, and medical care. 
The social determinants of health are interconnected and reinforcing."

Voices of Strength:
Immigrant Strength and Resilience 
 
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