1
00:00:05,764 --> 00:00:06,665
ALL RIGHT, SO LET'S GET

2
00:00:06,665 --> 00:00:07,333
STARTED THIS MORNING.

3
00:00:07,333 --> 00:00:09,301
THANK YOU ALL FOR JOINING US

4
00:00:09,301 --> 00:00:11,604
AGAIN TODAY'S.

5
00:00:11,604 --> 00:00:13,339
MY NAME IS JOHN GREYSON, I'M

6
00:00:13,339 --> 00:00:14,440
FROM THE NATIONAL INSTITUTE OF

7
00:00:14,440 --> 00:00:15,307
NURSING RESEARCH AND I'M PROUD

8
00:00:15,307 --> 00:00:16,842
TO BE ONE OF THE CO-CHAIRS OF

9
00:00:16,842 --> 00:00:18,143
THE IMPROVE COORDINATING

10
00:00:18,143 --> 00:00:18,410
COMMITTEE.

11
00:00:18,410 --> 00:00:21,647
SO WE HEARD SOME GREAT

12
00:00:21,647 --> 00:00:23,315
PERSPECTIVES AND LEARNED ABOUT

13
00:00:23,315 --> 00:00:24,183
SOME OUTSTANDING SCIENCE FROM

14
00:00:24,183 --> 00:00:26,585
OUR INVESTIGATORS AND COMMUNITY

15
00:00:26,585 --> 00:00:28,153
PARTNERS AND TECHNOLOGY TEAMS ON

16
00:00:28,153 --> 00:00:31,490
DAY ONE AND I'M REALLY LOOKING

17
00:00:31,490 --> 00:00:33,058
FORWARD TO HEARING MORE FROM

18
00:00:33,058 --> 00:00:35,227
MANY MORE OF OUR IMPROVE

19
00:00:35,227 --> 00:00:35,961
PARTNERS ON DAY TWO.

20
00:00:35,961 --> 00:00:38,397
YESTERDAY YOU HEARD FROM TWO OF

21
00:00:38,397 --> 00:00:40,266
THE IMPROVE EXECUTIVE CO-CHAIRS,

22
00:00:40,266 --> 00:00:41,667
DR. BIANCHI AND DR. CLAYTON, AND

23
00:00:41,667 --> 00:00:43,402
TO START US OFF TODAY, I'M VERY

24
00:00:43,402 --> 00:00:45,838
PLEASED TO INTRODUCE THE THIRD

25
00:00:45,838 --> 00:00:48,240
CO-CHAIR, DR. SHANNON ZENK,

26
00:00:48,240 --> 00:00:49,041
DIRECTOR OF THE NATIONAL

27
00:00:49,041 --> 00:00:49,842
INSTITUTE OF NURSING RESEARCH

28
00:00:49,842 --> 00:00:52,478
AND ALSO MY BOSS.

29
00:00:52,478 --> 00:00:55,714
SHE'LL SAY A FEW WORDS ABOUT

30
00:00:55,714 --> 00:00:57,216
IMPROVE'S EMPHASIS ON THE

31
00:00:57,216 --> 00:00:58,117
RELATIONSHIPS BETWEEN SOCIAL

32
00:00:58,117 --> 00:00:59,518
DETERMINANTS OF HEALTH AND

33
00:00:59,518 --> 00:01:00,953
HEALTH EQUITY AND MATERNAL

34
00:01:00,953 --> 00:01:04,123
MORBIDITY AND MORTALITY.

35
00:01:04,123 --> 00:01:05,891
DR. ZENK JOINED NINR AS ITS

36
00:01:05,891 --> 00:01:07,293
DIRECTOR IN 2020, WHERE SHE LED

37
00:01:07,293 --> 00:01:08,827
THE DEVELOPMENT OF A NEW

38
00:01:08,827 --> 00:01:09,862
STRATEGIC VISION AND STRATEGIC

39
00:01:09,862 --> 00:01:12,665
PLAN FOR THE INSTITUTE.

40
00:01:12,665 --> 00:01:13,766
THAT CENTERS ON SOCIAL

41
00:01:13,766 --> 00:01:14,867
DETERMINANTS OF HEALTH AND

42
00:01:14,867 --> 00:01:16,168
HEALTH EQUITY IN THE ROLE OF

43
00:01:16,168 --> 00:01:17,970
NURSES AND NURSE SCIENTISTS IN

44
00:01:17,970 --> 00:01:19,972
THE RESEARCH LANDSCAPE.

45
00:01:19,972 --> 00:01:21,940
DR. ZENK ALSO LEADS THE

46
00:01:21,940 --> 00:01:23,642
NEIGHBORHOODS AND HEALTH LAB IN

47
00:01:23,642 --> 00:01:24,476
THE NATIONAL INSTITUTE ON

48
00:01:24,476 --> 00:01:27,413
MINORITY HEALTH AND HEALTH

49
00:01:27,413 --> 00:01:28,514
DISPARITIES INTRAMURAL PROGRAM

50
00:01:28,514 --> 00:01:29,948
AND HER RESEARCH CENTERS ON

51
00:01:29,948 --> 00:01:31,450
ENVIRONMENTAL EXPOSURES AND

52
00:01:31,450 --> 00:01:32,651
INJUSTICE AND THE ROLE THOSE

53
00:01:32,651 --> 00:01:33,786
PLAY IN HEALTH DISPARITIES.

54
00:01:33,786 --> 00:01:35,621
WITH THE ULTIMATE GOAL OF

55
00:01:35,621 --> 00:01:37,823
PRODUCING EVIDENCE TO HELP

56
00:01:37,823 --> 00:01:39,358
ELIMINATE RACIAL/ETHNIC AND

57
00:01:39,358 --> 00:01:40,092
SOCIOECONOMIC HEALTH

58
00:01:40,092 --> 00:01:40,526
DISPARITIES.

59
00:01:40,526 --> 00:01:42,394
SO WITHOUT FURTHER DELAY, I'D

60
00:01:42,394 --> 00:01:44,363
LIKE TO INTRODUCE DR. SHANNON

61
00:01:44,363 --> 00:01:45,798
ZENK.

62
00:01:45,798 --> 00:01:55,007
[APPLAUSE]

63
00:01:55,007 --> 00:01:57,810
>> GOOD MORNING TO
EVERYONE AND

64
00:01:57,810 --> 00:02:00,346
WELCOME TO DAY TWO OF THE

65
00:02:00,346 --> 00:02:01,647
IMPROVE INITIATIVE'S FIFTH

66
00:02:01,647 --> 00:02:05,351
ANNIVERSARY MEETING.

67
00:02:05,351 --> 00:02:05,984
WELCOME.

68
00:02:05,984 --> 00:02:07,453
WE LEARNED YESTERDAY AND AS WE

69
00:02:07,453 --> 00:02:08,754
WILL SEE AGAIN TODAY THAT

70
00:02:08,754 --> 00:02:11,457
IMPROVE HAS MADE TREMENDOUS

71
00:02:11,457 --> 00:02:12,725
PROGRESS BECAUSE OF YOU OVER THE

72
00:02:12,725 --> 00:02:14,760
LAST FIVE YEARS.

73
00:02:14,760 --> 00:02:16,762
AND IT'S LAID A STRONG

74
00:02:16,762 --> 00:02:18,397
FOUNDATION FOR FUTURE

75
00:02:18,397 --> 00:02:21,700
DISCOVERIES THAT WILL HOPEFULLY

76
00:02:21,700 --> 00:02:22,768
SIGNIFICANTLY REDUCE THE RATES

77
00:02:22,768 --> 00:02:24,536
OF MATERNAL MORBIDITY AND

78
00:02:24,536 --> 00:02:26,705
MORTALITY IN THE U.S. AND THE

79
00:02:26,705 --> 00:02:28,240
TREMENDOUS DISPARITIES WE SEE IN

80
00:02:28,240 --> 00:02:30,309
THEM.

81
00:02:30,309 --> 00:02:32,945
WE HAVE ANOTHER PACKED AGENDA

82
00:02:32,945 --> 00:02:34,913
TODAY, SHOWCASING THE RESEARCH

83
00:02:34,913 --> 00:02:37,649
AND ACHIEVEMENTS OF THE MANY

84
00:02:37,649 --> 00:02:39,618
INVESTIGATORS WHO HAVE RECEIVED

85
00:02:39,618 --> 00:02:41,153
FUNDING UNDER IMPROVE.

86
00:02:41,153 --> 00:02:43,555
SO I'M GOING TO KEEP MY REMARKS

87
00:02:43,555 --> 00:02:46,825
BRIEF, BUT I WOULD LIKE TO TALK

88
00:02:46,825 --> 00:02:48,260
ABOUT ONE ASPECT OF IMPROVE THAT

89
00:02:48,260 --> 00:02:50,329
I AM ESPECIALLY PROUD OF, AND

90
00:02:50,329 --> 00:02:52,498
THAT IS IMPROVE'S FOCUS ON THE

91
00:02:52,498 --> 00:02:54,933
SOCIAL DETERMINANTS OF HEALTH.

92
00:02:54,933 --> 00:03:03,008
AND HEALTH EQUITY.

93
00:03:03,008 --> 00:03:04,109
MAYBE I DO NEXT SLIDE.

94
00:03:04,109 --> 00:03:04,743
THAT WILL HELP.

95
00:03:04,743 --> 00:03:11,116
MAYBE.

