This document discusses tools and techniques for assessing risk in home visitation programs. It identifies five key risk factors for infant morbidity and mortality: smoking, alcohol use, psychosocial stress, sleep positioning, and intimate partner violence. It then examines several screening tools that home visitors can use to assess for these risks, including tools for smoking, alcohol use, postpartum depression, and intimate partner violence. The document also reviews data on the prevalence of these risks in South Carolina and their relationship to poor health outcomes. Overall, the document provides home visitors with information on important risk factors to assess and validated screening tools to help evaluate client needs and keep infants and families safe.
The following PowerPoint gives a brief overview of the 2015 UN Goal to Improve Maternal Health. Originally created for TUNIV 200 through University of Washington Tacoma.
The following PowerPoint gives a brief overview of the 2015 UN Goal to Improve Maternal Health. Originally created for TUNIV 200 through University of Washington Tacoma.
Health Services is committed to assisting women at UNH learn how to be and stay well physically and emotionally. This slide show contains information regarding women's reproductive health, contraceptive options and wellness.
Thorsten Hagemann, microbiome researcher and enthusiast, gives a deep look into the benefits of preventive medical care across a wide array of different demographics.
Crimson Publishers-Care for Both Partners before Conception: The Logical Star...CrimsonPublishers-PRM
Crimson Publishers-Care for Both Partners before Conception: The Logical Starting Place To Improve Fertility and Every Aspect of Reproduction By Janette E Roberts* in Perceptions in Reproductive Medicine
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
Health Services is committed to assisting women at UNH learn how to be and stay well physically and emotionally. This slide show contains information regarding women's reproductive health, contraceptive options and wellness.
Thorsten Hagemann, microbiome researcher and enthusiast, gives a deep look into the benefits of preventive medical care across a wide array of different demographics.
Crimson Publishers-Care for Both Partners before Conception: The Logical Star...CrimsonPublishers-PRM
Crimson Publishers-Care for Both Partners before Conception: The Logical Starting Place To Improve Fertility and Every Aspect of Reproduction By Janette E Roberts* in Perceptions in Reproductive Medicine
Newborn Screening | Infant Care | Health Care | Baby's First Testjohndemello7
Baby's First Test is the nation's newborn screening education center for parents, health professionals, and the public on the newborn screening system.
Visit http://www.babysfirsttest.org/
Sample motion to modify child custody and visitation in CaliforniaLegalDocsPro
This sample motion to modify child custody and visitation in California is designed to be used by to request that the court modify a child custody or visitation order and should be used in conjunction with a notice of motion or request for order and requests a modification on several grounds including that a significant change of circumstances since the date of the last custody order requires a modification for the best interests of the minor child or children, the existing custody order is not a final custody order but is only an interim or temporary order, or the party is only requesting a modification in the visitation schedule instead of custody. The sample on which this preview is based is 13 pages and includes brief instructions, a memorandum of points and authorities with citations to case law and statutory authority and sample declaration. The author is an entrepreneur and freelance paralegal that has worked in California and Federal litigation since 1995 and has created over 300 sample legal documents for sale.
Maternal Mental Health: CA Department of Public Health Nov 6, 2014Joy Burkhard
Maternal Mental Health is an underground health crisis impacting women, infants and families. This presentation was provided Nov. 6 2014 to the California Department of Public Health and discusses symptoms, risk factors and prevalence; impact on child development, why providers don't routinely screen/diagnose and treat, and what we can do to collectively change this course.
This presentation was part of Embody's Safe Healthy Strong 2015 conference on sexuality education (www.ppwi.org/safehealthystrong). Embody is Planned Parenthood of Wisconsin's education and training programs. Learn more: www.ppwi.org/embody
DESCRIPTION
Reproductive life planning (RLP) is a client-based assessment of personal life goals to determine if and where childbearing fits in with education, family, relationships, work, and more. This assessment then informs the development of a flexible strategy to prevent or plan future pregnancies in order to successfully meet these goals.
However, getting patients to modify their health or sexual habits isn’t always easy. The practice of motivational interviewing (MI) is an effective catalyst for behavior change. MI is a quick, effective, client-centered counseling technique that allows clients to define their own goals and make their own choices by helping them identify what is personally meaningful and valuable in their own lives, and to act in ways that will help them meet their goals. Best of all, it works.
This full-day pre-conference workshop introduced participants to the core concepts of motivational interviewing, placed within the context of reproductive life planning, a process which allows individuals to make appropriate decisions regarding their sexual and reproductive health, desire to have children, and birth spacing.
Participants learned the basic techniques of motivational interviewing and discovered how to help clients assess their own goals, make a plan that will help them meet those goals, and find ways to overcome obstacles that may occur along the way.
