CityMatCH Teleconference
August 26, 2008
PPOR Level Two: Learning Network
Addressing Statewide Disparities in Infant Mortality: Lessons
Learned from the Florida Black Infant Health Practice
Initiative
Estrellita “Lo” Berry, MA
Project Director/Principal Investigator
Central Hillsborough County Federal Healthy Start Project
The Central Hillsborough Healthy Start Project is supported in part by project H49MC00090 from
the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and
Services Administration (HRSA), Department of Health and Human Services.
Definition:
Community Engagement &
Mobilization
The process of working collaboratively with and
through groups of people affiliated by
geographic proximity, special interest, or
similar situations to address issues affecting
the well-being of those people
Fawcett SB, Paine-Andrews A, Francisco VT, Schultz JA, Richter KP, Lewis RK, Williams EL, Harris KJ, Berkley JY, Fisher JL, Lopez CM.
(1995). Using empowerment theory in collaborative partnership for community health and development. American Journal of
Community Psychology, 23(5), 677-697.
Relevance of Community Engagement
and Mobilization
• Encourage recipients of services to own the
problem and hold themselves liable for good
outcomes
• Promote culturally sensitive and sustainable
interventions
• Expand current research focus to align
methodologies with the realities of the lives of
Blacks
• Foster the development of social networks longterm
• Influence re-examination of how providers
construct/implement services
• Mobilize political and social will
Key Words
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Mobilize
Galvanize
Relationship
Investment
Trust
Respect
Credibility
Sustainability
Partnerships
Timing
Quantitative/Qualitative Research (CBPR)
Rules of Engagement
• Gather data from credible (re)sources
• Collectively analyze data
• Disseminate data in a culturally
competent fashion (avoid Cosby effect,
WMWW effect)
• Mobilize cohorts
• Galvanize partners, cohorts,
adversaries, stakeholders, politicians,
community-at-large
• Claim success
Process and Procedures
(Spoken & Unspoken)
• Use personal relationships
• Call in favors
• Court the adversaries
• Embrace the “nay-sayers”
• Deal with systemic/institutional racism
• Openly discuss “What’s in it for me?”
• Define primary and secondary gains
• Honor history
• Celebrate success
Infant Mortality Rate, 1991-2005
Hillsborough County, FL
(Data from Healthy Start Coalition of Hillsborough County)
Healthy People 2010 Goal 4.5
Year
County
Number
Rate
White
Number
Rate
Black
Number
Rate
Nonwhite
Number
Rate
2000
116
7.91
62
5.56
51
17.10
54
15.54
2001
125
8.41
71
6.29
52
17.63
54
15.09
2002
133
8.80
84
7.30
43
14.50
49
14.10
2003
137
9.00
81
7.00
15
17.00
55
15.30
2004
142
8.90
78
6.50
59
18.80
63
15.40
2005
149
8.90
65
5.20
71
22.70
83
20.10
Overview
• July 2007 FL Legislature passes HB1269
(Florida Statute, Section 383.2162, Black Infant Health Practice
Initiative)
• Review of infant mortality in FL counties with
average nonwhite IMR at least 1.75 greater than
White IMR and at least 40 nonwhite infant
deaths for urban counties, 5 for rural counties 2003-2005
• Initiative implemented through collaborative
between Department of Health, Federal Healthy
Start consortia, State Healthy Start coalitions
and Universities with public health expertise
• Collective findings and recommendations to
legislature by January 1, 2010.
Governor Crist Signs HB 1269 in
Tampa
Black Infant Health Practice
Initiative (BIHPI)
• Champions: Senator Arthenia Joyner &
Representative Betty Reed
• Conveners: Central Hillsborough Healthy Start,
The Chiles Center, Healthy Start Coalition of
Hillsborough County, Community Partners
• Partners:
– FL Department of Health
– Recipients of Funding: Six urban countiesHillsborough, Miami-Dade, Palm Beach, Duval,
Orange & Broward-and two rural counties-Gadsden
& Putnam
– USF College of Public Health & FAMU College of
Public Health
BIHPI Steering Committee
• Serves as a sub-unit of the practice
collaborative.
• Includes representatives from USF, FAMU, State
Healthy Start Coalitions, Federal Healthy Start
Consortia, CityMatCH, and the Florida
Department of Health.
• Serves the purpose of combining the wisdom of
all parties involved to guide the Department in
carrying out the various activities of the Initiative.
• Meets twice a month via conference call to
provide progress updates, plan future meetings,
discuss sustainability options, and provide TA to
collaborative members.
BIHPI’s Charge
• Produce and submit recommendations to
the Legislature for sustainability
– Fetal Infant Mortality Reviews (qualitative
assessment)
– Perinatal Periods of Risk (quantitative
assessment)
– Community Engagement and Mobilization
(inclusive and reflective)
BIHPI Statewide Achievements
• Created website
http://www.healthystartcoalition.org/index.cfm/fuseaction/
Research.Black_Infant
• Created Blackboard access (share literature reviews,
sources of data, promising practices, etc.)
• Received Kellogg Grant (USF COPH, FAMU COPH)capacity building for Black leadership
• Created White Paper for BIHPI (sustainability)
• Established universal goals and objectives for all
partners
• Enhanced working relationship with FL DOH and other
MCH stakeholders
• Final Report of Recommendations and Findings due to
FLDOH 8/2008
• Enhanced culturally competent “messaging”
Where We Go from Here
• Build upon concerted efforts to influence
clinical practice and policy
• Strengthen and solidify local, state and
national partnerships
• Sustain community-based health agenda
that promote social justice and equity
• Eliminate the infant mortality and morbidity
disparity in FL
Estrellita “Lo” Berry, MA
Project Director/Principal Investigator
Central Hillsborough Healthy Start Project
A program of The Lawton and Rhea Chiles Center
for Healthy Mothers and Babies
University of South Florida, College of Public Health, Tampa, FL
For more information:
lberry@health.usf.edu
(813) 974-0312 (Phone)
(813) 558-5044 (Fax)