96
00:03:11,116 --> 00:03:13,519
SO MANY OF YOU ALREADY KNOW THIS

97
00:03:13,519 --> 00:03:14,820
BUT THE CONTRIBUTIONS OF THE

98
00:03:14,820 --> 00:03:18,223
SOCIAL DETERMINANTS OF HEALTH TO

99
00:03:18,223 --> 00:03:19,858
PUBLIC HEALTH ISSUES LIKE

100
00:03:19,858 --> 00:03:20,893
MATERNAL MORBIDITY AND MORTALITY

101
00:03:20,893 --> 00:03:23,495
ARE CERTAINLY PROFOUND.

102
00:03:23,495 --> 00:03:25,197
FACTORS AT MULTIPLE LEVELS FROM

103
00:03:25,197 --> 00:03:30,035
BIOLOGICAL TO SOCIETAL INTERACT

104
00:03:30,035 --> 00:03:31,236
TO INITIATE MATERNAL HEALTH.  SO

105
00:03:31,236 --> 00:03:32,438
WE'RE STRICTING OUR FOCUS TO

106
00:03:32,438 --> 00:03:37,276
ONLY THE MOST PROC MALL OF THE S

107
00:03:37,276 --> 00:03:38,644
OF THE CONTRIBUTING FACTORS AND

108
00:03:38,644 --> 00:03:40,345
CAUSES REALLY PROVIDES AN

109
00:03:40,345 --> 00:03:41,213
INCOMPLETE UNDERSTANDING AT BEST

110
00:03:41,213 --> 00:03:44,082
AND CAN BE MISLEADING, BUT

111
00:03:44,082 --> 00:03:46,251
ULTIMATELY MISDIRECTS RESOURCES

112
00:03:46,251 --> 00:03:48,654
AND CAN OVERLOOK SOLUTIONS.

113
00:03:48,654 --> 00:03:50,622
TO IMPROVE MATERNAL HEALTH

114
00:03:50,622 --> 00:03:52,825
OUTCOMES AND ELIMINATE

115
00:03:52,825 --> 00:03:54,660
DISPARITIES, OUR RESEARCH MUST

116
00:03:54,660 --> 00:03:56,428
EXTEND WELL BEYOND THE HOSPITAL

117
00:03:56,428 --> 00:03:59,898
AND CLINIC WALLS TO PRIORITIZE

118
00:03:59,898 --> 00:04:01,333
SOCIAL DETERMINANTS OF HEALTH,

119
00:04:01,333 --> 00:04:02,868
OR THE CONDITIONS IN WHICH

120
00:04:02,868 --> 00:04:04,970
PEOPLE ARE BORN, GROW, LEARN,

121
00:04:04,970 --> 00:04:06,271
WORK, PLAY, LIVE AND AGE.

122
00:04:06,271 --> 00:04:08,106
AND THE WIDER SET OF STRUCTURAL

123
00:04:08,106 --> 00:04:11,310
FACTORS THAT SHAPE THOSE

124
00:04:11,310 --> 00:04:11,610
CONDITIONS.

125
00:04:11,610 --> 00:04:13,278
AND WE HAVE TO PRIORITIZE THOSE

126
00:04:13,278 --> 00:04:14,913
CONDITIONS ON PAR WITH THE MORE

127
00:04:14,913 --> 00:04:17,749
PROXIMAL CAUSES OF MATERNAL

128
00:04:17,749 --> 00:04:19,818
MORBIDITY AND MORTALITY.

129
00:04:19,818 --> 00:04:22,287
NIH AS A WHOLE IS COMMITTED TO

130
00:04:22,287 --> 00:04:26,892
ADVANCING INOWE VAW INNOVATIVE N

131
00:04:26,892 --> 00:04:27,693
THE SOCIAL DETERMINANTS OF

132
00:04:27,693 --> 00:04:29,027
HEALTH WITH THE ESTABLISHMENT OF

133
00:04:29,027 --> 00:04:30,662
AN NIH-WIDE RESEARCH

134
00:04:30,662 --> 00:04:31,730
COORDINATING COMMITTEE.

135
00:04:31,730 --> 00:04:33,599
AND THAT'S ALSO WHY WE'VE WORKED

136
00:04:33,599 --> 00:04:35,367
REALLY HARD TO INTEGRATE A FOCUS

137
00:04:35,367 --> 00:04:38,837
ON SOCIAL DETERMINANTS OF HEALTH

138
00:04:38,837 --> 00:04:39,404
INTO IMPROVE.

139
00:04:39,404 --> 00:04:40,939
I'M GOING TO SHARE JUST A TINY

140
00:04:40,939 --> 00:04:43,609
EXAMPLE OF WHY.

141
00:04:43,609 --> 00:04:46,512
SO THE MATERNAL VULNERABILITY

142
00:04:46,512 --> 00:04:49,481
INDEX YOU MAY HAVE SEEN THIS

143
00:04:49,481 --> 00:04:50,682
BEFORE, IT GIVES US A PICTURE OF

144
00:04:50,682 --> 00:04:52,217
WHERE AND WHY BIRTHING PEOPLE

145
00:04:52,217 --> 00:04:54,820
ARE MOST VULNERABLE TO POOR

146
00:04:54,820 --> 00:04:56,788
MATERNAL HEALTH OUTCOMES.

147
00:04:56,788 --> 00:04:58,857
THE VULNERABILITY INDEX

148
00:04:58,857 --> 00:04:59,992
CONSIDERS PHYSICAL HEALTH,

149
00:04:59,992 --> 00:05:02,961
MENTAL HEALTH, AND SUBSTANCE

150
00:05:02,961 --> 00:05:03,262
USE.

151
00:05:03,262 --> 00:05:06,098
BUT IMPORTANTLY, IT ALSO

152
00:05:06,098 --> 00:05:06,965
INCORPORATES SOCIOECONOMIC

153
00:05:06,965 --> 00:05:08,934
FACTORS SUCH AS POVERTY AND

154
00:05:08,934 --> 00:05:10,903
EDUCATIONAL ATTAINMENT.

155
00:05:10,903 --> 00:05:12,671
ENVIRONMENTAL FACTORS SUCH AS

156
00:05:12,671 --> 00:05:16,909
VIOLENCE, CRIME, TRANSPORTATION,

157
00:05:16,909 --> 00:05:17,776
HOUSING, AND POLLUTION.

158
00:05:17,776 --> 00:05:20,145
AS WELL AS THE ACCESSIBILITY AND

159
00:05:20,145 --> 00:05:22,714
AFFORDABILITY OF HEALTHCARE.

160
00:05:22,714 --> 00:05:23,916
THE INDEX HIGHLIGHTS THAT WE

161
00:05:23,916 --> 00:05:25,217
MUST PAY ATTENTION TO ALL OF

162
00:05:25,217 --> 00:05:29,087
THESE FACTORS, INCLUDING SOCIAL

163
00:05:29,087 --> 00:05:30,856
DETERMINANTS OF HEALTH, AS ROOT

164
00:05:30,856 --> 00:05:32,658
CAUSES IN ORDER TO IMPROVE

165
00:05:32,658 --> 00:05:35,727
MATERNAL HEALTH OUTCOMES.

166
00:05:35,727 --> 00:05:36,929
AS MANY PRESENTATIONS

167
00:05:36,929 --> 00:05:38,363
HIGHLIGHTED YESTERDAY, EACH

168
00:05:38,363 --> 00:05:41,867
STATE, COUNTY AND COMMUNITY WILL

169
00:05:41,867 --> 00:05:43,735
HAVE UNIQUE AND DIFFERENT ISSUES

170
00:05:43,735 --> 00:05:45,804
TO ADDRESS THAT WILL REQUIRE

171
00:05:45,804 --> 00:05:47,439
INTERVENTIONS, TARGETED TO

172
00:05:47,439 --> 00:05:50,842
SPECIFIC POPULATIONS, AND

173
00:05:50,842 --> 00:05:51,610
CIRCUMSTANCES IN ORDER TO

174
00:05:51,610 --> 00:05:54,780
IMPROVE OUTCOMES.

175
00:05:54,780 --> 00:05:56,548
SO A FOCUS ON SOCIAL

176
00:05:56,548 --> 00:05:59,785
DETERMINANTS OF HEALTH THEN IS

177
00:05:59,785 --> 00:06:01,253
ABSOLUTELY CRITICAL TO

178
00:06:01,253 --> 00:06:02,421
ADDRESSING THE LARGE AND HIGHLY

179
00:06:02,421 --> 00:06:03,989
TROUBLING DISPARITIES IN

180
00:06:03,989 --> 00:06:05,624
MATERNAL MORBIDITY AND MORTALITY

181
00:06:05,624 --> 00:06:08,994
THAT WE SEE BASED ON RACE,

182
00:06:08,994 --> 00:06:09,962
ETHNICITY, SOCIOECONOMIC STATUS,

183
00:06:09,962 --> 00:06:12,364
AS WELL AS OTHER FACTORS.

184
00:06:12,364 --> 00:06:16,201
FOR EXAMPLE, BLACK AND AMERICAN

185
00:06:16,201 --> 00:06:17,102
INDIAN/ALASKA NATIVE BIRTHING

186
00:06:17,102 --> 00:06:19,371
PEOPLE ARE 2 TO 4 TIMES MORE

187
00:06:19,371 --> 00:06:21,006
LIKELY TO DIE OF

188
00:06:21,006 --> 00:06:22,441
PREGNANCY-RELATED CAUSES IN THE

189
00:06:22,441 --> 00:06:26,478
UNITED STATES THAN THEIR WHITE

190
00:06:26,478 --> 00:06:28,447
COUNTERPARTS.