ABOUT THE PRESENTERS
Meghan Benson, MPH, CHES, has worked in the field of sexuality education since she was a teen peer HIV educator in high school. Throughout her education and professional experience, she remained dedicated to advocacy and education around women’s sexual health. She completed her MPH in Community Health Sciences with a focus on adolescent health and development at the University of Illinois-Chicago and will be pursuing her PhD at the UW-Milwaukee Zilber School of Public Health in Fall 2015. As the director of Embody, Meghan develops programming and coordinates educational opportunities throughout the state. Meghan is a board member for the Association of Planned Parenthood Leaders in Education, a Wisconsin Alliance for Women's Health board member, and a member of the Dane County Youth Commission.
Anne Brosowsky-Roth has been with Planned Parenthood of Wisconsin for over 20 years. During that time, she has held various positions within the patient services and community education departments. In her current role, she provides direct education for Planned Parenthood staff and other health professionals on reproductive and sexual health. Anne also provides research and support for staff as the manager of the Maurice Ritz Resource Center, the Planned Parenthood of Wisconsin community library.
Technical brief decision making for mch and malaria service uptake in sironko...Jane Alaii
A research brief to assess characteristics of adopters of available maternal and child health services and malaria preventive services for pregnant women and children under 5 in a rural community in Uganda.
Community Wellness Through Improved Maternity Practices By Drs Jose Gorrin and Ana Parilla. Given at the Puerto Rican Cultural Center in September of 2003
Unsafe medication is a leading cause of harm, most of it preventable, in health care systems across the world. Medication incidents occur when weak medication systems and/or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administration and monitoring practices, which can then result in severe harm, disability and even death.
Full Details: https://goo.gl/gCQ64V
Day 3- Thursday 19 March 2015: Preparing for our Individual Challenge
Transformation & Technology Track: Wellness in the Workplace. Presented by Dr Vanessa Govender, Medical Doctor, Health and Wellness Executive, Aveng Limited.
#astdza2015
This training module will teach you:
*Why so many of our babies are dying of preventable sleep-related deaths
*How knowing the ABCDs of Safe Sleep can help you save a baby’s life
*How to make a Safe Sleep space for any baby
*What you can do to share the life-saving message
Created by the Safe Sleep Heroes Action Team 10, led by The MetroHealth System, University Hospitals, and Cleveland Clinic, part of the First Year Cleveland community movement to decrease infant mortality in the Greater Cleveland area and Cuyahoga County, Ohio.
Similar to Pregnant Women, Infants and Family Systems: Tools and Techniques to Assess Risks (20)
Pregnant Women, Infants and Family Systems: Tools and Techniques to Assess Risks
1. Tools and Techniques To Assess
Risk in Home Visitation
Amy Nienhuis, LISW-CP, MSW
Director of Programs
Children’s Trust of South Carolina
2. OBJECTIVES
Participants will be able to name 5 risk
factors for infant morbidity and
mortality.
Participants will identify 3 screening
tools to
use when assessing pregnant women,
infants, and family systems.
3. Risk Factors:
How Do I Know What Is
Important?
Proof is in the data Why is data important
to me as a home
visitor?
4. 2012 KIDS COUNT Data Book: State
Trends in Child Well-Being
5. Risk Factors to Assess
Smoking
Alcohol use
Psychosocial stress
Depression
Intimate Partner Violence
Sleep Positioning in Infants
6.
7. Smoking:
During Pregnancy and
Postpartum
o Smoking during pregnancy has been
linked to 10 percent of all infant deaths
and can impair fetal brain and nervous
system development.
o Babies who are born to women who
smoke are three times more likely to
die from Sudden Infant Death
Syndrome (SIDS) and are typically born
underweight.
o Smoking during pregnancy is also
associated with low birth weight in
infants
8. 2 As + R
SC Quitline
http://tcrc.rapidlearner.com/ContentRegi
stration.aspx?DocumentID=a50dd4e2-
d416-4b48-951d-
fbbefdcbd2ae&Cust=34622&ReturnUrl=/
p/3462221282
11. SBIRT: Screening, Brief Intervention,
Referral to Treatment
• SBIRT is a comprehensive, integrated, public health approach to the delivery of early
intervention and treatment services for persons with substance use disorders, as well
as those who are at risk of developing these disorders.
• Primary care centers, hospital emergency rooms, trauma centers, and other
community settings provide opportunities for early intervention with at-risk substance
users before more severe consequences occur.
• Screening quickly assesses the severity of substance use and identifies the
appropriate level of treatment.
• Brief intervention focuses on increasing insight and awareness regarding substance
use and motivation toward behavioral change.
• Referral to treatment provides those identified as needing more extensive treatment
with access to specialty care.
12. SBIRT Use in SC
DHHS: The program is specific to
pregnant women to include 12 months
postpartum.
