>> GOOD MORNING, EVERYONE.
WE'RE GOING TO GO AHEAD AND GET
STARTED.
MY NAME IS NAHIDA CHAKHTOURA FOR
T
THE IMPROVE INITIATIVE AND WE
LOOK FORWARD TO HEARING AND TO
HEAR WHAT YOU HAVE PLANNED.
THE IMPROVE INITIATIVE IS CO-LED
BY THE DIRECTOR OF THE EUNICE
KENNEDY SHRIVER NATIONAL
INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT DIANA BIANCHI
AND DR. JANINE CLAYTON AND THE
DIRECTOR OF THE NATIONAL
INSTITUTE OF NURSING RESEARCH,
DR. SHANNON ZENK.
DR. CLAYTON AND DR. BIANCHI WILL
KICK US OFF TODAY SHORTLY AND SO
I'D LIKE TO INTRODUCE THEM NOW.
DR. ZENK WILL PROVIDE OPENING
REMARKS TOMORROW MORNING.
DR. CLAYTON WILL PROVIDE US WITH
THE BACKGROUND AND HISTORY ON
IMPROVE.
SHE HAS BEEN THE DIRECTOR OF THE
OFFICE OF RESEARCH ON WOMEN'S
HEALTH SINCE 2012.
IN THAT ROLE SHE WORKS TO
STRENGTHEN SUPPORT FOR NIH
RESEARCH ON DISEASES, DISORDERS
AND CONDITIONS THAT AFFECT WOMEN
AND OVERSEES STRATEGIC
COORDINATION OF NIH-WIDE EFFORTS
TO MEET THAT MISSION.
PREVIOUSLY, DR. CLAYTON WAS
DEPUTY CLINICAL DIRECTOR OF THE
NATIONAL EYE INSTITUTE AND IS A
BOARD CERTIFIED OPHTHALMOLOGIST.
HER RESEARCH INTERESTS INCLUDE
AUTO IMMUNE OCULAR DISEASES AND
THE ROLE OF SEX AND GENDER IN
HEALTH AND DISEASE.
FOLLOWING DR. CLAYTON,
DR. BIANCHI WILL PROVIDE
EXCITING UPDATES ON THE RADX
TECH FOR MATERNAL HEALTH
CHALLENGE ANNOUNCING WINNERS.
IN HER ROLE AS THE NICHD
DIRECTOR, DR. BIANCHI OVERSEES
THE INSTITUTE'S APPROXIMATELY
$1.7 BILLION RESEARCH EFFORTS ON
PEDIATRIC HEALTH AND
DEVELOPMENT, MATERNAL AND
REPRODUCTIVE HEALTH,
INTELLECTUAL AND DEVELOPMENTAL
ABILITIES AND REHAB MEDICINE
AMONG OTHER AREAS.
SHE IS BOARD CERTIFIED IN
PEDIATRICS AND PERINATAL
MEDICINE AND GENITAL GENETICS
AND GENOMICS AND LEADS AN
INTRAMURAL RESEARCH LABORATORY
IN THE CENTER FOR PRECISION
HEALTH, RESEARCH AT THE NATIONAL
HUMAN GENOMIC RESEARCH INSTITUTE
WHERE PART OF THE RESEARCH
FOCUSES ON PRENATAL GENOMICS
WITH THE GOAL OF ADVANCING
NON-INVASIVE PRENATAL SCREENING
AND DIAGNOSIS.
DR. CLAYTON, I TURN THE MEETING
OVER TO YOU.
>> THANK YOU, SO MUCH DR. NAH
CHAKTOURA.
MATERNAL MORTALITY ARE OUR TOPIC
AND WE'RE THRILLED TO BE ABLE TO
SHARE THE EFFORTS OF THE IMPROVE
INITIATIVE.
THIS TOPIC IN THE UNITED STATES,
UNFORTUNATELY THE DATA SHOW IT'S
INCREASED IN RECENT YEARS AND WE
KNOW THE DATA INDICATE THE
UNITED STATES IS ONE OF THE
HIGHEST MORTALITY RATES AND HALF
THE DEATHS OCCUR POSTPARTUM
WITHIN ONE YEAR OF PREGNANCY
ENDING AND NEED TO BE MINDFUL OF
FACTORS OUTSIDE LABOR AND
DELIVERY THAT CAN LEAD TO
MORTALITY.
AS MANY AS 84% OF
PREGNANCY-RELATES DEATHS MAY BE
PREVENTIBLE AND EVEN MORE IN
SOME POPULATIONS.
WE ALSO KNOW THE MAJOR CAUSES OF
MATERNAL MORTALITY CAN VARY IN
POPULATIONS OF DIFFERENT RACES
AND ETHNICITY AND WHEN IMPROVE
BEGAN WE FOCUSSED ON THE
PREVIOUSLY KNOWN FACTORS SUCH AS
CARDIOVASCULAR DISEASE AND
COMPLICATIONS OF HEMORRHAGE BUT
RECENT DATA FROM MATERNAL
MORTALITY REVIEW COMMITTEES
DESCRIBE NOTABLE CONTRIBUTING
CAUSES OF MATERNAL DEATH
INCLUDING DISCRIMINATION, MENTAL
HEALTH CONDITIONS, SUBSTANCE USE
DISORDERS AND OBESITY.
SO THE CAUSES AND CONTRIBUTING
FACTORS RELATED TO MATERNAL
MORTALITY ARE IN FACT
MULTI-FACTORIAL.
AS THE IMPROVE PROGRAM EVOLVES
OVER TIME WE'RE CONSIDERING HOW
WE CAN INCORPORATE THAT NEW
INFORMATION.
MATERNAL MORTALITY DATA FROM THE
CDC FROM 2021 AND 2022 SHOW
CLEAR DISPARITIES IN MATERNAL
MORTALITY WHICH IS UNFORTUNATELY
NOT NEW DATA PARTICULARLY WITH
HIGHER RATES AMONG BLACK WOMEN.
WOMEN AGED 40 AND OLDER ARE AT
HIGHER RISK FOR MATERNAL
MORTALITY.
WE DID SEE A SLIGHT REDUCTION IN
MATERNAL MORTALITY FROM 2021 TO
2022 AND LIKELY INDICATIVE OF
RECOVERY FROM AN INCREASE FROM
THE COVID-19 PANDEMIC THE PEAK
AND A PERIOD OF TIME WHEN WOMEN
MISSED MANY PRENATAL
APPOINTMENTS AND EXPERIENCED
HIGHER MORTALITY RATES DUE TO
COVID INFECTION.
THE NIH IMPROVE INITIATIVE IS
NIH'S RESPONSE TO REDUCE
MATERNAL MORBIDITY AND MORTALITY
AND ADDRESSING IT ON MANY
LEVELS.
IMPROVE BEGAN IN 2019 WITH
COLLABORATION WITH THE INSTITUTE
CENTERS AND OFFICES.
IMPROVE AIMS TO REDUCE
PREVENTIBLE CAUSES OF MATERNAL
MORBIDITY AND MORTALITY AND
BUILDING CAPACITY AND RESEARCH
ORGANIZATIONS AND EXPANDING
IMPLEMENTATION OF EVIDENCE-BASED
MATERNAL HEALTH CARE PRACTICES
BEFORE, DURING AND AFTER
PREGNANCY AND ADDRESSING
DISPARITIES IN MATERNAL HEALTH
OUTCOMES.
THESE CRITICAL AIMS REQUIRE ALL
OF YOU, ALL OF US, WITHOUT YOUR
CONTRIBUTIONS IN THOSE EFFORTS
WE WILL NOT BE ABLE TO ACHIEVE
THESE GOALS.
IMPROVE IS A MULTI-PRONGED
EFFORT.
ONE AREA IS ON DISSEMINATION AND
IMPLEMENTATION RESEARCH TO MAKE
SURE EVIDENCE-BASED
INTERVENTIONS CAN BE
SUCCESSFULLY IMPLEMENTS IN
COMMUNITIES WHERE THEY'RE NEEDED
MOST.
ANOTHER INVESTMENT CREATED
LONGITUDINAL HEALTH RECORDS
CREATING LINKAGES ACROSS
PREGNANCY TO ALLOW FOR
ADDITIONAL DATA ANALYSIS.
A MAJOR COMPONENT OF THE IMPROVE
PROGRAM IS THE MATERNAL HEALTH
RESEARCH CENTERS OF EXCELLENCE
PROGRAM.
WE AWARDED 10 RESEARCH CENTERS
IN 2023 AND JUST ANNOUNCED TWO
MORE RESEARCH CENTERS IN 2024.
WE ALSO HAVE THE IMPROVE
COMMUNITY IMPLEMENTATION PROGRAM
THAT IS WORKING IN CLOSE
PARTNERSHIP WITH COMMUNITIES ON
IMPLEMENTATION SCIENCE.
THE IMPROVE INITIATIVE IS ALSO
SUPPORTED INNOVATIVE RESEARCH
THROUGH TWO CHALLENGES.
YOU'LL HEAR MORE ABOUT THE RADX
TECH FROM DR. BIANCHI IN JUST A
MOMENT.
THIS MAP DEPICTS THE
GEOGRAPHICAL SPREAD OF THE
IMPROVE PROGRAM.
THE AIM IS TO CENTER IMPROVE
PROGRAMS IN THE AREAS AND
POPULATIONS MOST HIGHLY IMPACTED
BY MATERNAL MORBIDITY AND
MORTALITY AND HERE YOU CAN SEE
THE LOCATIONS AND GEOGRAPHIC
BREADTH OF THE PROJECTS FOR THE
MULTIPLE IMPROVE COMPONENTS
INCLUDING THE MATERNAL HEALTH
RESEARCH CENTERS OF EXCELLENCE
HUBS AND MATERNAL HEALTH
CHALLENGE.
WE'LL NOW HEAR FROM FROM BIANCHI
TO TALK ABOUT THE IMPROVE RAPID
ACCELERATION OF DIAGNOSTICS AND
HEAR EXCITING UPDATES ABOUT THE
PROGRAM.
OVER TO YOU, DR. BIANCHI.
>> THANK YOU, DR. CLAYTON.
GOOD MORNING TO EVERYONE IN THE
AUDIENCE.
CONGRATULATIONS ON BECOMING PART
OF THE IMPROVE INITIATIVE,
GETTING YOUR RESEARCH FUNDED AND
WE'RE SO EXCITED TO HEAR ABOUT
YOUR SUCCESSES AND CHALLENGES
OVER THE PAST FEW YEARS.
SO I LIKE TO SHOW THIS SLIDE
BECAUSE IT REALLY GRAPHICICLY
DEMONSTRATES THE PROBLEM IN THE
UNITED STATES -- GRAPHICALLY
DEMONSTRATES THE PROBLEM IN THE
UNITED STATES THE LACK TO
ACCESS.
35 COUNTIES ARE IN MATERNITY
CARE DESERTS WHICH LACK
EXPERTISE IN OBSTETRIC CARE.
THE MOST CONCERNING SITES ARE
INDICATED IN PINK-RED.
WE KNOW THAT 2.3 MILLION WOMEN
OF REPRODUCTIVE AGE LIVE IN
MATERNAL CARE DESERTS IN THE
U.S. AND MORE THAN 150,000
BABIES BORN TO BIRTHING PEOPLE
ARE LIVING IN MATERNAL CARE
DESERTS AND THIS IS A GREAT
CONCERN FOR ALL OF US.
I'M OFTEN ASKED WHEN I MEET WITH
MEMBERS OF CONGRESS WHAT ARE WE
GOING TO REDUCE THE NUMBERS OF
MATERNAL DEATHS AND ONE THING
THAT WE CAN DO IS TO TRY TO
EXTENT THE NETWORK OF OBSTETRIC
CARE THROUGH HOME-BASED OR
POINTS OF CARE DIAGNOSTIC
DEVICES, WEARABLES AND OTHER
REMOTE SENSING TECHNOLOGIES.
I'M PLEASED TO ANNOUNCE NOW THE
WINNERS OF THE ENTIRE CHALLENGE
BUT WE HAVE CONTRIBUTED THROUGH
THE IMPROVE INITIATIVE UP TO $8
MILLION IN PRIZES AWARDED
THROUGH SEVERAL PHASES.
IT'S AN INNOVATION FUNNEL USED
DURING THE COVID PANDEMIC TO
DEVELOP THE HOME-BASED POINT OF
CARE TECHNOLOGIES I'M SURE YOU
USED YOURSELF TO TEST FOR COVID.
SEVERAL YEARS AGO WE GOT
PROPOSALS FROM INNOVATORS, 84 ED
AND 25 ELIGIBLE.
THEY WENT THROUGH AND WENT
THROUGH A VARIETY OF STAGES
WHERE THEY WERE JUDGED FOR
PRACTICAL ISSUES, VIABILITY AND
MOST RECENTLY WHETHER THE
TECHNOLOGY COULD BE SUCCESSFULLY
APPLIED TO REAL PEOPLE.
WE ARE NOW TRANSITIONING THE
TECHNOLOGIES TO NIH NETWORKS FOR
POTENTIAL CLINICAL STUDIES AND
IMPLEMENTATION OF RESEARCH
SUPPORT.
SO, HERE WERE THE 10 FINALISTS.
THEY ARE SUPPORTING, MONITORING
OF A RANGE OF ISSUES, ANEMIA,
HYPERTENSION, MENTAL HEALTH AND
POSTPARTUM HEMORRHAGE.
AND NOW, DRUM ROLL, I'M PLEASED
TO ANNOUNCE THAT WE'VE SELECTED
OUR FINAL WINNERS AND RUNNERS UP
FOR THE CHALLENGE AND I'D LIKE
TO THANK THE VARIOUS COMMITTEES
THAT PARTICIPATED IN EACH STAGE
OF THE CHALLENGE.
SO I'D LIKE TO CONGRATULATE OUR
RADX TECH FOR MATERNAL HEALTH
GRAND PRIZE WINNERS EACH OF
WHOLE WILL RECEIVE $525,000
INCLUDING SIBEL HEALTH, CARDIEX
FOR THEIR WEARABLE BLOOD
PRESSURE MONITOR AND CARETAKER
MEDICAL AND SANGUINA AND
HEMOSONICS AND GLOBAL ACCESS
DIAGNOSTICS.
THEY HAVE A POINT OF CARE
DIAGNOSTIC TO DETECT URINARY
TRACT INFECTION.
THERE'S TWO RUNNERS UP RECEIVING
$300,000 EACH.
ONE IS MYLUA HEALTH CARE
MANAGEMENT USING A MOBILE
APPROACH AND PYRAMES A WEARABLE
BLOOD PRESSURE MONITOR.
THE OTHER TWO IF YOU'RE KEEPING
TRACK WERE CONSIDERED TO BE
INELIGIBLE FOR THE FINAL PRIZES.
OUR SO OUR ASPIRATIONAL GOAL IS
TO LEVERAGE THE IN-PERSON
ATTENDANCE OF THOSE IN THE
AUDIENCE WHO ARE RADX TECH
FINALISTS AND CONNECTING TO THE
TEAMS TO BRAIN STORM ABOUT
IMPLEMENTING THESE INNOVATIVE
TECHNOLOGIES.
THEY WERE SELECTED BECAUSE THEY
HAVE GREAT POTENTIAL AND WE HOPE
THE CENTERS OF EXCELLENCE WILL
DEVELOP WAYS TO TEST THEM IN
LARGER AND MORE DIVERSE
POPULATIONS.
SO WITH THAT, MAY I HAVE A NEXT
SLIDE, PLEASE.
NOW I'M GOING TO TURN THE
MEETING OVER TO OUR MEMBERS OF
CONGRESS.
I'D LIKE TO INTRODUCE THE
VIDEOS.
I ALSO WANT TO ENCOURAGE ALL THE
MEETING PARTICIPANTS TO LISTEN
TO THE LIGHTNING TALKS ABOUT
THESE DEVICES AND APPLICATIONS
IF YOU'RE IN PERSON, PLEASE
CHECK OUT THE LIVE
DEMONSTRATIONS DURING THE POSTER
SESSIONS.
PLEASE TAKE ADVANTAGE OF BEING
IN PERSON TO TALK WITH OTHER
MEMBERS OF THE IMPROVE
INITIATIVE FAMILY, SO TO SPEAK,
TO TALK ABOUT WAYS YOU CAN
COLLABORATE AND INTEGRATE.
WE'VE HAD GREAT SUCCESS DOING
THAT WITH SOME OF OUR OTHER
CHALLENGES.
AND NOW I BELIEVE I'M GOING TO
INTRODUCE VIDEO REMARKS FROM TWO
CONGRESSIONAL SUPPORTERS OF
IMPROVE BUT THE SLIDE SAYS
JANINE CLAYTON.
ARE WE READY WITH THE VIDEOS?
LET ME INTRODUCE OUR CHAMPIONS
OF IMPROVE AT CONGRESS.
ONE IS SENATOR BUTLER WHO SERVED
AS THE UNITED STATES SENATOR
FROM CALIFORNIA SINCE 2023.
AND IS COMMITTED TO IMPROVING
MATERNAL HEALTH OUTCOMES.
REPRESENTATIVE UNDERWOOD HAS
SERVED AS UNITED STATES
REPRESENTATIVE FROM ILLINOIS
SINCE 2019.
REPRESENTATIVE UNDERWOOD HAS
BEEN A MAJOR CHAMPION FOR THE
IMPROVE INITIATIVE SINCE THE
INCEPTION AND MEMBER BLACK
CAUCUS.
ALONGSIDE REPRESENTATIVE ADAMS
AND BOOKER HAVE AN OMNIBUS ACT
TO ADDRESS EVERY DRIVER OF
MATERNAL MORBIDITY AND MORTALITY
IN THE UNITED STATES.
SENATOR BUTLER AND
REPRESENTATIVE UNDERWOOD ARE
ALSO THE SPONSORS OF THE IMPROVE
ACT WHICH WOULD AUTHORIZE FUNDS
FOR THE NIH IMPROVE INITIATIVE.
WE'RE TRULY GRATEFUL FOR THEIR
COMMITMENT TO REDUCING MATERNAL
MORBIDITY AND MORTALITY AND
HONORED THEY SHARED THEIR
REMARKS BY VIDEO TODAY TO MARK
THE SPECIAL ANNIVERSARY
OCCASION.
HOPEFULLY, WE CAN NOW GO TO THE
VIDEOS.
HELLO, AND THANK YOU TO NIH
FOR INVITING ME TO COMMEMORATE
THE IMPROVE INITIATIVE.
IT'S GREAT TO SPEAK TO PAST AND
CURRENT AWARDEES AND MATERNAL
HEALTH EXPERTS ABOUT THE
IMPORTANT WORK OF THE IMPROVE
INITIATIVE.
I'M PROUD TO BE AN IMPROVE
CHAMPION BECAUSE IT'S CRITICALLY
IMPORTANT TO REDUCE PREVENTIBLE
CAUSES OF MATERNAL DEATHS AND TO
IMPROVE HEALTH FOR WOMEN BEFORE,
DURING AND AFTER PREGNANCY.
ESPECIALLY IN COMMUNITIES OF
COLOR, YOUNG WOMEN, WOMEN OF
ADVANCED MATERNAL AGE AND FOR
PEOPLE WITH DISABILITIES.
DESPITE BEING A DRIVING FORCE IN
OUR ECONOMY, WORKING MOTHERS ARE
FACING A HEALTH CARE SYSTEM THAT
IS FAILING THEM.
THE UNITED STATES HAS THE
HIGHEST MATERNAL MORTALITY RATE
AMONG DEVELOPED NATIONS.
OVER THE PAST DECADE THOUSANDS
OF WOMEN HAVE LOST THEIR LIVES
DUE TO PREGNANCY RELATED
CAUTIONS AND FOR COMMUNITIES
THAT LACK MATERNAL HEALTH
RESOURCES, THIS CRISIS IS
DEVASTATING.
IN FACT, ACCORDING TO A MARCH OF
DIMES STUDY, ONE-THIRD OF ALL
COMMUNITIES IN THE COUNTRY ARE
MATERNAL CARE DESERTS.
MEANING THERE ARE NO HOSPITALS
PROVIDING OBSTETRIC CARE, NO
OBSTETRIC PROVIDERS AND NO BIRTH
CENTERS.
THAT'S WHY I'M A PROUD CHAMPION
OF KAMALA HARRIS AND SENATOR
BOOKER'S OMNIBUS ACT SEEKING TO
ADDRESS THE CRISIS.
I ALSO INTRODUCE THE NIH IMPROVE
ACT.
THIS BILL PROVIDES NIH THE
RESOURCES AND SUPPORT IT NEEDS
TO LOOK INTO AND DO THE
NECESSARY RESEARCH TO THE ROOT
CAUSES OF OUR COUNTRY'S MATERNAL
MORTALITY CRISIS.
THERE ARE HUGE GAPS IN MATERNAL
CARE ESPECIALLY ACROSS RACIAL
AND SOCIO ECONOMIC LINES AND THE
NIH IMPROVE ACT WILL SUSTAIN
MUCH NEEDED RESEARCH TO BETTER
UNDERSTAND HOW WE CAN PROTECT
MOTHERS AND END PREVENTIBLE
MATERNAL DEATHS.
OVER THE PAST FIVE YEARS THE
IMPROVE INITIATIVE HAS SUPPORTED
MORE THAN 60 PROJECTS TO HELP
ADDRESS THE ROOT CAUSES OF
MATERNAL MORBIDITY.
ADDITIONALLY, THE IMPROVE
INITIATIVE HAS SUPPORTED 12
RESEARCHERS CENTERS TO DEVELOP
AND EVALUATE INNOVATIVE
APPROACHES TO REDUCE
PREGNANCY-RELATED COMPLICATIONS
AND DEATH.
SO CONGRATULATIONS ON FIVE YEARS
AND THANK YOU FOR THE HARD WORK
OF THE PROJECTS THE IMPROVE
INITIATIVE HAS SUPPORTED TO
ADDRESS THE CARE CRISIS.
I'M EXCITED TO SEE IMPROVE
DEVELOP AND SUPPORT FUTURE
INITIATIVES TO HELP REDUCE
HEALTH DISPARITIES.
THANK YOU AGAIN FOR INVITING ME
TO COMMEMORATE THIS IMPORTANT
ANNIVERSARY WITH YOU TODAY AND
KNOW THAT I AM COMMITTED TO
EMPOWERING NIH WITH THE
RESOURCES IT NEEDS TO IMPROVE
HEALTH OUTCOMES FOR WOMEN ALL
ACROSS OUR COUNTRY.
HI, EVERYBODY.
I'M CONGRESS WOMAN UNDERWOOD AND
REPRESENT THE 14th DISTRICT IN
ILLINOIS AND PART OF THE BLACK
CAUCUS AND PROUD TO JOIN YOU FOR
THE IMPROVE INITIATIVE.
I'D LIKE TO START BY THANKING
THE LEADERSHIP AND STAFF AT THE
NATIONAL INSTITUTES OF HEALTH
FOR THE INCREDIBLE WORK WE'VE
DONE TOGETHER OVER THE YEARS.
YOUR LEADERSHIP HAS BEEN
REMARKABLE PARTICULARLY FOR THE
LEADERSHIP AND STAFF AT NICHD,
THE NATIONAL INSTITUTE FOR CHILD
HEALTH AND HUMAN DEVELOPMENT AND
OFFICE OF RESEARCH ON WOMEN AND
THE NATIONAL INSTITUTE FOR
NURSING RESEARCH.
THANK YOU ALL FOR ALL THAT YOU
DO AND FOR OUR AWARDEES AND
GRANTEES, CONGRATULATIONS AND
THANK YOU FOR CONTRIBUTING TO
THE KNOWLEDGE BASE AND THE WORK
WE'RE DOING TOGETHER TO END
PREVENTIBLE MATERNAL HEALTH IN
OUR COUNTRY AND TO ALL THOSE WHO
ARE COMMITTED TO THIS WORK OF
SAVING MOM'S LIVES.
THANK YOU FOR BEING WITH US
TODAY.
AS YOU MAY KNOW, THE UNITED
STATES LEADS THE INDUSTRIALIZED
WORLD IN PREVENTIBLE DEATH.
HERE IN THE UNITED STATES 80% OF
DEATHS ARE PREVENTIBLE.
IT'S A TRAGEDY.
WORKING WITH CONGRESS WOMAN
ADAMS OF NORTH CAROLINA WE
CO-FOUNDED AND CO-CHAIRED THE
BLACK MATERNAL HEALTH CAUCUS
WITH THE FOCUS OF ELEVATING THE
MATERNAL HEALTH CRISIS IN THE
UNITED STATES CONGRESS.
WE GREW TO BECOME ONE OF THE
LARG
LARGEST BIPARTISAN CAUCUS AND
ADDRESSING CLINICAL FACTORS
CONTRIBUTING TO OUR NATION'S
MATERNAL HEALTH CRISIS.
ONE OMNIBUS BILL HAS BEEN SIGNED
INTO LAW AND SECURED A COUPLE
HUNDRED MILLION DOLLARS BASED ON
OTHER OMNIBUS PRIORITIES AND
WORKED TOGETHER IN PARTNERSHIP
WITH THE LEADERSHIP AT NIH TO
DEVELOP THE IMPROVE INITIATIVE
WORKING IN PARTNERSHIP WITH THEN
DIRECTOR FRANCIS COLLINS WHO
LAUNCHED NIH IMPROVE AND EXCITED
TO CONTINUE THE PARTNERSHIP WITH
DR. BERTAGNOLLI AND HAVE WRITTEN
LEGISLATION TO CODIFY AND
PROTECT THE PROGRAM IN FEDERAL
LAW WORKING WITH THE HOUSE,
BRIAN FITZPATRICK AND IN THE
SENATE, SENATOR BUTLER.
WE'RE EXCITED OVER THE LAST FIVE
YEARS WE'VE BEEN ABLE TO
INCREASE THE FUNDING FOR THE
IMPROVE INITIATIVE FIVE FOLD.
RECENTLY IN FISCAL 2024 THE
APPROPRIATIONS BILL HAD $53.4
MILLION SIGNED INTO LAW WHAT AN
ACHIEVEMENT TO SUPPORT THE GREAT
WORK EACH OF YOU ARE DOING FOR
IMPACTFUL RESEARCH AND
LIFE-SAVING DISCOVERIES AND
INNOVATIONS THAT WILL
UNDOUBTEDLY SAVE LIVES AND ENDS
OUR NATION'S MATERNAL HEALTH.
WE'RE EXCITED TO WORK IN
PARTNERSHIP WITH YOU TO INCREASE
THE RESOURCES FOR YOUR WORK AT
NIH AND TO SPREAD THE WORD THAT
HEALTH IS ON THE WAY.
THANK YOU FOR JOINING US IN THIS
FIGHT AND FOR ALL YOU DO AND
CONGRATULATIONS ONCE AGAIN ON
FIVE YEARS OF REMARKABLE
ACHIEVEMENT.
TAKE GOOD CARE.
ISN'T IT WONDERFUL TO HAVE SUCH
GREAT CONGRESSIONAL CHAMPIONS.
I'LL TURN THE VIRTUAL MICROPHONE
OVER TO THE SESSION 1 PANEL.
I THINK THEY'RE GOING TO BE
COMING UP TO THE STAGE AND THE
MODERATORS ARE DOCTORS JUANITA
CHILDREN DR. BALKISSA OUATTARA
WHO WILL TAKE IT FROM HERE.
THANK YOU.
THANK YOU, DR. BIANCHI.
WE NOW CALL OUR PANELISTS UP TO
THE STAGE, PLEASE.
I'M JUANITA CHINN AT THE EUNICE
KENNEDY SHRIVER INSTITUTE OF
CHILD HEALTH AND HUMAN
DEVELOPMENT IN THE POPULATION
BRANCH.
I INVITE EVERY TO THE LEFT TO
INTRODUCE THEMSELVES.
>> I'M BALKISSA OUATTARA AT THE
OFFICE OF RESEARCH AND WOMEN'S
HEALTH.
>> MY NAME IS CASSANDRA
QUERDIBITTY FROM THE UNIVERSITY
OF OKLAHOMA HERE WITH THE CENTER
FOR INDIGENOUS CULTURE AND
MATERNAL HEALTH.
>> GOOD MORNING, EVERYONE.
I'M JULIE ST. JOHN WITH TEXAS
ATTACK HEALTH SCIENCE CENTER
WORKING ON IMPROVE PROJECT.
>> GOOD MORNING, EVERYONE.
I'M ZIINAB JAH AND CO-LEAD OF
THE COMMUNITY PARTNER WORE WITH
THE SOUTHERN CENTER UNIVERSITY
IN AUSTIN.
>> I'M KATELYN STRASSER AND
HONORED TO BE PART OF THE PANEL
TODAY.
>> AS A REMINDER, THIS PANEL IS
ENTITLED CENTERS ON COMMUNITIES
AFFECTED BY THE MATERNAL
MORBIDITY AND MORTALITY CRISIS.
THESE ARE SOME OF THE EXPERTS
THAT WE HAVE ON THE TOPIC.
BALKISSA WILL START WITH THE
MODERATING OF QUESTIONS.
>> THANK YOU.
WELCOME, ALL.
I'M GOING TO ASK EACH OF YOU TO
DESCRIBE YOUR ROLE ON THE CENTER
AND THE POPULATION YOU SERVE.
>> I'M WITH THE SOUTH DAKOTA
DEPARTMENT OF HEALTH MY
BACKGROUND IS NURSING AND PUBLIC
COMMENT AND MOST MY TIME SPENT
IN MATERNAL HEALTH AND I'M
CURRENTLY THE ROLE I HAVE AT THE
HEALTH DEPARTMENT IS OVERSEEING
OUR STATEWIDE PUBLIC HEALTH
NURSING SERVICES.
ALL OF OUR MATERNAL CHILD HEALTH
PROGRAMS AND OUR MATERNAL CHILD
HEALTH DATA TEAMS.
LIKE I SAID, I'M A COMMUNITY
PARTNER WITH THE RESEARCH SO I
HAVE A LITTLE BIT PROBABLY
DIFFERENT PERSPECTIVE THAN SOME
OTHERS IN THE ROOM HERE WHO ARE
MORE INVOLVED IN RESEARCH BUT I
AM PASSIONATE ABOUT USING DATA
AND RESEARCH TO INFORM OUR
PUBLIC HEALTH PRACTICE, OUR
SERVICE AND PROGRAM DELIVERY AND
OUR POLICY DEVELOPMENT AND
IMPLEMENTATION.
I CURRENTLY SERVE AS THE P.I. ON
SOUTH DAKOTA'S PREGNANCY RISK
ADMINISTERING BRANCH AND PCI ON
A NEWLY AWARDED MATERNITY HEALTH
GRANT AND I CONTINUE TO
PARTICIPATE IN THAT WORK AND
COLLABORATE ON SEVERAL STATEWIDE
INITIATIVES WITH DIFFERENT
PARTNERS TO IMPROVE MATERNAL
HEALTH ACROSS SYSTEMS IN SOUTH
DAKOTA AND AS FAR AS THE
COMMUNITIES I SERVE
SPECIFICALLY, PUBLIC HEALTH IS
CENTRALIZED WITH PARTNERS AND
PLAY A ROLE IN WORKING WIN
COMMUNITIES.
WE HAVE RURAL AND FRONTIER AREAS
ACROSS MOST THE STATE AND WORK
WITH OUR NINE AMERICAN TRIBES IN
SOUTH DAKOTA AS WELL.
>> SO AS I MENTIONED BEFORE I'M
WITH THE SOUTHERN CENTER OF
MATERNAL HEALTH EQUITY BASED IN
THE GULF SOUTH AND SO OUR CENTER
REALLY IS AN ACADEMIC HEALTH
CARE INSTITUTION AND COMMUNITY
INSTITUTION PARTNERSHIP IN WHICH
WE ARE TRYING TO ADDRESS
MATERNAL MORTALITY, MORBIDITY IN
LOUISIANA AND MISSISSIPPI AND
ARKANSAS AS WELL.
WE HAVE THREE RESEARCH PROJECTS.
ONE FOCUSSING ON IMPLEMENTING
COMMUNITY CARE AND EXPANDING
CONNECTED MOMS PROGRAM, BLOOD
PRESSURE MONITORING INTO
MATERNAL HEALTH DESERTS AND THEN
ALSO BE LOOKING AT LOUISIANA AND
COMPARING IT WITH MISSISSIPPI
AND ARKANSAS.
I LEAD THE COMMUNITY PARTNER
CORPS.
THAT IS VIEWED AS THE
ACCOUNTABILITY ARM.
ANY BACKGROUND IS IN
COMMUNITY-BASED RESEARCH AND
FIND WAYS TO INTEGRATE COMMUNITY
WITHIN RESEARCH AND THINKING
ABOUT DISSEMINATION EFFORTS AS
WELL.
WITH OUR COMMUNITY PARTNER CORE
WE TAKE PRIDE IN ENGAGING
COMMUNITY PARTNER WITH THE
RESEARCH PROJECTS AND AS WELL AS
PROVIDING MENTORSHIP WITH
TRAINEES AND OVER ARCHI II IING
DISSEMINATION OF EFFORTS TO MAKE
SURE IT GETS BACK TO COMMUNITY
THEMSELVES.
>> WE'RE WITH TEXAS TECH
UNIVERSITY HEALTH SCIENCE
CENTER.
WE'RE AN ACADEMIC HEALTH
INSTITUTION AND TRAIN LOTS OF
TYPES OF PROVIDERS BUT WE ARE
WEST TEXAS SO IT'S CONSIDERED
ANYTHING THAT IS WEST OF THE I35
THAT GOES THROUGH THE DALLAS/Ft.
WORTH METROPLEX AND WEST TEXAS
IS BIGGER THAN 42 STATES LAND
BIAS AND MORE COWS THAN PEOPLE.
THAT'S OUR WEST TEXAS AREA AND
OUR INSTITUTION SERVES ABOUT 100
COUNTIES, 254 IN TEXAS.
THAT'S THE CONTEXT AND HAVE SIX
CAMPUSES IN THAT AREA.
OUR PARTICULAR PROJECT SO WE ARE
FUNDED TO IMPROVE AND I'LL READ
THE NAME BECAUSE IT'S KIND OF
LONG BEAUTE WE'RE CALLED VIBRANT
MOMS AND THAT STAND FOR
VERIFYING AND IMPLEMENT BEING
EVIDENCE-BASED PROGRAMS FOR
MATERNAL HEALTH OUTCOMES,
MEASURES AND SUPPORT SO VIBRANT
MOMS.
OUR PARTICULAR FOCUS IF YOU LOOK
AT THE NORTHWEST PART OF TEXAS,
THE TEXAS PANHANDLE IS 26
COUNTIES AND SAYS THE TEXAS
PANHANDLE WHERE YOU LOOK FURTHER
AND SEE LESS THAN ANYWHERE ELSE.
THAT'S DESCRIPTIVE OF OUR AREA
IN THE PANHANDLE.
OUR PROJECT FOCUSES ON SIX OF 26
COUNTIES AND SO TWO OF THOSE ARE
URBAN AND THAT'S WHERE AMARILLO
OUR BIG CITY IN THE PANHANDLE
OVER 200,000 PEOPLE AND OUR
OTHER FOUR COUNTIES IN OUR AREA
ARE RURAL AND VERY UNDER SERVED
AREAS SO, IN THE WHOLE 26 COUNTY
REGION WE HAVE SIX HOSPITALS
THAT DELIVER AND FIVE COUNTIES
AND IN OUR PROJECT WE FOCUS ON
OTHER SIX COUNTIES, TWO COUNTIES
HAVE THREE HOSPITALS.
WE'RE VERY MUCH UNDER SERVED AND
MATERNAL HEALTH CARE DESERTS AND
WE'RE SEEING THAT TREND
CONTINUE.
OUR PROJECT IS TRYING TO FIGURE
OUT WHAT ARE THOSE BARRIERS AND
CHALLENGES AND WHAT
INTERVENTIONS MIGHT WORK TO HELP
IMPROVE THE OUTCOMES.
>> MY NAME IS CASSANDRA
QUERDIBITTY A CITIZEN OF
OKLAHOMA AND DESCENDENT OF AN
INDIGENOUS NATION AND MY HUSBAND
IS COMANCHE AND IT MEANS TO RISE
AND CONQUER.
WE HAVE 35 FEDERALLY RECOGNIZED
TRIBES.
AND THERE'S VARIATION AND
CONTEXT WHEN IT COMES TO
PRACTICE.
