What is the Story Behind the Curve?

We began our meeting discussing risk factors related to preterm births. The ones that rose to the surface were: 

-Smoking/substance use

-undocumented citizens and access to health care

-systemic racism and access to resources. 

-food insecurity

The group led with data, as the conversation and poll on Zoom revealed that anecdotal data points to substance abuse as a feasible place to begin exploration for preterm births. The group agreed that there needed to be more data analysis for substance-exposed infants before committing to building a strategy for this risk factor. Some questions were: Is this the cause of a substantial amount of preterm births? What other data points do we need to know more about? Are Hampton numbers higher because of the number of births at hospitals there? (Stacey clarified that the data points to the home address of the mother.) It was also noted that anytime there are self-reporting measures, there is the risk of getting incorrect information due to the distrust of systems. 

Overall, the group realized that Preterm Births is a complex, multifaceted indicator that requires more data to attack at the root. Taking the time to address low hanging fruit and evaluate some other potential factors is a more attainable approach. 

Factors pushing up the trendline?

• Prenatal care starts too late
• Smoking
• Substance abuse/substance-exposed infants
• Social determinates of health (Income, housing, transportation, etc.)

Factors pushing down the trendline?

• Quality prenatal care (starting early in pregnancy)
• Can advocate for themselves 
• Dual partnerships
• White women - Implicit bias in the health care system
• Access to needed services

Factors causing disparities.

• Racism in the health care system
• culture/language gaps
•  

Anticipated (future/emerging) factors?

• COVID-19
• Healthcare changes
•  

Factors requiring additional research?

• Research of health care providers in the communities (Race/Ethnicity/Gender)
• Who else works with teens/non-English speakers (teen pregnancy still an issue in black and brown communities)
• How do we work with partners who currently work with youth leaders to further impact this work?
• Are there any prevention programs for teens? schools, churches (abstinence programs)
• infant mortality (teens: 4 out of 73)

What are the top priority factors to address?

-Language gaps

-cultural competency and understanding 

-access to emerging technology (cell phones, telehealth)

-what services can be provided to teens of color to decrease teen pregnancy (prevention. female and male)

-data collection: how many substance-exposed children were preterm or low birth weight? disaggregated data on local teen pregnancy

​​​​​​Who are the Partners (internal or external) and their specific roles to Turn the Curve? (Address the priority factors)

• Bay Rivers Telehealth Alliance (Tappahannock)
• Churches (sex-positive/self confidence/self esteem)
• Riverside Regional Medical Center (free classes child birth prep, breast feeding)
• SEVHS
• Boys & Girls Club
• SBVP Prenatal Screening Program (can provide numbers on teens screened in Hampton and Newport News. 2020 170 teens sent to the prenatal screening program, actually screened 111)
• Planned Parenthood
• Obici, Suffolk: programs for teen moms (Lori White/Tandy Coyle. Kristen Miller will make contact by next meeting)
• CDR
• HRCAP
• Healthy Families (Hampton/Newport News)
• Alternatives (youth group)
• Crisis Pregnancy Resources/Adoption Agencies like CareNet and Catholic Charities
• Libraries
•  Hampton City Schools or/and Newport  New City Schools
  • Can we identify the family education instructors and incorporate them into this conversation
• Parks & Rec

What are the top priority factors to address? (November 2020 Mtg) January 20, 2021

-Language gaps and cultural competency and understanding 

-Teen pregnancy

what services can be provided to teens of color to decrease teen pregnancy (prevention female and male) 

Do we focus on preterm birth or teen pregnancy or both?

We need to actively work toward changing the agenda from abstinence-only vs pregnancy prevention.

How do we get the information to the teens? App? Tes will send a mock of an app to the group. Video that can be paused for discussion. Decision book? How will your/the story end? How do we make sure there is no shaming? How to value their bodies. Taking a different approach to understanding their bodies, understanding the impact of risky behaviors while pregnant (what happens to an infant when born addicted to drugs and other substances. Empowerment/control. Risks of social media: Access to cell phones without supervision can be dangerous and lead to risky behaviors (access to sexual content at an early age, violence, glorification of drug use) How to identify red flags, etc. 

• is there a correlation between teen pregnancy and preterm birth? Are they receiving prenatal care? They need to know about postnatal care as well. 
• Sex Ed class, multiple languages (instead of trying to convenience them not to have sex perhaps we talk to them about the importance of prenatal care?)
  • we need to talk to the teachers and equip them with the tools to ask tough questions. 
• Take back to Parent Group: Knowledge gaps about how their bodies work. Would families be interested vs just the teens just getting information, help bridge the gap between teen and parent communication? Teen/parent class and combination class=gaining trust. Breakout sessions.
• commercial for DHS/DSS? PSA
  • What is a good way to educate them? More than here is your BC, but why you should take it.
  • American culture vs other (non-American cultures

Can we get a copy of the Family Education curriculum from the school system?

• it is on the school system website
  • wellness education
    • health education
      •  

Potential Partners: SBVP Prenatal Screening Program/Planned Parenthood/Obici: Suffolk/Human Services (youth services division/Shardell Gerald), RRMC Betty Villar will look into how to make classes teen-friendly/School system curriculum developer to help create a specific NEW curriculum

-access to emerging technology (cell phones, telehealth)

• work with someone in the school system to do a class for parents/families on how to navigate technology (google drive, dropbox, etc) 
• Are there funds available to help get low-income families access to telehealth services, needed health technology

What Works to Turn the Curve? (Actions to address the priority factors)

Research and Evidence-Based?

Public Policy Changes?

Low or No-Cost Ideas?

Off-the Wall ideas? (No limit to cost or imagination)

The first step that the group will take is to complete a gap analysis of community support services. 

• Review the list of referral services that SBVP uses for prenatal screenings. 
• Find 3-5 resources that are not on the list. 
• Return to the group and compare the list with the risk factors for preterm births to see if there are services that are not being provided or that are missing. 
• While the HWG works on this project, the Data Action Team will work to gather information on substance exposed infants. 
• Is there a way for the Universal Screeners OR the OB doctors to close the loop with the consent of the mother to gather aggregate data about referrals compared to birth outcomes? What does that look like?