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Using Preconception Health Indicators to Shape Programs and Policy in California

Using Preconception Health Indicators to Shape Programs and Policy in California. 3 rd National Summit on Preconception Health and Health Care Improving Preconception Health in a New Era of Health Care Tampa/St . Petersburg, FL June 13, 2011 Flojaune Griffin, PhD, MPH

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Using Preconception Health Indicators to Shape Programs and Policy in California

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  1. Using Preconception Health Indicators to Shape Programs and Policy in California 3rd National Summit on Preconception Health and Health Care Improving Preconception Health in a New Era of Health Care Tampa/St. Petersburg, FL June 13, 2011 Flojaune Griffin, PhD, MPH Preconception Health Coordinator

  2. Acknowledgements • Preconception Health at the California Department of Public Health, Maternal, Child and Adolescent Health Division is funded by Title V federal block grant • Centers for Disease Control and Prevention for providing travel funding • CDPH Preconception Health Team • Connie Mitchell, MD, MPH • Sangi Rajbhandari, MPH • Moreen Libet, PhD • Michael Curtis, PhD • Jennifer Troyan, MPH • Shabbir Ahmad, DVM, MS, PhD • Preconception Health Council of California and the March of Dimes

  3. Presentation Objectives The participant will be able to: • Explain how California has used select California MIHA preconception health indicators (now included in Healthy People 2020) to identify statewide needs • Describe the value of the state-wide Preconception Health Council of California • Describe California Department of Public Health initiatives that were developed from the indicator surveillance

  4. Maternal & Infant Health Assessment (MIHA) • Annual population-based survey of California women with a recent live birth, since 1999 • ~ 7000 women since 2010 with WIC funding; before ~ 3000-3500 • Mailed survey with telephone follow-up to non-respondents • Available in English and Spanish • Ages 15 and older • Random stratified sample • Regions include top 20 birthing counties • Response rates ~70% • Based at MCAH • Similar to CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS)

  5. Selected MIHA Preconception Health Indicators • Folic Acid • During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin?

  6. Daily folic acid use during the month before pregnancy California Maternal and Infant Health Assessment 2009 Source: California Department of Public Health, Maternal, Child and Adolescent Health Program, Maternal and Infant Health Assessment Data are weighted to reflect the population of women delivering a live birth in the survey year.

  7. Selected MIHA Preconception Health Indicators • Folic Acid • During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin? • Smoking • Have you smoked any cigarettes in the past 2 years? • During the 3 months before you got pregnant, how many cigarettes or packs of cigarettes did you smoke on an average day?

  8. Did not smoke during the three months before pregnancy California Maternal and Infant Health Assessment 2009 Source: California Department of Public Health, Maternal, Child and Adolescent Health Program, Maternal and Infant Health Assessment Data are weighted to reflect the population of women delivering a live birth in the survey year.

  9. Selected MIHA Preconception Health Indicators • Folic Acid • During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin? • Smoking • Have you smoked any cigarettes in the past 2 years? • During the 3 months before you got pregnant, how many cigarettes or packs of cigarettes did you smoke on an average day? • Healthy Weight (Calculated BMI) • Just before you got pregnant, how much did you weigh? • How tall are you without shoes?

  10. Healthy Weight just before pregnancy (BMI 18.5-24.9 kg/m2)California Maternal and Infant Health Assessment 2009 Source: California Department of Public Health, Maternal, Child and Adolescent Health Program, Maternal and Infant Health Assessment Data are weighted to reflect the population of women delivering a live birth in the survey year.

  11. Selected MIHA Preconception Health Indicators • Folic Acid • During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin? • Smoking • Have you smoked any cigarettes in the past 2 years? • During the 3 months before you got pregnant, how many cigarettes or packs of cigarettes did you smoke on an average day? • Healthy Weight (Calculated BMI) • Just before you got pregnant, how much did you weigh? • How tall are you without shoes? • Postpartum Visit • Since your most recent birth, have you had a postpartum checkup (the medical checkup that is done about 6 weeks after a woman gives birth)?

  12. Six Week Postpartum Medical CheckupCalifornia Maternal and Infant Health Assessment 2009 Source: California Department of Public Health, Maternal, Child and Adolescent Health Program, Maternal and Infant Health Assessment Data are weighted to reflect the population of women delivering a live birth in the survey year.

  13. Preconception Health Council of California Activities • EveryWomanCalifornia Website • Public and Health Professionals • California Adoption of Colorado Guidelines for Clinical Care • Standardize the content of well women visits • Health Assessment • Management of Chronic Conditions • Appropriate contraception • Interconception Care Project of California • Standardize the content of postpartum visits

  14. California Department of Public Health Activities • Social Marketing Campaigns • HRSA First Time Motherhood Grant • Latina Folic Acid • African American • Youth (ages 15-24) • Black Infant Health Program Curriculum • Group life course intervention • 10 prenatal and 10 postpartum visits • Diabetes and Pregnancy Program • Provider training for pregnancy readiness • Institute of Medicine Recommendations • Gap in USPSTF Recommendations • Essential Health Care Benefit • Family Planning, Preconception and Interconception health services

  15. Conclusions • MIHA is useful in identifying areas of need and guiding program development • Strengths • MIHA response rate is 70% • Reflective of the annual population giving birth in California • Limitations • Preconception period is long and variable • Difficult to measure impact of targeted campaigns • MIHA only assesses live births • MIHA is useful, but not sufficient in measuring preconception health • Need more indicators of preconception health (morbidity and wellness) • Need data measuring health status and behaviors of • All women of reproductive age • Pregnant women with embryo or fetal deaths

  16. For Additional Information or Questions Contact: Flojaune Griffin, PhD, MPH Preconception Health Coordinator Maternal, Child and Adolescent Health Division Program Development Branch Flojaune.Griffin@cdph.ca.gov (916) 341-6333

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