SBIRT is important in increasing the
health outcomes of the mother and
infant.
Medicaid will currently pay $24.00 for
the screening
And $48.00 for the brief intervention
13. SBIRT:
ALCOHOL SCREENING
TOOL
Current barriers:
Educating physicians
about
The use and availability
Mandatory reporting
Laws
18. Intimate Partner Violence:
ACOG recommended questions
3 simple questions ACOG recommends:
1. Within the past year -- or since you have been
pregnant -- have you been hit, slapped, kicked
or otherwise physically hurt by someone?
2. Are you in a relationship with a person who
threatens or physically hurts you?
3. Has anyone forced you to have sexual
activities that made you feel uncomfortable?
24. Assessing and Educating on
Safe Sleep Environments
As a home visitor you have a unique
opportunity to actually assess the living
situation
Educate family on safe sleep
environment
Cribs for Kids in your area
Safe Kids
25. AAP Guidelines for Safe Sleeping
• Always place your baby on his or her back for every sleep time.
• Always use a firm sleep surface. Car seats and other sitting devices are not
recommended for routine sleep.
• The baby should sleep in the same room as the parents, but not in the same bed (room-
sharing without bed-sharing).
• Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and
bumper pads.
• Wedges and positioners should not be used.
• Pregnant woman should receive regular prenatal care.
• Don’t smoke during pregnancy or after birth.
• Breastfeeding is recommended.
• Offer a pacifier at nap time and bedtime.
• Avoid covering the infant’s head or overheating.
• Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
• Infants should receive all recommended vaccinations.
• Supervised, awake tummy time is recommended daily to facilitate development and
minimize the occurrence of positional plagiocephaly (flat heads).
Published 10/18/2011 12:00 AM
The Annie E. Casey Foundation has released its annual Kids Count Data Book for 2010. The Data Book presents ten indicators of child wellbeing with standardized, comparable data for the latest available years (2007 and 2008). South Carolina once again ranks among the bottom ten states in terms of child wellbeing. The 2010 report ranks SC 45th, ahead of only 5 states (Mississippi, Louisiana, Arkansas, Alabama, and New Mexico). Over the past two decades of the Kids Count Data Book, South Carolina has never ranked better than 42nd. Typically, SC ranks 45th or 46th. Fluctuations in low incidence indicators such as child and teen deaths tend to move states up or down within the bottom 10 states, but these fluctuations have little statistical meaning. The bottom line for SC is that we are very near the bottom, reliably ahead of only Mississippi and Louisiana.
First tool-PRAMS SC PRAMS is an ongoing, population-based survey that collects information on SC mothers who have recently given birth to a live-born infant. Monitors and describes maternal characteristics, attitudes, and behaviors during pregnancy and in early infancy and describes relationships between known risk factors occurring before or during pregnancy and selected adverse pregnancy outcomes It is important to remember that information in this module is representative of all South Carolina mothers delivering live infants in South Carolina. Thus, generalizations can be made to this group only. Also, keep in mind that all survey information is based on self-reports from the women I. Background In 2006, South Carolina’s infant mortality rate was 8.4 deaths per 1,000 live births. From 1989 to 2006, the overall infant mortality rate declined from 12.8 to 8.4. The race specific infant mortality rate for white babies was 5.7 deaths per 1,000 live births in 2006, while for black infants the rate was 13.2 deaths per 1,000 births in 2006. As compared to infants of white mothers, infants of minority mothers are more than twice as likely to die before they reach one year of age (2). Birthweight is a major determinant of infant death. Infants with a birthweight of less than 2,500 grams (LBW) are at increased risk of death and future chronic disabilities. A comprehensive report on the prevention of low birthweight calls for a better understanding of the behavioral, social, and health service utilization factors that may contribute to the health disparities among minority women and women of lower socioeconomic status (3). II.
Based on selected PRAMS survey topics—some risk factors show us that when working with families there are a few issues we need to make sure we assess—
Smoking Fact Sheet From 1993-2008: The percentage of women smoking during the last trimester of pregnancy fell from 15.9% in 1993 to a low of 11.4% in 2003, but has since returned to 15.9% in 2008. The percentage of women who quit smoking during pregnancy decreased from 54.0% in 1999 to 39.8% in 2008. The percentage of women who quit smoking during pregnancy and remained nonsmokers after delivery has fallen from a high of 29.2% in 2006 to 16.2% in 2008. From 2006-2008, the percentage of women who smoked during the last trimester has increased from 12.1% to 15.9%. This includes increases among mothers who were 18-34 years of age, mothers that had a high school education or less and mothers that were on Medicaid. In 2008, women who reported smoking during the last trimester of pregnancy were more likely to: be non-Hispanic white be unmarried and have less than a high school education. We have not yet reached the Healthy People 2010 goal to increase abstinence from tobacco by pregnant women to 99%. In 2008, just over 84% of mothers abstained from smoking during pregnancy.