191
00:06:28,447 --> 00:06:29,448
LOOKING AGAIN AT THE

192
00:06:29,448 --> 00:06:31,249
VULNERABILITY INDEX, WE SEE

193
00:06:31,249 --> 00:06:33,051
BLACK AND AMERICAN INDIAN,

194
00:06:33,051 --> 00:06:33,719
ALASKA NATIVE BIRTHING PEOPLE

195
00:06:33,719 --> 00:06:35,821
ARE MORE LIKELY THAN WHITE

196
00:06:35,821 --> 00:06:36,989
COUNTERPARTS TO LIVE IN AREAS

197
00:06:36,989 --> 00:06:39,157
WITH HIGH VULNERABILITY TO POOR

198
00:06:39,157 --> 00:06:41,793
MATERNAL HEALTH OUTCOMES.

199
00:06:41,793 --> 00:06:43,228
SO WE NEED TO BETTER UNDERSTAND

200
00:06:43,228 --> 00:06:45,731
THE STRUCTURAL AND SOCIAL

201
00:06:45,731 --> 00:06:46,965
FACTORS ROOTED IN STRUCTURAL

202
00:06:46,965 --> 00:06:49,267
RACISM AND OTHER DISCRIMINATORY

203
00:06:49,267 --> 00:06:53,171
SYSTEMS THAT LEAD TO THESE

204
00:06:53,171 --> 00:06:54,706
DISPARITIES AND IMPORTANTLY TO

205
00:06:54,706 --> 00:06:56,808
IDENTIFY EFFECTIVE SOLUTIONS AND

206
00:06:56,808 --> 00:06:59,945
IMPLEMENTATION STRATEGIES.

207
00:06:59,945 --> 00:07:01,713
TO DO THIS, WE NEED TO WORK

208
00:07:01,713 --> 00:07:03,348
WITHIN AND PARTNER WITH THOSE

209
00:07:03,348 --> 00:07:05,083
COMMUNITIES THAT ARE MOST

210
00:07:05,083 --> 00:07:05,517
AFFECTED.

211
00:07:05,517 --> 00:07:07,486
WE SAW THE SLIDE YESTERDAY BUT I

212
00:07:07,486 --> 00:07:12,658
WANTED TO EMPHASIZE THAT WE HAVE

213
00:07:12,658 --> 00:07:13,992
REALLY STRATEGICALLY MADE A

214
00:07:13,992 --> 00:07:14,926
DELIBERATE EFFORT TO SUPPORT

215
00:07:14,926 --> 00:07:16,695
PROJECTS UNDER THE VARIOUS

216
00:07:16,695 --> 00:07:21,833
IMPROVE PROGRAMS ACROSS THE U.S.

217
00:07:21,833 --> 00:07:23,735
INCLUDING THOSE WITH THE HIGHEST

218
00:07:23,735 --> 00:07:28,407
VULNERABILITY AND NEED.

219
00:07:28,407 --> 00:07:29,841
WITHIN EACH OF THE IMPROVE

220
00:07:29,841 --> 00:07:30,676
PROGRAMS, THERE ARE EFFORTS TO

221
00:07:30,676 --> 00:07:31,843
WORK WITH COMMUNITIES TO BETTER

222
00:07:31,843 --> 00:07:33,445
UNDERSTAND AND ADDRESS SOCIAL

223
00:07:33,445 --> 00:07:35,047
DETERMINANTS OF HEALTH AT THE

224
00:07:35,047 --> 00:07:38,684
COMMUNITY AND STRUCTURAL LEVEL,

225
00:07:38,684 --> 00:07:40,652
AND SOCIAL RISKS AND PROTECTIVE

226
00:07:40,652 --> 00:07:41,853
FACTORS AT THE INDIVIDUAL AND

227
00:07:41,853 --> 00:07:43,055
INTERPERSONAL LEVELS, AND THE

228
00:07:43,055 --> 00:07:44,156
IMPACT THAT THEY HAVE ON

229
00:07:44,156 --> 00:07:45,057
MATERNAL HEALTH.

230
00:07:45,057 --> 00:07:51,897
FOR EXAMPLE, THE MA TECI TERN HH

231
00:07:51,897 --> 00:07:53,899
RESEARCH CENTERS OF EXCELLENCE

232
00:07:53,899 --> 00:07:55,200
INCLUDE PRODUCTS THAT ADDRESS

233
00:07:55,200 --> 00:07:56,268
HOUSING, TRANSPORTATION, FOOD

234
00:07:56,268 --> 00:07:57,502
SECURITY, ACCESS TO CARE, AND

235
00:07:57,502 --> 00:07:59,271
OTHER SOCIAL DETERMINANTS OF

236
00:07:59,271 --> 00:08:01,673
HEALTH AND SOCIAL RISKS.

237
00:08:01,673 --> 00:08:03,608
IN THE RADX TECH FOR MATERNAL

238
00:08:03,608 --> 00:08:05,243
HEALTH CHALLENGE, WE KNOW THAT

239
00:08:05,243 --> 00:08:08,647
LOCATION IMPACTS ACCESS TO

240
00:08:08,647 --> 00:08:10,182
TRANSPORTATION, HEALTHCARE AND

241
00:08:10,182 --> 00:08:12,818
OTHER SOCIAL DETERMINANTS OF

242
00:08:12,818 --> 00:08:13,518
MATERNITY CARE.

243
00:08:13,518 --> 00:08:14,886
SEVERAL OF THE DEVICES THAT HAVE

244
00:08:14,886 --> 00:08:18,056
BEEN DEVELOPED ARE DESIGNED TO

245
00:08:18,056 --> 00:08:19,424
OVERCOME THESE SOCIAL BARRIERS

246
00:08:19,424 --> 00:08:21,226
AND BRIDGE THE GAP BETWEEN

247
00:08:21,226 --> 00:08:24,062
PATIENTS AND PROVIDERS.

248
00:08:24,062 --> 00:08:26,264
IN THE CONNECTING THE COMMUNITY

249
00:08:26,264 --> 00:08:27,999
FOR MATERNAL HEALTH CHALLENGE,

250
00:08:27,999 --> 00:08:31,737
THE CONNECTION IS EVEN MORE

251
00:08:31,737 --> 00:08:32,471
EXPLICIT.

252
00:08:32,471 --> 00:08:33,138
SOCIAL DETERMINANTS OF HEALTH

253
00:08:33,138 --> 00:08:34,139
ARE THE FOUNDATION FOR THE

254
00:08:34,139 --> 00:08:35,040
RESEARCH QUESTIONS THAT MANY OF

255
00:08:35,040 --> 00:08:38,710
YOU ARE ADDRESSING, AND THAT

256
00:08:38,710 --> 00:08:40,245
CONNECTING THE COMMUNITY WINNERS

257
00:08:40,245 --> 00:08:42,114
ARE EXPLORING.

258
00:08:42,114 --> 00:08:43,582
AND THE SAME IS TRUE IN THE

259
00:08:43,582 --> 00:08:45,617
COMMUNITY IMPLEMENTATION

260
00:08:45,617 --> 00:08:46,718
PROGRAM.

261
00:08:46,718 --> 00:08:47,886
WHERE AWARDEES PARTNER WITH

262
00:08:47,886 --> 00:08:49,821
COMMUNITIES TO MORE EFFECTIVELY

263
00:08:49,821 --> 00:08:52,057
UNDERSTAND ENABLING FACTORS AND

264
00:08:52,057 --> 00:08:53,291
BARRIERS RELATED TO SOCIAL

265
00:08:53,291 --> 00:08:54,626
DETERMINANTS OF HEALTH.

266
00:08:54,626 --> 00:08:58,096
AS PART OF THE PROCESS TO ADOPT

267
00:08:58,096 --> 00:09:01,133
INTERVENTIONS AT THE COMMUNITY

268
00:09:01,133 --> 00:09:03,201
LEVEL.

269
00:09:03,201 --> 00:09:05,537
SO AS I SAID, I AM REALLY PROUD

270
00:09:05,537 --> 00:09:07,139
OF WHAT WE HAVE ACHIEVED

271
00:09:07,139 --> 00:09:09,674
TOGETHER SO FAR IN IMPROVE, AND

272
00:09:09,674 --> 00:09:11,643
I REALLY CAN'T WAIT TO SEE WHAT

273
00:09:11,643 --> 00:09:12,744
WILL COME NEXT.

274
00:09:12,744 --> 00:09:14,279
THE WORK YOU'RE DOING THROUGH

275
00:09:14,279 --> 00:09:16,782
IMPROVE WILL PROVIDE IMPORTANT

276
00:09:16,782 --> 00:09:18,650
NEW KNOWLEDGE TO ADDRESS THE

277
00:09:18,650 --> 00:09:21,019
SOCIAL AND STRUCTURAL DRIVERS OF

278
00:09:21,019 --> 00:09:24,122
MATERNAL HEALTH AND I'M LOOKING

279
00:09:24,122 --> 00:09:25,257
FORWARD TO HEARING THE

280
00:09:25,257 --> 00:09:28,393
PRESENTATIONS AND LEARNING MORE

281
00:09:28,393 --> 00:09:28,593
TODAY.