AND WHEN YOU SAW I'M AN EXPERT
I'M FAR FROM IT.
I'M STARTING TO RELEARN WITH THE
HISTORY OF THE STATE OF OKLAHOMA
HOW TRIBES HAVE COME ALONG AND
POLITICAL CONTEXT AN WE'RE
RELEARNING ANDRY CLAIMING OUR
OWN CULTURE AND LANGUAGE AND
THINGS LIKE THAT.
I'M ALWAYS LEARNING AND WE'RE
WORKING WITH INDIGENOUS PREGNANT
PERSONS ACROSS THE STATE.
IT'S A DIFFICULT.
YOU DON'T WANT TO PUT THEM ALL
IN ONE BASKET.
AND IF YOU'RE NOT COMMUNITY YOU
WON'T UNDERSTAND WHAT IS
OFFENSIVE OR MAY NOT WORK FOR
THEM.
SO FAR THERE'S A STUDY A FOOD IS
MEDICINE STUDY WHICH I TRULY
APPRECIATE.
MY BACKGROUND HAS BEEN IN PUBLIC
HEALTH AND PRACTICE.
I WORKED ON INFANT MORTALITY,
BIRTH DEFECT REGISTRY AND THINGS
LIKE THAT BUT NOW IT'S SHIFTING
MORE TOWARDS MOM, BABY, WHOLE
FAMILY AND HOW DO YOU DEFINE
FAMILY?
HOW DO YOU DEFINE THE HOMES
YOU'RE WORKING IN.
WITH THE FOOD WORK FIGURING OUT
HOW DO WE POINT TOWARDS CULTURE
AND HOW DO WE SUPPORT MOMS IN
THAT VENTURE WITH TRYING TO
UTILIZE INDIGENOUS BIRTH WORKERS
NOW AND FOCUSSING ON WHAT DOES
THAT LOOK LIKE AND HOW DO WE
WORK WITH THE TRIBES.
AGAIN, 39 FEDERALLY RECOGNIZED
TRIBES.
THERE ARE I THINK FOUR AND A LOT
OF MY WORK IS FOCUSSED ON
COMMUNITY-BASED PARTICIPATORY
RESEARCH AND HOW DO YOU SHARE
POWER WHEN YOU COME FROM THE
UNIVERSITY SETTING AND I
RECENTLY TRANSITIONED TO THE
UNIVERSITY SETTING SO THAT'S
BEEN INTERESTING.
I ALSO SERVE ON MY TRIBE'S
HEALTH BOARD AND ADVISORY BOARD
ON THE INDIAN HEALTH CLINIC WE
ALSO WORK WITH AND HOW DO YOU
OVERCOME AND DO THAT AND HOW DO
YOU TRACK PATIENTS AND WHEN
YOU'RE HIGH RISK WHAT DOES THAT
MEAN FOR YOU TOO AND HOW DO YOU
NAVIGATE THIS HISTORICAL TRAUMA
AND ALSO THE MISTRUST THAT IS
ABSOLUTE APPROPRIATE.
SO I THINK I WENT A LITTLE OFF
BUT THAT'S ME.
I AM ALSO A CIRCLE SCHOLAR AND
LOOKING AT ENVIRONMENTAL
EXPOSURES DURING PREGNANCY AND
HOW THAT MIGHT AFFECT MATERNAL
HEALTH OUTCOMES AND WE'LL TEST
WEARABLES AND SEE WHAT CHEMICAL
EXPOSURES THERE ARE AND HOW TO
DIVE IN TO MITIGATE THOSE RISKS
AND SEE WHERE THEY ARE.
THERE'S BEEN A LOT OF THINGS AS
FAR AS ENVIRONMENTAL JUSTICE AND
DIVING INTO THE SOCIAL JUSTICE
OF HEALTH AND HOW WE HOLD THINGS
AND PEOPLE ACCOUNTABLE.
>> CASSANDRA, THE CONSTANT STATE
OF LEARNING AND THAT'S WHY
YOU'RE THE EXPERT.
YOU TOUCHED ON IT A LITTLE BIT
BUT THIS IS FOR ANYBODY WHO
WANTS TO JUMP IN AND ANSWER AND
IF YOU WANT TO ADD ADDITIONAL
THINGS.
WHAT DO YOU SEE ARE THE MOST
PRESSING CHALLENGES FOR THE
COMMUNITIES YOU SERVE WITHIN
YOUR WORK?
OFTEN TIMES THEY'RE ENGAGED BUT
NOT TRULY ENGAGED AND A GRANT
COMES OUT AND ACADEMIC
INSTITUTIONS LIKE OH, YEAH, I
HEARD OF THIS ORGANIZATION AND
LET'S TRY TO CALL THEM IN RATHER
THAN HAVING AN EXISTING
PARTNERSHIP BUILT AND OFTEN
FEELS EXTRACTIVE OFTEN HOW
RESEARCH CAN BE HARMFUL TO
COMMUNITIES.
OFTEN TIMES COMMUNITY MEMBERS
AND PARTNERS COME INTO THE WORK
FEEL LIKE THEY MAY BE HARMED AS
EXPERIENCE AND ALSO THINKING HOW
OFTEN THEY ENGAGE IN RESEARCH
BUT NEVER REALLY FEELS
SUSTAINABLE AND DOESN'T REALLY
CONTRIBUTE TO THE COMMUNITY.
OFTEN TIMES THAT'S A CHALLENGE
AND STRUGGLE THAT IS FACED WHEN
ENGAGING COMMUNITY IN THE
RESEARCH AND HAS BEEN GREAT ON
BUILDING EXISTING RELATIONSHIPS
THE FOLKS THAT HAVE WORKED
TOGETHER ON VARIOUS PROJECTS ARE
ABLE TO COME TOGETHER AND HOLD
SPACE FOR WHAT THEY THINK SHOULD
HAPPEN WITHIN THIS GRANT AND
IT'S SO GREAT IT'S SO LONG TO
PROVIDE OPPORTUNITY TO BE
IMPACTFUL AND PROVIDE TIME AND
SPACE TO BE INNOVATIVE IN THE
WAY WE'RE ENGAGING AND GIVING
BACK TO THE COMMUNITY.
>> THAT'S NOT MY STRENGTH.
AND I APOLOGIZE, I NOT SAY WHY
I'M UP HERE.
MY BACKGROUND IS IN PUBLIC
HEALTH AND HAVE BEEN DOING IT
THE LAST 25 YEARS PRIMARILY IN
ACADEMIC SETTING BUT MY ROLE HAS
BEEN COMMUNITY ENGAGED
PARTICIPATORY RESEARCH AND I'M
AN INVESTIGATOR AND HELP WITH
THAT PIECE OF IT AND ALSO HAVE
DONE WITH WORK WITH COMMUNITY
HEALTH WORKERS AND DO A LOT OF
POLICY AND TRAINING RELATED TO
THAT AND ENGAGE HEALTH WORKERS
IN OUR PROJECT.
SO, OUR PROJECT CHALLENGE IN OUR
COUNTIES WE SERVE IS DISTANCE TO
HEALTH CARE PROVIDERS.
FROM ONE END TO THE OTHER
THERE'S ABOUT A THREE HOUR
DRIVE.
THAT'S A CHALLENGE IN OUR
PROJECT BUT WHERE OUR
COMMUNITIES WE SERVE WOULD BE
DISTANCE AND THEN ALONG WITH
THAT IS TRANSPORTATION.
SO PUBLIC TRANSPORTATION DOES
NOT EXIST LIKE IT WOULD HERE AND
THAT'S A CHALLENGE.
SHORTAGE OF HEALTH CARE
PROVIDERS.
TRYING TO GET PEOPLE TO COME AND
SERVE IN OUR AREA.
SO WE HAVE A TREMENDOUS SHORTAGE
AND THEN SOME STATE POLICIES.
WE'RE INTEREST TEXAS.
THAT'S PROBABLY ENOUGH TO SAY
THAT.
BUT WE HAVEN'T SCOMBEXPANDED MED
AND THERE'S RECENT CHALLENGES
WHERE THERE'S BEEN IMPACT ON
DESCRIBING COMMUNITIES AND WHAT
TO FOCUS ON.
THAT'S BEEN ANOTHER CHALLENGE
AND ANOTHER ONE I WOULD SAY IS
MEETING DIVERSITY AND WE EMBRACE
DIVERSITY AND LOVE OUR
COMMUNITIES AND THEY'RE
DIFFERENT AND HAVE COMMONALITIES
BUT IT'S A CHALLENGE TO MEET
THOSE DIFFERENT NEEDS AND TO
TARGET OR TAILOR OUR APPROACHES
AND INTERVENTIONS BECAUSE WE ARE
RESOURCE FUNDED.
>> WE'RE DOING A LOT OF WITH
SURVEYS AND PARTNERS ACROSS THE
STITE.
SOME THEMES COMING UP FOR WOMEN
AND WHAT THEY'RE NEEDS ARE JUST
THE BASICS BUT THEY WANT TO
PROVIDE AFFORDABLE CHILDCARE AND
JOBS THAT MEET THEIR FAMILY
NEEDS, HEALTH INSURANCE AND
AFFORDABLE HOUSING AS WELL.
AS I MENTIONED, WE'RE A RURAL
AND FRONTIER STATE SO LACK OF
ACCESS TO CARE AFFECTS MANY
COMMUNITIES.
56% OF OUR COUNTIES ARE MATERNAL
CARE DESERTS.
THERE WAS A LOT OF PINK ON THE
MAP YOU SAW EARLIER WHERE THEY
DON'T HAVE ACCESS TO HOSPITALS,
BIRTHING CENTERS OR OB
PROVIDERS.
LACK OF TRANSPORTATION IS COMMON
IN OURP STA-- OUR STATES AND GO
DESERTS AND WITH DISPARITIES
WITH OUR AMERICAN INDIAN
POPULATION AS FAR AS MATERNITY
MORTALITY SINCE COVID OUR RATES
HAVE JUMPED.
THEY ARE FIVE TIMES HIGHER IN
OUR STATE THAN IN WHITE WOMEN
AND THERE'S PROTECTIVE CULTURAL
PRACTICES THAT CONTRIBUTED TO
THEIR RESILIENCY EVEN THROUGH
HISTORICAL TRAUMA AND THROUGH
HARMFUL POLICIES.
JUST THINKING HOW TO BRING THAT
CULTURAL PRACTICE BACK INTO
PUBLIC HEALTH AND HEALTH CARE IS
A BIG NEED AND CHALLENGE FOR US.
>> WONDERFUL.
>> I GUESS TO COME WHERE SHE
LEFT IT WHAT IS A CHALLENGE IS
OUR RESEARCH AND I'VE BEEN
TRAINING THIS WAY AND ALWAYS
HAVE TO UNTRAIN BUT IT'S STILL
FROM THE WESTERNIZED FRAMEWORKS
AND CONCEPTUAL MODELS, I EVEN
NOTICE WHEN ON CERTAIN THINGS
WHERE WE ARE TESTING A WHOLE
FRAMEWORK AND CHOOSING WHO TO GO
TO AND I THINK, IT DOESN'T FIT
WITH THE COMMUNITY BUT HOW DO
YOU OVERCOME THAT?
I'M NOT SURE HOW YOU NAVIGATE
THAT BUT IT'S WHERE THINGS ARE
THERE AND YOU MAY NOT KNOW THE
HISTORY AND IT MIGHT BE HARMFUL
OR I MAY BE OVERLY SENSITIVE.
I DON'T KNOW BUT I THINK IT'S
JUST BECAUSE THERE'S TWO
DIFFERENT WORLDS THAT WE'RE
SAYING WE WANT TO UPLIFT AND
RESPECT THIS OTHER ONE BUT STILL
OPERATING IN THIS ONE.
I THINK THAT'S A CHALLENGE.
>> I HAVE SOMETHING ELSE THAT I
MENTIONED EARLIER.
I WANT TO HOLD SPACE FOR THE
IMPACT OF THE CLIMATE CRISIS IN
THE SOUTH.
A LOT OF TIMES WE FIND THE CARE
IS SOMETHING OUR COMMUNITIES
FACE AND IT'S OFTEN TIMES
IMPACTED BY DISRUPTION OF CARE
AND LIKE THE RISE AND
EXACERBATION OF MATERNAL HEALTH
INEQUITIES WE'RE SEEING.
I WANTED TO HOLD SPACE FOR
ACKNOWLEDGING THE CLIMATE CRISIS
AS WELL.
>> THANK YOU SO MUCH.
SO ANOTHER QUESTION OR CHALLENGE
WE KNOW COLLABORATION WITH
COMMUNITY PARTNERS CAN BE
COMPLEX ESPECIALLY WHEN
HISTORICAL MISTRUST IS INVOLVED
AND YOU MENTIONED THAT.
SO WHAT HAVE YOU LEARNED ABOUT
BUILDING TRUST AND ENSURING
ACCOUNTABILITY WITH THE
COMMUNITIES THAT YOU SERVE?
>> I'VE NOTICED WE HAVE DONE A
GOOD JOB IN THE PROJECTS I'VE
BEEN INVOLVED IS BRINGING IN
COMMUNITY MEMBERS AND PAYING
THEM TO BE THERE.
THAT'S BEEN A HUGE THING.
BRINGING THEM IN AT THE
BEGINNING AND NOT AT THE END BUT
BUILDING THE SUSTAINABLE
RELATIONSHIPS THAT LAST NOT JUST
FOR THIS GRANT CYCLE BUT A LIFE
TIME RELATIONSHIP THAT YOU HAVE
AND ALSO MAKING THOSE
CONNECTIONS WITH COMMUNITY
MEMBERS AND ALSO BUILDING THEM
UP AND SEEING WHAT ARE YOUR
GOALS FOR YOURSELF AND HOW CAN
WE GET YOU THERE.
>> WHAT I WAS TALKING ABOUT
EARLIER IN DEVELOPING
RELATIONSHIPS EARLY ON, I THINK
WE ENGAGED OUR COMMUNITY
PARTNERS IN THE GRANT WRITING
PROCESS AS WELL.
THEIR NEEDS ARE REFLECTED IN THE
ACTUAL PROJECT WE WORK ON
TOGETHER AND WITH THE COMMUNITY
PARTNER CORE WE'RE FOSTERING
INTERNAL RELATIONSHIPS AND WE
ARE ABLE TO SHARE EACH OTHER'S
EVENTS HAPPENING AND ENSURING
WE'RE SHARING THEM WITH THE
CENTER AS WELL.
THEY'RE NOT ONLY SHOWING UP AND
ABLE TO PROVIDE TO OUR PROJECTS
BUT WE'RE ALSO SHOWING UP IN
THEIR COMMUNITIES AND GIVING
BACK AND LEARNING MORE ABOUT
THEM AS WELL.
I THINK IT'S TRULY INTENTIONAL
RELATIONSHIP BUILDING IS KEY IN
HEADLINING SPACE FOR THEM AS
EXPERTS AND PAYING THEM WELL AS
EXPERTS AS WELL.
THEY KNOW WHAT THEIR LIVED
EXPERIENCES ARE.
THEY KNOW WHAT THEIR COMMUNITIES
ARE EXPERIENCING.
I FEEL RESEARCH WON'T BE
IMPACTFUL IF IT'S NOT
INCORPORATING COMMUNITY VOICES.
I WOULD ECHO AND HAVE BEEN
HUMBLED JUST IN MY LEARNING IN
THIS SPACE AND TAKING AWAY I
NEED TO THROW AWAY MY TIME LINE
AND AGENDA FOR WHAT I THINK
NEEDS TO HAPPEN AND LISTEN MORE
THAN I SPEAK.
BUILDING TRUST IS GOING TO TAKE
TIME BUT YOU HAVE TO KEEP
SHOWING UP, BEING PRESENT,
HAVING AN OPEN MIND SET AND
ALWAYS WILLING TO LEARN AND
KNOWING THE RELATIONSHIP
BUILDING IS REALLY THE MOST
IMPORTANT PART OF YOUR WORK.
FORGET ABOUT THE OUTCOMES AND
JUST WORK ON THE RELATIONSHIP.
>> I AGREE WITH ALL THE COMMENTS
AND JUST A COUPLE THINGS TO ADD
SO THAT STARTING WITH THE TRUST
OF PEOPLE WITHIN THE COMMUNITY
AND DOING WHAT YOU SAY YOU'RE
GOING TO DO.
THAT'S BEEN BIG.
AND WHEN WE CAN'T, BEING
TRANSPARENT ABOUT WHY WHAT WENT
WRONG AND THERE ARE THINGS WE
HAVE TO HAVE HOOPS TO JUMP
THROUGH AND BEING TRANSPARENT
AND ASKING THEM, OKAY, WE DIDN'T
DO THIS, HERE'S WHY, CAN YOU
HELP US FIND A SOLUTION SO WE
CAN MAINTAIN AND BUILD ON THE
TRUST AND LIVING LIFE TOGETHER
NOT JUST THE PROJECT BUT BEING
INTENTIONAL AND IT'S BEEN HUGE
FOR US AND REMEMBERING, HONORING
AND EMBRACING OUR HUMANNESS.
SOMETIMES WE FORGET OR FEEL WE
CONSEQUENT BE HUMAN WITH ONE
ANOTHER AND BRINGING CIVILITY
BACK AND HAVE DIFFERENT IDEAS
AND APPROACHES AND STILL WORK
TOGETHER AND ACTIVE LISTENING
AND TAKING ACTION THAT REFLECTS
VOICES IS ANOTHER.
>> I WANT TO NOTE TOWARDS THE
END OF THE SESSION WE'LL TAKE
QUESTIONS FROM THE AUDIENCE IN
PERSON AND ONLINE.
WHILE WE WE ARE SPEAKING THERE
WERE LETS OF APPLAUSE AND RED
HEARTS ON THE ZOOM SCREEN.
I WANT YOU TO KNOW AND ALSO
ONLINE JUST USING THE Q&A BOX
AND WE'LL BE TAKING THOSE
QUESTIONS TOWARDS THE END OF THE
SESSION AS WELL.
YOU GUYS TOUCHED ON THIS A
LITTLE BIT WHEN YOU TALKED ABOUT
THE FRAMEWORKS FOR RESEARCH NOT
MATCHING THE CULTURAL NEEDS OF
THE COMMUNITY.
WHAT ARE SOME OF THE BIGGEST
BARRIER AND HOW DO YOU PROPOSE
TO OVERCOME THEM?
>> ONE OF OUR BIGGEST BARRIERS
IS OUR OWN INSTITUTION POLICIES.
SO THAT'S BEEN SOMETHING WE'VE
HAD TO HAVE LOTS OF PATIENCE AND
CONVERSATION.
AN EXAMPLE HAS BEEN PAIN
PROVIDING STIPENDS FOR COMMUNITY
MEMBERS ENGAGED IN THE RESEARCH.
IN OUR STATE THERE'S CERTAIN
INSTITUTIONS WHO WANT A SOCIAL
SECURITY FOR PAYMENT AND IF NOT
WE HAVE TO FACTOR IN THE TAX
RATE.
THAT'S BEEN A BIG BARRIER WITHIN
OUR PROJECT THEY PUT TOGETHER A
PANEL FOR US TO PROVIDE US SOME
FEEDBACK AND SOME IDEAS HOW TO
ADDRESS THAT.
WE DON'T HAVE A COMPLETE
RESOLUTION BUT WE CONTINUE TO
HAVE THE CONVERSATIONS BUT
THAT'S PROBABLY BEEN ONE OF OUR
BIGGEST CHALLENGES OR
OPPORTUNITIES FOR GROWTH AND OUR
DIVERSE NEEDS ACROSS OUR
POPULATION.
EVEN WITHIN OUR SIX COUNTIES
THERE'S DIFFERENT NEEDS.
SO TRYING TO FIGURE OUT HOW TO
DO THAT AND WHAT WE COME TO IS
ENGAGING, ASKING OUR COMMUNITIES
WHAT SHOULD WE DO AND REALLY
EMBRACING THEIR EXPERTNESS --
IS THAT A WORD?
EXPERTISE ABOUT THEIR OWN
COMMUNITIES.
>> I THINK EARLY ON WE HAD A
CENTER KICK OFF WE WERE ABLE TO
BRING IN COMMUNITY PARTNERS AND
HAVE COMMUNITY PARTNERS PRESENT
ON WHAT IT MEANS TO HAVE
COMMUNITY-ENGAGED RESEARCH AND
WE IMMEDIATELY SAW THE
DIFFERENCES IN CAPACITY WHEN IT
COMES TO LINKAGE WITH COMMUNITY.
IN MY ROLE I HOLD SPACE TO HEAR
FROM COMMUNITY PARTNERS WHAT
THEIR EXPERIENCE HAS BEEN TO
GIVE THEM SPACE TO VOICE THE
EXACT THINGS THEY'VE
EXPERIENCED.
I THINK IT'S INEVITABLE IT'S
GOING TO HAPPEN.
SOME HARM MAY HAPPEN
UNINTENTIONALLY BUT WE'RE TRYING
TO BE AS PROACTIVE AS POSSIBLE.
SO HOLDING SPACE, MELISSA AND I
WERE CO-LEADS AND HOLD OFFICE
HOURS EACH MONTH IN ADDITION TO
MONTHLY MEETINGS AND SURVEYS AND
THERE'S ALWAYS A SPACE TO
REFLECT ON THE GOOD AND BAD OR
CHALLENGES THAT MAY ARISE AND
TRY TO HOLD A LOT OF SPACE FOR
THAT.
ALSO WITHIN NEW ORLEANS A LOT OF
FOLKS ARE ENGAGED AND END UP
PART OF A LOT OF RESEARCH.
WE TRIED TO PROVIDE DIFFERENT
LEVELS OF ENGAGEMENT FOR
COMMUNITY PARTNERS TO BE
INVOLVED IN AND HAVE AN ACTION
COMMITTEE AND ADVISORY BOARD AND
IT CAN BE MORE INVOLVED MONTHLY
AND AS MUCH AS THEY WANT WHEREAS
THE BOARD MY MAY NOT CONTRIBUTE
AND DIFFERENT LEVELS OF
ENGAGEMENT AND UNDERSTAND WE
ALSO DON'T WANT THESE FOLKS TO
BURN OUT.
WE HAVE DATA SHARING AND
MODERNIZATION AND THERE'S WORK
IN MATERNAL HEALTH SPACE BUT
THERE'S A LACK OF DATA SHARING
BETWEEN EVEN SOME OF MY OWN
PROGRAMS OR STATE AGENCIES
BETWEEN STATE AND TRIBAL
PARTNERS AND WITH TRIBES WE HAVE
INTENTIONAL ABOUT THIS OVER THE
PAST FEW YEARS TO LOOK AT WHAT
DATA SHARING MEANS AND NOT TO
HOLD ON TO THE DATA BUT GIVE IT
BACK TO THE COMMUNITIES.
THEY'RE THE OWNERS OF IT AND HOW
DO WE CONTINUE TO HAVE THAT MIND
SET AND LOOKING TOWARDS DATA
MODERNIZATION.
I THINK WE'RE JUST LOOKING AT
HOW DATA ACROSS OUR PROGRAMS CAN
BE CAPTURED AND USED SOME BIG
DATA ANALYTICS TO LOOK AT
COMMUNITY HEALTH-BASED NEEDS AS
WELL.
THERE'S POTENTIAL WORK WITH OUR
COLLEAGUES FROM THEIR RESEARCH
TO SET UP SOME SYSTEMS THAT CAN
UTILIZE PUBLIC HEALTH AND HEALTH
CARE DATA TO GET THE PICTURE OF
MATERNAL HEALTH IN OUR STATE.
>> VERY SIMILAR.
TRYING TO GET PEOPLE PAID.
EVEN MYSELF ON THE UNIVERSITY
SIDE, WE WERE ON A PCORI GRANT
AND I DIDN'T GET PAID UNTIL THE
END WHICH WAS TWO YEARS LATER.
THERE'S A LOT OF RED TAPE AND
EVEN WORSE WHEN THERE'S SOMEBODY
FROM THE OUTSIDE.
WE HAVE FOLKS WORKING ON THAT
AND MY HEART GOES OUT FOR HOW
THEY FIGURE OUT THOSE
JUSTIFICATION CHANGES AND THINGS
LIKE THAT.
I ALSO YOU WERE TALKING ABOUT
THE DIFFERENT FRAME WORKS AND
METHODS.
WE'RE WORKING ON OUR NEEDS
ASSESSMENT AND LOOKING AT THE
VERIFIED SCALES AND
DISCRIMINATION AND HOW WE
MEASURE THAT AND WHICH IT MIGHT
BE A WHOLE DIFFERENT LAYER.
MAYBE WE NEED TO LOOK AT
HISTORICAL TRAUMA OR THE RIGHT
WAY TO COLLECT THE DATA FROM
PEOPLE.
I JUST THINK ABOUT CAUSING MORE
HARM AND I THINK HOW THIS MIGHT
GO DOWN AND ARE THEY GOING TO
WONDER WE'RE GOING TO TAKE THEIR
KIDS FROM THEM.
THERE'S A LOT OF DIFFERENT
THINGS THAT COULD BE TRIGGERS
AND CAUSE THESE MOMS ARE
STRESSED ALREADY DUE TO LACK OF
ACCESS IN A LOT OF DIFFERENT
THINGS.
AND BEING A PART OF THE SOLUTION
RATHER THAN THE PROBLEM A LOT OF
TIMES I THINK ABOUT HOW THE DATA
IS SACRED AND IT DEPENDS ON THE
DATA HOW THE STORY IS TOLD AND
WE HAVE POWER ON THE UNIVERSITY
SIDE.
A LOT OF THE PROJECTS I'VE BEEN
INVOLVED WITH HAVE DONE A GOOD
JOB WORKING WITH TRIBES AND
MAKING THEY'RE THE AUTHORS ON
THE PAPERS AND THEY'RE THE
OWNERS OF THE DATA AND DATA
SHARING DOES HELP BUT THERE'S A
LOT OF ISSUES IN YOU'RE STATE
WHERE THE STATE WANTS THE TRIBES
TO SHARE THEIR DATA WITH THEM
BUT THEY DON'T WANT TO SHARE THE
OPPOSITE DIRECTION AND I TELL
THEM YOU REALIZE YOU'RE ON A
DIFFERENT HIERARCHY AND THEY
WANT THE DATA.
DATA GENOCIDE IS A REAL THING.
EVEN LOOKING AT PRESENTATIONS,
WE DIDN'T MAKE IT AND IT DOESN'T
HELP OUR COMMUNITIES.
IT DOES WORSE.
BUT I UNDERSTAND WHY THERE'S A
MISTRUST AND IT'S PROPED TO N
NOT -- APPROPRIATE TO NOT WANT
TO BE INVOLVED BECAUSE OF THE
PAST AND IF YOU DO IT IN A GOOD
WAY RELATIONSHIP IS IMPORTANT
BECAUSE YOU'RE MAKING SURE
YOU'RE GIVING THEM DATA THEY CAN
LEVERAGE.
WE SHOULD BE WORKING OURSELVES
OUT OF A JOB EESPECIALLY WORKING
WITH -- ESPECIALLY WORKING WITH
TRIBAL NATIONS BECAUSE THEY CAN
DO THIS DATA ON THEIR OWN BUT
FUNDERS DON'T HAVE THE
CREDIBILITY BECAUSE PROBABLY I
BEING -- I HAVE A FRIEND THAT
WORKS FOR A TRIBE AND THEY CAN
HANDLE AN NIH GRANT BUT THEY
WERE TOLD YOU DIDN'T WRITE THIS.
THERE'S NO WAY.
IT'S THOSE KINDS OF THINGS WHERE
THERE'S STILL STEREOTYPES.
WE HAVE A LOT OF THESE BIASES
AND IT'S BECAUSE OF STORIES AND
BEING CAREFUL IN WHAT YOU
COLLECT.
I WANT TO BUILD CAPACITY AND
WOULD LOVE IT IF THEY NEED ME TO
COME HERE AND TALK TO PEOPLE HOW
DO WE CAPTURE DATA.
I USED TO DO PHONE SURVEYS BACK
IN UNDERGRAD AND IT WAS ELDERS
AND THEY WOULD TELL ME A WHOLE
STORY AND I'D BE LIKE SO YOU
WOULD SAY YOU STRONGLY AGREE?
IT'S A DIFFERENT EXPERIENCE AND
MAYBE THAT SURVEY ISN'T GETTING
WHAT YOU WANT BUT AN EASIER WAY
IN.
YOU THINK OF HOW MANY QUESTIONS
YOU HAVE ON THOSE THINGS TOO AND
CAN YOU REALLY SIT DOWN AND GO
THAT?
THERE HAS TO BE A BALANCE IN
UNDERSTANDING WHAT YOU'RE ASKING
AND WHAT THAT MEANS TO THE
PERSON ON THE OTHER SIDE BECAUSE
YOU MAY BE GETTING SOMETHING
TOTALLY OFF.
>> THANK YOU FOR SHARING THOSE
BARRIERS.
>> YOU CAN'T BE AT NIH AND SAY
IF SOMEONE DOES THAT, THEY NEED
TO REPORT THAT TO THE OFFICE OF
EXTRAMURAL RESEARCH.
THAT IS NOT REFLECTIVE OF THE
STANDARD AT WHICH WE ASSESS
SCIENCE.
AND THAT IS -- THANK YOU FOR
SHARING THAT.
WE NEED TO KNOW THAT BUT I HOPE
YOUR COLLEAGUE REPORTS IT AND
ANYONE ELSE THAT EXPERIENCES
THAT TYPE OF DISCRIMINATION
REPORTS IT BECAUSE THAT'S NOT
THE INTEGRITY WE HOPE TO HAVE IN
OUR SCIENCE.
>> SO IN WORKING WITH COMMUNITY
CAN YOU TELL US HOW YOU MAKE
SURE THAT YOUR TEAM IMPROVEMENT
TRULY UNDERSTAND THE COMMUNITY
YOU SERVE?
HOW DO YOU MAKE SURE THE
COMMUNITY CAN RELATE TO THE
RESEARCH TEAM?
>> I THINK FOR US IS CONTINUING
TO LEARN AND ENGAGE WITH
COMMUNITIES.
IN SOUTH DAKOTA WE JUST HAD OUR
FIRST INDIGENOUS HEALTH SUMMIT
WITH THE COLLABORATION OF THE
DEPARTMENT OF HEALTH AND TRIBAL
HEALTH AND CHAIRMEN.
IT WAS A NICE OPPORTUNITY TO
DISCUSS HOW TO BRING TRADITIONAL
HEALTH PRACTICES BACK INTO
HEALTH CARE AND LOOKING AT DATA
AND NOT ONLY LOOKING AT IT BUT
SHARING THE DATA WITH
COMMUNITIES FOR THEIR INPUT AND
INSIGHT.
JUST ASKING QUESTIONS, DOES THIS
LOOK LIKE YOU'RE COMMUNITY?
IS THIS REPRESENTATIVE MUCH YOUR
COMMUNITY?
DOES THIS ANALYSIS MAKE SENSE?
EVEN STRATIFYING BY RACE IN
REPRESENTING THE DATA.
WE ASK QUESTIONS AROUND THAT AND
ARE WE DOING THE BEST WE CAN?
I DON'T LIKE TO SAY WE CAN'T
SHARE DATA BECAUSE IT'S SMALL
NUMBERS BECAUSE IN SOUTH DAKOTA
EVERYTHING IS A SMALL NUMBER.
WE NEED TO BE MORE CREATIVE AND
INNOVATIVE AND THOUGHTFUL ABOUT
THAT.
I DON'T THINK THERE'S NECESSARY
BAD DATA WE COLLECT.
I THINK WE CAN ALWAYS USE IT
BECAUSE EVERY DATA POINT IS
SOMEONE'S STORY.
SO THOSE ARE SOME WAYS WE REALLY
TRY TO REFLECT THE CULTURE AND
COMMUNITIES IN OUR WORK.
>> AS I MENTIONED EARLIER WITH
OUR CENTER, IT'S AN ACADEMIC
INSTITUTION HEALTH CARE AND
COMMUNITY.
SO THERE'S A FULL TIME PERSON
THAT'S PART OF EVERY COMPONENT
OF THE PROJECT AND BRINGS BACK
THE COMMUNITY PERSPECTIVE AND WE
TRY TO BE REALLY INTENTIONAL
ABOUT BRINGING FOLKS TOGETHER TO
LEARN TOGETHER, TO GROW
RELATIONSHIPS AND LEARN MORE
ABOUT ONE ANOTHER.
IMMEDIATELY AFTER THIS I HAVE TO
FLY OVER TO NEW ORLEANS FOR A
DINNER WE'RE HAVING AND WE'RE
DOING WORKSHOPS TO WORK TOGETHER
IN THOSE SPACES.
SO CONSTANTLY FINDING WAYS TO
WORK WITH ONE ANOTHER AND
REGARDING OUR ACTION COMMITTEE
AND ADVISORY BOARD, THEY'RE
PAIRED DELIVERY RESEARCH
PROJECTS AND ATTEND ONE OF THE
MEETINGS EVERY MONTH AND ATTEND
A MEETING WITH MELISSA AND I AND
ARE ABLE TO ATTEND CENTER WIDE
MEETINGS AND DEEPLY ENGAGED IN
DIFFERENT WAYS AND ONE OF OUR
AIMS IS TO CREATE A RESEARCH
TRAINING LABORATORY WHERE
THEY'LL BE TRAINING THEMSELVES
AND THE CENTER STAFF AND NEARBY
RESEARCHERS CAN CONTRIBUTE AND
LEARN DIRECTLY FROM THEIR
EXPERIENCES, THEIR EXPERTISE AND
LIVED EXPERIENCE OF THE
COMMUNITIES THEY'RE A PART OF
AND ON TOP OF THAT, WE HAVE A
TRAINING CORE FOR SCHOLARS
HOWEVER, WE PROVIDE A TRAINING
TO PROVIDE THE TYPES OF TRAINING
THEY WANT TO LEARN AS WELL.
THERE'S SO MUCH SPACE AND
OPPORTUNITY TO ENGAGE THEM
WHETHER IT'S IN GROUP SETTINGS
AND WORKSHOPS WE'RE HAVING AND
ENSURING WE'RE ATTENDING THEIR
SUMMITS AND CONFERENCES AND
COMMUNITY EVENTS.
THERE'S SO MANY OPPORTUNITIES WE
TRY TO PROVIDE TO REALLY GET TO
KNOW ONE ANOTHER AND NOT JUST BE
THIS BI-DIRECTIONAL STRICT
RELATIONSHIP OF ONLY RESEARCH
SETTINGS ONLY.
WE WANT TO GET TO KNOW THE HEAR
THEIR STORIES AND GETTING TO
KNOW ONE ANOTHER AND PROVIDING
SPACE FOR THAT.
>> SO, WE PARTNERED WITH A BOARD
AND THE TRIBAL CENTER AND SO
THEY SERVE THE 43 FEDERALLY
RECOGNIZED TRIBES ACROSS
OKLAHOMA AND TEXAS AND KANSAS.
ALL THE SERVICE UNITS HAVE
REPRESENTATION ON THEIR
EXECUTIVE BOARD THAT MEANS THEY
COULD BE A TRIBAL HEALTH CENTER
TAKING OVER SERVICES OR IHS.
MY TRIBE HASN'T.
ADVISORY BOARD MEMBERS ARE ON
THAT COMMITTEE FOR THE CLINIC.
SO WE RELY LEVEL ON COMMUNITY
PARTNERS, GETTING PEOPLE ON
BOARD AND HOW DO YOU DO THAT AND
YOU TAKE UP YOUR TIME.
JUST BEING IN COMMUNITY MAKING
SURE WE'RE SEEN AT THEIR EVENTS
AND I BELIEVE THERE'S PLANS WE
WORK WITH THE TRIBES.
A LOT OF THINGS GO UNDER THE
SUMMER.
THEIR FESTIVALS AND THINGS LIKE
THAT.
THERE'S A LOT GOING ON ACROSS
THE WHOLE ENTIRE STATE WHEN IT
COMES TO THOSE THINGS AND SOME
MAKE THE JOURNEY ALL THE WAY
BACK HOME AND MAKING SURE
THEY'RE SEEN AND KNOWN AND THEY
HAVE AN ANNUAL TRIBAL HEALTH
CONFERENCE WHICH HAS GROWN
TREMENDOUSLY.