regnant women should take note that smoking during pregnancy as well as exposure to secondhand smoke is extremely detrimental to the cognitive development of the newborn baby. New research suggests that active and passive smoking are dangerous for the baby's mental growth. Read more at http://www.medicaldaily.com/articles/12138/20120915/smoking-during-pregnancy-impairs-mental-development-newborn.htm#XpM5iS8TbEtL0cZu.99
Why do we care about their drinking before the pregnancy? Because 50% of all pregnancies are unintended and therefore women may be consuming alcohol before they even know the are pregnant Remember this data is all self reported too
he new program, called the Screening, Brief Intervention and Referral to Treatment (SBIRT) program, will provide doctors tools and reimbursement to perform standardized screening and referrals to more than 30,000 pregnant women each year through receiving Medicaid benefits. Pregnant women will be asked a series of standardized questions by their doctor and/or plan care coordinator. The one-page questionnaire is specifically designed for ease of use and effectiveness in eliciting responses and – as with all medical records – remains strictly confidential. If a woman indicates she is using harmful substances, she will be referred for drug and alcohol treatment or to free smoking cessation counseling. Those with depression and victims of domestic violence will receive counseling and/or a referral to local women’s shelters. The SBIRT program includes SCDHHS, the SC Department of Alcohol and Other Drug Abuse Services (DAODAS) the SC Department of Health and Environmental Control, SC Department of Mental Health (DMH), as well as many other private non-profit organizations, such as the SC March of Dimes and the SC Coalition Against Domestic Violence and Sexual Assault. “ Problems caused by alcohol, tobacco and other drugs are the only completely preventable type of birth defects,” said DAODAS Director Bob Toomey. “It is crucial that we identify pregnant women using these harmful substances as early as possible and provide the help they need to stop. The health of their babies depends on it.” Both DAODAS and DMH have been actively engaged in the planning of SBIRT and will help ensure expectant mothers find placement in appropriate treatment programs available throughout the state. Primary care doctors enrolled in Medicaid coordinated care plans are receiving special training on the SBIRT questionnaire and referral tool and will receive an enhanced payment for the screening. To gauge the program’s effectiveness, researchers at the University of South Carolina will track the health outcomes of each baby born to mothers who received screenings and treatment. SBIRT will be made available to all pregnant Medicaid enrollees in the state in March following regional training.
On PRAMS survey we ask two questions related to depression—these are the results of the women who responded “yes” to feelings of depression-this is a profile of those women +PPD symptoms are seen more in non hispanic black women and those numbers are on the rise Usually between 18-24 Less than a high school education Not married
2 nd Screening Tool-Edinburgh, could also include another depression screening tool if desired This screening tool can be used with every woman postpartum You can find online free of charge with instructions on how to score This is a screening tool—not an diagnosis so if a woman scores high you need to refer them for treatment and further consultation When should you use the scale—some say to use 6-8 weeks postpartum BUT some hospitals are using right after delivery prior to d/c—controversy over that but at least the hospital is able to refer the woman back to OB-GYN sooner rather than later PROBLEM: Not all Ob-Gyns are willing to start a woman on an anti-depressant because you have to f/u with the patient etc. So please continue to follow this woman until she is into care with a MD.
South Carolina ranks 7 th in the Nation for women being killed at the hands of a partner This is serious business for everyone
We know women are more vulnerable during pregnancy to violence Remembering these numbers are SELF reported Much more violence against women goes Unreported
Behaviorally specific inquiries (for example, “ Does your partner ever hit, slap, kick, choke, or punch you?”) are critical to capturing intimate partner violence in clinical settings. Because the chart prompt embedded in our health history form was simply a line item stating “Physical/Sexual/Emotional Abuse,” health care providers may have underidentified victims of past or current abuse. Of note, before the implementation of the new annual health history forms in 2004, all health care providers were oriented to the form components and a brief update on intimate partner violence screening was provided. Since 2007, didactic sessions on intimate partner violence have been added to the residents’ core curriculum, new postgraduate year 1’s are now introduced during orientation to the hospital’s standard- 1164 Kang et al Interpersonal Violence and Screening OBSTETRICS & GYNECOLOGY ized intimate partner violence screening and interventional protocol, the Women’s Primary Care Center nurse practitioners now participate in a didactic session on intimate partner violence, and monthly audits of intimate partner violence screening in the Women’s Primary Care Center have begun as part of a hospitalwide initiative to improve preventive care. Finally, evidence-based screening questions have been directly incorporated into the annual examination forms, replacing the more general prompt of “ Physical/Sexual/Emotional Abuse