282
00:09:28,593 --> 00:09:30,228
SO WITH THAT, LET'S GET STARTED.

283
00:09:30,228 --> 00:09:31,997
I AM VERY PLEASED TO TURN THE

284
00:09:31,997 --> 00:09:37,135
MEETING OVER TO OUR MODERATORS,

285
00:09:37,135 --> 00:09:43,475
DFOR THE NEXT SESSION, WHICH IS

286
00:09:43,475 --> 00:09:45,010
INTERSECTIONS BETWEEN SOCIAL AND

287
00:09:45,010 --> 00:09:45,944
STRUCTURAL DETERMINANTS OF

288
00:09:45,944 --> 00:09:48,180
HEALTH AND MATERNAL MORBIDITY

289
00:09:48,180 --> 00:09:48,847
AND MORTALITY.

290
00:09:48,847 --> 00:09:50,715
SO WELCOME TO DAY TWO, AND ENJOY

291
00:09:50,715 --> 00:09:51,183
THE MEETING.

292
00:09:51,183 --> 00:10:01,359
[APPLAUSE]

293
00:10:06,464 --> 00:10:10,802
>> THANK YOU, EVERYONE,
AND GOOD

294
00:10:10,802 --> 00:10:13,772
MORNING.

295
00:10:13,772 --> 00:10:15,607
WE'D LIKE TO INTRODUCE OUR FIRST

296
00:10:15,607 --> 00:10:17,275
SPEAKER TODAY IN THE SESSION,

297
00:10:17,275 --> 00:10:20,445
INTERSECTIONS BETWEEN SOCIAL AND

298
00:10:20,445 --> 00:10:21,279
STRUCTURAL DETERMINE FLANTS OF

299
00:10:21,279 --> 00:10:22,514
HEALTH AND MATERNAL MORBIDITY

300
00:10:22,514 --> 00:10:24,382
AND MORTALITY.

301
00:10:24,382 --> 00:10:30,856
FIRST UP, WE HAVE JULIA DICKSON

302
00:10:30,856 --> 00:10:33,225
GOMEZ AND DALVERY BLACKWELL.

303
00:10:33,225 --> 00:10:43,401
[APPLAUSE]

304
00:10:46,004 --> 00:10:46,137
A

305
00:10:46,137 --> 00:10:50,075
>> THANK YOU, EVERYONE.

306
00:10:50,075 --> 00:10:50,508
, FOR

307
00:10:50,508 --> 00:10:51,276
COMING TODAY.

308
00:10:51,276 --> 00:10:54,679
I'M GOING TO START OFF WITH A

309
00:10:54,679 --> 00:10:55,881
CONFESSION.

310
00:10:55,881 --> 00:10:57,849
I'M NOT ACTUALLY A MATERNAL

311
00:10:57,849 --> 00:10:59,384
HEALTH EXPERT.

312
00:10:59,384 --> 00:11:09,928
I'M HERE BECAUSE OF THE HOUSING.

313
00:12:23,034 --> 00:12:24,035
>> ALL RIGHT, LET'S START
OVER.

314
00:12:24,035 --> 00:12:27,539
THANK YOU, EVERYONE, FOR COMING.

315
00:12:27,539 --> 00:12:30,475
I'M HERE TO PRESENT HOME, WHICH

316
00:12:30,475 --> 00:12:33,111
IS ABOUT HOUSING INSECURITY AND

317
00:12:33,111 --> 00:12:33,878
HOUSING STABILITY AND THE

318
00:12:33,878 --> 00:12:38,750
EFFECTS THAT IT HAS ON MATERNAL

319
00:12:38,750 --> 00:12:42,187
HEALTH.

320
00:12:42,187 --> 00:12:49,394
I'M HERE PRESENTING TODAY WITH

321
00:12:49,394 --> 00:12:51,162
DALVERY BLACKWELL, PART OF OUR

322
00:12:51,162 --> 00:12:52,897
COMMUNITY ENGAGEMENT PROJECT, SO

323
00:12:52,897 --> 00:13:01,072
TOGETHER, WE ARE HOME TEAM.

324
00:13:01,072 --> 00:13:02,807
THIS IS A VERY INTERDISCIPLINARY

325
00:13:02,807 --> 00:13:03,742
RESEARCH PROJECT AND YOU'LL SEE

326
00:13:03,742 --> 00:13:04,442
WHY.

327
00:13:04,442 --> 00:13:06,111
I'LL TAKE THIS SLIDE JUST TO

328
00:13:06,111 --> 00:13:10,582
SHOW YOU MY TEAM.

329
00:13:10,582 --> 00:13:13,218
WE HAVE PSYCHOLOGISTS, A

330
00:13:13,218 --> 00:13:17,922
SOCIOLOGIST, A GEOGRAPHER.

331
00:13:17,922 --> 00:13:19,691
ALONG WITH AN OB-GYN.

332
00:13:19,691 --> 00:13:22,327
NOW I'M GOING TO TURN IT OVER TO

333
00:13:22,327 --> 00:13:23,395
DALVERY, WHO WILL TELL A LITTLE

334
00:13:23,395 --> 00:13:24,596
BIT ABOUT WHY HOUSING.

335
00:13:24,596 --> 00:13:25,830
>> GOOD MORNING, EVERYONE.

336
00:13:25,830 --> 00:13:27,999
I DO HAVE A LOUD VOICE, I'M

337
00:13:27,999 --> 00:13:28,366
SORRY.

338
00:13:28,366 --> 00:13:29,868
I'LL TRY TO TONE IT DOWN.

339
00:13:29,868 --> 00:13:33,438
I'M DALVERY BLACKWELL, I SERVE

340
00:13:33,438 --> 00:13:35,040
AS EXECUTIVE DIRECTOR OF THE

341
00:13:35,040 --> 00:13:36,641
AMERICAN BREASTFEEDING NETWORK.

342
00:13:36,641 --> 00:13:39,844
WE'RE 15 YEARS YOUNG.

343
00:13:39,844 --> 00:13:42,113
OUR MISSION IMPACT IS TO

344
00:13:42,113 --> 00:13:48,586
ADVOCATE FOR BREASTFEEDING

345
00:13:48,586 --> 00:13:49,721
EQUITY AND MATERNAL CHILD

346
00:13:49,721 --> 00:13:50,588
HEALTH.

347
00:13:50,588 --> 00:13:51,656
I'M JUST GOING TO GET STARTED

348
00:13:51,656 --> 00:13:54,059
WITH OUR PRESENTATION TO SHARE

349
00:13:54,059 --> 00:13:56,928
ANOTHER REMINDER THAT HOUSING

350
00:13:56,928 --> 00:13:57,796
SHORTAGE UNFORTUNATELY HAS

351
00:13:57,796 --> 00:14:00,398
CAUSED AN INCREASE AS WE KNOW IN

352
00:14:00,398 --> 00:14:01,833
HOMELESSNESS AND ALSO IN HOUSING

353
00:14:01,833 --> 00:14:04,035
INSECURITY AND UNFORTUNATELY THE

354
00:14:04,035 --> 00:14:07,405
HIGH COST OF HOME OWNERSHIP.

355
00:14:07,405 --> 00:14:14,746
WE KNOW THAT THIS HOUSING CRISIS

356
00:14:14,746 --> 00:14:16,147
IN HOME INSTABILITY INTERSECTS

357
00:14:16,147 --> 00:14:17,482
WITH MANY, MANY SOCIAL

358
00:14:17,482 --> 00:14:19,551
DETERMINANTS OF HEALTH.

359
00:14:19,551 --> 00:14:22,387
AND AS A RESULT, UNFORTUNATELY,

360
00:14:22,387 --> 00:14:28,860
OUR POPULATION IS CHALLENGED

361
00:14:28,860 --> 00:14:31,196
WITH MENTAL, BEHAVIORAL,

362
00:14:31,196 --> 00:14:34,432
PHYSICAL WELL-BEING THAT

363
00:14:34,432 --> 00:14:34,999
DECLINES.

364
00:14:34,999 --> 00:14:36,401
IN MILWAUKEE, WISCONSIN ARE WE

365
00:14:36,401 --> 00:14:38,803
ACTUALLY WORK IN SOUTHEASTERN

366
00:14:38,803 --> 00:14:39,904
WISCONSIN, BIRTH WORKERS ARE

367
00:14:39,904 --> 00:14:42,207
CHALLENGED EACH AND EVERY DAY TO

368
00:14:42,207 --> 00:14:47,112
SUPPORT FAMILIES WITH SAFE,

369
00:14:47,112 --> 00:14:48,546
AFFORDABLE HOUSING, AND WITH THE

370
00:14:48,546 --> 00:14:51,282
VERY VULNERABLE POPULATION OF

371
00:14:51,282 --> 00:14:52,150
BLACK BIRTHING PEOPLE.

372
00:14:52,150 --> 00:14:58,189
SO I'M GOING TO SHARE THE SLI 

373
00:14:58,189 --> 00:14:59,824
SLIDES.