LAST I CHECKED THEY TRY TO USE
TRIBAL FACILITY TO HOST THE
CONFERENCES BUT LAST I HEARD
IT'S GROWN SO MUCH THEY MIGHT
HAVE TO CONSIDER GOING OUTSIDE
AND WHAT DO WE DO?
DO WE CONTINUE TO GROW IT AND GO
OUTSIDE THE FACILITIES OR KEEP
IT SMALL AND MAKE SURE WE'RE
SUPPORTING THE TRIBES IN THAT
WAY.
SO THAT HAS BEEN A BIG THING.
I BELIEVE WE HAD A BOOST AT THE
LAST TRIBAL PUBLIC HEALTH
CONFERENCE AND MAY HAVE BEEN A
TALK THERE TO INTRODUCE THE
PROJECT AND GET MORE INPUT AND
SET UP MEETINGS AND THINGS LIKE
THAT AND WE PARTNER WITH OSU,
OKLAHOMA STATE UNIVERSITY, THEY
HAVE A MEDICAL SCHOOL PARTNERED
WITH CHEROKEE NATION.
THEY HAVE ONE OF THE FOUR
BIRTHING FACILITIES AND HAVE A
MEDICAL SCHOOL THERE AND THERE'S
A PARTNERSHIP WITH THEM AS WELL.
MAKING SURE WE BRING OR MAYBE WE
JOIN THE TABLE, THE OTHER WAY
AROUND, TO BRING WORK THEY'RE
DOING AND THAT PARTNERSHIP
STARTED EVEN BEFORE THEY APPLIED
FOR FUNDING.
IT'S HUGE EVEN FOR PREVIOUS
STUDY THE FOOD IS MEDICINE STUDY
AND THERE'S BEEN A SUSTAINABLE
RELATIONAL NURTURED AND THIS IS
WHAT WE GOT FROM PCORI WAS THESE
MOMS WERE WANTING AND LOOKING AT
INDIGENOUS BIRTH WORKERS AND HOW
DO WE BRING THAT BACK IN AND
BRING CULTURE INTO IT AND ALSO
ANOTHER THING THAT I GOT TO WRAP
MY MIND AROUND TOO IS WHAT IS
TRADITIONAL FOOD AND HOW DO WE
GET BACK TO THAT?
MAKING SURE WE'RE TAPPED INTO
THAT AND YOU HAVE TO UNDERSTAND
COMMUNITY TO UNDERSTAND WHAT
THAT IS.
MAKING SURE THAT WE'RE TALKING
TO THE FOLKS THAT ACTUALLY HAVE
THAT KNOWLEDGE AND CAN BE --
EVEN WITH FAP THEY BROUGHT IN
WILD RICE BUT WE DIDN'T EAT WILD
RICE THE CLIENTS DIDN'T KNOW
WHAT TO DO WITH THAT.
UNDERSTANDING WE DIDN'T EAT ALL
THAT AND WE HAVE TO TAILOR OR
LET THE COMMUNITY TAKE THE LEAD
IN DECIDE AND TELL US WHAT DOES
THAT LOOK LIKE.
>> JUST A FEW OTHER THINGS WE'VE
DONE.
OUR COMMUNITY COALITION MEMBERS
ARE FROM THE AREAS INVOLVED IN
THE PROJECT.
INTENTIONALITY AND ASKING WHO IS
NOT THERE THAT SHOULD BE.
SO WE'VE GROWN OVER THE LAST
YEARS AND CONTINUALLY ADDED
MEMBERS TO THE COALITION AND
EMBRACING WITH EXPERIENCE AND
BEING FLUID AND ADAPTABLE AND
EMBRACING AND LOOK FOR CHANGE
AND THE CONCEPT OF ENLIGHTENED
SELF-INTEREST.
IT'S OKAY TO GET SOMETHING OUT
OF THIS AND ACKNOWLEDGING THAT
IN ALL OF OUR MEETINGS TO SAY
HOW CAN WE -- WHAT ARE NEEDS YOU
HAVE AND HOW CAN WE MEET THE
NEEDS NOT MAKING IT ALL ABOUT
THE PROJECT AND SOMETHING ELSE
OUR WONDERFUL PRINCIPLE
INVESTIGATOR HAS DONE IS CALL
PEOPLE JUST TO CALL THEM AND SAY
HEY, HOW'S IT GOING.
SHE DOES THAT VERY WELL.
NOT ONLY REACHING OUT TO PEOPLE
WHEN YOU HAVE A PROJECT NEED BUT
AGAIN BUILDING THAT COMMUNITY
AND THOSE RELATIONSHIPS.
THOSE ARE A FEW THINGS WE'VE
DONE.
>> I WANT TO ANSWER THAT TOO
BECAUSE IT'S SO IMPORTANT AND
SOMETHING THAT'S WORKED IS WE
CREATED A WHAT'S APP GROUP FOR
THE COMMUNITY PARTNERS.
THEY'RE ABLE TO SHOW WHAT
EXPERIENCES ARE GOING TO ON OR
CELEBRATIONS OF A BIRTHING STORY
OR ANY CHALLENGES SUPPORTING ONE
ANOTHER AND CHECKING IN DURING A
STORM.
I THINK HAS THAT PROVIDED SPACE
TO MAKE FRIENDS AND GET EXCITED
DO SEE ONE ANOTHER AND THE FOLKS
WE HAVE ON THE PROJECT ARE
REALLY ENGAGED AN PASSIONATE AND
BEING ABLE TO SHARE JOINT
PROJECTS FOR EXAMPLE WE HAVE
ROBERTSON AND OTHERS DOING
POLICY IN LOUISIANA AND HAVING
FOLKS SHOW UP AND THAT IS KEY.
>> I WANT TO INVITE OUR ONLINE
PARTICIPANTS TO PUT THEIR
QUESTIONS IN THE Q&A BOX SO THEY
DON'T GET LOST AND WE WON'T BE
ABLE TO MONITOR THAT AND ASK
QUESTIONS IN THE ROOM AND FOLKS
IN THE ROOM TO COME UP TO THE
MICROPHONE.
WE INVITE YOU TO ASK QUESTIONS
OF OUR PANELISTS OR GIVE
COMMENTS TO SHARE WITH THE
PANELISTS AS WE CONTINUE WITH
THIS SESSION.
THERE WAS ONE QUESTION IN THE
CHAT OR COMMENT I'M GOING TO
READ.
I JUST LOST IT A LITTLE BIT.
THE CLIMATE CRISIS IS A MASSIVE
EMERGING ISSUE.
SEVERAL OBSERVATIONAL DATA
DEMONSTRATE THE EXTREME HEAT IN
PREGNANCY HAVE ADVERSE EFFECTS
ON HYPERTENSION AND OTHER APOs.
THERE'S AN URGENT NEED FOR
PROSPECTIVE DATA.
THIS IS AN ISSUE IN THE USA AND
GLOBALLY.
THANK YOU FOR SHARING THAT
COMMENT.
>> I'M FROM WILL MILWAUKEE.
WE'RE OVER HERE NODDING LIKE
CRAZY.
I WAS REFERENCED DURING YOUR
DISCUSSION BUT FOUND WITHIN OUR
PARTNERSHIPS WE HAVE BEEN GIVEN
TREMENDOUS SUPPORT BY LEADERS IN
ACADEMIA AND COMMUNITY SETTINGS
TO PUT THE TIME IN REQUIRED.
YOU'RE TALKING ABOUT SO MANY
THINGS THAT ARE BUILDING
RELATIONSHIPS GETTING TO KNOW
EACH OTHER AND BREAKING BREAD
TOGETHER.
HOW HAS LEADERSHIP HELPED
SUPPORT OR ARE THERE
OPPORTUNITIES TO IMPROVE HOW
LEADERSHIP COULD BE SUPPORTING
THE TIME NEEDED TO FORM GENUINE
PARTNERSHIPS?
I FIND OUR EXPERIENCES ARE THE
EXCEPTION NOT THE NORM
SOMETIMES.
>> THANK YOU.
INVITING THEM TO COME TO YOUR
MEETINGS I THINK IS ONE WAY TO
DO THAT.
SO JUST INVITING THEM TO COME IN
AND BE THERE AND I THINK TO
BEING THEIR OWN BEST ADVOCATES
FOR THAT AND MAKING SURE WE ARE
COLLECTING THE DATA THAT
DEMONSTRATES THAT AND HOW MANY
PHONE CALLS AND SOMETIMES THE
REALITY IS MEMBERS SPEAK.
UNDERSTANDING WHO YOUR LEADERS
ARE, HOW DO THEY LEARN AND
RECEIVE INFORMATION, WHAT DO
THEY NEED IN ORDER TO UNDERSTAND
THE TIMING THAT IT TALKS BUT I
THINK JUST INVITING PEOPLE TO
THE TABLE SOMETIMES WE THINK
THEY'RE SO BUSY THEY WON'T COME
BUT LET'S ASK THEM AND IF THEY
DON'T COME THEN THAT'S ON THEM
BUT JUST ASKING PEOPLE TO COME
WILL GO A LONG WAY WITH THAT.
>> JUST SPEAK CLOSELY TO THE
MIKE.
THEY'RE HAVING TROUBLE ON THE
ZOOM SO WHEN YOU USE THE
MICROPHONES TALK LOUDER OR
CLOSER TO THE MICROPHONES.
>> ONE IS A COMMUNITY
ORGANIZERS.
PART OF LEADERSHIP IS COMMUNITY
AND I THINK THAT'S VERY CRUCIAL.
I THINK JUST HOLDING SPACE FOR
ALLOWING COMMUNITY TO PROVIDE
THEIR FEEDBACK AS WELL IS A
GREAT WAY TO LEARN HOW TO SHOW
UP AND DO BETTER AT INTEGRATING
THEM.
>> THANK YOU VERY MUCH.
>> HI, I'M JULIE WILLIAMSON.
I WAS LUCKY TO BE PART OF THE
RADX TECH CHALLENGE WHERE I GOT
TO BE PART OF THE INNOVATORS.
ONE OF THE INNOVATION BRINGS TO
YOUR MIND DIGITAL HEALTH
TECHNOLOGY ALL THIS KIND OF
STUFF.
YET A LOT OF COMMUNITIES THAT
WE'RE TRYING TO REACH MAY OR MAY
NOT BE TECH FRIENDLY OR TECH
SAVVY WAS AN ASSUMPTION AND FROM
YOUR POINT OF VIEW REACHING BE
OUT TO THE COMMUNITIES YOUR
TRYING TO GET OUT TO WHERE DOES
THE DIGITAL HEALTH TECHNOLOGY
COME INTO PLAY AND I ENJOY THE
PANEL.
THANK YOU.
>> THAT'S ONE OF OUR QUESTIONS
WE ASKED OUR FOCUS GROUPS IS THE
QUESTION ABOUT TECHNOLOGY.
WHAT WE ARE FINDING IS WITH ALL
OF OUR COMMUNITIES THEY HAVE
CELL PHONES AND SMART PHONES AND
THEY MAY NOT HAVE BROADBAND
SERVICE AT THEIR HOUSE.
IN FACT THEY PROBABLY DON'T AND
MAY NOT HAVE PERSONAL COMPUTERS
BUT HAVE THEIR CELL PHONE.
THAT'S SOMETHING WE'RE LEARNING.
SMART DEVICES, NOT AS MUCH
BECAUSE THEY'RE EXPENSIVE.
BUT CERTAINLY CELL PHONES I
THINK ANY TECHNOLOGY THAT CAN BE
TIED TO CELL PHONES AND THEY
SEEM VERY OPEN AND WE'VE ALSO
FOUND WE ASKED WHAT APPS DO YOU
USE AND A LOT OF OUR EXPECTANT
MOMS USE THOSE APPS AND POST
DELIVERY AS WELL.
FOUR OUR COMMUNITIES I THINK ONE
FOCUS GROUP WE CAME ACROSS ONE
PARTICIPANT WHO DIDN'T HAVE A
PHONE BUT ALMOST EVERYONE HAS
ONE AND KNOWS HOW TO USE IT.
>> SO, FOR OUR SECOND RESEARCH
PROJECT IS ABOUT THE CONNECTED
MOMS PROJECT BASICALLY IN NEW
ORLEANS FOR BLOOD PRESSURE
MONITORING.
WE'RE TRYING TO EXPAND IT WITHIN
NORTHERN LOUISIANA WHICH IS
SHREVEPORT AND MONROE AND WE'RE
FINDING WAYS TO SUPPORT
BROADBAND AND THAT'S BEEN
BENEFICIAL AND ASKING QUESTIONS
NOT ONLY OF THE PROVIDERS BUT
THE COMMUNITY AND HEARING ABOUT
THEIR DIRECT EXPERIENCES AND THE
WAY IN WHICH THIGH MAY UTILIZE
THE CELL PHONE OR WHERE TO GET
ACCESS AND HOW TO FIND AREAS
WITH WI-FI.
THAT'S ONE OF THE PROJECTS WHERE
WE'VE BEEN TRYING TO FIGURE OUT
THE BEST WAY TO INNOVATE DIGITAL
HEALTH AND FIND WAYS TO EXPAND
IT.
>> ONLINE WE HAVE TO THE SPEAKER
WHO WORKS WITH COMMUNITY HEALTH
WORKERS TO WHY IMPROVE MATERNAL
HEALTH.
I'D LOVE TO HEAR MORE ABOUT THAT
PROGRAM AND THE FUNDING SOURCE
THAT FEEDS THE EHWs.
>> LET ME MAKE SURE I'M
UNDERSTANDING THE QUESTION.
SO SO FROM THIS PARTICULAR
PROJECT WE DO HAVE COMMUNITY
HEALTH WORKERS AS PART OF OUR
PROJECT TEAM AND THEIR ROLE IS
TO WORK ON THE PROJECT ENGAGE.
TEXAS IS IS ONE OF THE STATES
THAT HAS CERTIFICATION OF
COMMUNITY HEALTH WORKERS AND HAS
SINCE THE LEGISLATION ENACTED
FROM 1999 AND 2001 THE PROGRAM
STARTED.
SO IN TEXAS THE WORK IS YOU'RE
SUPPOSED FOR CERTIFIED AND
THERE'S 7,000 COMMUNITY HEALTH
WORKERS IN TEXAS.
TO FUND THE PROGRAMS THERE'S
BEEN GRANT FUNDS AND OUR
CHALLENGE IN WEST TEXAS RURAL
AREAS IS THE MODEL HE'S NOT BEEN
AS COMMON.
FOR EXAMPLE I'VE LIVED IN SOUTH
TEXAS AND THAT MODEL IS VERY
COMMON.
SO THERE'S A LOT OF HEALTH
WORKERS.
WOE DON'T HAVE TO EXPLAIN TO
EMPLOYEES THE BENEFIT OF THAT.
OUR CHALLENGE IN THE PAN HANDAL
IN WEST TEXAS WITH EL PASO THEY
DON'T CONSIDER THEMSELVES WEST
TEXAS AND THE CHALLENGE FOR US
IS WE HAVE ASKED OUR FOCUS
GROUPS OUR PRIORITY POPULATION,
HEY, HAVE YOU HEARD OF COMMUNITY
HEALTH WORKERS AND THEY SAY NO
AND WE EXPLAIN WHAT IT IS.
THAT WOULD BE GREAT.
SOMEONE TO WORK ALONGSIDE ME AND
SOMEONE WHO SPEAKS MY LANGUAGE
AND IS MY NEIGHBOR?
THAT WOULD BE AMAZING.
THERE IS THIS IDEA THIS IS A
GREAT MODEL THAT OUR MAMAS WOULD
REALLY EMBRACE.
AND WHAT WE HAVE FIGURING OUT IN
HOW DO YOU PAY FOR IT IS HOW DO
YOU EXPAND THAT AND HAVE OTHER
PROJECTS WE'RE PILOT TESTING TO
FIGURE THAT OUT.
ONE WAY IS THERE ARE MANY STATES
WHO WORKED WITH HEALTH WORKERS
AND TEXAS JUST DID THAT.
THEY'LL BE ABLE TO BE REIMBURSED
FOR MANY SERVICES FOR MATERNAL
CHILD HEALTH AND IN FACT IT'S
ALMOST THE COMMUNITY HEALTH
WORKERS WHO WILL CONTRACT WITH
HMOs TO GET THE REIMBURSEMENT.
THE BOTTOM LINE IS WE HAVE TO
CONTINUOUSLY EDUCATE AND INFORM
AND HAVE DIALOGUE ON WHO
COMMUNITY HEALTH WORKERS ARE BUT
IT ISN'T BE ME.
IT SHOULD BE LED BY COMMUNITY
HEALTH WORKERS THEMSELVES.
AND NOTHING ABOUT US WITHOUT US
IS THEIR MANTRA AND CORE VALUES.
FINDING COMMUNITY HEALTH WORKERS
IN YOUR AREA AND IF YOU DON'T
HAVE ANY, INVITING THEM FROM
EARTH PLACES THAT MAY BE SIMILAR
IN ASKING HOW DO WE START THIS.
I DON'T KNOW IF I CAN QUICKLY
ANSWER THE QUESTION BUT IT IS
GETTING CREATIVE AND STARTING
WITH EDUCATION AND ALSO AT THE
POLICY LEVEL START HAVING THE
CONVERSATIONS AT THE STATE THAT
ARE NOT ALREADY OCCUR AND DRAW
ON EXPERIENCES FROM STATES DOING
THIS FOR A WHILE AND TRAUMA
COMMUNITY.
COMMUNITY HEALTH REPRESENTATIVES
HHS HAS HAD THAT AT A STRONG
LEVEL FOR A LONG TIME SO
EMBRACING THEM TOO.
>> YOU'RE DOING A GREAT JOB IN
WHAT WE CAN BRING.
FROM ALL OF YOU, DO YOU HAVE A
FEELING THE COMMUNITY IS ASKING
FOR SOME MATERNITY METHODOLOGY
TO REACH OUT TO THEM?
IT'S A PATHWAY WE EMBRACE AND
CONTINUE TO WORK IN TRYING TO
REACH THE COMMUNITY IN DOING
DIAGNOSTIC SCREENING.
SEVERAL EDUCATION.
SEVERAL OTHER WAYS IN WHICH WE
CAN REACH OUT TO THEM AND
IMPROVE IN THAT FOR THE SAKE OF
THE SYSTEM.
THANK YOU.
>> I'M NOT SURE THERE'S AN
ALTERNATIVE METHOD.
I THINK OFTEN TIMES WHAT WE HEAR
IS PROVIDING SPACE FOR THEM TO
BE HEARD.
LIKE BASELINE NOT BE RESPECTED
OR LISTENED TO SO THEY'RE
WANTING HELP IN ADDRESSING THAT
IN AND OF ITSELF.
THAT'S BEEN COMING UP A LOT FOR
US.
>> WE PROVIDE MATERNITY CARE AND
WE ARE TRYING TO FIGURE OUT THE
BEST WAY TO IMPLEMENT THIS BIAS
TRAINING AND ALSO HAVE A WARM
COMMUNITY HANDOFF WHICH
TYPICALLY ISN'T DONE.
THAT'S A WAY OF INTEGRATING
TRAINING WITHIN HOSPITAL SYSTEMS
AND INCORPORATING COMMUNITY AND
SUPPORTING PATIENTS THROUGH THAT
PROCESS.
I THINK THAT'S AN INNOVATIVE WAY
IN WHICH WE ARE TRYING TO ENGAGE
COMMUNITY AND GET THEM INVOLVED
AND GET FOLKS THE INFORMATION
THEY NEED.
>> THANK YOU SO MUCH.
UNFORTUNATELY, OR FORTUNATELY,
WE'RE ALMOST AT THE TOP OF THE
HOUR SO WE'RE GOING TO CLOSE.
I WANT TO START BY THANKING ALL
OF OUR PANELISTS.
>> THANK YOU SO MUCH.
I'M WITH A TEAM CONNECTING
COMMUNITY AND MATERNAL HEALTH
CHALLENGE THANK YOU FOR YOUR
COMMUNITY AND SUPPORT.
WHEN WE LOOK AT CENTERING ON THE
COMMUNITIES WE ALL AGREE 80% OF
MATERNAL TOGETHER IS PREVENTIBLE
AND IT'S HARD TO CONVINCE PEOPLE
IT'S A BIG ENOUGH PROBLEM.
SO WHEN YOU ARE IN YOUR
COMMUNITIES, IS THERE CERTAIN
DATA POINTS RELATED TO ECONOMIC
DEVELOPMENT, COST SAVINGS THAT
HAVE REALLY RUNG THE BELL IN
MOVING YOUR PROJECTS FORWARD
LONG TERM?
>> OUT IN TEXAS WE HAVE MATERNAL
MORBIDITY AND MORTALITY RATES,
WHEN YOU TELL THEM THAT, THESE
COUNTIES, WITH -- WE HAVE MAMAS
DYING IT'S ENOUGH TO JUST SAY
THAT AND SOMETIMES -- AND
THEY'RE ALMOST IN SHOCK.
THIS 21st CENTURY HOW IS IT
POSSIBLE WE STILL HAVE MOMS
DYING?
RESTATING THE FACTS -- IT JUST
SEEMS LIKE EVEN THOUGH IT'S OUT
THERE IT'S JUST NOT OUT THERE,
IF THAT MAKES SENSE.
FOR US IT'S REITERATING THIS IS
WHY WE'RE DOING THIS AND ALSO
OH, PEOPLE HAVE TO DRIVE TWO
HOURS TO GIVE BIRTH.
CONSTANTLY KEEPING THAT AND FOR
US IT'S BEEN SAYING IT LIKE IT'S
A PROBLEM AND THEY'RE LIKE WHAT
DO YOU MEAN THAT'S A PROBLEM AND
BE PREPARED WITH THE SPECIFIC
NUMBERS BUT BRINGING IT TO THE
FOREFRONT MORE.
I DON'T HAVE A BETTER ANSWER.
SORRY.
THAT'S KIND OF WHAT'S WORKED FOR
US.
>> IN SOUTH DAKOTA WE WERE
SUCCESSFUL IN GETTING
APPROPRIATIONS FOR STATEWIDE
FUNDING FOR OUR HOME VISITING
PROGRAM.
SOME OF THE STRATEGIES WE USED
YOU'RE ASKING ABOUT A RETURN ON
INVESTMENT WHICH IS ALWAYS HARD
IF YOU DON'T HAVE THE EXPERTISE
IN YOUR STATE BUT SHOWING THE
OUTCOMES THAT ARE HAPPENING
BECAUSE OF HOME VISITING AND
SHOWING THOSE THINGS TIED TO
FINANCIAL PIECES LIKE THE
PERCENT OF MOMS THAT WENT ON TO
HAVE A JOB THAT MET THEIR NEEDS
OR THE PERCENT OF MOMS THAT
COMPLETED THEIR HIGH SCHOOL
DIPLOMA OR WENT ON TO COLLEGE.
SHOWING THOSE OUTCOMES WAS
SUCCESSFUL AND HOW WE FRAMED THE
OUTCOMES I THINK YOU'RE LOOKING
FOR.
>> YOU MENTIONED IRBs,
BUREAUCRACY AND I JUST WANTED TO
TIPS ON HOW DO YOU KEEP
COMMUNITY PARTNERS ENGAGED WHILE
YOU ENGAGE WITH IRB OR THE
PAYMENT PROCESS AND IN TWO YEARS
WE EXPERIENCED THE CHALLENGES
AND YOU SAID YOU DON'T WANT TO
BE EXTRACTIVE AND WE'RE NOT
RECOGNIZING THEIR VALUE AND
CONTRIBUTION.
SO I WOULD BE CURIOUS TO HEAR
FROM THE PANEL HOW DO YOU
BALANCE THOSE THINGS?
>> WITH OUR NEEDS ASSESSMENT WE
HAVE BEEN PARTNERING CLOSELY
WITH OUR TRIBAL CENTER AND OTHER
PANELIST MENTIONED THAT
COLLABORATION.
THAT'S BEEN HELPFUL IN
ESTABLISHING THE RELATIONSHIPS
IF THEY'RE NOT THERE ALREADY.
SO WE DID HAVE A LOT OF SUPPORT
FROM OUR CENTER AND WENT IN WITH
THAT PARTNERSHIP TO THE TRIBES.
WE CONTACTED OUR TRIBES
SEPARATELY AND JUST ASKED IF
THREES WAYS TO PARTNER WITH THEE
NEEDS ASSESSMENT.
WE WENT ONE TRIBE WHERE WE WENT
IN PERSON AND HELD A COMMUNITY
CONVERSATION THAT IS SUCCESSFUL.
I THINK WE GAINED A LOT OF
UNDERSTANDING AND BUILT THAT
RELATIONSHIP AND WE ARE ALSO
WORKING ON THE ANALYSIS BUT LIKE
YOU SAID MAKING SURE THAT THAT'S
GIVING BACK TO THEM AND THE DATA
IS THEIRS AND WE WERE THERE WITH
THEIR COMMUNITY.
I GUESS THAT'S BEEN MY
EXPERIENCE WITH SHARING THAT
BACK AND WORKING WITH THE
EPICENTER TO ESTABLISH THAT
RELATIONSHIP.
>> ONE PRACTICAL THING WE DID
EARLY ON WHILE WAITING FOR THE
IRB, WE HAD BAGS WE PUT IN ABOUT
OUR PROJECT AND OUR PARTNERS
DELIVERED THEM TO ALL OF OUR
COUNTIES IN PERSON TO ENGAGE AND
TO GET TO KNOW THEM AND WE
CONTINUE TO DO THAT.
AND DELIVER THOSE FOR OTHERS IN
THE PROJECT TEAM.
THOSE ARE PRACTICAL THINGS WE
DID CONTINUING TO BUILD
RELATIONSHIP AND DO THE PHONE
CALLS AND E-MAILS AND CHECK IN
WHILE WE ARE WAITING FOR OTHER
THINGS TO MOVE.
>> FOR US IT WAS DIFFERENT
BECAUSE WE WERE INTENTIONAL IN
HAVING THE FUNDS RELATED TO
COMMUNITY COME THROUGH THE
PROJECT AND IT'S NOT REALLY IN
ACADEMIC INSTITUTION SO THERE'S
A DELAY AND IT'S STRAIGHTFORWARD
IN GETTING PAYMENT.
I THINK WE NEED TO BEING
INTENTIONAL ABOUT THAT EARLY ON
AND THINK OF WAYS OUTSIDE OF
ACADEMIC INSTITUTIONS YOU CAN
FUNNEL THOSE FUNDS.
THAT'S AN OPPORTUNITY AS WELL.
>> THANK YOU ALL.
I WANT TO THANK OUR PANELISTS
FOR A GREAT DISCUSSION.
I'M BIAS FOR SURE BUT THAT'S THE
BEST PANEL DISCUSSION THAT I'VE
EVER ATTENDED.
.
THANK YOU ALL AND FOR THE
QUESTIONS.
WE ARE GOING TO TAKE A BREAK NOW
AND PLEASE COME BACK AT 10:40
FOR THE NEXT SESSION PRESENTERS
AND COME BACK THREE MINUTES
BEFORE.
THANK YOU ALL. SESSION CLOSED.
>> I'M KEISHER HYSMITH AND I'M
AND TAMARA LEWIS JOHNSON.
WE'LL ADDRESS THE MENTAL HEALTH
AND SUBSTANCE USE DISORDER
CRISIS.
AND OUR FIRST PANELIST SO BEFORE
I GET STARTED WE'LL HAVE
MULTIPLE GROUPS OR PROJECTS
PRESENT.
WE HAVE FOUR IN THE FIRST
SESSION.
THE FIRST WILL BE THE BUFFALO
PRENATAL NETWORK UNIVERSITY OF
BUFFALO DR. SPERLICH TALKING
ABOUT THE PROGRAM.
>> GREETINGS.
I'M SOW HAPPY TO BE HERE TO
PRESENT INVOLVING THE SURVIVOR
MOMS COMPANION.
I'M THE CO-DEVELOPER OF THE
SURVIVOR MOM'S INTERVENTION AND
CO-FOUNDER OF THE NON-PROFIT
GROWING FORWARD TOGETHER THAT
HOLDS THE LICENSE FROM
UNIVERSITY OF MICHIGAN TO
DISSEMINATE THE SURVIVOR MOM'S
COMPANION AND I WANT TO
ACKNOWLEDGE NOT ALL PREGNANT
PERSONS OR CAREGIVERS IDENTIFY
AS FEMALE.
OUR PARTNERSHIP IN THE SCHOOL OF
SOCIAL WORK AND I'M A FORMER
MID-WIFE AND OUR BUFFALO PRE
NATAL NETWORK.
OUR SOCIAL WORK IS TO THE FIRST
TO EMBRACE A TRAUMA INFORMED
RIGHTS PERSPECTIVE AND IT'S A
VITAL ORGANIZATION IN BUFFALO
THAT PROVIDES HOME VISITING AND
WRAP AROUND SERVICES TO PREGNANT
PEOPLE AND THEIR FAMILIES WHO
BEAR CONSIDERABLE BURDEN OF
POVERTY, ADVERSITY AND
DISPARITIES AND PRIMARILY LIVE
IN THE ZIP CODES IN BUFFALO WITH
THE HIGHEST RATES OF RISK FOR
POOR MATERNAL AND INFANT HEALTH
OUTCOMES.
IN TERMS OF PREVALENCE, IF WE
TAKE ABOUT HEALTH TREATMENT AND
GENDER VIOLENCE WE CAN SAY ONE
IN THREE WOMEN ARE TRAUMA
EXPOSED.
OVER ALL, THE U.S. PREVALENCE,
PTSD PREVALENCE FOR WOMEN IS
JUST UNDER 5% WITH 12% MEETING
THE DIAGNOSIS AT SOME POINT IN
THEIR LIFE TIME.
ABOUT HALF OF WOMEN WITH PTSD
STRUGGLE WITH IT AS A CHRONIC
CONDITION AND KNOW COMORBIDITY
WITH OTHER CHALLENGES LIKE
DEPRESSION AND SUBSTANCE USE AND
DISASSOCIATION AND INTERPERSONAL
SENSITIVITY CAN MAKE IT HARD TO
TREAT.
WE ALSO SEE THAT PTSD IS
ASSOCIATED WITH HIGH MEDICAL
UTILIZATION ON THE ONE HAND BUT
LOW MENTAL HEALTH TREATMENT ON
THE OTHER.
WE KNOW DEALING WITH THE
SYMPTOMS IS ASSOCIATED WITH
MORBIDITY AND EARLY MORTALITY
AND THE RISK IS TWOFOLD FOR
WOMEN.
FOR THOSE WHO EXPERIENCE
SYMPTOMS IT'S NOT PTSD PER SE
THAT SEEMS TO BE INFLUENTIAL BUT
RATHER SPECIFICALLY MALTREATMENT
RELATED PTSD AND THOSE SO
EFFECTED HAVE A 12 FOLD RISK FOR
MEETING THE RISK IN PREGNANCY.
BIRTH RELATED EXPOSURES
INCLUDING PTSD FROM A PREVIOUS
LOSS OR PRIOR MEDICAL TRAUMA OR
HAVING AN INFANT IN THE NICU OR
EXPERIENCING MEDICAL
MALTREATMENT MAY BE VERY
INFLUENTIAL.
PTSD RELATED TO MALTREATMENT AND
COMORBID TREATMENT HAVE CYCLES
AND THERE'S MANY PLACES TO
INTERVENE AND INTERVENING DURING
PREGNANCY WHEN PATIENTS ACCESS
MEDICAL CARE WITH SUCH FREQUENCY
SEEMS OPPORTUNE.
THERE'S MANY MANIFESTATIONS OF
POSTTRAUMATIC DISTRESS IN THE
CHILD BEARING YEAR, LOWER BIRTH
WEIGHT, IMPAIRED GESTATION AND
IMPAIRED MOTHER TO INFANT
BONDING AND POSTPARTUM MENTAL
HEALTH AND IT'S ASSOCIATED WITH
SUBSTANCE USING WHICH CAN LEAD
TO PREMATURITY OR LOW BIRTH
WEIGHT.
WHETHER BY PAST OR CURRENT
TRAUMA, WHAT SEVERAL QUALITATIVE
INVESTIGATIONS HAVE SHOWN IS
PREGNANCY ITSELF IS A TRIGGER
FOR PTSD WITH SOME WOMEN AND MAY
FEEL PREGNANCY IS AN INESCAPABLE
TIME AND MAY STRUGGLE WITH
PREPARING FOR THE ROLE OF
MOTHERHOOD.
WE ALSO KNOW FROM LISTENING TO
WOMEN'S NARRATIVES OF THEIR
EXPERIENCES PRE NATAL CARE CAN
BE A TRIGGER OF POSTTRAUMATIC
STRESS SYMPTOMS BOTH IN THE CASE
OF INTRUSIVE PROCEDURES LIKE
GYNECOLOG
GYNECOLOGICAL EXAMS AND
EXISTENCE WITH WHAT IS AN
INTIMATE AND PERSONAL
EXPERIENCE.
THROW QUALITATIVE RESEARCH BASED
ON NARRATIVES OF 81 WOMEN, WOMEN
TOLD US WHAT THEY WANTED US TO
KNOW ABOUT BEING A TRAUMA
SURVIVOR AND JOURNEY TO
MOTHERHOOD.
THEY WANTED US TO KNOW ABOUT THE
CONSTELLATION OF ISSUES COULD BE
CONCEPTUALIZED AS POSTTRAUMATIC
STRESS AND THERE'S TREATMENT AND
WANTED INFORMATION AND TO LEARN
SKILLS TO MANAGE SYMPTOMS.
THEY ALSO SHARED A DESIRE FOR
INTEGRATED MATERNITY CARE.
WE ALSO KNEW PREGNANT PEOPLE
HAVE MANY COMPETING DEMANDS
DURING THE CHILD BEARING YEARS
AND THE FACT THAT WOMEN GET PTSD
IS STILL NOT WIDELY
ACKNOWLEDGED.
AND PERINATAL HEALTH SYSTEMS
TREAT DEPRESSION WHICH IS GREAT
BUT THERE'S HIGH RATES OF
COMORBIDITY THAT GO UNADDRESSED.
THOUGH THERE ARE SEVERAL
INTERVENTIONS FOR ADDRESSING
PERINATAL DEPRESSION,
INTERVENTIONS TO ADDRESS
PERINATAL PTSD ARE MUCH FEWER.
THEREFORE WE DESIGN THE SURVIVOR
MOMS COMPANION PROVIDING
INFORMATION FOR SURVIVORS OF
ABUSE DURING PREGNANCY AND EARLY
POSTPARTUM PERIOD AS A FRONT
LINE INTERVENTION THAT CAN BE
ACCESSED THROUGH MATERNAL CARE
SETTINGS.
IT'S ADAPTED FROM OTHER
EVIDENCE-BASED PRAOGRAMS FOR
THOSE ENTERING LONG EXPOSURE
TREATMENT FOR PTSD AND INCLUDES
SOME ELEMENTS OF BEHAVIORAL
THERAPY.
IT INCLUDES THE BASIC ELEMENTS
OF BEST PRACTICES FOR PSYCHO
EDUCATION WHICH INVOLVES NOT
ONLY THE PROVISION OF
INFORMATION, WHICH IS HOW PEOPLE
HO
OFTEN THINK ABOUT IT AND SKILL
BUILDING IN THE CONTEXT OF
EMOTIONAL SUPPORT WITH THE GOAL
OF EMPOWERING PARTICIPANTS AND
FULLY MANUALIZED PROGRAM WITH
ASSESSMENTS AND INTERVENTIONS
AND DESIGN TO BE OFFERED VIA
PRIMARY CARE SETTING AND FRONT
LINE APPROACH WITH REFERRAL TO
SPECIALTY CARE PROBABLY FOR 10%
TO 15% OF WOMEN.
IT COULD BE OFFERED IN PERSON OR
VIA TELEHEALTH AND THE
INTERVENOR IS THE ACTIVE
INGREDIENT TO PROVIDE THE
EMOTION AT SUPPORT AND CONNECT
WOMEN TO OTHER APPROPRIATE OTHER
SERVICE AS NEEDED.
THE DESIGN OF THE SMC WAS
RESPONSIVE TO BOTH CLINICAL
EXPERIENCE AS MIDWIVES WORKING
WITH SURVIVORS AND ALSO TO WHAT
WOMEN TOLD US MIGHT BE HELPFUL
IN QUALITATIVE RESEARCH.
IT'S ALSO INFORMED BY PRIOR NIH
RESEARCH CHARACTERIZING THE
AFFECTS OF POST-TRAUMATIC STRESS
ON THE CHILDBEARING YEAR AND
DESIGNING SYMPTOM DEVELOPMENTS
AND DEVELOPMENT NEEDS IN TANDEM.
