What are the positive factors that are contributing to you reaching your desired result?

• Navarro Regional Hospital and OBGYNs, Hope Center: Prenatal care is available to families in our county
• Hope Clinic in Ennis: Provides low-cost medical care.
• Local Health Department: Offers the PEDIA Clinic as well as support for WIC. 
• Healthcare available in nearby cities: If there are issues during pregnancy or after delivery, there are higher level facilities close enough for residents.

What are the negative factors that are restricting you from reaching your desired result?

• Affordability of healthcare: Lack of insurance and options for families that take their insurance. Lack of an indigent care program.
• Education: Women may not know they are pregnant or they lack education on what to do. There are also women in fear of letting others know about their pregnancy. 
• Transportation: Restrictions on getting to doctor as well as hours doctors are available. 
• Low usage of preventative programs: Barriers to getting families and individuals into health programs and keeping them engaged.
• Information: Families don't know what programs are available to them and what information they need to prepare for a child on the way. 

What populations are the most disadvantaged and what causes these disparities?

• Low-income population: Those that lack health insurance
• Teens who become pregnant: Often lack of education on knowing they are pregnant or conceal pregnancy and are high-risk because of their age. 
• Rural residents: Those who are far away from resources.

Are there foreseeable factors that will affect your work over the next few months to a year?

• COVID-19: Less individuals and families are going to see their doctor
• COVID baby boom
• Loss of insurance due to unemployment by COVID

What additional research is needed to better understand the factors that influence the slope of the curve and related disparities? 

• High maternal mortality rates for African-American women
• How many more people will be unemployed or underemployed because of COVID?
• What are helpful engagement strategies to help to parents to education events?
• In communities that have free or low-cost prenatal care, have they been able to turn the curve?

Who are the partners that can help you reach your desired outcome? List partners and their roles.

• Residents/Families-Learning more and going to get prenatal care. 
• Early Childhood Coalition
• Hope Center: Offers free services such as ultrasounds.
• Early Childhood programs: New Life, Growing Together, ECI who work to build parent skills early and educate families.
• OBGYNS: Building relationships with their clients and encouraging them to come in for prenatal care.
• Labor and Delivery nurses: They are educators to our community.
• Outside partners: Dallas areas agencies doing March for Dimes. 

Research/Evidence-Based Practices:

• More options for prenatal care such as midwifery. 
• Public Health Campaigns: Flyers, ads, etc. about importance of prenatal care.
• Expanding Medicaid and insurance options for families
• Working with local hospital and OBGYNs to streamline access to care

Low Cost/No Cost Solutions:

• Planned Parenthood: available in outlying communities
• Hope Center: offers some services for free to the community
• Sex Education in schools, allowing for teaching not just on abstinence

Innovative/Out-the-Box Solutions: 

• Free prental care and health insurance for all
• New OBGYN center for our community
• Free and available pregnancy tests for all
• Expand availability of nurses in school systems
• Support groups for pregnant teens
• Outlying communities: making prenatal care more available to them

Additional Research:

• Does the Health Department offer free pregnancy test?
• What is taught through sex education in school systems?
• What is the total cost of prenatal care for an average mom?
• How many visits do women have to their doctor over the course of a pregnancy?

• What programs are being offered to pregnant teens in school systems?