374
00:14:59,824 --> 00:15:03,628
MILWAUKEE MIRRORS MOST OF OUR

375
00:15:03,628 --> 00:15:07,332
COUNTRY AND SURPASSES THE

376
00:15:07,332 --> 00:15:09,534
COUNTRY IN RACE RESIDENTIAL

377
00:15:09,534 --> 00:15:10,568
SEGREGATION, DISPARITIES,

378
00:15:10,568 --> 00:15:11,936
PREGNANCY OUTCOMES AND

379
00:15:11,936 --> 00:15:13,805
UNFORTUNATE EVICTION RATES.

380
00:15:13,805 --> 00:15:14,772
WHICH JULIA WILL TALK MORE

381
00:15:14,772 --> 00:15:17,642
ABOUT.

382
00:15:17,642 --> 00:15:19,911
AGING HOUSING AND INFRASTRUCTURE

383
00:15:19,911 --> 00:15:23,915
INCLUDES HIGH LEVEL OF LEAD

384
00:15:23,915 --> 00:15:25,083
EXPOSURE, DISPROPORTIONATELY

385
00:15:25,083 --> 00:15:27,218
IMPACTING LOW INCOME AND

386
00:15:27,218 --> 00:15:32,423
MINORITY POPULATIONS, PEOPLE OF

387
00:15:32,423 --> 00:15:33,591
COLOR COMMUNITIES.

388
00:15:33,591 --> 00:15:35,226
NEEDS ASSESSMENT INDICATE

389
00:15:35,226 --> 00:15:36,494
MEDICAL MISTRUST UNFORTUNATELY,

390
00:15:36,494 --> 00:15:40,265
AS WE'VE LEARNED THROUGHOUT OUR

391
00:15:40,265 --> 00:15:49,140
TIME TOGETHER, AND MISTRUST AND

392
00:15:49,140 --> 00:15:51,209
HOUSING LARGEST UNMET NEED AMONG

393
00:15:51,209 --> 00:15:51,976
PREGNANT PEOPLE LIVING IN

394
00:15:51,976 --> 00:15:52,644
MILWAUKEE.

395
00:15:52,644 --> 00:15:54,812
EVICTION RATES ARE AMONG THE

396
00:15:54,812 --> 00:15:56,915
HIGHEST UNITED STATES, WITH

397
00:15:56,915 --> 00:15:59,751
16,000 INDIVIDUALS.

398
00:15:59,751 --> 00:16:00,084
 DISPLACED PER

399
00:16:00,084 --> 00:16:04,022
YEAR.

400
00:16:04,022 --> 00:16:05,990
STRESS FROM UNSAFE AND

401
00:16:05,990 --> 00:16:07,926
UNSANITARY LIVING CONDITIONS

402
00:16:07,926 --> 00:16:10,562
CONTRIBUTES POORLY TO PREGNANCY

403
00:16:10,562 --> 00:16:11,896
OUTCOMES, INCLUDING PRETERM

404
00:16:11,896 --> 00:16:13,965
BIRTH AS WE KNOW, AND LOW BIRTH

405
00:16:13,965 --> 00:16:14,265
WEIGHT.

406
00:16:14,265 --> 00:16:15,500
AND NOW I'M GOING TO TURN IT

407
00:16:15,500 --> 00:16:25,243
BACK OVER TO MY PARTNER, JULIE.

408
00:16:25,243 --> 00:16:30,048
>> SO HOW I BECAME
INVOLVED IN

409
00:16:30,048 --> 00:16:32,784
THIS IS BECAUSE I HAVE HAD A

410
00:16:32,784 --> 00:16:35,186
LONG HISTORY OF WORKING IN

411
00:16:35,186 --> 00:16:38,556
HOUSING AND LOOKING AT HOW

412
00:16:38,556 --> 00:16:39,557
HOUSING AFFECTS HEALTH.

413
00:16:39,557 --> 00:16:40,858
SO THE SPECIFIC AIMS OF THIS

414
00:16:40,858 --> 00:16:43,161
PROJECT ARELILY TO LOOK AT

415
00:16:43,161 --> 00:16:45,063
PERSONAL AND NEIGHBORHOOD

416
00:16:45,063 --> 00:16:46,931
CHARACTERISTICS THAT WILL LEAD

417
00:16:46,931 --> 00:16:52,604
TO INCREASED HOUSING STABILITY

418
00:16:52,604 --> 00:16:54,872
AMONG BIRTHING PEOPLE.

419
00:16:54,872 --> 00:16:59,244
SO -- AND THEN AIM TWO IS TO

420
00:16:59,244 --> 00:17:00,979
EXPLORE THE IMPACT OF HOUSING

421
00:17:00,979 --> 00:17:02,947
INSTABILITY AND HOMELESSNESS AND

422
00:17:02,947 --> 00:17:03,615
NEIGHBORHOOD CONDITIONS ON THE

423
00:17:03,615 --> 00:17:04,582
PHYSICAL AND MENTAL HEALTH OF

424
00:17:04,582 --> 00:17:05,683
PREGNANT PEOPLE, AND THEN

425
00:17:05,683 --> 00:17:07,652
FINALLY, TO IDENTIFY THE SERVICE

426
00:17:07,652 --> 00:17:12,790
NEEDS OF PREGNANT PEOPLE.

427
00:17:12,790 --> 00:17:15,226
SO YEAR ONE WAS PHASE ONE, AND

428
00:17:15,226 --> 00:17:18,296
I'M HAPPY TO REPORT THAT WE

429
00:17:18,296 --> 00:17:19,464
MOSTLY COMPLETED EVERYTHING WE

430
00:17:19,464 --> 00:17:20,031
NEEDED TO DO.

431
00:17:20,031 --> 00:17:23,534
WE FORMED A CAB AND PERFORMED A

432
00:17:23,534 --> 00:17:25,803
QUALITATIVE NEEDS ASSESSMENT AND

433
00:17:25,803 --> 00:17:29,540
FINALIZED OUR SURVEY PROTOCOL.

434
00:17:29,540 --> 00:17:31,609
THIS IS A PICTURE OF I THINK OUR

435
00:17:31,609 --> 00:17:33,911
VERY FIRST COMMUNITY ADVISORY

436
00:17:33,911 --> 00:17:34,512
BOARD.

437
00:17:34,512 --> 00:17:36,414
WE HAVE MEMBERS -- OH, GOSH,

438
00:17:36,414 --> 00:17:40,051
FROM THE PUBLIC HOUSING

439
00:17:40,051 --> 00:17:42,453
AUTHORITY, FROM FEDERALLY

440
00:17:42,453 --> 00:17:44,088
QUALIFIED HEALTH CENTERS, FROM

441
00:17:44,088 --> 00:17:44,756
THE DEPARTMENT OF HEALTH

442
00:17:44,756 --> 00:17:47,258
SERVICES, HOUSING ADVOCATES,

443
00:17:47,258 --> 00:17:50,228
PEOPLE WHO PROVIDE EMERGENCY

444
00:17:50,228 --> 00:17:55,133
SHELTER, MPS, AS WELL AS OB-GYN.

445
00:17:55,133 --> 00:17:57,468
WE MET FIVE YEARS -- OR FIVE

446
00:17:57,468 --> 00:18:00,104
TIMES IN THE FIRST YEAR.

447
00:18:00,104 --> 00:18:02,040
AND BASICALLY COVERED ALL OF THE

448
00:18:02,040 --> 00:18:04,442
STUDY PROTOCOL, AND FINALIZED IT

449
00:18:04,442 --> 00:18:07,145
AND ALSO GOT A REALLY GOOD

450
00:18:07,145 --> 00:18:09,147
ENVIRONMENTAL SCAN OF THE

451
00:18:09,147 --> 00:18:11,316
SITUATION IN MILWAUKEE.

452
00:18:11,316 --> 00:18:15,453
THIS IS OUR MODEL.

453
00:18:15,453 --> 00:18:16,888
AS WE WERE TALKING ABOUT

454
00:18:16,888 --> 00:18:19,524
STRUCTURAL DETERMINANTS OF

455
00:18:19,524 --> 00:18:20,625
HEALTH, IT'S ALWAYS VERY

456
00:18:20,625 --> 00:18:23,561
DIFFICULT TO FIND THE LINKS

457
00:18:23,561 --> 00:18:25,229
BETWEEN THE LARGEST STRUCTURAL

458
00:18:25,229 --> 00:18:28,933
FACTORS LIKE HOUSING AND ACTUAL

459
00:18:28,933 --> 00:18:29,567
OUTCOMES.

460
00:18:29,567 --> 00:18:37,241
SO AS USUAL, I HAVE A MARMOT

461
00:18:37,241 --> 00:18:40,945
MODEL THAT SHOWS MEDIATING OR

462
00:18:40,945 --> 00:18:41,879
MODERATING POTENTIAL FACTORS.

463
00:18:41,879 --> 00:18:43,481
SO WE'RE NOT ONLY LOOKING AT THE

464
00:18:43,481 --> 00:18:44,449
HOUSING STATUS, BUT WE'RE

465
00:18:44,449 --> 00:18:46,250
LOOKING AT THE COMMUNITY

466
00:18:46,250 --> 00:18:47,018
EFFECTS, HOUSING STABILITY,

467
00:18:47,018 --> 00:18:48,286
MEANING HOW LIKELY IS IT THAT A

468
00:18:48,286 --> 00:18:49,487
PERSON IS GOING TO BE ABLE TO

469
00:18:49,487 --> 00:18:52,857
STAY WHERE THEY ARE.