THERE'S 10 MODULES AND THE CORE
FOUR HAVE A FOCUS AND THE
REMAINING SIX HAVE ADDRESS
POTENTIAL PROBLEMS AND ISSUES
SALIENTED TO CHILDBEARING YEAR
AND MODULES TO INCREASE
FLEXIBILITY MUCH DELIVERY AND
IMPORTANTLY THE INTERVENTION IS
NOT A DEEP TRAUMA INTERVENTION.
IT USES INSTEAD EMBEDDED
VIGNETTES TO DEMONSTRATE THE
CORRESPONDING SKILLS.
A PARTICIPANT CAN CHOOSE TO
PERSONALIZE THAT INFORMATION TO
THEMSELVES OR COULD GO THROUGH
THE ENTIRE PROGRAM WITHOUT EVER
DISCLOSING ASPECTS OF THEIR OWN
TRAUMA EXPERIENCE.
THE DESIGN OF THE SMC IS
RESPONSIVE TO BOTH OUR CLINICAL
AS MIDWIVES WORKING WIN
SURVIVORS AND TO WHAT WOMEN TOLD
US MIGHT BE HELPFUL.
SO THERE'S SKILLS AND MANAGING
POSTTRAUMATIC STRESS, REACTION
SKILLS, INTERPERSONAL REGULATION
AND INTERPRETING SKILLS AND
AFFECT REGULATION WE CALL THE
CALMING SKILLS.
SEVERAL STUDIES HAVE BEEN WITH A
PILOT IN MICHIGAN AND AUSTRALIA
WITH SOCIAL WORKERS AS THE
INTERVENERS.
QUASI-EXPERIMENTAL ANALYSIS
COMPARING OUTCOMES FOR THE SM
MATCH WITH THE STUDY I
PREVIOUSLY STUDIED.
A CVPR PROJECT WITH BUFFALO
PRENATAL IN BUFFALO NEW YORK TO
ASSESS THE TRAINING AND
IMPLEMENTATION ASPECTS WITH
COMMUNITY HEALTH WORKERS AND A
SECOND PILOT DELIVERED BY
COMMUNITY HEALTH WORKERS AND OUR
CURRENT IMPROVE FUNDED PROJECT.
OUR OVER ALL TAKEAWAY SO FAR IS
THE SMC SEEMS TO MAKE A
DIFFERENCE AND WOMEN AND TUTORS
LIKE IT.
OUR IMPROVE PROJECT HAD TWIN
GOALS OF ESTABLISHING THE
PROGRAM FOR SUSTAINABILITY AT
BUFFALO PRENIGATAL AND EVALUATE
EFFICACY FOR PTSD SYMPTOMOLOGY
COMPARED TO A CONTROL GROUP AND
ASSESS SUSCEPTIBLE AND PLAN TO
RANDOMIZED PARTICIPANT TO DO A
MINIMUM OF THE FIRST FOUR
MODULES OR WAIT LIST CONTROL
GROUP.
LET ME WALK YOU THROUGH SOME
ADMINISTRATIVE AND IRB AND OTHER
HURDLES THAT AFFECTED OUR TIME
LINE AND BUDGET AND OUR
RECRUITMENT WAS DELAYED BY
SEVERAL MONTHS.
AS A RESULT WE DID NOT MEAN OUR
PLANNED END OF 60 PARTICIPANTS.
WE TRIED TO MAKE UP TIME AND WE
AMENDED OUR IRB TO RECRUIT IN
THE POSTPARTUM PERIOD AS WELL AS
PREGNANT MOTHERS.
THOUGH WE ORIGINALLY WANTED TO
CONSTRAIN OUR CRITERIA TO
PREGNANCY ONLY AND ENGLISH
SPEAKERS ONLY FOR COMPARISONS,
AS A TEAM, WORKING TOGETHER WE
THOUGHT THIS DIDN'T REALLY
REFLECT OUR VALUES GIVEN SO MANY
OF THE BUFFALO PRENATAL CLIENTS
ARE SPAINISH -- SPANISH AND
RECRUITED 33 PARTICIPANTS WITH
30 ULTIMATELY AVAILABLE FOR
ANALYSIS.
OUR SAMPLE WERE PRIMARILY IN
THEIR 20s OF AFRICAN AMERICAN OR
LATINX AND ANNUAL HOUSEHOLD
INCOME OF LESS THAN $25,000.
OUR SAMPLE POPULATION HAD'
CHILDHOOD EXPERIENCES MEASURE OF
NEARLY SIX ADVERSITIES AND 78.8%
REPORTING A SCORE OF FOUR OR
MORE ACES.
AND A LARGE BODY ESTABLISHED
THAT IS SORT OF THE THRESHOLD HA
INFERS ADDITIONAL RISK FOR
OUTCOMES.
ALMOST 80% OF PARTICIPANTS MET
THE PROVISIONAL DIAGNOSIS FOR
PTSD AND MET THE DIAGNOSIS FOR A
SUBTYPE AND 90% HAD MILD
DEPRESSION AND 60% HAD BOTH TT
SD AND DEPRESSION.
WE SAW SIGNIFICANT REDUCTIONS AS
A RESULT OF THE SMC AND
INTERPERSONAL SENSITIVITY AND
TREND LEVEL CHANGES FOR
DEPRESSION AND EMOTION
REGULATION.
THOUGH THESE RESULTS MAP WELL
YORCHBT OUR PREVIOUS PILOT
STUDIES SHOULD BE INTERPRETED
DIFFERENTLY SINCE WE HAD TO
PIVOT FROM THE PREVIOUS DESIGN
AND ASSESSED ACCESSIBILITY OF
THE PROGRAM BY THE CLIENT
SATISFACTION SCALE AND
OVERALL-MEAN WAS 29.9 AND OUR
RANGE WAS 24 TO 32 INDICATING
HIGH LEVEL OF SATISFACTION.
ONE PARTICIPANT SHARED I LIKE IT
ALL.
I CAN'T TAKE A DOT OUT I LIKE
THE PROGRAM AND IT GOES ON FROM
THERE.
I'M GOING BACK TO MY GOOD FUTURE
AND GO FROM THERE.
AND ASKED PARTICIPANTS WHY YOU
WOULD OR WOULD NOT RECOMMEND IT
AND ONE SAID THEY WOULD
RECOMMEND IT BECAUSE IT HELPED
WITH TRAUMA.
I LIKE HOW YOU LEARN TO OVERCOME
YOUR FEARS AND GETTING HELP FROM
OTHERS AND THE OTHER SAID IT
HELPED ME BOND WITH BABY MORE.
I CAN LOOK AT HUMANS AND SAY I
MADE YOU AND LOVE YOU AND HERE
FOR YOU AND HELPED ME WITH
COMMUNICATION.
WE ALSO LIKED WHAT FOLKS VALUED
ABOUT THE SMC ONE SAID AFTER THE
PROGRAM SAID IT HELPED ME LEARN
HOW TO SELF-REFLECT AND
SELF-CARE.
ANOTHER SHARED THAT THERE'S A
LOT OF INFORMATION IN HERE TO
HELP SOMEONE GET THROUGH CERTAIN
SITUATIONS AND HELP FIGURE OUT
OTHER WAYS TO GET THROUGH THAT
SPECIFIC ISSUE.
I COULD RELATE AND CONNECT WITH
THE MODULES.
FIGURING OUT HOW TO WORK IT INTO
THE HEALTH WORKERS WAS TRICKY.
THIS IS A GROUP OF WOMEN WITH
HIGH CASELOADS, A LOT OF
COMPETING DEMANDS THOUS GOING
FORWARD WITH THE NEW ROUND OF
PRIZE MONEY FROM IMPROVE
FIGURING OUT THE BUDGET TO
INSTITUTE A DEDICATE D SMC TUTO
ON A FULL-TIME BASIS AND CRACK
THE NUT OF HOW TO BILL FOR THE
SERVICE ULTIMATELY WHICH WE
THINK WOULD ULTIMATELY PROVIDE
FOR SUSTAINABILITY.
AND SEEKING CONSULTATION WHICH
WE THINK WILL AFFECT OUR
IMPLEMENTATION DESIGN GOING
FORWARD.
WE ARE AWARE WE SHOULD EXPAND TO
OTHER AREA AGENCIES AS WELL AND
THEY HAVE EXPRESSED INTEREST IN
THAT.
ANOTHER THING WE WANT TO EXPLORE
IS THIS HIGH-LEVEL OF
DISASSOCIATION WE FOUND IN THE
CURRENT SAMPLE AND WE WOULD LIKE
TO EMBED A QUALITATIVE COMPONENT
INTO OUR RESEARCH GOING TO
FORWARD AND OUR COLLABORATION.
WE ALSO THINK EMBEDDING MEASURES
OF STRUCTURAL RACISM AND SELF
EFFICACY AND TREATMENT SEEKING
MAKES SENSE GOING FORWARD ON
WHAT WE FOUND.
WE ALSO WANT TO ADD A REFERRAL
RESOURCES TRACKING COMPONENT.
WE ASKED PEOPLE DID YOU GET A
REFERRAL BUT DIDN'T ASK DID YOU
FOLLOW-UP.
WE WANT TO GO THERE.
ULTIMATELY OUR PLAN IS TO PUT
ALL THE MEASURES IN PLACE SO
THAT WE CAN REALLY BETTER MEET
THE NEEDS OF THE COMMUNITY WE'RE
SERVING.
OKAY.
MY LAST SLIDE WAS TO EXPRESS
GRATITUDE FOR THE STUDY
COORDINATOR FOR ALL THE
COMMUNITY HEALTH WORKERS AND FOR
THE PARTICIPANTS AND JUST SAY A
DEEP THANKS.
>> GREAT PRESENTATION.
WE HAVE TIME FOR ONE QUESTION IN
THE AUDIENCE OR VIRTUAL.
>> WE HAVE NO QUESTIONS FROM
VIRTUAL.
IF YOU HAVE QUESTIONS AND YOU'RE
WATCHING VIRTUALLY YOU CAN
SUBMIT THEM IN OTHER
PRESENTATIONS OF THE SESSION.
>> WE HAVE ONE QUESTION.
>> I'M BRIANNA WITH HEALTH NET
ONE.
I NOTICE YOUR TARGET POPULATION
ARE THE MAJORITY OF PEOPLE
WITHIN THE POPULATION WERE BLACK
AND AFRICAN AMERICAN AND YOU HAD
A TRAUMA INFORMED AND HUMAN
RIGHTS BUT WOULD YOU BE
INTERESTED IN REPLICATING THIS
FOR A MORE BLACK FEMINIST
STANDPOINT OR LIKE A SUPER WOMAN
SHIMA WHEN WE THINK OF THE
INTERSECTION OF RACE AND SEX AND
THAT'S SPECIFIC TO THE
POPULATION YOU SERVED?
>> WE'RE IN CONVERSATION ABOUT
THAT AND IN THE GROWING FORWARD
TOGETHER, THE NONPROFIT.
WE'RE ALL ABOUT BRINGING IN MORE
DIVERSITY.
BRINGING IN MORE VOICES,
CONNECTING WITH COMMUNITY.
WE'RE CONNECTING WITH THE
PERINATAL HEALTH COLLABORATIVES
THERE.
PEOPLE WHO HAVE BEEN VERY ACTIVE
IN DEVELOPING BIRTH DETROIT.
I WAS AT THE RIBBING ON --
RIBBON CUTTING AT A NEW FACILITY
AND WE'RE PILOTING A GROUP
VERSION OF THIS IN BLACK
NEIGHBORHOOD IN MICHIGAN.
IT'S A CONVERSATION WE'RE HAVING
AND HOPING TO LEARN.
THANK YOU.
>> THANK YOU, DR. SPER LICH FOR
YOUR PRESENTATION.
I'D LIKE TO INVITE DR. AVER
YAKUBU.
JOIN ME IN WELCOMIIING HER AND
EMILY LITTLE TO THE STAGE.
>> HI, EVERYONE.
THANKS FOR HAVING US.
I'M EMILY LITTLE, EXECUTIVE
DIRECTOR OF NURTURE LEE.
I WASN'T SURE I'D BE ABLE TO
ATTEND SINCE I RECENTLY GAVE
BIRTH AND HAPPY TO BE HERE WITH
MY COLLEAGUE, DR. AVER YAKUBU
PVP .
WE'RE HERE REPRESENTING A SOCIAL
CHANGE ORGANIZATION DEDICATED
BUILDING A WORLD WHERE WELLNESS
FOR INFANTS AND CAREGIVERS IS A
HUMAN RIGHT NOT A PRIVILEGE.
AND I IMAGINE PE SHARE THIS
MISSION WITH MANY IF NOT ALL OF
YOU IN THE AUDIENCE HERE TODAY.
I STARTED NURTURELY AFTER
LEAVING A Ph.D. PROGRAM NOT
WANTING TO GO IN ACADEMIA
BECAUSE I SAW A NEED TO CONNECT
THE ACADEMIC RESEARCH HAPPENING
ON A ROBUST AND WONDERFUL LEVEL
WITH THE REALLY AMAZING WORK
HAPPENING AT THE COMMUNITY
LEVEL.
AND SO WE'RE HONORED TO BE HERE
TO REPRESENT THE CONNECTING THE
COMMUNITY FOR MATERNAL HEALTH
CHALLENGE AND HAPPY TO HAVE
NIH'S SUPPORT IN EXACTLY THIS IN
BUILDING RESEARCH COMMUNITY FOR
COMMUNITY-BASED ORGANIZATIONS
LIKE NURTURELY.
WE KNOW WE'RE IN A CRISIS HERE
IN THE UNITED STATES FOR BOTH
PREGNANCY AND BIRTH AND
POST-PART TUM HEALTH OUTCOMES
AND THEY OFTEN ARE THE MOST
NEGLECTED OUT OF ALL THESE
CRISES WE ARE FACING.
AS FAR AS THE DISPARITIES THAT
WE FACE IN POSTPARTUM MENTAL
HEALTH AND PERINATAL RATES ARE
TOO HIGH IN THE UNITED STATES.
WE KNOW BLACK PARENTS ARE
DISPROPORTIONATELY AFFECTED BY
PERINATAL MOOD AND ANXIETY AND
ALONG WITH HIGH RATES OF
DEPRESSION HAVING LESS ACCESS TO
CULTURALLY APPROPRIATE SCREENING
AND PREVENTION.
WE KNOW TOOLS LIKE THE EPDS
THOUGH THEY'RE TRANSLATED TO
MANY LANGUAGE ARE NOT CULTURALLY
APPROPRIATE.
WE KNOW PRIMARY TREATMENT FOR
POSTPARTUM TREATMENT AND
THERAPIES ARE NOT NECESSARY
CULTURALLY APPROPRIATE AND THEN
CO-EXISTING WITH THAT IN THE
POSTPARTUM HEALTH ARENA WE HAVE
LACTATION DISPARITIES WHICH ARE
VERY MUCH BI-DIRECTIONAL WITH
PERINATAL AND POSTPARTUM MENTAL
HEALTH AND BLACK WHY INFANTS ARE
LESS LIKELY TO BE BREAST PLAYING
A ROLE IN POSTPARTUM DEPRESSION
AND INCOME AND EDUCATION ARE NOT
PROTECTIVE FOR BLACK PARENTS AS
THEY ARE FOR OTHER RACES.
THE SOCIAL DETERMINATES OF
HEALTH WE SPENT SO LONG TRYING
TO MITIGATE AND IMPROVE WITH
INCOME, EDUCATION AND ACCESS ARE
NOT HELPING IMPROVING OUTCOME
FOR BLACK PARENTS AND WE KNOW
THAT IS BECAUSE OF THE ROOT
CAUSE BEING RACISM ON MANY
LEVELS.
SYSTEMIC RACISM IN THE HEALTH
CARE ARENA AND BLACK INFANTS ARE
NINE TIMES MORE LIKELY TO BE
OFFERED FORMULA IN THE HOSPITAL
SETTING THAN WHITE INFANTS.
THIS IS INTERPERSONAL RACISM ON
A SYSTEMIC LEVEL IN THE HEALTH
CARE SYSTEM WHICH HAS DESERVEDLY
GOTTEN INFORMATION AND
INVESTMENT IN TRYING TO FIX
WHICH IS AMAZING.
WE WANT TO FOCUS ON AN AREA
WHICH HASN'T GOTTEN AS MUCH AS
ATTENTION, CULTURAL RACISM.
SO CULTURAL RACISM WE'RE TALKING
ABOUT LACK OF INCLUSION OF
TRADITIONAL AND CULTURAL
PRACTICES.
POSTPARTUM HEALTH IS INHERENTLY
CULTURAL YET SURPRISING AT THE
CLINICAL LEVEL, AT THE ACADEMIC
RESEARCH LEVEL, CULTURE IS OFTEN
NOT PART OF THE CONVERSATION AS
FAR AS HOW WE ARE PRESENTING AND
TREATING POSTPARTUM HEALTH
DISPARITIES AT MANY LEVELS.
SO NURTURELY'S RESEARCH HAS
PREVIOUSLY BEEN ON EXPOSING THE
BIASES THAT WE HAVE IN OUR POST
PARTUM HEALTH RESEARCH SAMPLING
AS FAR AS FROM A GLOBAL LEVEL
PRIMARILY FROM WESTERN COUNTRIES
LIKE THE UNITED STATES AS WELL
AS WITHIN THE UNITED STATES
BEING FROM A BIASSED SAMPLE AS
WELL OFTEN FROM
UNIVERSITY-ADJACENT MIDDLE CLASS
FAMILIES THERE'S RESULTS OF THE
BIAS SAMPLING APPROACH STUDYING
HOW WE ARE APPROACHING
INTERACTION AND RESEARCH
FOCUSSED ON ONE AREA WE
NEGLECTED PARENT INFANT CONTACT
AND PHYSICAL CONTACT.
WE CAN SEE THAT AROUND THE WORLD
THE UNITED STATES IS REALLY AN
OUTLIER IN OUR LACK OF CONTACT
AND EMPHASIS ON CONTACT FOR
POSTPARTUM HEALTH FOR INFANT
DEVELOPMENT AND WE HAVE
DOCUMENTED AROUND THE WORLD WHAT
COMMUNITIES ALREADY KNOW WHICH
IS PARENT-INFANT CONTACT IS
IMPORTANT FOR LEARNING,
DEVELOPMENT AND PARENTS'
RECOVERY FROM BIRTH AND INFANT'S
DEVELOPMENT AND ENTRY TO THE
WORLD AND BREAST FEEDING OF
COURSE.
THIS HAS BEEN STUDIED AT A
CLINICAL LEVEL.
WE NOW HAVE OVER 50 YEARS OF
RESEARCH ON PARENT-INFANT SKIN
TO SKIN CONTACT AS A CLINICAL
INTERVENTION AND WE'VE GOTTEN
ROBUST DATA FROM THAT ON THE
IMPORTANCE OF THIS CONTACT FOR
POSTPARTUM MENTAL HEALTH AND FOR
MANY POSTPARTUM AND INFANT
HEALTH OUTCOMES BUT WE'RE NOT
SEEING THIS INTEGRATION OF
INFANT CAREGIVER CONTACT AS A
CULTURAL PRACTICE IN THE WAY WE
SEE IT MANIFEST AROUND THE
WORLD.
IN THE PHOTO ON THE RIGHT WHICH
IS TAKEN IN KENYA, WHICH IS
REPRESENTATIVE OF GLOBAL
MAJORITY COMMUNITIES AROUND THE
WORLD AND CARING AND WEARING
YOUR BABY WITH YOU AROUND
THROUGHOUT YOUR DAY AS MANY
PARENTS DO AROUND THE WORLD.
LOOKING AT THIS NOT ONLY FROM A
CLINICAL AND HOSPITAL-BASED
WESTERNIZED INTERVENTION OF SKIN
TO SKIN IN THE GOLDEN HOUR AND
HOW THIS CONTACT IS DIFFERENT
MANIFESTED AROUND THE WORLD.
TAKING A GLOBAL PERSPECTIVE TO
THIS.
OUR RESEARCH WAS DONE IN THE
UNITED STATES AND PREVIOUSLY WE
PUBLISHED A RANDOMIZED CONTROL
TRIAL WITH WILL THE LATINX
PARENTS WITH COMMUNITY HEALTH
WORKERS AND THE WHOLE
INTERVENTION WAS LED BY LATINX
COMMUNITY HEALTH WORKERS AND
PERINATAL NAVIGATORS AND WERE
ABLE TO SHOW WITH A RANDOMIZED
CONTROL TRIAL DESIGN THAT INFANT
CARRYING IN THE FIRST SIX MONTHS
OF LIFE INFECTION OUTCOMES AND
REDUCED POST PAR TURM
DEPRESSION.
-- POSTPARTUM DEPRESSION.
>> MY NAME IS AVER YAKUBU AND
YOU CAN FOLLOW-UP WITH US
AFTERWARDS FOR MORE DETAILS.
SO, OUR MINE FOCUS WAS TO LOOK
AT DOES OUR CULTURALLY INFORMED
TRAINING INCREASE KNOWLEDGE AND
CONFIDENCE?
SECONDLY, WE UTILIZED THE USE OF
AN INFANT CARRIER AND SEE DOES
IT AFTER BIRTH DECREASE SYMPTOMS
OF POSTPARTUM DEPRESSION AND
INCREASE LACTATION IN BLACK
MOTHERS.
SO WE DID THIS THROUGH THREE
MAIN AIMS.
ONE TO GENERATE A LIST OF TEST
ITEMS FOR FOUR NOVEL MEASUREMENT
SCALES WHICH I'LL GO MORE IN
DEPTH AND TWO, TEST A TRAIN THE
TRAINER MODEL AND CURRICULUM TO
TEACH PROFESSIONALS ON WHEN THE
CULTURAL IMPLY WAYINGCATION --
IMPLICATIONS AND BEGIN
RECRUITMENT FOR RANDOMIZED
CONTROL TESTING THE
EFFECTIVENESS.
I'VE ALREADY SUMMARIZED THE
THREE AIMS BUT YOU CAN SEE IN
THE FIGURE HOW WE WENT ABOUT
EACH STAGE.
WITH AIM ONE WE USED INSIGHT
FROM SUBJECT MATTER EXPERTISE TO
DETERMINE WHAT THE FINALIZED
SCALES WILL BE WHICH I'LL GO
INTO IN DEPTH.
AS I DESCRIBED, WE ASSESSED
SELF-ADVOCACY, CONFIDENCE AND
KNOWLEDGE AND USABILITY OF
CARRIERS AND DOULA AND TALK
ABOUT THE BEGINNING OF OUR RCT
STUDY.
HERE'S THE PRELIMINARY RESULTS
FOR RESULTS.
AND THERE'S CULTURAL
IMPLICATIONS OF CARRIERS
THEMSELVES AND THEN WE HAVE THE
INFANT CARING CONFIDENCE SKILL.
HOW CONFIDENT IS A PERSON OR
SUPPORT PERSON IN UTILIZING
CARRIERS AND THEN THE INFANT
CARING KNOWLEDGE SKILL AND
ASSESSING THE KNOWLEDGE OF AND
WE LOOKED AT FAMILIES AND LOOKED
AT THE PRE NATAL TIME AND
POSTPARTUM.
FOR LESSONS, I KNOW WE'RE AT
TIME.
I WON'T GO THROUGH THIS BUT WE
HAD GREAT LESSONS LEARNED AND
ABLE TO UTILIZE THE LEARNINGS WE
HAD TO SUBMIT AN R21 PROPOSAL TO
CONTINUE THE RCT PHASE AND WITH
THE HOPE TO SUBMIT AN RO1.
SO THANK YOU SO MUCH.
GREAT GRATITUDE TO THE IMPROVE
TEAM AND WE'RE ALSO ACCEPTING
APPLICATIONS FOR RESEARCH
FELLOWS AND ALSO FOR POSITIONS
FOR POST DOC OR RESEARCH
MANAGERS AND IF YOU KNOW ANYONE
PLEASE GET THE WORD OUT AND
HAPPY TO ANSWER QUESTIONS LATER.
>> THE NEXT SESSION IS THE
ARIZONA STATE UNIVERSITY
COMMUNITY IMPLEMENTATION
PROGRAM.
THEY WILL TALK ABOUT LISTEN TO
THE VILLAGERS A COMMUNITY
REASONIVE COMMUNITY ENGAGED
PROCESS TO PROMOTE MATERNAL
INFANT HEALTH IN INDIGENOUS
COMMUNITIES.
JOIN ME IN WELCOMING THEM TO THE
PROGRAM.
>> I'M HERE WITH MY COLLEAGUES.
I WANT TO TALK ABOUT OUR WORKING
COMMUNITY TO SUPPORT MATERNAL
HEALTH IN BLACK, LATINA AND
INDIGENOUS COMMUNITIES.
OUR VISION IS WOE WORK TO MAKE
THIS A REALITY SO VILL ANDS
PROVIDING PEER SUPPORT AND
EDUCATION AND RESOURCE.
WHEN THEY WANTED TO KNOW IF WE
WANTED TO COLLABORATE I WENT
STRAIGHT OUR VILLAGES AND
COMMUNITY LEADERS AND PARTNERS
WHO WORK WITH US THROUGH OUR R3
DEMOGRAPHIC SPACE TRIMESTER OF
TR
VILLAGES AND LONG STANDING
RELATIONSHIPS WITH DEAR FRIENDS
WHOM WE'VE WORKED WITH A LONG
TIME.
WHAT THEY TOLD ME WAS THAT THIS
PROFESSION COULD BE GOOD IF WE
DID IT THE RIGHT WAY.
IF WE SUPPORT THE COMMUNITY
RATHER THAN TAKE FROM THE
COMMUNITY AND MOVING AT THE
SPEED OF TRUST THIS PROBLEM
DIDN'T HAPPEN IN A DAY AND WOULD
BE FIXED IN COMMUNITY BUT IT
WOULD TAKE TIME.
AND SO WE STARTED THIS PROCESS
WITH SOME VERY INTENTIONAL
FRAMEWORKS AROUND HOW WE WOULD
LISTEN TO THE COMMUNITIES AND
LISTEN TO THE VILLAGES AND BEGIN
TO ENGAGE AND CONTINUE THIS
ENGAGEMENT THROUGH THE RESEARCH.
TO THE THINGS I WANT TO TALK
ABOUT ARE RESPECT FOR CULTURE
AND WE CREATED CULTURALLY
SPECIFIC COMMUNITY-LED STEERING
COMMITTEES FOR EACH OF OUR
GROUPS.
WE HAVE THREE YOU'LL HEAR MORE
ABOUT IN A FEW MINUTES.
OUR LISTENING SESSIONS WITH
COMMUNITY ARE LED BY THE
COMMUNITY ONLY.
I'M NOT THERE, KATIE'S NOT THERE
AND THE RESEARCH COMMUNITY IS
MADE OF COMMUNITY.
WE ALSO MADE SURE AND THIS WAS
BASED ON OUR COMMUNITY WE HAD
MENTAL HEALTH INTEGRATED AND
BEHAVIORAL HEALTH CONSULTATIONS
INTEGRATED POST.
SO I'M GOING TO STEP OUT OF THE
WAY AND LET THEM TELL YOU WHAT
THEY DID.
>> I'M LAKISA MUHAMMAD AND HAVE
BEEN WORK IN THE AREA OF BLACK
MATERNAL HEALTH OVER 20 YEARS.
I HELP LEAD OUR PROJECT IN BOTH
THE BLACK MAMA SUPPORT VILLAGE
AND WITH BIRTH WORKERS OF COLOR
AS I DO LEAD A NON-PROFIT
ORGANIZATION ARIZONA BIRTH
WORKERS OF COLOR WHERE WE
SUPPORT THOSE WHO SUPPORT
FAMILIES THROUGHOUT THE
PERINATAL PERIOD.
I'D BE REMISS IF I DID NOT
HIGHLIGHT MY BOSSES IN THIS
WORK.
YOU SEE HERE OUR RESEARCH TEAM
AND ARE THARCHBD REPRESENT THE
BEST TO OFFER IN ACADEMIA AND
CLINICAL CARE AND
COMMUNITY-BASED EVIDENCE IN
RESEARCH.
WE ALWAYS WANT TO KEEP COMMUNITY
VOICES AT THE CENTER.
AS WE MOVE TO DIFFERENT PHASES
AND UP THE LADDER WE KNOW THE
PERSPECTIVE AND LENS CAN GET
BLURRY AT TIMES.
WE WANT TO MAKE SURE COMMUNITY
IS ALWAYS CENTERED IN THIS WORK.
WE'VE BEEN ABLE TO HOLD FOUR
LISTENING SESSIONS THUS FAR.
TWO FOR BIRTH WORKERS OF COLOR
AND TWO FOR BLACK PARENTS WHERE
MOTHERS AND FATHERS WERE
REPRESENTED IN OUR BLACK PARENT
LISTENING SESSIONS.
WE WERE BELIEVED TO HEAR
COMPELLING CREATE HEART
WRENCHING STORIES FROM TIMES OF
THE BIRTHS OF THEIR CHILDREN.
THERE WERE 72 CUMULATIVE YEARS
OF EXPERIENCE REPRESENTED WITHIN
THE ROOM AND 85% OF THOSE BIRTH
WORKERS SERVED ALMOST
EXCLUSIVELY FAMILIES OF COLOR
WITHIN OUR COMMUNITY.
WHAT DID WE LEARN?
DID THEY TELL US?
WE TOOK PART IN A NEW TERM FOR
ME.
OUR SCRIBE FROM OUR RESEARCH
TEAM PROVIDED US WITH ALMOST
WORD FOR WORD TRANSCRIPTS FROM
OUR LISTENING SESSIONS THAT
MYSELF AND OUR LEADERSHIP TEAM
WERE ABLE TO PARSE THROUGH AND
THEMING THE COMMENTS.
INTERESTING ENOUGH THERE WAS
INTERSECTION WITH WHAT BIRTH
WORKERS HAD TO TELL US AND
LARGELY CENTERED AROUND POLICY
EDUCATION FOR PARENTS AND CARE
PROVIDERS AND WORKFORCE AND
ACCESS TO CARE AND LASTLY ACCESS
TO MENTAL HEALTH CARE FOR
SERVING FAMILIES AND BIRTHING
PEOPLE.
WE'RE WORKING CLOSELY WITH OUR
IMPLEMENTATION SCIENTIST TO DIG
DEEPER INTO WHAT WE'RE CALLING
OUR THREE-PRONGED INTERVENTION
APPROACH.
WE ARE UTILIZING THE DATA FROM
OUR COMMUNITY AND LOOKING AT THE
EFFECTIVENESS AND FEASIBILITY
AND IMPACT OF UTILIZING
PERINATAL COMMUNITY HEATH
WORKERS, WORKING DIRECTLY WITH
OUR FAMILIES.
MEASURING THOSE EFFECTS BECAUSE
IF WE CAN'T MEASURE IT WE CAN'T
MANAGE IT.
WE NEED TO LOOK AT HOW IT'S
WORKING AND NOT ONLY LOOKING AT
THE CLINICAL ASPECTS OF CARE BUT
TO THE EXPERIENCES.
WHAT ARE OUR FAMILIES GOING
THROUGH AND HOW TO CHANGE IT AND
TURN IT AROUND AND LASTLY
EXPLORE RESPECTFUL MATERNITY
CARE PROGRAMS FOR OUR BIRTHING
FACILITIES WITHIN OUR STATE.
I'LL NOW PASS YOU OVER TO THE
WONDERFUL HANDS OF MY FRIEND AND
COLLEAGUE, MS. KIMBERLY
MOORE-SALAS.
[SPEAKING NON-ENGLISH]
IT'S IMPORTANT I SAY MY CLANSHIP
TO IDENTIFY MYSELF AND REMIND MY
ANCESTORS I'M STILL HERE.
THIS IS OUR STEERING COMMITTEE
FOR THE INDIGENOUS VILLAGE.
IT CONSISTS OF SEVERAL COMMUNITY
MEMBERS THAT WE PRETTY MUCH HAND
SELECTED FROM ARIZONA.
WE HAVE WE OPEN UP WITH PRAYER
AND LET THE COMMUNITY STEER THE
CONVERSATION IN HOW TO DO THE
WORK.
WITH THAT NEXT STEP WE DID A
COMMUNITY EVENT THAT I'LL TALK
ABOUT THE NEXT SLIDE ENGAGING
COMMUNITY IN HOW WE'LL MOVE INTO
THIS WORK.
AND THEN WE HAVE REACH OUT TO
OUR KEY LEADERS.
ABOUT THE STEERING COMMITTEE,
EVERYBODY WORKS WITH EACH OTHER
AND EVERYBODY KNOWS EACH OTHER.
I DO NATIONAL WORK AND SO WE ALL
KIND OF KNOW EACH OTHER AND SO
KEEPING THE COMMUNITY ENGAGED,
FINDING THE KEY LEADERS TO HELP
ADVOCATE THIS WORK FOR US WAS
REALLY IMPORTANT TO US.
AND HOPEFULLY MOVE MORE TO A
LISTENING SESSION I'LL TALK
ABOUT IN THE END.
THIS IS OUR URBAN COMMUNITY
EVENT WE HAD THIS YEAR FOR THE
INDIGENOUS MEDICINE WEEK OF
AUGUST 2024.
THIS IS A GOOD OPPORTUNITY TO
ENGAGE WITH PEOPLE THAT
ATTENDED.
WITH THE COMMUNITY EVENT WE HAD
FEEDBACK ASKING WHAT DOES THEIR
BIRTH LOOK LIKE AND WHAT
CULTURAL PRACTICES THEY WANT TO
INCLUDE IN THEIR EXPERIENCE AND
ASKED QUESTIONS.
SOME OF THE QUESTIONS WE ASKED
WAS QUOTES THEY SAID OF HOW THEY
FELT ABOUT THE IMPORTANCE OF
HAVING CULTURAL CARE IN THEIR
BIRTH EXPERIENCE OR BREAST
FEEDING.
LET ME QUICKLY GO BACK.
SOME OF THE QUESTIONS THAT
GEARED TOWARDS THEIR SUPPORT WAS
WHAT THEY WANTED AT THEIR BIRTH
WAS A DOULA AND SUPPORT WAS THE
HIGHLIGHT OF THIS FEEDBACK FROM
THE COMMUNITY.
FOR OUR NEXT STEPS, WE ARE GOING
TO HAVE OUR NEXT URBAN LISTENING
SESSION THAT WILL HAPPEN
PROBABLY IN DECEMBER.
WE'RE REALLY EXCITED ABOUT WITH
THIS LISTENING SESSION WE'LL
INCLUDE PRACTITIONERS AND
MEDICINE PEOPLE TO COME IN AND
HELP GUIDE THIS MENTAL WELLNESS
AT THE END OF HEARING PEOPLE'S
BIRTH STORIES OBTAINING THE
WELLA IRB IN THE SPRING AND
NAVAJO LAST BECAUSE THEY'RE
CHALLENGING TO GET WHICH IS
ACTUALLY MY NATION.
WE'RE WORKING AT THE SPEED OF
TRUST.
NEXT I'LL INTRODUCE OUR
COLLEAGUE FRIENDS WHO IS AN
ASSOCIATE PROFESSOR.
>> I THINK YOU HEARD MOST OF THE
IMPORTANT THINGS WE WANTED TO
CONVEY AND I KNOW OUR TIME IS
LIMITED BUT WANTED TO SHARE NEXT
STEPS.
AS WE'VE BEEN GOING THROUGH THE
PROCESS WE'VE BEEN USING THE
IMPLEMENTATION RESEARCH LOGIC
MODEL TO MAP OUT THE KEY
DETERMINATES IN OUR COMMUNITIES
RELATED TO SUPPORT FOR THE PRE
AND POST NATAL PERIOD.
I DON'T HAVE TIME TO GO OVER ALL
THESE BUT THINKING ABOUT THERE
ARE ELEMENTS AT MULTIPLE LEVELS
BOTH SUPPORTING AND PREVENTING
US FROM PROVIDING THIS TYPE OF
SUPPORT FOR MOMS.
AND SO THAT'S WHAT'S IN THE FAR
LEFT COLUMN.
WE'RE THINKING ABOUT WE'RE
HEARING FROM THE BIRTH WORKERS
THAT THERE'S A LACK OF TRAINING
AND EDUCATION OPPORTUNITIES.