470
00:18:52,857 --> 00:18:55,493
SOCIAL SUPPORT AND ALL THE REST,

471
00:18:55,493 --> 00:18:57,829
AND THEN LOOKING AT HOW THAT

472
00:18:57,829 --> 00:19:00,331
AFFECTS THE BIRTH OUTCOMES.

473
00:19:00,331 --> 00:19:01,165
ONE OF THE THINGS THAT I THINK

474
00:19:01,165 --> 00:19:03,501
IS REALLY UNIQUE ABOUT OUR

475
00:19:03,501 --> 00:19:05,370
PROJECT IS THAT WE ARE GOING TO

476
00:19:05,370 --> 00:19:10,608
BE MEASURING ALLOSTATIC LOAD.

477
00:19:10,608 --> 00:19:14,645
THIS IS KIND OF A PROXY MEASURE

478
00:19:14,645 --> 00:19:18,683
FOR THE EFFECT OF WEATHERING ON

479
00:19:18,683 --> 00:19:20,118
THE BODY IF ANYONE HAS HEARD OF

480
00:19:20,118 --> 00:19:20,718
THAT.

481
00:19:20,718 --> 00:19:22,320
BASICALLY IT'S A WAY OF

482
00:19:22,320 --> 00:19:25,923
MEASURING CHRONIC STRESS AND

483
00:19:25,923 --> 00:19:28,526
INFLAMMATION, AND THE

484
00:19:28,526 --> 00:19:30,728
PSYCHOLOGIST TERRY CASINI, WHO

485
00:19:30,728 --> 00:19:32,029
IS ONE OF THE PARTNERS IN THIS

486
00:19:32,029 --> 00:19:33,798
PROJECT, HAS DONE A LOT ON

487
00:19:33,798 --> 00:19:38,403
TRAUMA AND STRESS.

488
00:19:38,403 --> 00:19:43,307
OUR HOUSING HISTORY MATRIX IS

489
00:19:43,307 --> 00:19:44,275
VERY DETAILED.

490
00:19:44,275 --> 00:19:46,144
USUALLY IN MOST STUDIES, THERE

491
00:19:46,144 --> 00:19:49,113
IS A DICHOTOMOUS MEASURE, IF

492
00:19:49,113 --> 00:19:53,050
YOU'RE HOUSED OR UNHOUSED.

493
00:19:53,050 --> 00:20:01,559
WOULD HE WE ARE ACTUALLY GEOCODR

494
00:20:01,559 --> 00:20:03,227
ADDRESSES SO WE CAN MAP THEM

495
00:20:03,227 --> 00:20:05,730
SPATIALLY AND DO GEOSPATIAL

496
00:20:05,730 --> 00:20:06,597
ANALYSES, BUT IN ADDITION TO

497
00:20:06,597 --> 00:20:07,899
THAT, WHEN WE ASK PEOPLE ABOUT

498
00:20:07,899 --> 00:20:09,133
THEIR HOUSING, WE WILL BE ASKING

499
00:20:09,133 --> 00:20:10,435
ABOUT THE HOUSING CONDITIONS.

500
00:20:10,435 --> 00:20:16,574
FOR EXAMPLE, PRESENCE OF MOLD,

501
00:20:16,574 --> 00:20:20,711
FLOODING, THE NUMBER OF PEOPLE

502
00:20:20,711 --> 00:20:22,880
IN THE APARTMENT AND THE NUMBER

503
00:20:22,880 --> 00:20:24,749
OF ROOMS, KIND OF TO GET A

504
00:20:24,749 --> 00:20:28,820
MEASURE OF OVERCROWDING.

505
00:20:28,820 --> 00:20:30,455
THE RENT AND UTILITIES, HOW MUCH

506
00:20:30,455 --> 00:20:34,492
ALL THE EXPENSES ARE TOGETHER,

507
00:20:34,492 --> 00:20:36,360
AND EVICTIONS AND OTHER FORCED

508
00:20:36,360 --> 00:20:40,832
MOVES AND HOUSING SATISFACTION.

509
00:20:40,832 --> 00:20:45,269
LIKE MOST OF YOU, WE'LL ALSO BE

510
00:20:45,269 --> 00:20:46,437
MEASURING A LOT OF THE MENTAL

511
00:20:46,437 --> 00:20:48,172
AND PHYSICAL OUTCOMES AS WELL AS

512
00:20:48,172 --> 00:20:50,708
OTHER EXPOSURES, LIKE INTIMATE

513
00:20:50,708 --> 00:20:54,278
PARTNER VIOLENCE, BUT OUR MAIN

514
00:20:54,278 --> 00:20:57,348
OUTCOMES WILL BE PHYSICAL AND

515
00:20:57,348 --> 00:21:02,386
MENTAL HEALTH.

516
00:21:02,386 --> 00:21:05,122
ALONG WITH SOME OF THE

517
00:21:05,122 --> 00:21:06,657
NEIGHBORHOOD DEPRIVATION, WE

518
00:21:06,657 --> 00:21:09,327
ALSO WANT TO LOOK AT THE

519
00:21:09,327 --> 00:21:10,728
POSITIVE AND THE ASSETS IN THE

520
00:21:10,728 --> 00:21:12,330
COMMUNITY TO BE ABLE TO AMPLIFY

521
00:21:12,330 --> 00:21:15,299
AND BUILD ON THOSE.

522
00:21:15,299 --> 00:21:17,368
HERE YOU SEE SOME LOVELY

523
00:21:17,368 --> 00:21:19,670
PICTURES THAT DALVERY IS IN WITH

524
00:21:19,670 --> 00:21:21,105
SOME OF THE COMMUNITY EVENTS

525
00:21:21,105 --> 00:21:25,776
THAT THE AFRICAN AMERICAN

526
00:21:25,776 --> 00:21:27,111
BREASTFEEDING NETWORK ORGANIZES.

527
00:21:27,111 --> 00:21:28,779
BUT I THINK YOU CAN ALSO SEE IF

528
00:21:28,779 --> 00:21:32,683
YOU DIDN'T SEE THIS SOMEWHERE

529
00:21:32,683 --> 00:21:35,419
HOW BEAUTIFUL OUR CITY ACTUALLY

530
00:21:35,419 --> 00:21:37,188
IS WITH THE PARKS.

531
00:21:37,188 --> 00:21:39,156
BUT OF COURSE WE'RE ALSO

532
00:21:39,156 --> 00:21:40,658
MEASURING THE OTHER THINGS THAT

533
00:21:40,658 --> 00:21:42,727
HAVE A NEGATIVE IMPACT ON

534
00:21:42,727 --> 00:21:46,998
HEALTH, LIKE VIOLENCE, OH, I

535
00:21:46,998 --> 00:21:48,332
ALREADY TALKED ABOUT THIS,

536
00:21:48,332 --> 00:21:49,200
DIDN'T I?

537
00:21:49,200 --> 00:21:55,106
OH, THE RACIAL SEGREGATION AND

538
00:21:55,106 --> 00:21:59,477
MULTIPLE, MULTIPLE MEASURES OF

539
00:21:59,477 --> 00:22:01,445
DISADVANTAGE.

540
00:22:01,445 --> 00:22:02,547
ONE OF THE THINGS WE TALKED

541
00:22:02,547 --> 00:22:06,350
ABOUT IN OUR CAB IS DIFFERENT

542
00:22:06,350 --> 00:22:08,786
WAYS OF ACTUALLY MEASURING

543
00:22:08,786 --> 00:22:11,589
SOCIAL VULNERABILITY AND WHICH

544
00:22:11,589 --> 00:22:12,757
WOULD BE MOST APPROPRIATE.

545
00:22:12,757 --> 00:22:15,459
TO USE PROBABLY -- I THINK WE

546
00:22:15,459 --> 00:22:20,464
WILL USE A LOT OF DIFFERENT

547
00:22:20,464 --> 00:22:26,203
ONES, BUT ALSO WE'LL BE LACKING

548
00:22:26,203 --> 00:22:32,843
LOOKINGAT THE EFFECT OF RACIAL

549
00:22:32,843 --> 00:22:33,844
SEGREGATION AND HOUSING

550
00:22:33,844 --> 00:22:34,211
DISCRIMINATION.

551
00:22:34,211 --> 00:22:35,780
WE TALKED A LOT ABOUT THIS WITH

552
00:22:35,780 --> 00:22:40,151
THE CAB, BECAUSE, OF COURSE,

553
00:22:40,151 --> 00:22:45,323
RACE IS VERY DIFFICULT TO

554
00:22:45,323 --> 00:22:48,025
CAPTURE, AND -- I'M VERY SORRY.

555
00:22:48,025 --> 00:22:50,461
AND IT CAN BE A PROTECTIVE

556
00:22:50,461 --> 00:22:53,497
FACTOR SOMETIMES IF YOU'RE IN A

557
00:22:53,497 --> 00:22:54,532
RACIALLY SEGREGATED COMMUNITY OR

558
00:22:54,532 --> 00:22:55,800
IT CAN BE A RISK FACTOR.

559
00:22:55,800 --> 00:22:57,768
IT REALLY DEPENDS ON THE

560
00:22:57,768 --> 00:22:58,102
CONTEXT.

561
00:22:58,102 --> 00:22:59,604
THERE ARE PROTECTIVE AND

562
00:22:59,604 --> 00:23:02,707
INSULATING EFFECTS.