BUT ON THE OTHER HAND, SITTING
OR LISTENING TO THIS GROUP OF
WOMEN SPEAK, I'VE NEVER MET A
MORE HIGHLY TRAINED GROUP WITH
MORE DEGREES AND CERTIFICATIONS
AND HUNGRY FOR KNOWLEDGE AND
SKILLS ABOUT HOW TO SOLVE THIS
PROBLEM THAT HAS BEEN SO
INTRACTABLE BUT WE'LL OVERCOME
IT.
SO AN EXAMPLE OF A WAY WE
IMPLEMENT STRATEGY WE WANT TO
USE TO OVERCOME THAT OR MAY USE
IS PROVIDING THE TRAINING AND
MENTORSHIP OPPORTUNITIES AND
PULLING THE CULTURAL PIECE INTO
THAT.
AND WITH THE HOPE OF REACHING
PEOPLE WITHIN THE COMMUNITIES TO
ENHANCE THE USE OF THESE
CULTURAL PRACTICES THAT WE KNOW
FOSTER RESILIENCE FOR BIRTHING
INDIVIDUALS.
ANOTHER THING WE CAME UP A LOT
WAS THE EXPERIENCE IN THE
HOSPITAL SETTING THAT WE'VE
SPOKEN TO A LOT OF DOULAS WHO
HAVE FACED I WOULD SAY HOSTILITY
EVEN IN THE HEALTH CARE SYSTEM.
AND FEEL EXCLUDED THAT OB-GYNs
ARE UNDERMINING THE WORK AND
THERE'S CONFLICT AND IF YOU WANT
TO THINK ABOUT TRAUMA ACROSS THE
BOARD THE MOMS HAVE EXPERIENCED
TRAUMA AND THINKING HOW TO
ADDRESS THAT ACROSS THE BOARD.
WE KNOW HURT PEOPLE HURT PEOPLE
AND HEALED PEOPLE HELP HEAL
PEOPLE.
AND WE'LL CONTINUE TO FILL IN
THIS LOGIC MODEL TO FIGURE OUT
ADDITIONAL BARRIERS AND
FACILITATORS AN STRATEGIES
WITHIN OUR INDIGENOUS PARENTS
AND LATINA COMMUNITIES.
SO THANK YOU VERY MUCH.
>> YOU KNOW WE'RE SHORT ON TIME.
>> I'M CHRIS FROM MICHIGAN STATE
UNIVERSITY MIRACLE CENTER.
I SAW ONE OF THE IMPLEMENTATION
SCIENCE STRATEGIES WERE LIVABLE
WAGES.
IF YOU COULD TALK MORE WHAT YOU
HAVE IN MIND FOR COMMUNITY
HEALTH WORKERS.
>> SOCIETY DOESN'T SEEM TO VALUE
AS ONE OF THE MOST IMPORTANT
JOBS IN THE WORLD.
WE RECENTLY HAD IN THE STATE OF
ARIZONA MOVEMENT TOWARDS BEING
ABLE TO FOR COMMUNITY WORKERS
AND DOULAS AND DO YOU ACTUALLY
GET REIMBURSED AND DOES
REIMBURSEMENT LEAD TO A LIVABLE
WAGE.
YOU HAVE TO THINK OF HOW
GEOGRAPHICALLY DIVERSE ARIZONA
IS, A LIVABLE AGE PLAY BE ONE
THING AND IN MAYOR COMA COUNTY
EVERYTHING IS DENSE AND
EVERYTHING'S TOGETHER AND IN THE
TRIBAL COMMUNITIES LIKE WHAT
DOES IT MEAN TO HAVE I ALIVE --
HAVE A LIVABLE WAGE AND THOSE
ARE CONSIDERATIONS FOR TAKING
INTO ACCOUNT.
WE HAVE OUR STATE MEDICATE
OFFICE REPRESENTATIVES FROM
THERE TO HELP US THINK THROUGH
MAKING SURE THIS IS SOMETHING
THAT WE COMPENSATE TO THE DEGREE
IT'S REFLECTIVE OF THE
IMPORTANCE OF SOCIETY.
>> THANK YOU FOR YOUR QUESTION
AND RESPONSE.
PLEASE JOIN ME IN THANKING
ARIZONA STATE UNIVERSITY TEAM.
NOW WE HAVE OUR LAST
PRESENTATION FOR THIS FIRST
PARTS OF THE SESSION FROM THE
INVESTIGATION OF NEBRASKA
MEDICAL CENTER, CIP TEAM,
THEY'RE VIRTUAL.
WE'LL TURN OUR ATTENTION TO THE
SCREEN.
>> CAN YOU HEAR US?
>> YES.
>> WONDERFUL.
[SPEAKING NON-ENGLISH]
>> I'M GOING TO PASS IT OFF FOR
INTRODUCTIONS BEFORE WE ROLL
INTO POWER POINT.
>> GOOD MORNING.
MY NAME IS DR. IDOATE ON THE
PROJECT HERE AND INVESTIGATOR
I'LL PASS TO IT MY COLLEAGUE,
CHARISSE.
>>
[SPEAKING NON-ENGLISH]
OUR PRESENTATION THE NEBRASKA
TRIBE FOR MATERNAL KINSHIP.
AND MISREG -- MS. REGINA WILL
TAKE THE PRESENTATION.
>> CAN EVERYONE NOW SEE OUR
SCREEN?
I WANT TO ACKNOWLEDGE DR
DRDR
DR. SUFONTE AND BARBON WHO WERE
PART OF THIS.
WE ALL FROM AS PART OF A
COLLABORATION WEN THE WIN BAY GO
HEALTH DEPARTMENT AND NEBRASKA
HEALTH CENTER.
I'M A MOM AND TEACHER RESEARCHER
AT THE UNIVERSITY AND WE'RE
GOING TO TRY BECAUSE WE'VE BEEN
WATCHING THESE AND REALIZE WE
DON'T HAVE A LOT OF TIME SO
WE'LL TRY TO JAM THROUGH OUR
SLIDES AND THEN OPEN IT UP FOR
ENGAGEMENT TO TRY TO EMBODY WHAT
WE'RE HERE TO SHARE TODAY.
IS THERE ANYONE IN THE ROOM WHO
IS PRESENT WHO WOULD LIKE TO
OFFER AN OPENING PRAYER?
OKAY.
I'LL THEN DO THAT TO KEEP US
MOVING.
I'LL SHARE A WRITING FROM CORN
MOTHER'S WISDOM AND EVERY MONTH
SOMEWHERE IN THE WORLD A CROP OF
CORN COMES RIPE.
EVERY DAY SOMEWHERE IN THE WORLD
THEY SING OF SURVIVAL.
OUR CHEROKEE NATION SAYS WE MUST
EXPAND OUR CONCEPT OF HOME AND
FAMILY TO INCLUDE OUR
ENVIRONMENT AND OUR PEOPLE.
WE MUST TRUST OUR OWN THINKING.
TRUST WHERE WE'RE GOING AND GET
THE JOB DONE.
SOMEWHERE IN THE WORLD SAILORS
ALWAYS SING.
SO WITH THAT WE ASK THE GREAT
SPIRIT KNOWN BY SO MANY NAMES
YOU CONTINUE TO BLESS OUR TIME
TOGETHER TOGETHER.
WE THANK YOU FOR YOU'LL WE GET
TO HEAR AND SHARE AND ASK YOU
OPEN OUR MINDS AND HEARTS TO
HEAR AND SHARE THE THINGS WE
NEED TO BE BURDENED SHARED AND
THANK YOU FOR ALL THE GOOD WORK
AND SUPPORT WE HAVE IN THIS
WORK.
THIS IS ARTWORK CREATED BY OUR
COALITION MEMBERS.
WE'RE DOING SOMETHING A LITTLE
DIFFERENT THAN SOME OTHER
PRESENTATIONS IN WE'RE AIMING TO
SHARE OUR COMMUNITY
COLLABORATION SYSTEM.
THE PROCESS, NOT JUST OUR AIMS
OR WHERE WE'RE AT BUT YOU'LL SEE
WHERE WE'RE AT WITH OUR WORK BUT
WE WANT TO SHARE HOW WE CAME
TOGETHER.
WE LOVE WORKING ON THIS AND
TOGETHER AND IT IS A JOINT LIKE
WE WHEN WE SAY COMMUNITY IT'S
COMMUNITY THERE ARE MANY PEOPLE
INVOLVED AND WE'RE GRATEFUL TO
ALL OF THEM.
WITH THAT WE'RE GOING TO FOCUS
THOUGH ON OUR COMMUNITY
COALITION AND KINSHIP.
SO OUR COMMUNITY COALITION IS A
REALLY DIVERSE GROUP OF
COMMUNITY-BASED INDIVIDUALS.
WE HAVE 12 MEMBERS.
SEVEN OF THOSE ARE TRIBAL
MEMBERS FROM WINNEBAGO AND WE
ALSO HAVE MEMBERS WHO DON'T
IDENTIFY AS NATIVE AMERICAN OR
TRIBAL MEMBERS.
YOU CAN SEE HERE THE MANY
DIFFERENT DEPARTMENTS AND AREAS
ACROSS SECTORS IN THE COMMUNITY
THAT HAVE COME TOGETHER TO FORM
THIS COALITION.
THIS IS WHAT WE LOOK LIKE IN
ACTION.
AND WE'RE GOING TO GO THROUGH
WHAT THAT PROCESS LOOKS LIKE
WHEN WE DO GET TO COME TOGETHER
WHICH IS MONTHLY.
WE ARE WORKING THROUGH VARIOUS
FRAMEWORKS.
WE TAKING PARADIGMS ALONG WITH
WESTERN PARADIGMS, METHODS,
VIEWS, PERSPECTIVES AND THEN
ALSO REALLY CENTERED AND
GROUNDED IN THE LOCAL VALUES AND
PERSPECTIVES AND WAYS OF BEING
AND KNOWING AND DOING.
SPECIFIC TO THE WINNEBAGO PEOPLE
IN NEBRASKA.
SO WITH THAT WE HAVE DIFFERENT
FRAMEWORKS GUIDING OUR WORK.
ONE OF THOSE IS LIKE AN APP
INVESTIGATE, DESIGN, PRACTICE,
REFLECT.
THAT'S THE OUTER IMAGE OF THE
FRAMING OF AN INDIGENOUS
FRAMEWORK BY WHO DEVELOPED THE
PROCESS OF ACTUALIZING A VISION
CALLED THE CONNECTED RINGS WE GO
FROM BEING AN INVESTIGATOR THE
BEGINNING OF THE PROCESS.
WE GO FROM BEING TO ASKING TO
SEEKING, TO MAKING AND HAVING
AND CELEBRATING.
WE'LL QUICKLY SHARE WHAT THAT
LOOKS LIKE ON THE GROUND.
SO WE'VE HAD MORE THAN EIGHT
WORKSHOPS BUT SHARING THE FIRST
YEAR HERE AND WHAT THAT LOOKS
LIKE FROM THE BEGINNING.
WE MET IN DECEMBER AND HAD A
MONTH TO COME TOGETHER AND GET
TO KNOW EACH OTHER AND HAD
MONTHLY MEETINGS WORKING THROUGH
THE RINGS OF INDIGENOUS
VISIONING.
AND THEY ALWAYS SEEM TO BE NOT
ENOUGH TIME TO BE HONEST AND
WHEN WE MEET IN PERSON WE HAVE
MORE TIME TOGETHER BECAUSE WE
SHARED MEALS TOGETHER, LUNCH AND
DINNERS AND HAVE MORE TIME.
WE START WITH BEING AND TRYING
TO FIGURE OUT WHO ARE WE AND
WHAT IS THIS THE LANDSCAPE, THE
WINNEBAGO LANDSCAPE AND THOSE
INVOLVED IN SUPPORTING MATERNAL
CHILD HEALTH AND KINSHIP IN
PREGNANCY WHICH IS THE GOAL OF
OUR PROJECT.
THE COALITION CAME UP WITH THESE
SPECIFIC AREAS THAT ARE PROGRAMS
AND PEOPLE AND PLACES INVOLVED
IN THAT.
WE STARTED MAPPING COMMUNITY
ASSETS AND IDENTIFYING THE
PLAYERS.
THEN WE MOVED INTO FIGURING OUT
WHAT IS OUR MISSION AND OUR
MISSION IS TO SUPPORT VALUES IN
THE JOURNEY OF MOTHERHOOD AND
HOCAK HAS THROUGH THIS PROCESS
STARTED OFF WRITTEN IN A
DIFFERENT WAY AND NOW IT'S
ACTUALLY WRITTEN IN THE HOCAK
LANGUAGE.
IT'S AN ITERATIVE PROCESS.
THIS IS ALL FROM COMMUNITY
INPUT.
EACH MONTH WE'RE ASKING
QUESTIONS AND ASKING FOR DATA
FROM THE COALITION MEMBERS AND
THEY'RE GIVING US RESPONSES TO
SPECIFIC QUESTIONS AND THEN
WE'RE SYNTHESIZING, ANALYZING IT
AND BRINGING IT BACK IN THE NEXT
WORKSHOP.
IT'S A PROCESS OF MOSQUE FORWARD
AND REFLECTING LIKE SHARING DATA
AND REFLECTING ON IT.
THE VALUES THAT SURFACED THROUGH
THAT PROCESS DURING THE ASKING
WORKSHOP.
WE COLLECT THE DATA BEFORE HAND
AND BRING IT TO THE WORKSHOP AND
THEN TALK ABOUT IT LIKE A LOT OF
YOU MENTIONED LIKE WHAT LOOKS --
DOES THIS LOOK LIKE?
THERE'S CHECKING AND FOR THOSE
WHO DIDN'T GET TIME TO FILL OUT
THE DATA, DATA RESPONSES THEN
THEY GET TO ADD IN DURING -- WE
ASK FOR THEM TO ADD IN DURING
THE WORKSHOPS THEMSELVES.
ALSO WE DID DO A COMMUNITY
READINESS MODEL AN ASSESSMENT
INTERVIEWING COMMUNITY MEMBERS
SECTORS AND FOUND WE'RE AT THIS
LEVEL OF VAGUE AWARENESS FOR
PROMOTING KINSHIP, INVOLVEMENT
IN PREGNANCY.
THAT MEANS IT'S SOMETHING PEOPLE
SHOULD BE DONE ABOUT THIS BUT
MAYBE SOMEONE ELSE WILL WORK ON
IT.
SO WE WERE ABLE TO IDENTIFY
DIFFERENT DIMENSIONS OF
COMMUNITY READINESS WHICH ARE
KNOWLEDGE OF EFFORTS,
LEADERSHIP, COMMUNITY CLIMATE,
KNOWLEDGE OF THE ISSUE OF
KINSHIP INVOLVEMENT IN PREGNANCY
AND RESOURCES.
WHAT WE CAME TO FIND IS THAT
THAT KNOWLEDGE OF KINSHIP
SUPPORT OF PREGNANCY WAS THE
LOWEST SCORING OF READINESS
THESE MOST ATTENTION.
SO WE DO A LOT DURING ASKING AND
STARTS TO MOVE QUICKER.
WE WENT INTO WHAT ARE THOSE
PEOPLE, PLACES AND PROGRAMS MORE
SPECIFICALLY AND MAP TO THOSE IN
THE COMMUNITY.
LOOKING AT WHAT IS THE BUILT
INFRASTRUCTURE AND BEYOND THAT,
WE LOOKED AT WORK ON COMMUNITY
CAPITALS AND FOUND CULTURE
REALLY IS THE GREATEST ASSET IN
THE COMMUNITY.
WE QUANTIFIED WHAT CAME IN IN
CAPITAL ASSETS REALLY AND MAPPED
IT OUT AND EACH MONTH WE'RE
COMING BACK AN ASKING WHAT DO
YOU NOTICE ABOUT THE DATA AND DO
YOU AGREE WITH THIS AND WHY OR
WHY NOT AND WHAT IS THE DATA
TELLING US?
THESE ARE THE THINGS WE GET
REALLY ENGAGED IN DISCUSSING
DURING OUR MONTHLY WORKSHOPS
WITH THE COALITION.
WE THEN MOVED INTO IDENTIFYING
BARRIERS AND FACILITATFACILITAT.
THIS ASKING PHASE LASTED QUITE A
WHILE AND THE MOST ENGAGED RING
IN THE PROCESS ONCE WE
IDENTIFIED BARRIERS AND
FACILITATORS THE RESEARCH TEAM
COULD DETERMINE WHAT
EVIDENCE-BASED INTERVENTIONS
MATCH AND THE BARRIERS AND
FACILITATORS TO KINSHIP AND WHAT
THE COMMUNITIES IDENTIFY AS
KINSHIP SUPPORT IN PREGNANCY AND
THAT'S WHAT YOU SEE ON THE LEFT
HERE IS THESE SPHERES OF KINSHIP
INVOLVEMENT OR FLUENCY AND
DEVELOPED BY THE COALITION AND
COMMUNITY MEMBERS THEMSELVES AND
CAME TO FINALIZE THE MISSION OF
KEEPING THE SACREDNESS OF
TRADITIONS ALIVE DURING PRE
PREGNANCY AND BIRTH.
WE ASKED WHAT THAT LOOKS LIKE
AND ASKED COALITION MEMBERS TO
BRING IN ITEMS THAT REPRESENT
THE ESSENCE OF OUR VISION AND
WHAT KINSHIP SUPPORT LOOKS LIKE
IN PREGNANCY AND THESE ARE SOME
OF THE THINGS.
I'M LOOKING AT TIME AND KNOW I
NEED TO MOVE FORWARD AND LEAVE
TIME FOR QUESTIONS AND TALK WITH
YOU ESPECIALLY SINCE WE'RE NOT
THERE IN PERSON TODAY.
AND WE ALSO WORKED ON DEVELOPING
THAT VISION OR VERBAL ACCOUNT OF
THE VISION INTO ARTWORK.
THIS WAS A PIECE THAT CAME TO US
AS PART OF DEVELOPING THE VISION
AND THEN THERE ARE PIECES THAT
CAME OUT OF DEVELOPING THE
VISION BY WORKING WITH
ARTS-BASED RESEARCHERS AND
COMMUNITY ARTISTS.
AND WE MOVED INTO MAKING PHASE.
WE ALL CREATED THE ART PIECES
YOU SAW IN THE FIRST SLIDE AND
THIS IS FUN.
WE ALWAYS LAUGH AND ALWAYS CRY.
IT'S JUST HOW IT GOES.
WE DEVELOPED EACH COMMUNITY
MEMBER CREATED A PIECE THAT WHY
EMBODIED THE VISION OR REFLECT
THE VISION FROM THEIR
PERSPECTIVE AND THEN PUT ALL
THOSE TOGETHER WITH A WINNEBAGO
TRIBAL MEMBER AND INCREDIBLE
ARTIST WHO PULLED ALL THIS FROM
A VISION WHEEL AND CREATED
ARTWORK THAT REFLECT THAT AND
WILL BE SHARED IN COMMUNITY.
THEN WE WORKED WITH THE MODEL
WHICH IS PART INTEGRATING THE
WESTERN WITH THE VALUES THE
COMMUNITY IDENTIFIED EARLIER ON
AND THEN CAME UP WITH OUR
SELECTION CRITERIA FOR MATCHING
OR FOR SCORING OUR
EVIDENCE-BASED INTERVENTIONS
IDENTIFIED AS POTENTIAL FITS
WERE SCORED OFF AN INTEGRATION
OF BOTH THAT MOMENTED AND
COMMUNITY VALUES.
>> DR. ADOATE, WE'RE AT TIME.
>> I THOUGHT I HAD FOUR MINUTES.
>> WE WANTED TO LEAVE TIME FOR A
QUESTION OR TWO FROM THE
AUDIENCE.
ARE THERE ANY QUESTIONS WITHIN
THE AUDIENCE IN HOUSE FIRST?
WE'RE HAVING TECHNICAL
DIFFICULTIES.
WE DON'T HAVE ACCESS TO THE
QUESTION AND ANSWER CHAT BOX
VIRTUALLY.
SO DR. IDOATE DO YOU SEE
QUESTIONS IN THERE?
>> I DON'T SEE ANY QUESTIONS IN
THERE.
>> FANTASTIC.
ANY QUESTIONS IN THE ROOM?
OKAY.
WELL, I JUST WANT TO THANK YOU
AND YOUR TEAM FOR YOUR
PRESENTATION AND SHARING YOUR
LESSONS LEARNED FROM YOUR
RESEARCH AS WELL AS THANK
EVERYONE.
ALL THE PANELISTS THAT CAME UP
THIS MORNING TO PRESENT ON THEIR
PROJECT.
WE TRULY APPRECIATE ALL THE HARD
WORK YOUR TEAM IS DOING AND
HIGHLIGHTING THE IMPORTANCE OF
COMMUNITY ENGAGEMENT AND HOW
COMMUNITY PARTNERS SHOULD BE
INVOLVED TO THE END AND BE A
PART OF THE RESEARCH TEAM.
WE APPRECIATE ALL YOUR EFFORTS.
JOIN ME IN THANKING ALL THE
PANELISTS.
THANKS, EVERYONE.
>> SO, BEFORE WE BREAK FOR LUNCH
WE HAVE LUNCH AT 12:00 AND I
HAVE A SCRIPT HERE.
I WANT TO READ IT TO YOU AND
MAKE SURE I TELL YOU ALL THE
IMPORTANT INFORMATION.
SO LUNCH BREAK IS UNTIL 1:00
P.M.
SO STARTS AT 12:00 AND ENDS AT 1:00 P.M.
>> WE ARE STARTING WITH THE
ADDRESSING CO-OCCURRING MENTAL
HEALTH AND SUBSTANCE USE
DISORDER CRISIS AND THE FIRST IS
MOREHOUSE SCHOOL OF MEDICINE AND
ANNE DUNLOP AND NIA MITCHELL AND
TALKING ABOUT COMMITMENT TO
REDUCING BEHAVIORAL HEALTH YKTS
AMONG BLACK AND BIRTHING PEOPLE.
>> I'M NIA MITCHELL, MY PRONOUNS
HAVE SHE HER AND EXCITED TO JOIN
THE CENTER TO ADVANCE
REPRODUCTIVE JUSTICE AND THE
CENTER IS IN COLLABORATION WITH
EMORY UNIVERSITY AND I AM JOINED
ALONG WITH DR. DUNLOP DIRECTOR
OF CLINICAL RESEARCH IN THE
DEPARTMENT OF OBSTETRICS AND
GYNECOLOGY AND ONE OF THE THREE
CO-P.I.s FOR THE PROJECT.
I'M MART OF THE COMMUNITY
ADVISORY BOARD OR ACCOUNTABILITY
BOARD, EXCUSE ME, AND ALSO AS A
QUALITATIVE RESEARCH
METHODOLOGIST AND THE RESEARCH
IN EVALUATION DEPARTMENT.
THE TITLES IS JUSTICE TO
WELLNESS, CORAL'S COMMITMENT TO
REDUCING BEHAVIORAL HEALTH
INEQUITIES AMONG BLACK BIRTHING
PEOPLE.
HERE'S AN OVERVIEW OF OUR
PRESENTATION.
I'LL PROVIDE AN OVERVIEW OF
CORAL AND THE COMMUNITY
PARTNERSHIP COVER AND DR. DUNLOP
WILL PROVIDE AN UPDATE ON THE
PROJECT AND CORAL FELLOWSHIP
PROGRAM.
AS MANY OF YOU KNOW UNTREATED
BEHAVIORAL HEALTH CONDITIONS ARE
THE LEADING PREVENTIBLE CAUSE OF
MORBIDITY AND THE LEADING CAUSE
OF ALL DEATHS FROM DELIVERY
THROUGH 12 MONTHS.
BLACK WOMEN ARE IMPACTED BY
INCREASING RATES OF OVERDOSES
AND SUBSTANCE USE DISORDERS
ALREADY A LEADING CAUSE OF
MATERNAL MORTALITY OF BLACK
WOMEN IN MULTIPLE STATES.
FURTHERMORE, PERINATAL MOOD
DISORDERS AND PTSD ARE PREVALENT
AMONG BLACK WOMEN.
THE UNITED STATES IS ILL
PREPARED TO ADDRESS THE CRISES
BECAUSE OF INTERSECTIONAL
DISCRIMINATION.
CORAL AIMS TO HELP BLACK WOMEN
SURVIVE AND THRIVE WHILE
PREGNANT IN POSTPARTUM BY
TRANSLATING RESEARCH INTO
MULTI-LAYERED ACTION TO
COMMUNITIES.
CORAL CONSISTS OF A COMMUNITY
ACCOUNTABILITY BOARD, COMMUNITY
PARTNERSHIP, TRAINING AND ADMIN
CORES AND THE OVAL RESEARCH
PROJECT.
A LITTLE BIT MORE ABOUT THE
COMMUNITY PARTNERSHIP CORE.
TOO OFTEN APPROACHES DO NOT
APPROPRIATELY ENGAGE COMMUNITY
STAKEHOLDERS.
AS A RESULT THE INFRASTRUCTURE
TO SUPPORT ENGAGEMENT AMONG
BLACK WOMEN WITH LIVED
EXPERIENCE AND ORGANIZATIONS AND
INDIVIDUALS THAT SERVE THEM AND
ACADEMIC INVESTIGATORS AROUND
THE DEVELOPMENT OF BEST
PRACTICES FOR THE ELIMINATION OF
MATERNAL BEHAVIORAL HEALTH
INEQUITIES.
THE COMMUNITY PARTNERSHIP CORE
IS LED BY DR. GREEN AND
DR. CLARK AND CAPRICE WELSH.
THE COMMUNITY PARTNERSHIP CORE
AND CORAL OVER ALL IS GROUNDED
IN THE FOLLOWING FRAMEWORKS AND
METHODS.
THERE'S THE HUMAN RIGHT TO
RETAIN BODILY AUTONOMY, HAVE
CHILDREN, NOT HAVE CHILDREN AND
PARENT THE CHILDREN WE HAVE IN
SAFE AND SUSTAINABLE
COMMUNITIES.
RESEARCH JUSTICE SEEKS TO
TRANSFORM STRUCTURAL INEQUITIES
IN RESEARCH BY CENTRALIZING
COMMUNITY VOICES AND LEADERSHIP
IN AN EFFORT TO FACILITATE GIN
GENUINE CHANGE AND GAIN
KNOWLEDGE AND EXPERIENCES THAT
ARE COMMUNITY-CENTERED AND
COMMUNITY DRIVEN TO COUNTER THE
SYSTEMIC HARM PERPETRATED ON
BIPOC COMMUNITIES THROUGH
OPPRESSIVE DATA PRACTICES.
LASTLY, THE ACE CONCEPTUAL MODEL
CENTERS COMMUNITY ENGAGEMENT AND
CORE AND PRINCIPLES.
THESE FRAMEWORKS ARE
OPERATIONALIZED IN CORAL'S
MISSION, AIMS, INFRASTRUCTURE,
DECISION MAKING, THE FOCUS ON
THE CONDUCT OF RESEARCH AND THE
DISSEMINATION OF FINDINGS TO
INFORM MOBILIZING AND ORGANIZING
EFFORTS.
SO, THE COMMUNITY PARTNERSHIP
CORE WILL WORK WITH THE TRAINING
CORE TO RECOGNIZE, ENGAGE AND
INVEST IN UNDER REPRESENTED
RESEARCHERS AND COMMUNITY
SCIENTIST TO SUPPORT THE
CRITICAL WORK TO ADDRESS
INEQUITIES AND CREATE
COMMUNITY-DRIVEN SOLUTIONS AND
RESPONSE TO MATERNAL HEALTH GAPS
THROUGH THE DEVELOPMENT OF WHICH
HE THE COMMUNITY ACCOUNTABILITY
BOARD, WHICH HAS ALREADY BEEN
FORMED, ENGAGEMENT TO ADVANCE
BLACK MATERNAL HEALTH AND
INFRASTRUCTURE TO ACHIEVE THE
AGENDA AND PROJECTS MORE BROADLY
AND THE APPLICATION OF
INNOVATIVE METHODS TO
DISSEMINATE AND IMPLEMENT CORE
RESEARCH LEARN WITH PARTNER
ORGANIZATIONS AND POLICY MAKERS.
THIS IS JUST ANOTHER VISUAL OF
CORAL'S ORGANIZATIONAL STRUCTURE
WITH ARROWS DENOTING THE
DECISION MAKING AND HERE'S A
LIST OF OUR CURRENT CAB MEMBERS.
THE CAB IS DEVELOPING THE
RESEARCH AGENDA.
HOWEVER, SEVERAL CAB MEMBERS ARE
ALREADY COLLECTING DATA ON
MATERNAL BEHAVIORAL HEALTH
CONDITIONS AND I FEW ARE
INTERESTED IN SHARING THE
INFORMING WITH CORAL.
SO IT'S CURRENTLY IN
DEVELOPMENT.
NEXT THE CORE WILL CONDUCT
INTERVIEWS WITH CAB INTERVIEWS
AND USE THE CONSENSUS APPROACH
TO DETERMINE PRIORITIES FOR THE
RESEARCH AGENDA.
NOW I'LL TURN THE PRESENTATION
OVER TO MY COLLEAGUE.
>> GOOD AFTERNOON.
I'M ANNE DUNLOP.
ONE OF THE MPIs AND THE CORE IS
THE COMMUNITY PARTNERSHIP CORE
LED BY THE COMMUNITY
ACCOUNTABILITY BOARD.
I'M GOING TO SPEND THE NEXT FEW
MINUTES TELLING YOU ABOUT SOME
OF THE CORE RESEARCH PROJECT
THAT KICKED OFF OUR CENTER AND
THIS PROJECT IS CALLED OVAL,
OVERDOSES AMONG PREGNANT AND
POSTPARTUM PEOPLE AND LAWS
GOVERNING DRUG USE IN PREGNANCY.
I'LL DO MY BEST TO CONVEY TO
YOU, I PARTICIPATED IN THIS
PROJECT FROM THE HEALTH SERVICES
PERSPECTIVE AND THIS PROJECT
REALLY SPANS ALL LEVELS.
IT HAS A LOCAL HEALTH SYSTEM
COMPONENT.
IT HAS A STATE AND REGIONAL
COMPONENT AND ALSO HAS A
NATIONAL FOCUS.
THE AIMS OF OUR OVAL RESEARCH
STUDY ARE FOUR.
FIRST, TO ANALYZE THE RACIALIZED
IMPLEMENTATION OF LAWS GOVERNING
DRUG USE IN PREGNANCY IN THE
UNITED STATES SECOND THE
MEASURES TO OVERDOSE AND
DISORDER TREATMENT AND PRENATAL
AND POSTPARTUM CARE WITH A FOCUS
AMONG BLACK PEOPLE ON MEDICAID
ACROSS THE STATES.
THIRD, WE'LL BE CONDUCTING A
QUALITATIVE CASE STUDY IN THE
ATLANTA METRO AREA IN THE HEALTH
SYSTEMS THERE TO IDENTIFY
INTERVENTION TARGETS IN LEGAL
IMPLEMENTATION PATHWAYS TO
SUPPORT ENHANCED ENTRY TO
TREATMENT AND DECREASE
PUNISHMENT AMONG BLACK PREGNANT
AND POSTPARTUM PEOPLE AND
METHODS TO MOBILIZE AROUND
SELECT INTERVENTION TARGETS AND
THROUGHOUT ALL OF THESE AIMS THE
FIRST TWO AIMS WERE REALLY
DEVELOPED WITH LOCAL SCIENTIFIC
AND COMMUNITY ADVISORY BOARDS AT
THE LOCAL AND STATE LEVEL AND
THERE IS A NATIONAL ADVISORY
BOARD WITH INPUT ON THE MEDICAID
DATA IN THE STUDY OF THE
PATHWAYS ACROSS THE VARIOUS
STATES IN WHICH THE LAWS
OPERATE.
THE RESEARCH STUDY IS REALLY A
MIXED METHODS SEQUENTIAL
EXPLANATORY DESIGN.
IT USES MEDICAID DATA FROM MUCH
THE QUANTITATIVE DATA ANALYSIS
INVOLVING THE USE OF MEDICAID
CLAIMS AND EXISTING INVENTORIES
OF LAWS THAT ARE ON THE BOOKS
AND THEN IN DEPTH QUALITATIVE
INTERVIEWS AND LAWS AS THEY ARE
IMPLEMENTED.
AND THE DESIGN OF THE STUDY IS
ROOTED IN THE PUBLIC HEALTH LAW
RESEARCH MODEL WHICH IS
ILLUSTRATED HERE THAT STARTS
WITH STUDYING LAWS ON THE BOOKS
BEGINNING TO STUDY LEGAL
PRACTICES AND HOW THOSE LAWS ARE
IMPLEMENTED AND LOOKING AT HOW
CHANGES IN THE ENVIRONMENT AND
IN BEHAVIOR BASED ON THE LAWS
AND IMPLEMENTATION INFLUENCE
POPULATION HEALTH.
THIS RESEARCH MODEL SERVES AS A
FRAMEWORK.
THIS IS DONE THROUGH THE LENS OF
REPRODUCTIVE JUSTICE AND
TOGETHER WHEN WE EMPLOYEE THE
PUBLIC HEALTH LAW RESEARCH MODEL
TOGETHER WITH THE RESEARCH
JUSTICE FRAMEWORK WE'RE TRYING
TO CALL ATTENTION THAT LAWS
GOVERNING DRUG USE IN PREGNANCY
AND THE WAYS IN WHICH THE LAWS
ARE IMPLEMENTED CAN SHAPE BLACK
MATERNAL HEALTH AND HEALTH CARE
SEEKING BEHAVIOR AND THEREBY
STUDY THE PATHWAYS IN WHICH THE
LAWS AND IMPLEMENTATION ARE
SHAPING OVERDOSE AND HEALTH CARE
UTILIZATION PATTERNS WITH A
FOCUS ON BLACK PREGNANT AND
POSTPARTUM PEOPLE.
WE WILL FOCUS ON THREE LAWS FOR
THE OVAL STUDY.
THE FIRST ARE LAWS REQUIRING
SUBSTANCE USE TREATMENT PROGRAMS
PRIORITIZE PREGNANT PEOPLE.
SECOND WE'LL FOCUS ON LAWS
REQUIRING HEALTH CARE PROVIDERS
REPORT PREGNANT PEOPLE WHO USE
DRUGS TO CHILD PROTECTIVE
SERVICES AND THE THIRD WILL BE
LAWS THAT CLASSIFY DRUG USE IN
PREGNANCY AS CHILD ABUSE AND
NEGLECT.
WE NOTED THAT THE FOCUS ON LAWS
1 AND 2 BECAUSE THEY DIRECTLY
TARGET HEALTH CARE PROVIDERS AND
SPHERES AND SHAPES THE CHILD
PROTECTIVE SERVICES RECORDING.
AS WE PROCEED THROUGH OUR AIMS
AND GET TO OUR CASE STUDY WE
WILL BE PERFORMING OUR CASE
STUDY IN GEORGIA AND ATLANTA AND
METROPOLITAN AREA WHERE ALL
THREE OF THESE LAWS ARE
OPERATIVE AND IMPLEMENTED IN
VARIOUS WAYS.
WE'LL GET A RICH QUALITATIVE,
QUANTITATIVE ANALYSIS.
IN ADDITION TO OUR CORE RESEARCH
PROJECT, THROUGH A PARTNERSHIP
WITH THE COMMUNITY PARTNERSHIP
CORE AND THE TRAINING CORE,
CORAL IS SPONSORING TRAINING
RESEARCH PROJECTS AND WE HAVE A
CORAL TRAINING CORE FELLOWSHIP
PROGRAM WITH THE GOAL OF
BUILDING CAPACITY ON THE NEXT
STAGE OF INVESTIGATORS
CONDUCTING COMMUNITY-DRIVEN
TRANS DISCIPLINARY RESEARCH INTO
THE MULTI-LAYERED DETERMINATES
AND THE INTERSECTION OF POOR
BEHAVIORAL MATERNAL HEALTH IN
THE BLACK COMMUNED.
WE DEVELOPED AN RFA FOR THE
FELLOWSHIP PROGRAM THE CORE LED
THE DEVELOPMENT OF THAT RFA AND
WHEN INDIVIDUALS APPLY AND WERE
SELECTED AS FELLOWS, THEN BY
BEING SELECTED AS FELLOWS
THEY'RE ABLE TO LEVERAGE THE
MENTORSHIP AND EXPERTISE ACROSS
OUR COMBINED ORGANIZATIONS,
MOREHOUSE SCHOOL OF MEDICINE,
EMORY UNIVERSITY AND THE RICH
COMMUNITY ORGANIZATIONS THAT
PARTICIPATE IN OUR COMMUNITY
CORE.
AND WE ALSO AWARD PILOT PROGRAMS
TO LINK THESE FELLOWS TO A
PRACTICE COMMUNITY TO REALLY
DEVELOP AND IMPLEMENT AND
CONDUCT THEIR RESEARCH.
AND I WILL END.
I KNOW I'M AT TIME WITH A BRIEF
INTRODUCTION MUCH OUR TRAINEES
IN THE FIRST YEAR.
THERE'S QUITE A DIVERSE GROUP.
WE HAVE MYAH GRIFFIN AT
MOREHOUSE SCHOOL OF MEDICINE AND
FETAL MEDICINE SPECIALIST AND
WILL BE IMPLEMENTING MENTAL
HEALTH CARE IN OUR SYSTEM FOR
MOTHERS AT RISK FOR PRETERM
BIRTH.
WE HAVE SHAWANA MOORE AND
CAPTURING LIVED EXPERIENCES OF
BLACK BIRTHING PEOPLE THROUGH A
PHOTO VOICE STUDY AND FROM OUR
EMORY SCHOOL OF PUBLIC HEALTH WE
HAVE ELIZABETH RHODES WITH A
POSTPARTUM DEPRESSION PREVENTION
PROGRAM WITH BLACK WOMEN IN
GEORGIA USING A HUMAN-CENTERED
DESIGN AND THEY CAME WITH IDEAS
FOR RESEARCH PROJECTS IN ORDER
TO GET SELECTED INTO THE
FELLOWSHIP PROGRAM AND THEN
THROUGH THE MENTORSHIP IN THE
INTERACTION WITH OUR COMMUNITY
PARTNERSHIP CORE THEY'RE FURTHER
SHAPING AND TRYING TO
INCORPORATE ELEMENTS OF THE
COMMON DATA ELEMENTS MOVING
FORWARD AND WILL CONTINUE WITH
THE FELLOW SELECTION YEAR OVER
YEAR IN THE YEARS THAT COME.
>> THANK YOU SO MUCH FOR THE
PRESENTATION.
NOW WE'LL TAKE QUESTIONS EITHER
FROM THOSE OF YOU ONLINE AND
WE'LL ALSO TAKE QUESTIONS FROM
THE AUDIENCE.
>> I CAN START WITH A QUESTION.
THE PUBLIC HEALTH LAW RESEARCH
FRAMEWORK MODEL YOU'RE USING,
ARE YOU FOCUSSED ON LAWS AND
COUNTIES THROUGHOUT THE STATE OR
CERTAIN PARTS OF GEORGIA?
CAN YOU TALK MORE ABOUT YOUR
LEGAL RESEARCH MODEL?
>> WE'RE ACTUALLY -- FOR THAT
PART OF STUDYING THE LAWS ON THE
BOOKS AND THEIR IMPLEMENTATION
IS BEING DONE THE FIRST TWO AIMS
ACROSS THE STATES.
SO IT'S FOCUSSED ON A COMPENDIUM
OF LAWS CONSTRUCTED AND UP TO
DATE THROUGH 2022.
AND THE THREE FOCUS AREAS AND
THROUGH CASE STUDIES, WE'LL BE
DOING A FOCUS ON HOW THE LAWS
ARE IMPLEMENTED IN THE STATES
AND THERE'S VARIOUS MEASURES
THAT WORKED WITH OUR SCIENTIFIC
AND COMMUNITY ADVISORY BOARD.
SO, THAT WILL BE A MULTI-STAKE
STUDY LOOKING ACROSS THE STATES
AND AGAIN LINKING TO THE
MEDICAID DATA.
WE'RE LOOKING FOR THE HEALTH
OUTCOMES IN A MEDICAID
POPULATION AND VERY MUCH
FOCUSSED ON THE METROPOLITAN
STATISTICAL AREAS AND LOOKING AT
HOW THE EXISTENCE OF THESE LAWS
JUST DO THEY EXIST OR NOT IN THE
STATE?
ARE THEY ENACTED?
DOES IT INFLUENCE CARE SEEKING
BEHAVIORS AND PRENATAL AND
POSTPARTUM CARE TO TREATMENTS TO
THOSE DIAGNOSED AND THE NEXT
LAYER IS TO DO CASE STUDIES OF
THE IMPLEMENTATION OF THE LAWS
AND WORKING WITH BIRTHING
CENTERS AND WE HAVE THESE LAWS
ON THE BOOKS BUT HOW DO THEY
ACTUALLY PLAY OUT AND THAT'S
MORE OF ADDING THE QUALITATIVE
COMPONENT AND SEEING IF THAT
QUALITATIVE RICHNESS WHEN WE
INCLUDE THAT IN THE QUANTITATIVE
ANALYSIS FURTHER INFLUENCES
THOSE CARE SEEKING PARTICIPATION
BEHAVIORS.
>> GREAT, THANK YOU.
AS A MOREHOUSE AND EMORY ALUM
IT'S GREAT TO SEE AND THE
COMMUNITY ADVISORY BOARD IS
DRIVING WHAT'S COMING OUT OF
CORAL'S WORK.
CAN YOU SHARE A LITTLE BIT MORE
AGAIN THE RESEARCH FELLOWS AND
ADVISORY BOARD.
CAN YOU SHARE FROM THE COMMUNITY
PERSPECTIVE ON HOW THAT
TRANSPIRED?
>> THANK YOU FOR YOUR QUESTION.
I'M ALSO A MOREHOUSE SCHOOL OF
MEDICINE ALUM FROM THE PROGRAM
AND I'LL SAY AS PART OF RESEARCH
JUSTICE SHIFTING THAT POWER TO
COMMUNITIES SO THE COMMUNITY
ACCOUNTABILITY BOARD DEFINITELY
HAS A SAY IN TERMS OF THE
DEVELOPMENT OF RFAs WILL SERVE
ON THE REVIEWS OR REVIEW LIKE
THE APPLICATION NOT JUST ON THE
FACULTY SIDE BUT EVEN ON THE
COMMUNITY SCIENTIST SIDE AS WELL
AND FACILITATE THE SELECTION OF
THE RESEARCH PROJECTS WHICH
SHOULD BE IN ALIGNMENT WITH THE
RESEARCH AGENDA DEVELOPED BY THE
COMMUNITY ACCOUNTABILITY BOARD.
THAT'S JUST LIKE AN EXAMPLE OF
HOW WE'VE SHIFTED POWER AND THEN
HOW IT'S WORKING WHERE THE
COMMUNITY AND I'LL SAY THE
COMMUNITY ACCOUNTABILITY BOARD
IS A COMBINATION OF PEOPLE WITH
LIVED EXPERIENCE,
COMMUNITY-BASED ORGANIZATIONS
AND EVEN FOR THE FOLKS THAT ARE
SERVING, COMMUNITIES AND
PATIENTS PEOPLE THEMSELVES HAVE
LIVED EXPERIENCES AS WELL TI
TIRE -- THEY'RE BRINGING TO THE
TABLE AND VERY RICH AND
BI-DIRECTIONAL BETWEEN THOSE
ENTITIES WITH THE ACADEMIC
INSTITUTIONS AND THE SELECTION
OF THE RESEARCH PROJECTS.
>> I THINK A HUGE PART TOO OF
THE FELLOWS CAME FORWARD WITH
THE RESEARCH IDEAS THE WAY IN
WHICH TO ACT THE REFRAMING OF
THE RESEARCH QUESTION OR
ADDITION OF MEASURES OR
COMPONENTS WE USE THE MAHD
FRAMEWORK AND WHETHER SOME OF
THE PEOPLE WITH LIVED
EXPERIENCES FROM OUR COMMUNITY
BOARD ARE REFERENCING THE
FRAMEWORK ARE BRINGING THOSE
DIFFERENT LAYERS AND DOMAINS TO
THEIR RESEARCH IN A WAY THEY
HADN'T THOUGHT ABOUT.
SO THAT'S BEEN A REALLY POWERFUL
WAY TO WORK TOGETHER AS WELL.
>> I'LL GIVE ONE EXAMPLE.
ONE FELLOW WAS INTERESTED AND I
THINK DOING IMPLEMENTATION
RESEARCH WITH AN EVIDENCE BASED
INTERVENTION AND SOMETIMES OUR
MODELS OF CARE OUR PROGRAMS OR
THE WAYS IN WHICH WE SERVE AND
TAKE CARE OF COMMUNITIES IS NOT
CONSIDERED EVIDENCE BASED.
SO, WHAT'S THAT LOOK LIKE TO
SUPPORT PROGRAM WE KNOW WORK AND
EVACUATE AN IMPACT IN
COMMUNITIES.
MAYBE THEY'VE HAD THE FUNDING OR
RESOURCES TO BE OFFICIALLY
LABELS AS EVIDENCE BASED.
>> THANK YOU SO MUCH FOR THE
RESPONSES TO THOSE QUESTIONS.
WE'LL GIVE A ROUND OF APPLAUSE.
WE INVITE THE NEXT PRESENTERS
FROM THE UNIVERSITY OF UTAH TO
COME TO THE STAGE.
THE PRESENTERS ARE TORII AND
MICHELLE AND CASEY.
MICHELLE IS PRESENTING AND THE
TITLE IS CULTURALLY ADAPTIVE
MULTI-DISCIPLINARY PRENATAL AND
POSTPARTUM CARE CLINIC
ADDRESSING GABZ IN SUBSTANCE USE
DISORDERS IN NATIVE MOTHERS.
>> I'M ASSISTANT PROFESSOR OF
MATERNAL FETAL MEDICINE AT THE
UNIVERSITY OF UTAH AND HONORED
TO BE HERE TO PRESENT.
THE PROJECT WE WERE ASKED TO
PRESENT ON TODAY IS JUST ONE
SMALL PIECE OF THE ELEVATE
CENTER.
WE'LL TALK ABOUT THE CEREMONY
PROJECT.
I'D LIKE TO FIRST SHARE REGRETS
FROM OUR PARTNERS WHO WERE NOT
ABLE TO BE WITH US TODAY AND
HOPE I CAN BE AN ACCURATE VESSEL
FOR THEIR VOICES, CONCERNS AND
NEEDS AS WE GO THROUGH THE
PRESENTATION TODAY.
BECAUSE THEY'RE NOT ABLE TO BE
HERE WITH US TODAY I WANT TO
OFFER AN ACKNOWLEDGEMENT OF
LAND.
I DON'T HAVE FINANCIAL
DISCLOSURES.
I'M FUNDED BY IMPROVE AS MANY
HERE ARE ALSO.
CEREMONY STANDS FOR CULL TRURLY
ENGAGED RECOVERY MOMS CONNECTED
THROUGH NATIVE COMMUNITY AND
IT'S A MULTI-YEAR PARTNERSHIP
THROUGH WHICH WE CONDUCTED
SEVERAL PRELIMINARY FOCUS GROUP
STUDIES REGARDING PREGNANCY
EXPERIENCE AND SUBSTANCE USE
DISORDERS IN NATIVE COMMUNITIES
AND MANY USE THE RESPONSE AS
PREGNANCY AS A CEREMONY AS A WAY
TO IDENTIFY HOW THEIR
COMMUNITIES AND RELATIVES SAW
THE IMPORTANCE OF PREGNANCY AND
THE WAY IT COULD BE A WINDOW TO
ENGAGING INDIVIDUALS IN CARE AND
RECOVERY.
WE ALSO HEARD FROM OUR
RESPONDENTS THAT TREATMENT
OPTIONS LACK CULTURAL AWARENESS
AND NOT JUST FOR SUBSTANCE USE
DISORDER BUT IN GENERAL THE
THINGS OFFERED IN PREDOMINANTLY
WHITE HEALTH CARE INSTITUTION
INAPPROPRIATELY AWARE OF THE
WAYS IN WHICH THEY'RE EFFORTS
AND TREATMENT OPTIONS ARE NOT IN
LINE WITH THE VALUES AND NEEDS
OF THOSE THEY ARE SERVE.
THE SACRED CIRCLE REQUESTED TO
WORK TOGETHER TO ADDRESS
SUBSTANCE USE DISORDER IN
PREGNANCY.
IT WAS WELL VERSE AND ACTIVE IN
THE SUBSTANCE USE DISORDER SPACE
DOING TREATMENT OPTIONS,
BEHAVIORAL AND MENTAL HEALTH
APPROACHES AND ADDICTION AND HAD
NOT ENGAGED IN THE PRENATAL
SPACE.
WE WERE JOINING THEM AT THEIR
TABLE AS SOMEONE EARLIER SAID
TODAY TO BRING UNIVERSITY
EXPERTISE FROM OUR PREGNANCY
SUBSTANCE USE DISORDER CLINIC
CALLED SUPER RAD.
THE FRAMEWORK IS ONE OF
INTEGRATED CARE AND YOU SEE THE
MODEL IT'S BASED UPON WHICH
INVOLVES BRIDGING TOGETHER
MENTAL HEALTH CARE AND WRAP
AROUND SERVICES IN THE MENTAL
HEALTH SPACE AT THE SAME TIME TO
PROVIDE UNIFIED CARE FOR
INDIVIDUALS AND SUBSTANCE USE
DISORDER AND PREGNANCY THROUGH
THE GUIDING PRINCIPLES OF
TRAUMA-INFORMED CARE APPROACHES
AND ANTI-STIGMA AND CARE
APPROACH.
WE NOTED THAT SUD CARE IMPROVES
FOLLOW-UP AND ENGAGEMENT WITH
TREATMENT.
WHO IS SACRED CIRCLE?
THEY'RE TRIBAL AFFILIATION IS
THE CON FED RATED TRIBES OF THE
GOSHUTE RESERVATION AND THEY
TAKE CARE OF INDIVIDUALS FROM
ALL ACROSS THE SPECTRUM AND ALL
WALKS OF LIFE.
THEIR MISSION IS TO DELIVER
QUALITY HEALTH CARE WITH
HARMONY, RESPECT AND INTEGRITY
AND PROVIDE A WHOLE HOLISTIC
CONTINUUM OF CARE.
THESE ARE SOME OF OUR PARTNERS
AT SACRED CIRCLE AT RECOVERY
DAYS.
NINO RAYOS IS A SOCIAL WORKER
PICTURED HERE.
THE OVERLYING I THINK FRAMEWORKS
THAT GUIDE SOME OF OUR WORK ARE
TO UNDERSTAND STIGMA, RACISM AND
COLONIALISM AND PERINATAL
ADDICTION AND HOW THEY CREATE
DISCRIMINATION AGAINST
INDIVIDUALS WHO USE DRUGS AND
PUSHES THEM TO THE MARGINS.
WE HAVE NEUROBIOLOGICAL EVIDENCE
IT CREATES BRAIN CHANGES AND
IMPACTS FOR PARENTING PEOPLE
FROM MARGINALIZED COMMUNITY CAN
FURTHER INCREASE DISCRIMINATION.
INDIGENOUS WOMEN AND SUBSTANCE
USE DISORDERS IS ANOTHER AREA
WHERE INTERSECTION OF RACISM,
COLONIALISM AND STIGMA AND A.
ONGOING TRAUMA INTERSECT AND
WOMEN HAVE THE HIGHEST RISK OF
DYING FROM AN OPIOID OVERDOSE
WHICH INCREASED BY 39% IN 2020.
ALCOHOL CONSUMPTION IS ALSO
LIKELY GROSSLY OVER ESTIMATED IN
THE PERIPARTUM PERIOD AND
INDIVIDUALS FROM AMERICAN INDIAN
AND ALASKAN NATIVE AND
INDIGENOUS COMMUNITIES FACE
BARRIERS TO DEFINING RISK NEEDS
AND ACCESSING RECOVERY SUPPORT
BECAUSE OF THE WAYS STRUCTURAL
COLONIALISM IMPACT CARE.
ONE OF THOSE IS THE THREAT OF
MATERNAL SEPARATION AND WE'RE
FOCUSSING ON PERIFLATE --
PERINATAL CARE AND THE NUMBER OF
DEATHS OCCUR AFTER SEVEN WEEKS
POSTPARTUM.
SO OUR SPECIFIC AIMS WHICH ARE
CREATED IN COLLABORATION WITH
OUR COMMUNITY PARTNERS AND IN A
COMMUNITY ENGAGED WAY AIM TO
ADDRESS THESE CRITICAL GAPS IN
CULTURALLY INTEGRATED AND
TRAUMA-INFORMED CARE.
WE'RE ADAPTING A MODEL AND TO
CREATE A PROTOCOL AND ASSESS THE
IMPLEMENTATION SCIENCE ASPECTS
AND THE ACCESSIBILITY AND
FIDELITY OF A NEW INTEGRATED
CLINICAL CARE OFFERING.
AND THEN TO ASSESS THE CLINICAL
AND PATIENT-CENTERED OUTCOMES.
I'LL FOCUS ON ADAPTATION AND I'M
EXCITED TO BE ABLE TO SHARE THE
WORK OF THE FOLKS AT SACRED
CIRCLE AND OUR COLLABORATIONS.
WE'RE USING THE ADAPTIVE
FRAMEWORK COMBINED WITH HEALTH
EQUITY PERSPECTIVES AND RAPID
FEEDBACK STRATEGIES OF
HUMAN-CENTERED DESIGN AND DOING
IN A RAPID CIRCULAR FASHION AN
ADVISORY BOARD INCLUDES NUMEROUS
FOLKS.
WE HAVE REGULAR HYBRID MEETINGS
ONCE A PUBLIC HEALTH AND MOST
ATTEND IN PERSON BUT WE'RE
WORKING TO MAKE HYBRID OPTIONS
INTEGRATE OUR FOLKS WHO CONSENT
COME IN PERSON AS WELL AS MEET
AND WE IMPLEMENT CEREMONY.
UNDERSTANDING THE INTEGRATIVE
PERI-NA NNATAL CARE MODEL WE WO
DISMANTLE THAT AND PUT IT BACK
IN A WAY THAT WORKS FOR SACRED
CIRCLE AND THE PEOPLE WITH LIVED
WISDOM THEY SERVE.
OVER THE COURSE OF THE LAST FIVE
MEETINGS WE IDENTIFIEDFUL
FACILITATORS AND BARRIERS IN
THREE DOMAINS AND ASKED PARTNERS
AND COMMUNITY INDIVIDUALS TO
HELP US TO COMBINE THEM INTO
THEMES AND DOUGH PLAINS AND TO
HELP US REALLY IDENTIFY THE
PRIORITIES WE NEED TO BE FOCUSES
ON.
-- FOCUSSED ON.
I WON'T GO THROUGH EVERY DETAIL
ON THE SLIDE IN THE INTEREST OF
TIME BUT TO POINT OUT WE HAD OUR
TEAM ESSENTIALLY RANK ORDER THE
FACILITATORS AND BARRIERS BY
PRIORITY AND ALSO FREQUENCY.
THAT ALLOWED US TO IDENTIFY
THINGS WE FELT WERE IMPORTANT
AND ALSO TO IDENTIFY THINGS THAT
WERE OF MAYBE SLIGHTLY LESS
IMPORTANCE BUT PEOPLE THOUGHT
WERE IMPORTANT.
COLLABORATION ACROSS DEPARTMENTS
WITHIN SACRED CIRCLE HEALTH CARE
AND MULTIPLE COLLABORATION WAS A
WELL-NOTED FACILITATOR IN
FREQUENCY AND OVER THERAPY
APPOINTMENTS WERE EXCITED AS
VERY IMPORTANT BARRIERS TO
ADDRESS AS WELL AS
INTERGENERATIONAL TRAUMA.
WITHIN THE DOMAIN OF
IMPLEMENTING AND TESTING WE HAD
FACILITATORS NOTED INCLUDE
ACCESS THROUGH ELEVATE TO PEOPLE
WHO SPECIALIZE IN INDIGENOUS LAW
AND ON THE BARRIER SLIDE
DISCONNECTS BETWEEN CHILDCARE
AND TRANSPORTATION AND PREGNANCY
CARE AND SUBSTANCE USE CARE
WHICH OCCURRED AT TWO DIFFERENT
SITES WITHIN THE FOUR CLINIC
COLLABORATION WHICH IS SACRED
CIRCLE.
AND THEN FINALLY WITHIN THE
BARRIERS AND FACILITATORS TO
CULTURALLY ADAPT CARE FACIL
FACILITATORS WITH THE
AVAILABILITY OF CURB SIDE CARE
AND PSYCHIATRIC AND ADDICTION
SPECIALISTS AND ACCESS TO
CULTURAL MEDICINE.
BARRIERS OF COURSE INCLUDE
INTAKE, MULTIPLE PROVIDERS NOTED
AND PEOPLE WITH LIVED WISDOM
NOTED INTAKE IS TRIGGERING AND
CAN BE AN IMMEDIATE BARRIER TO
CARE.
AND WHO IS ASKING THE QUESTIONS
IS A CRITICAL PIECE OF THAT
BARRIER AND TRUST IS HARD TO
EARN AND YOU HAVE TO HAVE
CONTINUITY AND YOUR FIRST
CONTACT NEEDS TO BE SOMEBODY
WITH KNOWLEDGE.
AFTER ALL THE DISCUSSIONS AROUND
BARRIERS AND FACILITATORS, THE
SACRED CIRCLE TEAM AND COMMUNITY
ADVISORY BOARD FELT THE BEST
PRENATAL CARE MODEL WOULD NOT BE
AN INTEGRATIVE PRENATAL CAPRENAL
MODEL AND LOOKED AT STANDARD
INDIVIDUALIZED CARE AND CARE AT
DIFFERENT SITES WITH DIFFERENT
PROVIDERS, THE INTEGRATIVE MODEL
AND GROUP CARE MODEL.
GROUP PRENATAL CARE AS MANY KNOW
IS PRENATAL CARE PROVIDED FOR
SIX TO EIGHT PEOPLE AT ONE TIME
WITH AN O.B. PROVIDER USING A
COMMON TREATMENT GOAL AND
SOMETIMES INCLUDES THEIR
PARTNERS.
THIS PROVIDES GROUP DISCUSSION,
ACTIVITY AND SUPPORT AND PRO
PROTECTED TIME FOR PRIVATE
QUESTIONS.
GROUP PRE NATAL CARE HAS BEEN
DEMONSTRATED TO IMPROVE PATIENT
EDUCATION AND OPPORTUNITIES FOR
PEER SUPPORT AND NETWORK
CREATION.
IN PARTICULAR, ONE OF THE
REASONS THAT WE SETTLED ON THIS
AS A GROUP IS THAT THERE ARE
IMPLEMENTATIONS FOR INDIGENOUS
PREGNANT AND PARENTING PEOPLE
AND THE GROUP PRENATAL CARE WAS
FELT TO ALIGN WITH THE MODEL OF
THE TRADITION OF HEALING BY
PRIORITIZING RELATIONSHIPS
BETWEEN PEOPLE ATTENDING THE
GROUPS, PROVIDERS AND THEIR
COMMUNITY AS WELL AS DELVING
INTO CEREMONY AND COMMUNICATION
AS WAYS OF RECOVERY AND HEALING.
WE ALSO FELT THE TEAM FELT
SIGNATURES AND PRAYING AND
LEARNING AS A GROUP PROMOTING
POSITIVITY AND SUPPORT.
AND THE OPPORTUNITY TO INTEGRATE
CULTURAL PRENATAL CARE AND
SESSIONS INTO THE GROUPS WAS OF
PARTICULAR IMPORTANCE.
NEXT STEPS WILL BE DEVELOPING
THE PRENATAL GROUP MODEL
TOGETHER AND HOW WE CAN USE THE
DESIGN TO MITIGATE BARRIERS AND
I WANT TO SAY THANK YOU TO THE
ENTIRE CEREMONY TEAM.
THESE ARE ALL THE FOLKS WEARING
OUR SUN GLASSES AT OUR LAST
MEETING.
THANK YOU VERY MUCH AND I'M
HAPPY TO TAKE ANY QUESTIONS.
[APPLAUSE]
>> THANK YOU FOR THE
PRESENTATION.
FOR FOLKS ONLINE I CAN SHARE
YOUR QUESTIONS.
ARE THERE ANY QUESTIONS FROM THE
AUDIENCE?
OKAY.
>> YOU MENTIONED ROOM NEEDING
EXPERTISE IN INDIGENOUS LAW AND
WONDERING IF YOU CAN EXPAND ON
HOW IT PLAYS OUT IN TERMS OF
INDIGENOUS LAW VERSUS STATE LAW
OR LOCAL LAW ESPECIALLY IN TERMS
OF WHETHER OR NOT THE CHILD GOES
INTO PROTECTIVE CUSTODY AND WHAT
THE RAMIFICATIONS ARE.
>> THANK YOU FOR THAT QUESTION.
IT'S CRITICAL TO UNDERSTAND THE
DIFFERENCES BETWEEN TRIBAL LAW
AND LOCAL AND STATE LAW WITH
REGARD TO CHILD CUSTODY IN
PARTICULAR.
THOSE WHO MAY HAVE BEEN PAYING
ATTENTION TO THE SUPREME COURT
LAST YEAR WOULD HAVE NOTED IT
WAS THE INDIAN CHILDCARE WELFARE
ACT WAS BEING CONTESTED AT THE
SUPREME COURT LEVEL AND WAS
UPHELD UNDER SOVEREIGNTY
PRINCIPLES.
I THINK ONE OF THE THINGS OUR
TEAM AT SACRED CIRCLE WAS
INTERESTED IS THE CONNECTION TO
THE LAW SCHOOL THROUGH THE
ELEVATE CENTER AND WE HAVE
SEVERAL INDIGENOUS SCHOLARS ABLE
TO PROVIDE CONSULTATION IN WHAT
WOULD MANDATORY REPORTING LOOK
LIKE.
WHAT WOULD THE CHANNELS BE IF WE
WERE MANDATED TO REPORT.
WHAT IS THE CUSTODY CHAIN LOOK
LIKE.
FOR THOSE NOT AWARE, IT ALLOWS
FOR CHILDREN WHO ARE FROM NATIVE
FAMILIES TO STAY WITHIN KINSHIP
CIRCLES IF CUSTODY NEEDS TO BE
TEMPORARY OR PERMANENTLY REMOVED
FROM THE CHILD'S PARENTS.
THEY GO TO IMMEDIATE KINSHIP
CIRCLES AND THEN WITHIN OTHER
NATIVE AND INDIGENOUS FAMILIES
BEFORE ENTERING THE MORE BROAD
FOSTER CARE SYSTEM.
DOES THAT ANSWER YOUR QUESTION?
I'M SORRY.
>> THANK YOU FOR RESPONDING TO
THAT QUESTION?
ARE THERE OTHER QUESTIONS?
IF NOT, THANK YOU.
THE NEXT PRESENTATION IS ANDREA
CUBITT NAVIGATION OF MATERNAL
MEN HALL TEAMING RISK IN
POSTPARTUM PERIOD USING AMONG
LAR PASSIVE DIGITAL SCREENING
TOOL AND COMBINED EPIGENETIC
BLOOD TEST.
>> THANK YOU FOR ALLOWING US TO
PARTICIPATE IN THE RADX PROGRAM.
ONE OF THE MOST IMPACTFUL WE'VE
BEEN INVOLVED IN WITH SEVERAL
ACCELERATORS.
YOU MAY BE ASKING WHAT DOES THE
TRANSGENDER WOMAN BRING TO THIS
SURELY THEY'VE NEVER EXPERIENCED
POSTPARTUM DEPRESSION.
THERE'S A FEW THINGS TO THINK
ABOUT AS A TRANS PERSON.
ONE IS WE DO ARE UNDERSTAND
DISTRESS AND SOCIAL STRESS AND
STIGMA AND MEDICAL AGENCIES.
I DON'T WALK IN A BLACK WOMAN'S
SHOES, I DO UNDERSTAND WE HAVE A
GREAT PATIENT FOCUSSED APPROACH.
SO THE COMPANY REALLY WAS OTHER
FLA
-- ORIGINATED ON HORMONES AND
SOMETHING UNIQUE ABOUT ME
COMPARED TO MOST IN THE ROOM IS
EXPERIENCED STRUCTURAL LEVELS
AND EXPERIENCED LOW OR NO
TESTOSTERONE LEVELS AND CHANGING
ESTROGEN LEVELS AND THOSE
PARAMETERS FROM A SELF-OBSERVANT
PERSON I VARIED MY HORMONES
DRAMATICALLY AND IT'S ENTRUSTING
AND MOOD STATES I NEVER
EXPRESSED BEFORE AS A GUY AND
THERE WERE ALSO I THINK FOR MOST
MEN EXPERIENCES THEY ARE NEVER
EXPERIENCED.
MEN NEVER GET THIS.
AND I THINK THAT IS THE WAKE-UP
MESSAGE TO ME THAT WE NEED TO DO
SOMETHING THIS BECAUSE IT'S 50%
OF THE POPULATION HAVE NO IDEA
WHAT'S HAPPENING.
AND I THINK THAT'S PROFOUND.
SO I POSITIONED A PSYCHIATRY
COMPANY AIMING TO DISRUPT CARE
MODELS AND MOVE MENTAL HEALTH
CARE TO A COMPLETELY DIFFERENT
SPACE REALLY THINKING ABOUT ALL
THE BIOLOGICAL FACTORS AND
SOCIAL CULTURAL FACTORS THAT CAN
CREATE SITUATION TO DRIVE
SOMEONE TOWARDS MENTAL ILLNESS
AND THAT'S THE BIG IDEA,
PREVENTION AND ACCURATE
TREATMENT AND SOLUTIONS.
ONE THING INTERESTING ABOUT
POSTPARTUM DEPRESSION SPACE AND
THE MENTAL HEALTH
CHARACTERISTICS OF WOMEN
COMPARED TO MEN.
AND IT'S INTERESTING TO US MAYBE
THIS IS A CLUE THAT REPRODUCTIVE
REACHES THIS DELTA AND
DEPRESSION RATES ARE DRIVEN BY
THE DIFFERENCES AND
OPPORTUNITIES TO UNDERSTAND
MENTAL HEALTH IN A MORE UNIFORM
FOR ANTIDEPRESSANTS AND THAT'S
WHERE WE'RE AT TODAY.
WE'RE STARTING TECHNOLOGY FOR
PRE MENTAL DISORDER AND PRE
MENOPAUSAL DISCUSSION AND
HORMONE LEVELS CHANGING MOOD
STATES AND DOING WORK LOOKING AT
TEENAGERS AND TRYING TO
UNDERSTAND WHETHER OR NOT
BIOMARKERS PROMOTE OR GIVE US AN
UNDERSTANDING FOR SUICIDAL
IDEATION OR SUSCEPTIBILITY.
I'LL SHOW EXCITING DATA LATER
SHOWING REDUCED SIGNAL ENRICHED
IN WOMEN WHO EXPERIENCED THIS
AND HERE'S THE TECHNOLOGY.
WE HAVE THE OPPORTUNITY TO
DEFINE CHARACTERISTICS OF WOMEN
TO BE MORE SENSITIVE TO LARGE
HORMONAL CHANGES AND THAT COULD
BE POTENTIALLY PRETTY PROFOUND
FOR THINKING HOW WE ADDRESS
THESE AND PREVENT.
SO WHAT WE'RE THINKING ABOUT IS
A FORM OF MAJOR DEPRESSION
AFFECTING WOMEN THROUGHOUT THEIR
LIFE CYCLE THAT ASSOCIATE WITH
HORMONAL CHANGE.
THE BIG DISCOVERY AND INSIGHT
CO-FOUNDERS HAD A DECADE AGO WAS
THIS THINKING ABOUT MENTAL
ILLNESS FROM A DIFFERENT
PERSPECTIVE WHICH IS WHY DON'T
WE JUST PICK POSTPARTUM
DEPRESSION AS A MODEL AND GET
CAUSE AND EFFECT.
WE KNOW WHEN WOMEN GET PREGNANT.
WE CAN SAMPLE SPECIFIC TIMES
WHERE AND USE INFORMATION TO GET
TO CAUSE AND EFFECT.
THAT WAS DECADE OF RESULTS
MOVING FORWARD TO UNDERSTAND IN
WE MEASURE CAN WE IDENTIFY A
SIGNATURE TO PREDICT IF WOMEN
GET ILL OR HAVE TRANSITION TO
DEPRESSION AND WE'RE GETTING
READY TO COMMERCIALIZE.
BEACH HEAD IS IN POSTPARTUM
DEPRESSION AND WE'VE HAD
PRESENTATIONS ON THE
CONSEQUENCES.
I'LL SKIP THAT SLIDE FOR SPEED
HERE.
AND YOU SEE THE GREEN TO RED AS
A FALSE POSITIVE RATE.
IT'S NOT DESTINY NOT TO SAY
YOU'LL GET POSTPARTUM DEPRESSION
BUT SAY YOU'RE AT RISK.
AND CHOLESTEROL AND WE CAN DO
THINGS TO CHANGE IT.
IT'S ABOUT 85% ACCURATE.
WE'RE CHANGING THE SPECIFICITY
TO MAKE IT MORE OF A SCREENING
TOOL.
IT WORKS BETTER IN BLACK
AMERICAN WOMEN AND WE THINK IT
MAY BE RELATED TO HIGHER STRESS
LEVEL IN THAT POPULATION AS WELL
AS HIGHER RATES OF ADVERSITY IN
THEIR LIVES AND IT'S IMPORTANT
FROM TRANSITIONAL COVERAGE SO
IT'S ONE OF THE THINGS WE WANT
TO DO.
I THINK THE TITLE HERE IS MAYBE
MOVED AROUND A LITTLE BIT.
THIS IS REALLY POSSIBLY ONE OF
THE MOST IMPORTANT SLIDES WHICH
IS WHAT WE KNOW ABOUT WOMEN WHO
HAVE BIOMARKERED POSITIVE VERSUS
NEGATIVE.
THEY'RE MORE ANXIOUS COMPARED TO
WOMEN WHO DON'T HAVE THESE
BIOMARKERS.
THEY TEND TO DEVELOP DEPRESSION
EARLIER WHICH GETS TO ANOTHER
DISCUSSION WHICH IS WE ALL ARE
CLUMPING POSTPARTUM DEPRESSION
AS A CULTURAL PHENOMENON BUT
THERE'S SOCIAL CULTURAL DRIVERS
AND THERE'S DIFFERENT BIOLOGICAL
FORMS OF RESPONSE TO DEPRESSION
AND THAT'S CONSISTENT WITH HOW
WE'RE USING OUR TEST TO
DETERMINE WHICH INDIVIDUAL WOULD
BE MORE AFFECTED AND MOST
CRITICAL IS THE FACT THAT WE NOW
UNDERSTAND THIS IS RELATED TO
ADVERSE CHILDHOOD EVENTS IN
THEIR LIFE.
IT GIVES A FIRST SCREENING TOOL
EARLY IN SOMEONE'S LIFE AS A
TEENAGER AND FROM A PREDICTIVE
WE'RE USING THE SCREENING TOOL
TO FIGURE OUT WHO IS NOT AT
HIGHER RISK AND WE IDENTIFIED
WOMEN WHO ARE AT HIGHER RISK.
AND THEN WE CAN REALLY USE THIS
IN COMBINATION WITH ALL THE
OTHER ADDITIONAL A.I. TOOLS AND
UNDERSTAND SOCIAL RISK TO DRIVE
TOWARDS A TREATMENT PLAN WHERE
WE CAN REALLY USE OUR
INFORMATION TO HAVE
CONVERSATIONS WITH DAD, FAMILY,
MOTHERS, CAREGIVERS, HEALTH CARE
PROFESSIONALS AND QUICKLY FIGURE
OUT WHAT WORKS FOR THAT WOMAN IN
A WAY THAT IS MOST EFFECTIVE AND
I'M SUPER EXCITED ABOUT THE
POSSIBILITY OF COLLABORATING
WITH ALL YOU GUYS AND WE'RE VERY
COLLABORATE.
IF YOU THINK YOU WOULD LIKE TO
WORK WITH US WE NEED TO KNOW TE
CYCLE TIME OF THE WOMAN YOU'RE
STUDYING.
THANK YOU VERY MUCH.
>> ANY QUESTIONS?
>> I WAS JUST THINKING IT'S VERY
EXCITING MODEL YOU'VE CREATED.