563
00:23:02,707 --> 00:23:05,977
WE DID AN ENVIRONMENTAL SCAN

564
00:23:05,977 --> 00:23:10,781
AGAIN OF -- THIS WAS FROM THE

565
00:23:10,781 --> 00:23:12,216
CENTRAL REFERRAL, CENTRALIZED

566
00:23:12,216 --> 00:23:16,387
REFERRAL FOR THE HOUSING.

567
00:23:16,387 --> 00:23:20,858
I DON'T KNOW IF ANYBODY KNOWS,

568
00:23:20,858 --> 00:23:24,261
IN EVERY MUNICIPALITY, HOUSING

569
00:23:24,261 --> 00:23:27,531
SERVICES, YOU HAVE TO HAVE

570
00:23:27,531 --> 00:23:29,767
INTAKE.

571
00:23:29,767 --> 00:23:31,802
THIS IS TO MEASURE PEOPLE'S

572
00:23:31,802 --> 00:23:32,770
VULNERABILITY AND MAKE SURE THAT

573
00:23:32,770 --> 00:23:38,209
EACH PERSON -- OR THAT PEOPLE

574
00:23:38,209 --> 00:23:39,677
GET HOUSING AND PRIORITIZE

575
00:23:39,677 --> 00:23:40,645
HOUSING WHO ARE THE MOST

576
00:23:40,645 --> 00:23:44,048
VULNERABLE.

577
00:23:44,048 --> 00:23:47,084
WE HAD PR PREGNANT WOMEN, BUT

578
00:23:47,084 --> 00:23:51,022
PREGNANCY ACTUALLY ISN'T A

579
00:23:51,022 --> 00:23:53,124
VULNERABILITY INDEX, OR IS NOT A

580
00:23:53,124 --> 00:23:55,292
MEASURE OF VULNERABILITY THAT

581
00:23:55,292 --> 00:23:59,130
PRIORITIZES YOU FOR HOUSING.

582
00:23:59,130 --> 00:24:01,532
WE'VE ALSO DONE SOME IN DEPTH

583
00:24:01,532 --> 00:24:05,369
INTERVIEWS WITH WOMEN WHO ARE

584
00:24:05,369 --> 00:24:10,307
FACING HOUSING INSTABILITY, AND

585
00:24:10,307 --> 00:24:13,344
I'LL JUST SHARE ONE QUOTE WITH

586
00:24:13,344 --> 00:24:13,577
YOU.

587
00:24:13,577 --> 00:24:18,616
THIS IS FROM A WOMAN WHO DID NOT

588
00:24:18,616 --> 00:24:19,817
EXPERIENCE HOMELESSNESS BUT HAD

589
00:24:19,817 --> 00:24:24,088
A HARD TIME MAKING ENDS MEET.

590
00:24:24,088 --> 00:24:25,489
AND ACTUALLY WAS TALKING A BIT

591
00:24:25,489 --> 00:24:26,824
ABOUT FEELING LIKE SHE SHOULD BE

592
00:24:26,824 --> 00:24:28,993
ABLE TO DO THIS, AND SHE FELT SO

593
00:24:28,993 --> 00:24:30,761
ASHAMED THAT SHE FELT LIKE

594
00:24:30,761 --> 00:24:33,264
KILLING HERSELF SOMETIMES.

595
00:24:33,264 --> 00:24:35,132
I MEAN, I THINK THE TRUTH OF THE

596
00:24:35,132 --> 00:24:36,667
MATTER IS THAT NOBODY CAN MAKE

597
00:24:36,667 --> 00:24:38,202
ENDS MEET.

598
00:24:38,202 --> 00:24:42,339
WORKING A REGULAR JOB WITH

599
00:24:42,339 --> 00:24:45,609
CHILDREN AND AFFORDING HOUSING.

600
00:24:45,609 --> 00:24:46,811
AND I'LL HAND IT BACK TO

601
00:24:46,811 --> 00:24:47,044
DALVERY.

602
00:24:47,044 --> 00:24:47,578
>> OKAY.

603
00:24:47,578 --> 00:24:49,380
I THINK WE GOT AN INDICATION

604
00:24:49,380 --> 00:24:50,114
WE'VE GOT 2 MINUTES.

605
00:24:50,114 --> 00:24:52,083
I'M GOING TO GO THROUGH THE

606
00:24:52,083 --> 00:24:52,717
SLIDES QUICKLY.

607
00:24:52,717 --> 00:24:55,019
SO OUR NEXT TEPS.

608
00:24:55,019 --> 00:24:55,820
LONGITUDAL SURVEY THIS MONTH,

609
00:24:55,820 --> 00:24:57,088
WE'RE REALLY EXCITED ABOUT THAT.

610
00:24:57,088 --> 00:24:58,622
JULIE TALKED A LITTLE BIT ABOUT

611
00:24:58,622 --> 00:25:01,926
THAT.

612
00:25:01,926 --> 00:25:03,160
ALSO A PHOTO VOICE PROJECT IS

613
00:25:03,160 --> 00:25:04,495
COMING UP IN OUR COLLABORATION

614
00:25:04,495 --> 00:25:06,864
WITH MKE-EVICT AND LANDLORD

615
00:25:06,864 --> 00:25:10,134
PROJECT.

616
00:25:10,134 --> 00:25:13,471
SO A LITTLE BIT ABOUT THE

617
00:25:13,471 --> 00:25:14,071
PHOTOVOICE PROJECT.

618
00:25:14,071 --> 00:25:15,506
IT'S A PARTICIPATORY PROCESS IN

619
00:25:15,506 --> 00:25:16,807
WHICH PEOPLE ARE GIVEN PROMPTS

620
00:25:16,807 --> 00:25:19,910
AND A CAMERA TO TAKE PICTURES,

621
00:25:19,910 --> 00:25:21,946
FOLLOWED BY GROUP INTERVIEWS AND

622
00:25:21,946 --> 00:25:22,913
OFTEN PRESENTATIONS TO

623
00:25:22,913 --> 00:25:27,718
OUTSIDERS.

624
00:25:27,718 --> 00:25:30,354
GOOD FOR BETTER UNDERSTANDING

625
00:25:30,354 --> 00:25:31,555
LINKS BETWEEN HOUSING AND HEALTH

626
00:25:31,555 --> 00:25:32,957
BUT ALSO ADVOCACY, WHICH IS

627
00:25:32,957 --> 00:25:33,524
REALLY IMPORTANT.

628
00:25:33,524 --> 00:25:37,495
AND WE PLAN TO USE THIS TO SHOW

629
00:25:37,495 --> 00:25:40,631
DURING OUR ANNUAL ASCEND RETREAT

630
00:25:40,631 --> 00:25:41,932
THAT'S COMING UP IN 2025.

631
00:25:41,932 --> 00:25:45,002
A LITTLE BIT ABOUT MKE-EVICT AND

632
00:25:45,002 --> 00:25:46,437
LANDLORD PROJECT COLLABORATION.

633
00:25:46,437 --> 00:25:51,342
EVICTION RECORDS HAVE TRA BEEN

634
00:25:51,342 --> 00:25:53,310
TRACKED IN MILWAUKEE SINCE 2000

635
00:25:53,310 --> 00:25:54,745
AT ADDRESS LEVEL.

636
00:25:54,745 --> 00:25:56,413
LANDLORD MAPPER FROM MILWAUKEE

637
00:25:56,413 --> 00:25:59,850
PROPERTY OWNERSHIP NETWORK HAS

638
00:25:59,850 --> 00:26:02,086
BEEN WORKING TO IDENTIFY RENTAL

639
00:26:02,086 --> 00:26:05,122
PROPERTY OWNERS.

640
00:26:05,122 --> 00:26:07,224
GEOCODED HOUSING DATA FROM OUR

641
00:26:07,224 --> 00:26:08,726
PROJECT CAN ALSO BE LINKED TO

642
00:26:08,726 --> 00:26:09,927
THIS DATA.

643
00:26:09,927 --> 00:26:12,129
POWERFUL TOOLS FOR ADVOCATING AS

644
00:26:12,129 --> 00:26:15,199
WE FIGHT AGAINST HOUSING

645
00:26:15,199 --> 00:26:20,337
OWNERSHIP OBSCURITY.

646
00:26:20,337 --> 00:26:21,672
AND WE JUST WANT TO TAKE THIS

647
00:26:21,672 --> 00:26:25,843
OPPORTUNITY TO THANK IMPROVE --

648
00:26:25,843 --> 00:26:27,244
THE IMPROVE INITIATIVE FOR THIS

649
00:26:27,244 --> 00:26:28,546
WONDERFUL OPPORTUNITY TO WORK TO

650
00:26:28,546 --> 00:26:32,483
IMPROVE THE HEALTH OUTCOMES IN

651
00:26:32,483 --> 00:26:33,217
MATERNAL CHILD HEALTH.

652
00:26:33,217 --> 00:26:33,717
THANK YOU SO MUCH.

653
00:26:33,717 --> 00:26:40,491
[APPLAUSE]

654
00:26:40,491 --> 00:26:41,559
>> THANK YOU SO MUCH.

655
00:26:41,559 --> 00:26:43,327
WE'LL TAKE QUESTIONS FROM THE

656
00:26:43,327 --> 00:26:45,496
AUDIENCE, AND FOR THOSE THAT ARE

657
00:26:45,496 --> 00:26:46,797
LISTENING IN VIRTUALLY, WE HAVE

658
00:26:46,797 --> 00:26:50,734
THE QUESTION AND ANSWER SESSION

659
00:26:50,734 --> 00:26:55,873
OPEN SO CAN YOU JUST YOU CAN DRR

660
00:26:55,873 --> 00:26:56,774
QUESTIONS INTO THAT CHAT BOX.