LOOKING AT THOSE WHO HAVE
BIOMARKERS THAT ARE TESTING
POSITIVE AND DEPRESSION DURING
PREGNANCY AND KNOWS WHO HAVE
DIFFERENT BIOMARKERS WHERE
DEPRESSION MIGHT OCCUR DURING
THE POSTPARTUM PERIOD, HOW WOULD
YOU INTERFACE THIS WITH VERN
VERNOXILOME.
>> WE THINK IT DIRECTLY
CORRELATES TO RESPONSES.
AND THE TROUBLE IS SAGE DOESN'T
HAVE A LOT OF MONEY RIGHT NOW
AND THE SECRET IS PHARMA
COMPANIES AND IF WE IDENTIFY
PEOPLE WHO DON'T RESPONSE IT
DOESN'T HELP AND WE'RE
INCREASING THE MARKER AND WE'RE
ALSO WORKING WITH BAYER THAT ARE
MORE INTERESTED BECAUSE IT'S NOW
A 20 TIMES BIGGER MARKET AND
THEY'RE INTERESTED IN TRYING TO
HEAD OFF THESE THINGS AND IT
REALLY IS ABOUT PREVENTION
MODELS AND PHARMA COMPANIES ARE
NOT PARTICULARLY COMFORTABLE
WITH THAT PSYCHIATRY APPROACH.
>> YOU HAVE A QUESTION?
>> NOT A QUESTION BUT QUICK
COMMENT.
I CAN'T SPEAK ON BEHALF OF
ANYONE BUT MYSELF BUT I WANT TO
AONCE NO WHAT DOES A TRANSGENDER
WOMAN TALKING ABOUT THIS I
THOUGHT HOW BEAUTIFUL FOR
SOMEONE WHO IS PART OF A
POPULATION FACING OPPRESSION ON
THEIR OWN IS ADVOCATING FOR US.
>> IF YOU LOOK AT THE HORRIBLE
RATES OF MORTALITY IN AMERICA
TODAY AND THE HIGH RATES OF
SUICIDALITY AND THEY'RE NOT SO
DISSIMILAR FROM THE TRANS
POPULATIONS.
>> THANK YOU.
IF THERE ARE NO OTHER
QUESTIONS -- YES, A QUESTION?
>> SORRY, JENNY BEIBER.
THANK YOU FOR THE PRESENTATION.
I'M CURIOUS HOW YOU SEE THIS
IMPLEMENTED IN A HEALTH CARE
OPTION WHERE PARENTS OPT-IN TO
BE SCREENED?
I'M CURIOUS ABOUT THAT PART.
>> WE ARE DOING A COUPLE
COLLABORATIVE PROJECTS.
ONE IN RURAL COLORADO LOOKING AT
FRONTIER STATES.
I DIDN'T SAY IT IN THE
PRESENTATION BUT WE DO HAVE A
TEST KIT.
YOU CAN TAKE IT HOME AND THAT'S
WHERE WE'RE GOING WITH THIS IS
POINT-OF-CARE TESTING AND
DEVELOPING A SIMPLE SALIVA TEST
AND LOOKING AT FOR EXAMPLE FIRST
TRIMESTER TEST BECAUSE WE KNOW
WE CAN ANTICIPATE PERINATAL
DEPRESSION AND A DIAGNOSTIC TEST
AT SIX WEEKS POSTPARTUM.
SO FILL IN THE GAPS.
WE KNOW SOME WOMEN DON'T ALWAYS
SHOW UP AND CAN'T MAKE THE
APPOINTMENTS.
25% OF WORK IN MENTAL HEALTH
SPACE, 25% OF THE PEOPLE WHO GET
PRESCRIBED MEDICATIONS TAKE
THEM.
HOW DO YOU MOTIVATE A WOMAN WHO
IS A BIT NERVOUS ABOUT TAKING
ANTIDEPRESSANT THAT SHE SHOULD?
THESE ARE ONE OF THE THINGS WE
WANT TO WORK WITH YOU GUYS ABOUT
IS CULTURAL FACTORS AND
SOCIAL-CULTURAL NORMS.
ONE GREAT EXAMPLE WAS A DEVICE
SELF-ADMINISTERED CHEMOTHERAPY
AGENT AND NO ONE WOULD USE IT
AND THIS IS A SERIOUS DISEASE
AND HAD THREE CHOICES, GO TO AN
INFUSION CENTER OR DO IT IN THE
PRIVACY OF YOUR HOME OR DIE.
THAT WAS IT.
THE ONLY THING THAT WOULD
MOTIVATE THEM WAS IF WHEN THE
EVENT WAS TAKING ONE DEVICE GAVE
$100 TO HELP OTHER PEOPLE WITH A
CANCER OR CURE NOT HAVE TO GO
THROUGH THE SAME HORRIBLE
EXPERIENCE.
THAT'S WHERE WE'RE TRICK TO
REALLY -- LIKE HOW DO WE HAVE
THE CONVERSATION WITH MOM IF
THIS IS THE RIGHT THING FOR BABY
AND HER THOUGH SHE MAY BE
ADVERSE TO TAKING A
PHARMACEUTICAL AGENT.
THAT'S WHAT WE'RE THINKING ABOUT
TOO.
>> THANK YOU.
>> I'M CURIOUS TO HEAR MORE
ABOUT MATCHING PEOPLE WITH
CERTAIN MEDICATIONS THAT MIGHT
WORK BETTER FOR THEM BECAUSE I
KNOW A LOT OF MEDICATIONS ARE
NOT TESTED IN PEOPLE PREGNANT,
BREAST FEEDING AND POSTPARTUM
DEPRESSION TEND TO GO HAND IN
HAND.
THERE'S A LOT OF HESITATION TO
START MEDICATION IF YOU WANT TO
BREAST FEED.
CURIOUS TO HEAR MORE ABOUT THE
PROCESS.
>> IT'S FIGURING OUT WHAT A
WOMAN WILL RESPOND TO RAPIDLY
AND THE EARLY DATA CLEARLY
SUCTIONS WOMEN WHO ARE
REPRODUCTIVE UNIQUELY AND
RAPIDLY RESPOND TO
ANTIDEPRESSANTS WITHIN 24 HOURS
AND I CAN'T SHOW THE DATA WHERE
IT WORKS WITH THE SEROTONIN
UPTAKE INHIBITOR.
I THINK WHAT WE NEED TO DO IS
CHANGE THE RISK TO BALANCE
DISCUSSION IF YOU HAVE A
BIOMARKER POSITIVE AND HISTORY
OF MOOD DISORDER AND STOPPING
ANTIDEPRESSANTS.
AND THE PEOPLE THERE HAVE THE
WORSE OUTCOMES.
AGAIN AS I SAYS BEFORE IT'S HOW
DO YOU CHANGE BEHAVIOR AND GET
PEOPLE TO FEEL MORE COMFORTABLE
WITH TAKING ANTIDEPRESSANT AS TO
OPPOSED SELF-MEDICATING WITH AN
OPIOID OR SOMETHING.
THAT'S WHERE WE'RE WORKING WITH
THESE GUYS AND I'M SUPER
EXCITED.
>> THANK YOU.
>> SO, THAT CONCLUDES PART TWO
OF SESSION 2.
SO YOU HAVE A 10-MINUTE BREAK.
COME BACK AT 1:00 P.M. FOR
SESSION 3 AND THOSE
PARTICIPATING FOR SESSION 3 ARE
ASKED TO MOVE TO THE FRONT OF
THE AUDIENCE.
THANK YOU. ENJOY YOUR BREAK.
GOOD AFTERNOON AND THANK YOU TO
THE PANELISTS FOR BEING ON TIME.
WELCOME.
WE HAVE A TIGHT SCHEDULE SO
WE'RE TRYING TO STICK TO IT.
SORRY, WE HAVE A LOT OF GROUND
TO COVER.
THIS IS SESSION 3, BRINGING
MATERNAL HEALTH CARE HOME.
I'M ANTONELLO PILEGGI FROM THE
EUNICE KENNEDY SHRIVER AND HERE
WITH MY COLLEAGUE, DR. MONICA
LONGO.
EVERYBODY'S READY.
I'LL HAND IT TO MONICA.
THE FIRST PRESENTATION WILL BE
15 MINUTES WITH A FEW MINUTES
AND RUSH INTO FIVE-MINUTE
PRESENTATION AND DISCUSSIONS.
I WANT TO ENCOURAGE EVERYBODY TO
JOIN US IN THE POSTER SESSION.
THE COMPANIES HERE AND HAVE
TARGETS TO FEATURE FOR YOU OR TO
TALK ABOUT THE PROGRESS MADE.
WITHOUT FURTHER DUE, I'LL HAND
IT TO MY COLLEAGUE.
>> THANK YOU FOR COMING TO THE
LAST BUT NOTE LEAST SESSION.
I'M MONICA LONGO THE MEDICAL
OFFICER AT NICHD AND OUR FIRST
PRESENTATION IS FROM CRISTIAN
MEG MECK TALKING ABOUT COMMUNITY
PARTNERED MULTI-LEVEL
INTERVENTIONS WITH A FOCUS ON
HOME VISITING DIGITAL HEALTH AND
IMPLEMENTATION SCIENCE.
>> LAST NAME IS CHRIS MEGHEA.
TO 15 MINUTES, BEFORE I GO IN
THE PRESENTATION I WANT TO
ACKNOWLEDGE MY COLLEAGUES.
WE'RE HERE ON BEHALF OF WHAT WE
CALL OURSELVES THE MIRACLE
CENTER IN MICHIGAN.
IT'S A PARTNERSHIP ACADEMIC
COMMUNITY HEALTH AND IT'S THE
FOUR OF US BUT WE'RE A VERY
LARGE TEAM.
I'M NOT GOING TO LIST EVERYBODY
BUT JUST BELIEVE ME WHEN I SAY
THERE'S A LOT OF US.
ALL RIGHT.
SO THE MIRACLE CENTER THIS IS
WHAT WE CALL THE THREE NAMES AT
THE TOP ARE THE P.I.s AND
PRINCIPLE INVESTIGATORS AND
CO-PRINCIPLE INVESTIGATORS WITH
THE MENTION WE'RE TWO ACADEMICS
AND PEGGY IS THE COMMUNITY P.I.
SO TO SPEAK.
WE HAVE THE SAME TYPE OF
REPRESENTATION, COMMUNITY HEALTH
AND ACADEMIC AT EACH OF THE
PROJECT LEVELS AND TRAINING
PROGRAM LEVEL AND AT THE
COMMUNITY CONSORTIUM LEVEL AS
WELL.
SO THE GOAL OF THE CENTER AS
CALLED UPON BY THE IMPROVE
INITIATIVE AND FUNDING IS TO
REDUCE PREGNANCY RELATE AND
ASSOCIATED MORBIDITY AND
MORTALITY AND WE CAME UP WITH
THIS ACRONYM.
AND REDUCED PROGRAM DISCOVERIES
FOR PRIMARILY AFRICAN AMERICAN
AND HISPANIC AND RURAL
POPULATIONS AN IMPLEMENTATION
RESEARCH PROJECTS.
THE STRUCTURE IS THREE LARGE
PROJECTS RO1 SIZE SCOPE, IF YOU
WILL AND TRAINING CONSORTIUM AND
WHEN WE COME FROM MICHIGAN WE'LL
SHOW YOU THE COUNTIES ARE WHERE
THE THREE PROJECTS WILL
INTERVENE.
THOSE ARE THE INITIAL COUNTIES.
WE'RE EXPANDING IN MORE
COUNTIES.
WITHOUT GOING THROUGH THE WHOLE
LIST, JUST GIVING YOU A SENSE OF
PARTNERS, HEALTH CARE, COMMUNITY
GOVERNMENT POLICY AND QUALITY
IMPROVEMENT I'LL JUST NAME A
FEW.
THE MICHIGAN DEPARTMENT OF
HEALTH AND HUMAN SERVICES LONG
STANDING PARTNERSHIP AND
PROBABLY THE TWO LARGEST HEALTH
SYSTEMS IN THE STATAGE SO I'LL
BRING IT HOME, I PROMISE I WILL.
I UNDERSTAND THE PURPOSE OF THIS
SESSION BUT I WANT TO TALK
BRIEFLY ABOUT THE OTHER
COMPONENTS.
I'LL START WITH COMMUNITY
PARTNERSHIP CONSORTIUM AND WE
HAVE ONE OF THE TWO CO-P.I.s.
SOME MAY HAVE ATTENDED OR BEEN
PART OF THE AND YOU'VE SEEN THE
INITIATIVE AND PRESENTATIONS AND
THE PURPOSE IS TRULY WHAT YOU
SEE ON THE SLIDE.
TO BE INCLUSIVE AND INTENTINAL
IN HOW COMMUNITIES ARE ENGAGED
AND REPRESENTED AND STARTED AT
THE PROPOSAL STAGE WHEN WE MET
AND TALKED ON WHAT WE THINK THE
STANDARD COULD BE AND SHOULD.
I WON'T READ ALL THE WORDS ON
THE SLIDE.
THE TRAINING PROGRAM THEY HAVE A
TRAINING PROGRAM COMPONENT.
WHAT WE WANT TO DO IS ENGAGE
COLLABORATING SCHOLARS.
THINK TRAINERS AND COMMUNITY
BASED THROUGH A THREE-YEAR
ONE-ON-ONE MENTORING AND PROVIDE
OPPORTUNITIES MORE BROADLY FOR
OTHER EARLY STAGE AND JUNIOR
INVESTIGATORS AND POSTDOC.
WE LAUNCH STARTED THE INTERVIEW
PROCESS AND WILL IDENTIFY THE
COHORT OF THREE AND SAME THING
IN TWO OR THREE YEARS FROM NOW
WITH THE SECOND COHORT.
I'LL START IN REVERSE ORDER SO I
CLOSE WITH THE ONE MOST RELEVANT
TO THE PANEL.
IF I COULD DESCRIBE THIS IN
THREE DETAILS IS THE PROJECT AND
THE EVIDENCE BASED INTERVENTION
TO BE IMPLEMENTED IF YOU'RE
FAMILIAR WITH AIM THIS IS THE
COMMUNITY CARE VERSION OF
MATERNAL SAFETY PANELS.
SOME OF OUR PARTNERS AND WE'RE
HELPING IN GRAND RAPIDS IN KENT
COUNTY, MICHIGAN.
WE'VE BEEN ONE OF THE PILOT
SITES CALLED THE AIM COMMUNITY
CARE INITIATIVE.
TO ADAPT IN NON-HOSPITALS
SETTINGS BUILDING ON THE EARLY
EVIDENCE WHERE WE BUILT A
PROJECT AROUND IMPLEMENTING
THOSE COMMUNITY CARE BUNDLES.
THE PROJECT WILL WORK IN 12
MICHIGAN COUNTIES AND THE FOCUS
REALLY IS ON COMMUNITY CARE
PROVIDERS OR SETTINGS SERVING
MAINLY OR EXCLUSIVELY MEDICARE
INDIVIDUALS.
THE SECOND IS DIGITAL
INTERVENTION FOR PRAMM
DISABILITIES AND THE SHORT
VERSION OF WHAT IT IS IS
BUILDING ON A PREVIOUSLY
DEVELOPED APP.
I'LL CALL IT AN APP BUT IT'S
EASY TO USE AND WEB BASED AND
CAN BE USED ON ANY MOBILE DEVICE
AND CAN BE USED ON A TABLET.
THE IDEA IS TO USING IT AS A
SCREENING TOOL WHILE PREGNANT
INDIVIDUALS WAIT TO RECEIVE
CARE.
IT LEVERAGES THE EXISTING
TECHNOLOGY AND APP THAT'S
ALREADY BEING IMPLEMENTED IN
VARIOUS SETTINGS.
IT FOCUSES AND ADDS MORE RISK
FACTORS TO BE SCREENED THAT ARE
RELEVANT TO PREGNANCY RELATED
AND ASSOCIATED MORBIDITY AND
MORTALITY AND PROVIDES IMMEDIATE
FEEDBACK TO THE PREGNANT
INDIVIDUAL, PROVIDES FEEDBACK TO
THE FIRST AND OB-GYN THAT WILL
LIKELY SEE THE PREGNANT
INDIVIDUAL WITHIN THE NEXT FEW
MINUTES AND PROVIDES WHAT WE
CALL A BRIEF MOTIVATIONAL
INTERVIEW COULD BE BRIEF
MOTIVATIONAL MESSAGES RELATED TO
WHATEVER THE RISK FACTORS THAT
WOULD SCREEN POSITIVE.
I WANT TO MENTION ONE THING WHAT
THE PROJECT CALLS APPATHONS
WHICH ARE TEAMS COMPETING ON
VARIOUS PIECES AND THIS IS ONE
EXAMPLE OF THE COMMUNITY
INVOLVEMENT IN THE DEVELOPMENT
OF THE INTERVENTION.
I'M GETTING TO WHAT WE CALL
PROJECT 1.
IT'S PROBABLY THE MOST RELEVANT
TO THIS PANEL.
IT'S ANOTHER MULTI-LEVEL
INTERVENTION.
FOCUSSED ON NON-HISPANIC BLACK
AND HISPANIC MEDICAID
INDIVIDUALS.
THE IDEA IS TO TEST WHAT WE CALL
A SCALE HAD AND HOME VISITING
PROGRAM THAT INTEGRATES
COMMUNITY HEALTH WORKERS AND THE
PROGRAM WE'RE BUILDING ON SMALL
BEGINNINGS IN KENT COUNTY,
MICHIGAN.
IF YOU HAVE QUESTIONS ABOUT THE
PROGRAM ONCE I'M DONE I'M HERE
TO ANSWER THOSE.
THERE'S RACE, ETHNICITY,
LANGUAGE CONCORDANT HEALTH
WORKERS AND THE PROGRAM IS
DESIGN FOR BLACK AND HISPANIC
PERSONS.
THE IDEA IS TO ENHANCE THE HOME
VISITING PROGRAM WITH PROGRAM
RELEVANT SPECIFIC COMPONENT,
INTERVENTION, IF YOU WILL.
AND ALSO RELEVANT COMORBID
INTERVENTION AT THE COMMUNITY
LEVEL.
AT THE COMMUNITY LEVEL WE'RE
WORK WICK PRACTICES AND I'LL SAY
PROVIDE INFORMATION FOR LACK OF
A BETTER WORD AND CAN GO INTO
DETAILS DURING QUESTIONS AND
WRAP UP IN THE NEXT TWO MINUTES.
WE HAVE WAYNE COUNTY AND LARGEST
IN MICHIGAN, 2, 3, MILLION IF
NOT MORE.
KENT COUNTY THE HOME OF THE
SECOND LARGEST METROPOLITAN
AREA, GRAND RAPIDS AND SPLINT.
I'LL TALK ABOUT THE CHALLENGES
AND THINGS THAT WERE PART AND
WHAT WE LEARNED IT'S BEEN A SLOW
START.
SOMEONE MENTIONED MOVING AT THE
SPEED OF TRUST.
AND WE HAVE RANDOMIZED TRIALS.
THAT'S OKAY.
I TALKED TO SOMEBODY MENTIONED
LIVING WAGES.
AND REIMBURSEMENT ISSUES I CAN
GO INTO THIS IN THE Q&A SECTION
BUT IT'S HARD WITH LOW MEDICAID
REIMBURSEMENT TO SUPPORT HEALTH
WORKERS AND WITH A LIVING WAGE
PARTNERING WITH THE STATE HEALTH
DEPARTMENT TRYING TO FIND
CHAMP
CHAMPIONS WORKING WITH PEOPLE IN
THE SENATE AND HOUSE AND ONLY
PLANNING PHASE IS GREAT.
ALWAYS PLAN FOR A PLANNING
PHASE.
IT TAKES A VILLAGE.
STAYING ENGAGED AND EVEN IF
THINGS DON'T MANY MOVE AS FAST
SOMETIMES IT'S FINE.
IT WORKS BETTER IN THE LONG
TERM.
SO I'LL STOP AND IF WE HAVE
QUESTIONS, PLEASE, I HAVE HELP
UP HERE.
>> THANK YOU FOR THE WONDERFUL
PRESENTATION AND OPEN FOR ONLINE
QUESTION AND GO DEEPER ON
REIMBURSEMENT AND THE IESSUES
FROM THAT AND WHAT YOU WOULD
HAVE DONE DIFFERENT.
>> AT THE RATE MEDICAID PAYS
WHICH IS LOW, EVERYTHING WE KNOW
AND THE DATA AND THE TRUE COST
OF SUSTAINING A COMMUNITY HEALTH
PROGRAM AND WE HAVE DATA FROM
PARTNERS THE REIMBURSEMENT
COVERS HALF AT BEST IN TERMS OF
BEING ABLE TO OFFER LIVABLE
WAGES IN TERMS OF ADMINISTERING
SUCH A COMMUNITY HEALTH WORKER
PROGRAM IN TERMS OF PAYING
SUPERVISOR SALARIES.
EVERYTHING ELSE IN TERMS OF COST
THAT COMES WITH SUCH A PROGRAM.
IS
>> QUESTION FROM THE AUDIENCE?
>> THANK YOU FOR YOUR
PRESENTATION.
I WAS WONDERING YOUR PROCESS FOR
PRIORITIZATION FOR THE
APPLICATIONS COMING TO THE
PROJECT 2 SORRY IF I BURCHER ER
BUTCHERED THE NAME.
>> THE APPATHONS THERE'S NOBODY
FROM THE PROJECT HERE.
ARE THE ZOOM MIKES OPEN?
JUST FOR FAIRNESS, I CAN'T
REALLY EXPLAIN YOU'LL THE
DETAILS OF THE PROJECT SO I'M
NOT SURE I CAN ANSWER THE
QUESTION.
>> IT'S OKAY.
DON'T WORRY.
ANYBODY ELSE?
>> APPATHONS ARE LIKE
HACKATHONS.
THANK YOU FOR THAT VERIFICATION.
>> YES, THINK HACKATHONS.
I THOUGHT YOUR QUESTION WAS HOW
DO THEY PRIORITIZE TOPICS.
IF THAT'S WHAT YOU'RE ASKING.
>> YES, WITHIN THE PROGRAM HOW
DO YOU PRIORITIZE WHICH IS GIVEN
PRIORITY TO BE IMPLEMENTS?
-- IMPLEMENTED?
>> THE PROJECT HAS A COMMUNITY
ADVISORY BOARD AND PRIORITIZE
WHAT'S THE NEXT TOPIC.
I COULDN'T GIVE YOU A SPECIFIC
DETAIL BUT PROCESS WISE I KNOW
IT'S IN PARTNERSHIP WITH THE
COMMUNITY ADVISORY BOARD.
>> THEY WROTE ABOUT AN ADVISORY
BOARD.
WE'LL COLLABORATE.
THANKS A LOT.
OKAY.
THE NEXT PRESENTATION IS THE
ANDREW WHEELER FROM GLOBAL
ACCESS DIAGNOSTICS AT-HOME
URINARY TRACT INFECTION
DIAGNOSTICS.
>> I'LL TALK ABOUT OUR NOVEL
HOME USE TEST FOR URINARY TRACT
INFECTION.
A QUICK DISCLAIMER THOUGH, THE
TEST IS A PROTOTYPE DEVICE.
IT'S NOT AUTHORIZED FOR SALE.
THE FINAL PERFORMANCE ISN'T YET
KNOWN.
I WANT TO SAY THAT FROM AN FDA
PERSPECTIVE TO MAKE SURE
EVERYONE'S CLEAR.
IS OUR LEGAL NAME IS MOLOGIC
DOING BUSINESS AS GLOBAL ACCESS
DIAGNOSTICS.
THE REASON WE DO THAT IS A
COUPLE YEARS AGO WE WERE
ACQUIRED BY A GROUP OF
PHILANTHROPIC INVESTORS WITH THE
MISSION TO SEE HEALTH CARE MOVED
ACROSS THE WORLD TO LOW AND
MIDDLE INCOME COUNTRIES.
WE HAVE A WEIRD BUSINESS MODEL.
WE COLLECT PROFITS BUT INSTEAD
OF GETTING OUR OWNERS WEALTHY WE
TAKE THE PROFITS AND INVEST IT
INTO PUBLIC HEALTH.
SO WHY IS URINARY TRACT
INFECTION IMPORTANT IN MATERNAL
HEALTH?
FIRST, THERE'S NOT A GREAT
STANDARD OF CARE OR UTI
DIAGNOSIS AND DANGEROUS IF LEFT
UNTREATED.
IT'S A SITUATION WHERE THERE'S
PAIN AND DOCTORS DON'T OFTEN
BELIEVE WOMEN.
WE HAVE SOME EXAMPLES OF
ARTICLES.
UTI FROM HELL, THAT KIND OF
STUFF.
WE THOUGHT WE NEEDED A NEW
SOLUTION TO THIS PROBLEM CURRENT
AT-HOME SOLUTIONS LACK ACCURACY
AND CONFUSING TO DETERMINE.
UP TALKED TO A CLINICIAN LAST
WEEK THAT SAID SHE DOESN'T
RECOMMEND TO HER PATIENTS TO USE
THEM.
DON'T BOTHER WITH THEM THEY'RE
NOT ACCURATE ENOUGH.
OUR WORK FLOW, WE DESIGN THE
TEST TO BE SIMILAR TO A
PREGNANCY TEST.
IT WORKED BY DETECTING THE
DEGRANULATION OF NEUTROPHILS.
AND THE BIOMARKERS DETECTED IN
ONE LINE AND THE INNOVATION
ARISES FROM MANY YEARS OF OUR
FOUNDER'S WORK WHO LED THE WORK
AND LED TO THE PREGNANCY TEST
PRODUCT LINE.
IT'S DONE IN FIVE MINUTES AND
CREATED A HOUSING WITH A HANDLE
ON IT FOR BETTER POSITIONING.
IT WORKS WITH MID STREAM OR CUP
BASED METHOD FOR COLLECTION OF
URINE AND HAS TWO DIFFERENT
TESTING CONTROL LINE AREAS.
VERY EASY TO INTERPRET WHEN
USED.
THE BEHIND IT AND WHAT MAKES IT
INTERESTING IS THAT THE BODY
CREATES IT'S OWN AMPLIFICATION
LOOP SYSTEM.
WHEN NEUTROPHILS ARE SCATTERING
AROUND AND FIND INFECTION IN THE
BLADDER OR UTERINE TRACT THEY
RELEASE CHEMICALS AND THAT
SIGNALS MORE NEUTROPHILS TO
ARRIVE, MORE NEUTROPHILS TO
ACTIVATE.
IT GOES AND GOES UNTIL THERE'S
ENOUGH CHEMICALS TO BE DETECTED
ON OUR TEST AND WE CAN DETECT IT
AROUND THE POINT WHERE CULTURE
IS ABLE TO BE DETECTED A LITTLE
BIT EARLIER AND THEN OF COURSE
NEUTROPHILS THEMSELVES BEING
DETECTED.
WE LOOK AT THIS AS A FIRST
APPRO
APPROACH TO MEASURING UTI.
THIS DATA IS NOT OFFICIAL BUT
PREVIOUS TRIALS DURING THE
PROJECT.
WE USED A COMPOSITE REFERENCE
STANDARD THAT IS NATIONALLY
RECOGNIZED STANDARD OF URINARY
TRACT INFECTION WHERE YOU HAVE
WHITE BLOOD CELL COUNT AND
BACTERIA LEVEL CULTURE ABOVE A
CERTAIN LEVEL AND 97%
SPECIFICITY AND SENSITIVITY IN
THE DIVERSE POPULATION.
IT'S VERY GOOD UTILITY IN
PATIENTS ABOVE 10 YEARS OLD.
WHEN WE TALKED TO THE FDA ABOUT
THE DE NOVO PROCESS THEY ARE LAD
A STANDARD AND ASKED US TO GO
BACK AND THINK ABOUT WHAT TO DO
WITH CLIN TRAL TRIAL AND AS IT
CLINICAL DIAGNOSIS INSTEAD OF
JUST CULTURE OR JUST WHITE BLOOD
CELLS.
IF WE WERE TO JUST TAKE CULTURE
OUR TEST WOULD HAVE HIGH
SENSITIVITY AND CULTURE IS NOT
KNOWN TO BE VERY SENSITIVE.
WHAT WE DID INSTEAD IS DECIDED
WE'D DO WHAT IS HAPPENING IN THE
FIELD.
INSTEAD OF HAVING CULTURE OR
WHITE BLOOD CELLS WE LOOK AT ALL
THE DATA FROM THE PATIENT
HISTORY, TEMPERATURE, WHITE
BLOOD CELLS, NITRATES, ALL THE
PICTURE AND THEN THEY'LL DECIDE
WHETHER THE PATIENT HAD A UTI OR
NOT.
WE HAD DONE THIS BEFORE AND
FOUND OUR TEST CORRELATED BETTER
THAN CULTURE DID.
IT'S A DE NOVO PROCESS THROUGH
THE FDA.
WE'RE BASICALLY READY TO DO
ANALYTICAL VALIDATION AND THE
CLINICAL TRIAL IS PLANNED FOR
FEBRUARY 2025.
THANK YOU VERY MUCH.
>> THANK YOU FOR SHARING.
WE DON'T HAVE QUESTIONS ONLINE.
WE INVITE ATTENDEES ON LINE TO
SUBMIT.
DO WE HAVE QUESTIONS HERE IN THE
AUDIENCE?
>> DO YOU HAVE PLANS THIS COULD
COVER IT AND IS THERE
PERSPECTIVE IN THE FUTURE THIS
IS TO TELL YOU YES OR NO ARE YOU
THINKING ABOUT THE DIRECTION?
>> I THINK YOU'RE TALKING ABOUT
ANTIBIOTIC SPECIFICITY.
YEAR GOING AFTER A SCREENING
TOOL BUT IN THE FUTURE YOU CAN
PAIR THIS WITH A POINT OF CARE
MOLECULAR TEST TO DETERMINE WHAT
BACTERIA WAS THE CAUSATIVE AGE
IN THE.
INTERESTING ENOUGH THOUGH
THERE'S NOT VERY MUCH DETERMINED
THE BIGGEST MARKET IS FOR UTI
SCREEN NOT TO DETERMINE WHAT THE
BACTERIA IS.
>> WILL THE CLINICAL TRIAL BE
POWERED TO DETERMINE DIFFERENCES
BETWEEN RACE AND ETHNICITIES?
>> THAT'S A GOOD QUESTION.
WE'VE DESIGN A CLINICAL TRIAL
PROTOCOL WHERE IT'S ALL COMERS
AND THAT'S WHAT THE FDA LIKES.
BUT PUTTING CLINICAL TRIAL SITES
IN DIFFERENT AREAS WE PLAN TO
GET DIFFERENT POPULATIONS IN
THERE.
WE'D LOVE TO HAVE PREGNANT
PEOPLE INVOLVED.
WE DON'T HAVE AN INCLUSION
CRITERIA THEY HAVE TO BE THIS
BUT WE ARE NOT EXCLUDING THEM
EITHER.
WE INTEND TO HAVE A DIVERSE
POPULATION AS POSSIBLE.
>> WONDERFUL.
WE'VE MOVE TO THE NEXT
PRESENTATION FROM CARETAKER
MEDICAL.
KEVIN FARINHOLT AND HE IS
MATERNAL HEALTH MONITORING WITH
THE VITAL STREAM.
THANK YOU.
>> THANK YOU.
GOOD AFTERNOON, EVERYONE.
REALLY APPRECIATE THE
OPPORTUNITY TO BE HERE FOR
SUMMARIZING OUR WORK ON THE RADX
PROJECT.
MY NAME IS FARINHOLT I'M A DATA
SCIENTIST WITH CARETAKER IN
CHARLOTTESVILLE, VIRGINIA AND
PROVIDE AN OVERVIEW OF OUR
DEVICE TO IMPROVE MATERNAL
HEALTH CARE IN THE HOME SETTING.
THE PLATFORM PROVED -- PROVIDES
A WEARABLE DEVICE WITH THE RISK
UNIT AND FINGER SENSOR THAT
LOOKS AT THE DIGITAL ARTERIES
WITHIN THE PATIENT.
WITH FIVE FDA CLEARANCES WE RELY
ON OUR ANALYSIS TECHNIQUE TO
BEST CALCULATE 16 HEMODYNAMIC
PARAMETERS FOR NON-INVASIVE
ALTERNATIVE CATHETERS AND
PROVIDES HIGH ACUTITY PATIENT
MONITORING AND THE IT CAPTURES
AND PRESENTS THE DATA TO THE
PATIENT OR THE CLINICIAN AND HAS
THE ABILITY TO PAIR WITH
TEMPERATURE SENSORS AND OTHERS
TO SCOMBAND THE MONITORING OF
THE PATIENT.
DATA COULD BE DISPLAYED ON THE
TABLET OR SMARTPHONE AND
IMPORTED INTO EMRs AND HAVE A
MONITORING SYSTEM AND PORTAL
WHERE DATA CAN BE ACCESSED
REMOTELY FOR AT-HOME
DIAGNOSTICS.
FOR THE RADX PROJECT OUR FOCUS
HAS BEEN ON HOW VITAL STREAM CAN
IMPROVE HEALTH CARE DESERTS AND
HEMORRHAGE AND SEPSIS RELATED
COMPLICATIONS.
THEY ACCOUNT FOR A THIRD OF
MATERNAL DEATHS WITHIN THE
U.S. AND ESTIMATES ARE HALF ARE
PREVENTIBLE AND IT'S THOUGHT
EARLY DETECTION IS KEY TO
DETECTING CHANGES AND DETECTING
HEMODYNAMIC PARAMETERS WE CAN
IMPROVE HEALTH WITHIN THE
MATERNAL POPULATION AND CAN
EXTEND TO GENERAL PATIENT
POPULATION ACROSS HOSPITALS.
THE CONCEPT OF CARETAKER MEDICAL
IS DEVELOPED FOR THE MATERNAL
HEALTH FOCUSSING ON PROMOTING
MONITORING BY MOTHERS AT HOME,
BEFORE, DURING OR AFTER DELIVERY
WHERE THE PATIENT IS PRESCRIBED
A VITAL STREAM FOR 10 MINUTE
SESSIONS A FEW TIMES A DAY OR
WHILE THEY SLEEP AT NIGHT
ALLOWING THE MONITOR TO ANALYZE
INFORMATION TO PROVIDE AN
ASSESSMENT BASED ON THE
INDIVIDUAL SESSION AS WELL AS
LOOKING AT DAY TO DAY TRENDS AND
HOW THEY INDICATE WHETHER THE
MOTHER'S HEALTH IS IMPROVING OR
DECLINING IN THE DAYS, WEEKS AND
MONTHS POSTPARTUM.
ANOTHER GOAL IS TO WHY EMPOWER
WOMEN IN THEIR HEALTH DECISIONS
AND DISCUSSIONS WITH HEALTH CARE
PROVIDERS AND DATA CAN BE
UPLOADED AND ACCESSED BY THE
MOTHER'S CLINICIAN AND SUPPORT
TELEHEALTH OR OUT PATIENT CARE.
ADDITIONALLY, WITH THE MOTHER'S
CONSENT IT CAN BE DE-IDENTIFY
FOR RESEARCH.
AS THE MODELS ARE TRAINED AND
DEVELOPED THEY CAN BE REAPPLIED
USING THE DATA DISSEMINATION TO
THE DEVICES OUT IN THE FIELD.
THE PROJECT WE WORKED ON
COMPLIMENTS A NUMBER OF EXISTING
CLINICAL STUDIES FOCUSSED ON
MATERNAL HEALTH IN POSTPARTUM
MOTHERS AND MONITOR PATIENTS AT
RISK FOR HYPERTENSIVE EVENTS AND
PROVIDES AN OUTCOME OF CLINICAL
TRIALS THAT EVOLVE MONITORING IN
THE CLINICAL SETTING AND OUR
TEAM IS ACTIVELY SEEKING
COLLABORATION WITH MEDICAL
EXPERTS AND ACADEM YOU CAN
RESEARCHERS SEEKING NONINVASIVE
SOLUTIONS AND THE PROGRAM HAS
BEEN AN INVALUABLE OPPORTUNITY
TO LEVERAGE CLINICAL TRIALS
FOCUSSED ON SEPSIS MONITORING
INCLUDING TRIALS WHERE VITAL
STREAM HAS BEEN USED TO MONITOR
PATIENTS WITH PREVIOUS SEPSIS
DIAGNOSES AND OTHER HIGH-RISK
SURGICAL PROCEDURES WHERE THE
ONSET OF SEPSIS WAS CAPTURED AND
WERE ABLE TO PROVIDE VALUABLE
INSIGHT INTO THE CHALLENGES OF
GAINING PATIENT TRUST AND THE
PROMISE OF ADEQUATE INFORMATION
THAT CAN HELP EMPOWER WOMEN IN
THEIR DISCUSSIONS WITH THEIR
HEALTH CARE PROVIDERS AND
THEY'VE ALSO PROVIDED GUIDANCE
ON SUPPORTING RURAL COMMUNITIES
AND OBTAIN BUY-IN BY HOSPITALS
AND INSURANCERS AND HEALTH CARE
PROVIDERS TO GET THESE DEVICES
INTO THE HANDS OF MOTHERS WHERE
THEY ARE HAVE NO TRUSTED HEALTH
CARE OPTIONS.
THE VITAL STREAM DEVICE COMBINED
WITH THE EMORY USABILITY STUDY
HAVE HELPED US IDENTIFY FEATURES
OF THE PLATFORM SITUATED FOR
MATERNAL HEALTH AND TO IMPROVE
THE DATA PRESENTATION WORK FLOW
TO SIMPLIFY THE DEVICE AND
ACHIEVE THE HIGHEST LEVEL OF
COMPLIANCE WITH PATIENTS AND THE
IMPROVE RADX PROGRAM HAVE
PARTNERSHIPS AND THE UNIVERSITY
OF VIRGINIA.
THESE STUDIES ARE SHAPING UP TO
BE IMPACTFUL FOR OUR COMPANY.
AND WE ALIGN WITH OUR GOAL OF
PARTNERING WITH OTHERS IN
MATERNAL HEALTH AND WELLNESS.
WE'RE LOOKING TO REPLICATE THESE
WITH OTHER COLLABORATORS AS
THEY'RE INTERESTED.
I APPRECIATE YOUR TIME.
>> THANK YOU.
WE HAVE TIME FOR QUESTION IF
THERE'S ANY FROM THE AUDIENCE.
>> I'M WITH THE DOULA COCO-OP OF
NEVADA IN THE CHALLENGE
PARTICIPANTS.
THESE HAVE THE POTENTIAL TO BE
LIFE SAVING AND INTEGRATED MODEL
FOR BLOOD PRESSURE MONITORING.
IN TERMS OF ACCESS, THE COST OF
MEDICAL DEVICES AND THE COST OF
MEDICAL DEVICES TO BE DEVELOPED
AND ALSO CONTRIBUTED, INSURANCE
COMPANIES DON'T OFTEN COVER THE
COST OF MEDICAL DEVICES FOR
AT-HOME USE.
HOW CAN PEOPLE USE THESE IN A
WAY TO ALLOW THEM TO FULLY
UNDERSTAND THEIR SYMPTOMS
ESPECIALLY IN RURAL AND UNDER
SERVED COMMUNITIES WHERE THEY
DON'T HAVE EXTRA FUNDS FOR WHAT
WOULD MAYBE BE CONSIDERED A
LUXURY ITEM?
I'M WONDERING IF INSURANCE IS
PART OF THAT?
>> WE'RE LOOKING AT THE
INSURANCE MODELS AND CRITICAL
ACCESS 4079S.
THEY HAVE DIFFERENT PROTOCOLS
AND STANDARDS.
WE'RE LOOKING AT THATS AWAY WAY
TO LOOK AT THE UNDER SERVED
SETTING AND LOOKING AT WAYS TO
REDUCE THE COST OF THE DEVICES.
THOSE ARE THE TWO PRIMARY
METHODOLOGIES.
>> WE HAVE ONLINE QUESTION
SIMILAR TO WHAT WAS JUST ASKED
AND IF YOU WOULD BREAK IT DOWN
MORE ABOUT THE PRICE OF THE
DEVICE.
>> RIGHT NOW THE DEVICE IS
CLOSER TO THE THOUSANDS OF
DOLLARS BECAUSE RIGHT NOW
THEY'RE IN A SURGICAL DEPARTMENT
AND TRYING TO GET THAT DOWN TO
THE HUNDREDS OF DOLLARS RANGE
AND THAT'S WHAT WE'RE LOOKING AT
THROUGH IMPROVEMENTS IN THE
ELECTRONICS AS WELL AS REDUCTION
IN SIZE AND CONSIDERING OPTICAL
TECHNIQUES AS WAYS TO AUGMENT
THIS.
>> AT SOME POINT SAY THE TRIAL
WILL SHOW YOU'RE PREVENTING 20%
OF THE TESTS, THAT'S A LOT OF
VALUE LOOKING AT THAT WITH THE
NUMBER OF DEVICES IN THE
POPULATION AND THE SAFKS ARE
HIGHER THAN THE COST THEN THAT
THE WHAT YOU SHOW THE INSURANCE
AND SHOW, WELL, YOU CAN SAVE
MONEY.
>> I APPRECIATE THAT POINT.
WE'VE LOOKED AT THE RISK AND
REDUCING THAT AS ONE METHODOLOGY
FOR THE RETURN ON INVESTMENT.
>> WE NEED TO MOVE ON AND
CONSIDER THE IMPACT ON THE
QUALITY OF HEALTH CARE PROPER IF
HE PATIENT.
ALL RIGHT.
NEXT IS SANGUINA ERIKA TY BURST
SKI TALKING ABOUT THE ANEMOCHECK
MY MOBILE MORE MATERNAL HEALTH
AND ANEMIA MANAGEMENT.
>> HELLO.
LATE IN THE AFTERNOON.
THANK YOU THANKS FOR STICKING
AROUND.
MY NAME IS ERIKA.
I'VE HAD ANEMIA MY WHOLE LIFE
AND HAD SEVERE ANEMIA AFTER
DELIVERING AND I HAD TO MONITOR
MYSELF AT HOME AND WE'RE ONE OF
THE RADX AWARDEES.
IN ATLANTA, GEORGIA WE SEE BIG
HEALTH CARE EQUITY DISPARITIES.
HAVING OUR COMPANY THERE WAS
IMPORTANT.
I WANTED TO CREATE TOOLS AS
ACCESSIBLE AS POSSIBLE TO
UNDERSTAND INFORMATION WITH YOUR
HEALTH.
IF WE CAN DO IT WITHOUT
EQUIPMENT, LET'S DO IT.
IF WE CAN DO IT FULLY DISPOSABLE
AND AFFORDABLE, WHY NOT.
THAT'S THE GENESIS BEHIND WHAT
YOU ARE OUR COMPANY DOES.
WE CREATE SMART PHONE APPS AND
LOOK THE ACUTE ILLNESS AND
CHRONIC DISEASE AND HAVE A LOT
OF THAT IN THE STATE OF GEORGIA
EVEN 20 MILES OUTSIDE THE CITY.
YOU CAN GET INTO A MATERNITY
DESERT AND MAKE TESTING HAPPEN.
ANEMIA IS A FIRST TARGET.
I HAVE GREAT CO-FOUNDERS WHO
HAVE EXPERIENCES WITH ANEMIA.
IT EXISTS IN 2.4 BILLION PEOPLE
ON THE PLANET.
IT'S THE MOST COMMON BLOOD
DISORDER AND IT'S VERY MUCH LIKE
A VITAL SIGN IN SAYING SOMETHING
IS OUT OF WHACK IN YOUR SYSTEM.
IT CAUSES NON-SPECIFIC SYMPTOMS.
FATIGUE, DIZZINESS, IT CAN CAUSE
COMPLICATIONS SPECIFICALLY IN
PREGNANCY AND POSTPARTUM
POPULATIONS.
IF I USE THE WORD HEMOGLOBIN
IT'S JUST A METRIC AND THE
NUMBER IS IN LOW RESOURCE
SETTINGS AND EVEN AT HOME WE
HAVE A BIG POPULATION THAT'S
ANEMIC.
WE CREATED TWO TOOLS FOR
DETECTING ANEMIA.
THE FIRST ONE IS A HOME TEST KIT
THAT USED A DROP OF BLOOD FOR
HEMOGLOBIN DETECTION AND IT'S
GETTING FOR A LAUNCH FOR HOME
USE.
WE'RE VERY PROUD OF THAT.
IT'S A SIMPLE TEST AND TAKES TWO
MINUTES AND WE'LL BE PRICING IT
SIMILAR TO OTHER DISPOSABLE
TESTS IN THE MARKET.
I HOPE BE EXCITING NEWS IN THE
FUTURE.
THE REASON I BRING IT UP IS WE
DECIDED TO PUSH THE ENVELOPE
FURTHER AND DO ANEMIA TRACKING
AND MANAGEMENT WITHOUT TOOLS AND
EQUIPMENT TAKING OFF THE-SHELF
COMPONENTS AND FOR US THAT WAS A
SMARTPHONE.
AS SOMEONE ALLUDED TO EARLIER
EVERYONE HAS A SMART PHONE AND
PEOPLE ARE CONNECTED AND THEY'LL
FIND WI-FI EVEN IN A FREE
LIBRARY AND HOW CAN WE TURN THE
PHONE INTO SOMETHING THAT HELPS
WITH MEDICAL TRACKING?
WE CREATED A NON-INVASIVE
TECHNOLOGY THAT USES OLD SCHOOL
MEDICINE LOOKING AT THE PALENESS
OF NAIL BEDS AND YOU TAKE A
PICTURE AND IT'S AVAILABLE ON
THE APP STORES IT'S CALLED ANEMO
CHECK GLOBAL AND IN A MATTER OF
SECONDS IT BALANCES BACK TO GIVE
IN ESTIMATE OF YOUR HEMOGLOBIN
LETTER ON SCREEN AND FROM THERE
YOU CAN TRACK RESULTS.
WE LAUNCHED THIS TWO OR THREE
YEARS AGO AND IT'S A PRETTY GOOD
SCREENING TOOL AND THERE'S
VARIABILITY WITH LIGHTING AND
PERSON AND TESTED THIS ON MANY
SKIN TONES TO CHARACTERIZE HOW
IT WORKS.
THIS IS WHERE THE MAJOR OF THE
TWO TECHNOLOGIES COMES INTO
PLAY.
IF YOU HAVE A BASELINE RESULT
WHETHER A LAB OR OUR SINGLE USE
DISPOSABLE TEST YOU CAN
CALIBRATE THE APP SO IT'S KRAEKT
-- CREATED FOR YOUR HOME AND
ANYTHING INTRAPERSONAL TO YOUR
NAIL BEDS.
WE GET AS GOOD AS A BLOOD TEST
AND HAVE DONE STUDIES WITH THE
RADX AND IN CHRONIC DISEASE
POPULATIONS BUT THE PROGRAM HAS
BEEN THE LAUNCH PAD TO LOOK AT
THIS FOR PREGNANCY AND
POSTPARTUM.
ANYONE WITH A SMART PHONE CAN
START TRACKING THEIR HEMOGLOBIN
LEVEL AT HOME.
I LIKE TO TALK ABOUT HOW MANY
PEOPLE WE'VE BEEN ABLE TO REACH
SO FAR WE HAVE 231,000 USERS IN
THE U.S. ONLY.
WE'RE LOOKING TO EXPAND
WORLDWIDE.
THERE'S A FEW LOGISTICAL THINGS
BUT EXCITED TO BRANCH IT OTHER
COUNTRIES AND HAVE A MILLION AND
A HALF TESTS AND WHEN WE TALK
ABOUT ACCESS I LIKE THESE
NUMBERS THE MOST.
THANK YOU.
HAPPY TO TAKE ANY QUESTIONS.
>> WE STARTED PARTNERSHIPS WITH
FOLKS IN WEST AFRICA AND
WONDERING IF YOU TEST THE
PRODUCT ON DIFFERENT RACIAL
BACKGROUNDS.
WHAT'S THE LOOK LIKE IN TERMS OF
NAIL BEDS?
>> WE HAVE A COUPLE PARTNERSHIPS
IN AFRICA RIGHT NOW.
WE LOVE PARTNERING WITH LOCAL
RURAL AREAS TO COLLECT DATA AND
TO BE HONEST A LOT OF OUR DATA
HAS BEEN DONE IN AFRICAN
AMERICAN AND AFRICAN AMERICAN
COMMUNITY COMMUNITIES.
WE LOOKED AT THOSE DEMOGRAPHICS.
>> HI, I'M FROM STANFORD
UNIVERSITY.
CAN YOU COMMENT ON DIFFERENT
TYPES OF ANEMIA, HEREDITARY OR
IRON DEFICIENCY.
HAVE YOU LOOKED BEYOND
HEMOGLOBIN?
>> WE HAVE A GOOD DATA SET ON
ANEMIA DUE TO DIFFERENT REASONS.
IRON DEFICIENCY IS PROBABLY THE
BIGGEST.
WE HAVE PEOPLE WITH BLOOD
DISORDER.
WE HAVE DONE A LOT WITH SICKLE
CELL AND THALASSEMIA AND KIDS
AND ADULTS AND HAVEN'T TESTED
EVERY SINGLE REASON WHY SOMEONE
IS ANEMIC BUT THE BEAUTIFUL PART
ABOUT CALIBRATING IS WE CAN GET
THAT PERSON'S BASELINE WHEREVER
IT PLAY BE AND WHATEVER
CONDITION THEY PLAY BE DEALING
WITH AND THE IDEA THEY'LL BECOME
MORE PALE AS THEY BECOME ANEMIC
HAS BEEN TRUE.
IF THERE'S A SPECIFIC CONDITION
YOU WANT TO TALK ABOUT I'M HAPPY
TO.
6:
>> HELLO.
I'M DEIDRE LYLE FROM STANFORD.
CAN YOU TALK ABOUT VALIDATION
WHEN YOU LOOKED AT THE NAIL BED
AND HEMOGLOBIN LEVELS NOT IN THE
SEVERE RANGE.
YOU FOCUSSED ON MAYBE SEVERE
ANEMIA BUT MAYBE HEMOGLOBIN, 10,
11 AND 12?
>> THE ALGORITHM IN OUR WELLNESS
TOOL FOR IRON SCORE AS OF RIGHT
NOW AND ANEMIA THE BEST RANGE IS
BETWEEN 10 AND 13 AND LOOKING AT
THE PEOPLE JUST BORDERLINE
ACCORDING TO W.H.O. STANDARDS
FOR WOMEN AND MEN.
I WOULD SAY YES AND I THINK THE
MORE SEVERE THE MORE IMPORTANT
IT IS TO BASELINE WITH THE
CALIBRATION.
>> I'M IN MY OTHER LIFE I'M A
LACTATION CONSULTANT AND THIS IS
MAYBE MORE OF A COMMENT BUT ONE
THING WE OFTEN LOOK FOR IS
ANEMIA WIN MOMS WITH LOW MILK
SUPPLY.
>> LET'S TALK.
WE PARTNER WITH SYMPTOMOLOGY AND
THERE'LL BE A PUBLICATION WHERE
IN A DIFFERENT DISEASE STATE WE
DID THAT AND PARTNERING WITH THE
RIGHT QUESTIONS AND TECHNOLOGY,
SENSITIVITY WENT THROUGH THE
ROOF TO DETECT A CONDITION.
I'LL LOVE TO PARTNER.
I WAS TAKING SCREEN SHOTS OF
YOUR PRESENTATION TOO.
>> GREAT DISCUSSION
>> NEXT IS KELSEY MAYO FROM
ARMOR MEDICAL AND TALKING ABOUT
MANY TERM ARMOR PROTECTION
THROUGH EARLY HEMORRHAGE
DETECTION.
>> I'M KELSEY MAYO THE
CO-FOUNDER AND CEO OF ARMOR
MEDICAL.
OUR COMPANY IS PIONEERING
WEARABLES TO SAFEGUARD MATERNAL
HEALTH.
WE'RE HERE TO CELEBRATE THE
IMPROVE INITIATIVE.
MY GOAL IS FIRST AND FOREMOST TO
SAY THANK YOU.
AND TO EMPHASIZE HOW IMPORTANT
PROGRAMS LIKE THIS HAVE HELPED
TACKLE THE CRISIS.
I'M STANDING HERE AS AN
ENGINEER, AS A MOM AND SURVIVOR
OF HEMORRHAGE TO UNDER SCORE THE
FACT THAT HEMORRHAGE IS A GLOBAL
LEADING CAUSE OF MATERNAL DEATH
AND MORBIDITY AND IT IS UP TO
90% PREVENTIBLE WITH EARLY
DETECTION AND TREATMENT.
WHY AREN'T WE ABLE TO DETECT
HEMORRHAGE EARLY TODAY?
WELL, EARLY BLEEDING IS OFTEN
SILENT.
PREGNANT PEOPLE CAN LOSE UP TO
25% OF THEIR TOTAL BLOOD VOLUME
BEFORE WE'LL SEE A CHANGE
REFLECTED IN THEIR HEART RATE
AND BLOOD PRESSURE.
AND THIS BLOOD LOSS IS OFTEN
TIMES INTERNAL AND HIDDEN.
THIS DEPICT THE BODY'S RESPONSE
TO INCREASING BLOOD LOSS AND
ALSO HIGHLIGHTS HOW THE
TREATMENTS BECOME INCREASINGLY
MORE INVASIVE AND EXPENSIVE.
SO LET'S FACE IT, FOLKS,
PROVIDERS NEED BETTER TOOLS.
THE CURRENT STANDARD OF CARE
INCLUDES VISUAL ESTIMATION OF
BLOOD LOSS, WEIGHING BLOOD
SOAKED PADS AND LOOKING AT
TRADITIONAL VITAL SIGNS.
IT'S NOT WORKING.
OUR TEAM AT ARMOR MEDICAL
RECOGNIZES THE MATERNAL HEALTH
CRISIS AND DEVELOPED A
TECHNOLOGY THAT WE BELIEVE WILL
BECOME THE NEW GOLD STANDARD OF
CARE.
OUR DEVICE DETECTS THE EARLIEST
SIGN OF HEMORRHAGE WHICH IS
COMPENSATION.
MATERNAL ARMOR IS A WRIST WORN
BLOOD FLOW HEMORRHAGE USED TO
DETECT RISK IN REAL TIME.
THE PATENTED TECHNOLOGY WORKS BY
SENSING AND ALERTING PROVIDERS
TO THE CHANGES AND BLOOD FLOW
THAT HAPPENS AS THE BODY
SHOULDN'T FROM BLOOD FROM THE
PERIPHERY TO THE CORE AND
ACCURATE AND ALLOWS PROVIDERS TO
STAY ONE STEP AHEAD IN
RECOGNIZING AND RESPONDING TO A
HEMORRHAGE.
WE BELIEVE THAT EARLY AND
ACCURATE DETECTION IS THE
SOLUTION AND STUDIES AT
WASHINGTON UNIVERSITY IN
ST. LOUIS SHOWS OUR DEVICE
DETECTS EARLIER THAN STANDARD OF
CARE AND WORKS ROBUSTLY IN
DIVERSE PATIENT POPULATIONS.
THIS HELPS US ACHIEVE BETTER
HEALTH OUTCOMES FOR ALL.
SO, AS YOU CAN SEE HERE, WE ARE
ONE OF THE FINALISTS IN THE RADX
TECH FOR MATERNAL HEALTH
CHALLENGE AND WANT TO TAKE A
MOMENT ON THE PROGRESS ENABLED
THROUGH THE RADX PROGRAM.
ONE THING WE'VE BEEN ABLE NO DO
IS TALK TO IMPRESSIVE AND
INCREDIBLE THANK YOU FOR
DONATING YOUR TIME, ALL THE
CLINICAL KOLs AND THE MEMBERS OF
THE COMMUNITIES THAT WE AIM TO
SERVE.
WE PARTNERED WITH THEM AND WITH
THEIR HELP WE'VE BEEN ABLE TO
ESTABLISH A NOW PATENT-PENDING
METHOD FOR PERSONALIZING OUR
RISK ASSESSMENT AND WE'VE
IMPROVED BOTH OUR FORM FACTOR
AND WEARABILITY AND USABILITY
AND COMFORT AND FURTHERMORE IN A
RECENT CLINICAL STUDY CONFIRMED
OUR ABILITY TO GO BEYOND BLOOD
FLOW AND MEASURE ADDITIONAL
PARAMETERS WITH OUR PLATFORM
THAT WILL HELP US EXPAND OUR
PRODUCT PIPELINE INTO ADDITIONAL
APPLICATIONS THAT SERVE MOMS AND
PREGNANT PEOPLE.
ANOTHER THING THAT WE'VE
ACCOMPLISHED WITHIN THE RADX
PROGRAM IS WE FINE TUNED OUR
REGULATORY STRATEGY TO BETTER
LEVERAGE OUR STATUS AS AN
INNOVATIVE NON-INVASIVE DEVICE
AND POSITION OURSELVES TO SECURE
ADDITIONAL REIMBURSEMENT HELPING
TO ACHIEVE GREATER ACCESS TO THE
TECHNOLOGY IN REGIONS THAT NEED
IT MOST.
WE'VE RECEIVED A LOT OF
RECOGNITION FOR OUR WORK AND
PROGRESS OVER THE LAST TWO YEARS
AND PROUD TO SAY WE'RE ON TRACK
TO LAUNCH OUR TECHNOLOGY TO
U.S. MARKETS IN 2027.
THIS IS NOT SOMETHING THAT I'VE
DONE ALONE.
I'M SO THANKFUL TO BE A PART OF
AN INCREDIBLE TEAM AND WANT TO
EXTEND A SINCERE THANK YOU TO
MANY IN THE AUDIENCE AND PEOPLE
FROM NIH AND HHS AS WELL AS THE
INCREDIBLE COMMUNITY OF PARTNERS
MANY REPRESENTED ON THE SLIDE.
WITHOUT THEM, WITHOUT YOU, I
DON'T THINK WE WOULD HAVE BEEN
ABLE TO MOVE THIS QUICKLY AND I
AM DEEPLY GRATEFUL FOR YOUR
COLLABORATION AND SUPPORT.
THANK YOU FOR DARING TO INNOVATE
WITH US BECAUSE TOGETHER WE WILL
SAVE LIVES.
>> QUESTION FROM THE AUDIENCE?
OKAY.
>> DO YOU SEE A FUTURE WHERE THE
TECHNOLOGY IN A SMART PHONE OR
WHERE EVERYBODY CAN AFFORD?
>> I LOVE THE QUESTION EARLIER
ABOUT ACCESS.
I THINK IT'S A SUPER POWER.
WE DEMONSTRATED WE CAN
MANUFACTURE THE DEVICE AT LOW
COST.
WE'VE BEEN VERY INNOVATIVE IN
OUR BUSINESS MODEL AS WELL AS
OUR TECHNOLOGY TO THINK ABOUT
MANUFACTURING OUR DEVICE SO THAT
IT IS ACCESSIBLE WHERE NEEDED
MOST.
A QUICK ASIDE THE DEVICE DOESN'T
HAVE A SCREEN THAT WAS
INTENTIONAL TO LOWER THE COST OF
MANUFACTURING BECAUSE WE CAN DO
IMPORTANT WORK WITHOUT
INCREASING THE COST OF THE
DEVICE SO IT BECOMES AFFORDABLE
AND COULD THE TECHNOLOGY BE
EMBEDDED TO OTHER WEARABLES?
IN THE FUTURE IT COULD BE.
RIGHT NOW THE DEVICE WORKS YOU
CAN'T DO ABOUT WHAT WE DO WITH
EXISTING SMART WATCHES BUT I'M
OPEN TO THAT REACH PEOPLE IN THE
REMOTE MONITORING AND PATIENT
CONSUMER QUESTIONS.
>> ONE IS IS THIS DEVICE MORE
JUST FOR THE HOSPITAL OR THE
PLANNING TO DEPLOY WITH MORE
DATA AND THE SECOND WHICH IS
SIMILAR, AND ALSO IS IT BASED ON
SENSITIVITY?
OUR TEAM THOUGHT LONG AND HARD
WHERE DO WE START?
DO WE START WITH REMOTE PATIENT
MONITORING AND THINKING ABOUT
SECONDARY POST PARTUM HEMORRHAGE
AT HOME?
WHAT WE DECIDED IS MOST
HEMORRHAGE HAPPENS IN THE 24
HOUR WINDOW.
THAT'S WHERE WE NEED TO START.
THAT'S NOT WHERE WE ARE
STOPPING.
WE'LL FIRST DEPLOY OUR DEVICE
BOTH IN TRADITIONAL HOSPITAL
SETTINGS BUT ALSO CLAIMS SUCH AS
THIS DEVICE CAN BE USED BY
CERTIFIED NURSE MIDWIVES AND
BIRTHING CENTERS.
WE ABSOLUTELY BELIEVE WE HAVE A
ROLE IN ADDRESSING GAPS IN CARE
AND I'M BULLISH ON THAT POINT.
WE WILL BE EXPANDING INTO
AT-HOME SETTINGS LOOKING AT POST
SECONDARY HEMORRHAGE AND WE
BELIEVE IT'S A PLATFORM
TECHNOLOGY AND THERE'S SO MANY
OF MY INCREDIBLE PEERS ON THIS
STAGE AND THROUGHOUT THE
CONFERENCE HAVE SPOKEN TO SO
MANY OTHER RELATED
CARDIOVASCULAR COMPLICATIONS
THAT DISPROPORTIONATELY AFFECT
WOMEN IN THIS PERIOD OF LIVES
AND BELIEVE WE CAN MAKE AN
IMPACT IN THAT SETTING AS WELL
AS.
THAT'S THE FIRST PART.
THE SECOND QUESTION, CAN YOU
REMIND ME?
>> IS THE DEVICE ABLE TO
STRATIFY OR BE MORE PROPER FOR
AT RISK WOMEN OR THE SAME
SENSITIVITY ACROSS?
IN THIS RESPECT TO THIS.
>> WE LOOKED AT THE ACOG
GUIDELINES WHERE ALL PREGNANT
PEOPLE ARE SCREENED FOR
POSTPARTUM HEMORRHAGE BECAUSE
THEY LAP CAN HAPPEN WITH THOSE
WITHOUT RISK FACTORS BUT BELIEVE
IT SHOULD BE STANDARD OF CARE
AND AVAILABLE TO ALL MOTHERS.
GREAT QUESTIONS.
THANK YOU ALL.
THANK YOU FOR YOUR TIME.
>> WE WANT TO THANK ALL THE
PRESENTERS AND AUDIENCE ONLINE
AND HERE FOR THE GREAT
ENGAGEMENT.
I WOULD LIKE TO INVITE DR
DR. CHAKTOURA TO DO THE WRAP-UP
FOR THE DAY AND WHILE SHE COMES
UP I WANT TO THANK ALL THE
FINALISTS AGAIN IT'S WONDERFUL
TO SEE THE DEVICES MATURE TO THE
END AND ALL THE PEOPLE INVOLVED
BEHIND THE SCENES.
THANK YOU VERY MUCH.
>> I WANT TO THANK EVERYONE THAT
PRESENTED TODAY AND EVERYONE IN
THE AUDIENCE AND OUR VIRTUAL
AUDIENCE AS WELL.
A GREAT ROUND OF APPLAUSE FOR
EVERYBODY.
I KNOW IT'S A LONG DAY AND JUST
TO SAY RADX MATERNAL HEALTH
PARTNERS WILL BE UPSTAIRS SO
PLEASE JOIN THEM FOR THE
DEMONSTRATION.
AGAIN, ENCOURAGE YOU ALL TO
COLLABORATE TOGETHER ON THESE
ACTIVITIES.
THE IS THE FIRST MEETING WHERE
ALL THE IMPROVE WORK STREAMS
HAVE MET TOGETHER AND COME
TOGETHER TO SHARE THEIR WORK AND
THEIR FUTURE WORK AND WHAT THEY
ARE HAVE ONGOING.
REALLY ENCOURAGED BY
COLLABORATION.
JUST A BRIEF HIGH-LEVEL SUMMARY
FOR THE DAY.
WE REALLY APPRECIATE THE FOCUS
ON CENTERING THE COMMUNITIES AND
THE COMMUNITIES AFFECTED IN THIS
MATERNAL HEALTH CRISIS WE HAVE
IN THE U.S.
WHAT WE UNDER SCORED IS THAT
BUILDING RELATIONSHIPS TO BUILD
TRUST AND WE DO WANT ARIZONA'S
T-SHIRTS FOR ALL THE NIH FOLKS.
I'M JOKING BUT NOT REALLY
JOKING.
I'D LOVE ONE.
RESPECTING AND INCORPORATING
CULTURAL PRACTICES IN RESEARCH
DESIGNS AND MAKE SURE THERE'S
MULTI-LEVEL ENGAGEMENT WITH THE
COMMUNITY PARTNERS ACROSS WHAT'S
ALREADY PRESENTED AND BEING
PLANNED AND WHAT CAME THROUGH
LOUD AND CLEAR AND IMPORTANT
FROM OUR PERSPECTIVE AND NIH
PERSPECTIVE AND KNOWING IT'S
GOING TO TAKE TIME TO BUILD THAT
IF IT'S NOT ALREADY EXISTING TO
BUILD THAT RELATIONSHIP AND
MAKING SURE IT'S NOT REALLY
TRANSACTIONAL BUT INFORMED BY
THE COMMUNITIES YOU ALL SERVE
AND AMPLIFYING THE VOICES OF THE
COMMUNITY AND JOINING THEM AT
THEIR TABLE.
I LOVED THAT STATEMENT.
I DON'T KNOW WHO SAID IT BUT I
LOVE THAT STATEMENT MAKING SURE
WE JOIN THE COMMUNITY AT THEIR
TABLE.
OPPORTUNITIES TO INCORPORATE
TECHNOLOGIES.
YOU HEARD OF THE VARIOUS RADX
MATERNAL HEALTH WINNERS AND
SEEING WHAT OPPORTUNITIES EXIST
IN INCORPORATING THAT TO YOUR
WORK WHETHER IT'S NOW OR FUTURE
OPPORTUNITIES.
AND INTEGRATING THE COMMUNITY
HEALTH WORKERS IN VARIOUS WAYS,
UNDERSTANDING THAT'S ALSO
POTENTIALLY A CHALLENGE OR NOT
POTENTIALLY BUT THAT'S A
CHALLENGE SOMETIMES IN YOUR WORK
BECAUSE THEY MAY NOT GET
REIMBURSED IN THE SAME WAY
ACROSS THE STATES AND
COMMUNITIES THAT YOU SERVE.
AND REALLY OPPORTUNITIES TO
LEARN FROM EACH OTHER INCLUDING
CHALLENGES.
I THINK WE HAVE TWO PRESENTERS
TALK ABOUT THE CONSEQUENCES OF
LEGAL PULSE AND POLICY SCENARIOS
IN THEIR SPACE AND HOW THAT
EFFECTS THE CARE OF THE WOMAN
AND ACCESS TO CARE WHETHER
THAT'S BEING ABLE TO CARE FOR
THEMSELVES, THE RISK FOR
THEMSELVES AND THE RISK OF
SEPARATION FROM THEIR INFANTS.
SO THAT'S IMPORTANT FOR US TO
CONSIDER.
THERE'S REIMBURSEMENTS WE TALKED
ABOUT AND THE THEME ACROSS
TRANSPORTATION, FOOD INSECURITY
AND BASIC NEEDS INDIVIDUALS NEED
THROUGHOUT THEIR LIVES BUT
ESPECIALLY IN PREGNANCY AND THE
POSTPARTUM PERIOD WERE
HIGHLIGHTED.
THOSE ARE HIGH-LEVEL SUMMARIES
OF DAY ONE AND AGAIN THANK YOU
ALL FOR YOUR PARTICIPATION AND
ENGAGEMENT AND GREAT
PRESENTATIONS.
AND NOW IT IS MY PLEASURE TO
INTRODUCE ONE MORE PERSON THAT
WILL TALK TO US SO DR. ANDREA IS
GOING TO COME UP AND CREATING A
DATA MOSAIC AND SHARING THE
WINNER OF THAT CHALLENGE.
WE INVITED CONTRIBUTIONS FROM
ALL THE CENTERS OF EXCELLENCE.
WE RECEIVED EIGHT SUBMISSIONS
POSTER SUBMISSIONS AND
PRESENTATIONS OF ITE DIFFERENT
RESEARCH STUDIES AND DIFFERENT
AUTHORS AND FOLKS COMING DEATH
AND BRIDGIE IIE IING -- BRINGI
DATA.
I'LL START WITH THE MOST
COMPELLING VIEWS OF DATA
COLLECTED BEFORE THE PANDEMIC
AND DURING AND AFTER THE
PANDEMIC.
AND THIS POSTER AWARDS GOES TO
DR. EMILY HARTWELL FROM TULANE
UNIVERSITY.
THANK YOU SO MUCH.
I HAVEN'T DONE THIS BEFORE BUT
IT'S VERY FUN.
THE TITLE OF THE PRESENTATION IS
INFERENCE OF THE COVID-19
PANDEMIC PARTICIPATION IN
CONNECTED MOM.
WE LEARNED ABOUT THE PROGRAM IN
THE FIRST PANEL THIS MORNING.
CONGRATULATIONS TO YOU AND YOUR
TEAM.
THE POSTER AWARD FOR BEST USE OF
MIXED METHODS GOES TO
DR. McCORMACK FROM COLUMBIA
UNIVERSITY.
THE TITLE OF THE POSTER IS LOW
COST, HIGH BARRIERS AND IMPACT
OF STRUCTURAL RACISM IN HEALTH
EARLY IN THE COVID-19 PANDEMIC.
CONGRATULATIONS.
THE AWARD FOR BEST USE OF LINK
DATA GOES TO DR. COLES FROM
UNIVERSITY OF OKLAHOMA.
THE TITLE IS IMPACT OF COVID-19
ON MATERNAL HEALTH SERVICE AND
OUTCOMES IN OKLAHOMA.
THE AWARD FOR BEST USE OF FLASHL
DATA GOES TO DR. QOQALI FROM
COLUMBIA UNIVERSITY.
CONGRATULATIONS.
BEST USE OF STATE MEDICAID DATA.
THIS POSTER AWARD GOES TO
DR. ZU.
THIS IS MICHIGAN STATE
UNIVERSITY.
CONGRATULATIONS.
THE TITLE IS ON RACIAL
DISPARITIES AND COMORBIDITY
DURING THE PANDEMIC.
THE POSTER AWARD FOR ENGAGEMENT
OF EARLY STAGE EVALUATORS GOING
TO DR. MEDEA, MICHIGAN STATE
UNIVERSITY AND THE POSTER TITLE
WORKING WITH SEVEN EARLY STAGE
INVESTIGATORS.
THE TITLE WAS SEVERE MATERNAL
DISPARITIES IN A MEDICAID
POPULATION IN MICHIGAN.
WE HAVE TWO MORE AWARDS.
THE POSTER AWARD FOR MOST
INNOVATIVE USE OF VALIDATED
MEASURES GOES TO CHRISTINE
YOKUMS FROM UNIVERSITY OF
OKLAHOMA.
THE TITLE IS CHILD WITH
ADVERSITY AND COVID OUTCOMES ON
MATERNAL HEALTH.
AND THE AWARD FOR MOST
INNOVATIVE USE OF DATA VISUALS
GOES TO DR. GALE -- I WON'T BE
ABLE TO PRONOUNCE THIS WELL, AND
THE TITLE OF THE POSTER IS BIRTH
WEIGHT ASSOCIATED WITH INTERVAL
OF TIME BETWEEN COVID DIAGNOSIS
AND DELIVERY.
THANK YOU FOR THE YOU
OPPORTUNITY.
WE'LL HAVE THE DATA MOSAIC
CHALLENGE AGAIN NEXT YEAR
BECAUSE WE'LL DO THIS EVERY TIME
WE MEET WITH THE CENTERS OF
EXCELLENCE.
THE THEME THIS YEAR AS YOU KNOW
ALREADY I'M GOING THROUGH IT FOR
EVERYONE WAS INFLUENCE OF
COVID-19 ON NEWBORN HEALTH
OUTCOMES AND THE THEME NEXT
WE'RE WILL BE DIFFERENT.
WE INVITE WIDE PARTICIPATION BY
CENTERSES -- CENTERS NEXT YEAR
AND INVITE YOU TO SEE THE
POSTERS FOR THIS YEAR'S
CHALLENGE UPSTAIRS.
THANK YOU SO MUCH.
>> SO, I'D INVITE EVERYBODY TO
GO UPSTAIRS FOR THE POSTER
SESSION AS WELL AS THE
DEMONSTRATION.
PLEASE JOIN US UPSTAIRS AND
THANK YOU AGAIN FOR A GREAT DAY.