661
00:26:56,774 --> 00:27:07,218
DO WE HAVE ANY QUESTIONS?

662
00:27:07,885 --> 00:27:14,191
WE DO HAVE ONE.

663
00:27:14,191 --> 00:27:15,459
>> GOOD MORNING.

664
00:27:15,459 --> 00:27:15,993
OUTSTANDING PRESENTATION.

665
00:27:15,993 --> 00:27:17,328
I WANTED TO HEAR A LITTLE BIT

666
00:27:17,328 --> 00:27:21,899
MORE ABOUT PREGNANCY AS IT

667
00:27:21,899 --> 00:27:25,636
RELATES TO NOT BEING A FACTOR

668
00:27:25,636 --> 00:27:27,204
FOR PRIORITIZING HOUSING.

669
00:27:27,204 --> 00:27:30,574
THAT'S WHAT I HEARD YOU SAY.

670
00:27:30,574 --> 00:27:32,009
IS THAT THE ISSUE NATIONALLY?

671
00:27:32,009 --> 00:27:36,247
IS THAT SOMETHING THAT IS, YOU

672
00:27:36,247 --> 00:27:37,147
KNOW -- IF YOU COULD SAY A

673
00:27:37,147 --> 00:27:38,649
LITTLE MORE ABOUT THAT BECAUSE

674
00:27:38,649 --> 00:27:41,185
PREGNANCY IS ACUTELY AN ISSUE IF

675
00:27:41,185 --> 00:27:45,122
HOUSING IS NOT AVAILABLE.

676
00:27:45,122 --> 00:27:52,429
>> SO THERE WAS A LOT OF

677
00:27:52,429 --> 00:27:53,864
MOVEMENT I THINK ABOUT 10 YEARS

678
00:27:53,864 --> 00:27:56,433
AGO TO EXPAND PERMANENT

679
00:27:56,433 --> 00:27:59,103
SUPPORTIVE HOUSING TO HOUSE THE

680
00:27:59,103 --> 00:28:01,305
SO-CALLED CHRONICALLY HOMELESS,

681
00:28:01,305 --> 00:28:04,241
AND THOSE ARE PEOPLE WHO HAVE

682
00:28:04,241 --> 00:28:08,646
BEEN HOMELESS, LIVING ON THE

683
00:28:08,646 --> 00:28:11,148
STREET FOR A YEAR, OR WHO HAVE

684
00:28:11,148 --> 00:28:14,551
HAD THREE PERIODS OF

685
00:28:14,551 --> 00:28:15,719
HOMELESSNESS WITHIN THE LAST

686
00:28:15,719 --> 00:28:16,620
THREE YEARS, I THINK.

687
00:28:16,620 --> 00:28:17,488
AND IN ADDITION TO THAT, THEY

688
00:28:17,488 --> 00:28:20,758
HAVE TO HAVE A QUALIFYING

689
00:28:20,758 --> 00:28:22,526
CONDITION, SO SERIOUS MENTAL

690
00:28:22,526 --> 00:28:26,363
ILLNESS OR HIV OR SUBSTANCE USE.

691
00:28:26,363 --> 00:28:32,703
SO THIS WAS -- IT HAS BEEN RU --

692
00:28:32,703 --> 00:28:36,040
ROLLED OUT TO HOUSE A LOT OF

693
00:28:36,040 --> 00:28:36,307
VETERANS.

694
00:28:36,307 --> 00:28:39,777
THERE WAS A LOT OF MONEY ROLLED

695
00:28:39,777 --> 00:28:42,012
OUT TO STOP HOMELESSNESS AMONG

696
00:28:42,012 --> 00:28:46,116
VETERANS AND ALSO, I THINK IT

697
00:28:46,116 --> 00:28:48,319
WAS TO REALLY FOCUS ON THAT

698
00:28:48,319 --> 00:28:50,087
GROUP OF SERIOUSLY MENTALLY ILL

699
00:28:50,087 --> 00:28:55,225
AND CHRONICALLY HOMELESS.

700
00:28:55,225 --> 00:28:58,595
IN TERMS OF WHAT THERE ARE FOR

701
00:28:58,595 --> 00:29:01,899
PEOPLE WHO ARE JUST LOW INCOME,

702
00:29:01,899 --> 00:29:06,470
THERE IS SECTION 8 OR HOUSING

703
00:29:06,470 --> 00:29:08,038
CHOICE VOUCHERS, BUT AS YOU

704
00:29:08,038 --> 00:29:08,872
KNOW, THOSE ARE VERY HARD TO

705
00:29:08,872 --> 00:29:09,340
GET.

706
00:29:09,340 --> 00:29:10,741
THERE ARE RAPID REHOUSING

707
00:29:10,741 --> 00:29:13,677
PROGRAMS IN MANY CITIES.

708
00:29:13,677 --> 00:29:17,748
MILWAUKEE HAS ONE OF THOSE, AND

709
00:29:17,748 --> 00:29:19,183
IT'S AN INTERESTING, I THINK,

710
00:29:19,183 --> 00:29:20,718
MODEL WHERE THE HOUSING

711
00:29:20,718 --> 00:29:23,320
ASSISTANCE IS VERY TEMPORARY,

712
00:29:23,320 --> 00:29:24,555
3 TO 6 MONTHS, AND JUST ENOUGH

713
00:29:24,555 --> 00:29:27,825
TIME TO GET PEOPLE ON THEIR

714
00:29:27,825 --> 00:29:32,196
FEET.

715
00:29:32,196 --> 00:29:33,497
SO I THINK THERE'S GROWING

716
00:29:33,497 --> 00:29:37,868
CONCERN ABOUT THAT, AND

717
00:29:37,868 --> 00:29:38,869
DEFINITELY MOVEMENT FOR

718
00:29:38,869 --> 00:29:40,270
EXPANDING HOUSING.

719
00:29:40,270 --> 00:29:42,039
THERE'S ALSO SOME MOVEMENT

720
00:29:42,039 --> 00:29:43,140
AROUND BASIC INCOME, PROVIDING

721
00:29:43,140 --> 00:29:45,209
THAT FOR PREGNANT PEOPLE, AND

722
00:29:45,209 --> 00:29:47,511
THERE'S SOME THINKING ABOUT

723
00:29:47,511 --> 00:29:51,548
ACTUALLY USING MEDICAID IN MANY

724
00:29:51,548 --> 00:29:54,051
CASES FOR PAYING FOR HOUSING.

725
00:29:54,051 --> 00:29:55,819
IF YOU THINK ABOUT IT, HOW CAN

726
00:29:55,819 --> 00:30:02,826
YOU BE HEALTHY AND DEALING WITH

727
00:30:02,826 --> 00:30:04,795
SERIOUS CONDITIONS.

728
00:30:04,795 --> 00:30:05,996
>> THANK YOU SO MUCH.

729
00:30:05,996 --> 00:30:06,497
THANK YOU VERY MUCH.

730
00:30:06,497 --> 00:30:12,002
[APPLAUSE]

731
00:30:12,002 --> 00:30:14,171
NEXT WE HAVE DR. MARY SHAW FROM

732
00:30:14,171 --> 00:30:15,572
JACKSON STATE UNIVERSITY, PART

733
00:30:15,572 --> 00:30:17,374
OF THE MISSISSIPPI DELTA CENTER

734
00:30:17,374 --> 00:30:18,075
OF EXCELLENCE IN MATERNAL

735
00:30:18,075 --> 00:30:21,979
HEALTH.

736
00:30:21,979 --> 00:30:32,156
[APPLAUSE]

737
00:30:36,126 --> 00:30:36,927
>> GOOD MORNING.

738
00:30:36,927 --> 00:30:47,204
CAN YOU HEAR ME?

739
00:30:56,480 --> 00:30:56,947
GOOD MORNING.

740
00:30:56,947 --> 00:30:59,149
GLAD TO BE HERE THIS MORNING.

741
00:30:59,149 --> 00:31:03,220
I'M GOING TO MAKE SURE YOU KNOW

742
00:31:03,220 --> 00:31:05,589
MY PARTNERS IN MY TEAM, AND IF I

743
00:31:05,589 --> 00:31:06,790
LOSE MY VOICE, THEY'RE GOING TO

744
00:31:06,790 --> 00:31:08,559
COME UP, SO WE HAVE SOMEONE HERE

745
00:31:08,559 --> 00:31:09,626
FROM EACH ONE OF THE PROJECTS.

746
00:31:09,626 --> 00:31:10,727
SO I'M GLAD TO BE HERE THIS

747
00:31:10,727 --> 00:31:14,264
MORNING.

748
00:31:14,264 --> 00:31:15,866
I REPRESENT THE MISSISSIPPI

749
00:31:15,866 --> 00:31:16,633
DELTA CENTER OF EXCELLENCE IN

750
00:31:16,633 --> 00:31:17,501
MATERNAL HEALTH, WHICH IS

751
00:31:17,501 --> 00:31:19,169
ACTUALLY HOUSED AT JACKSON STATE

752
00:31:19,169 --> 00:31:21,672
UNIVERSITY, WHICH IS AN HBCU

753
00:31:21,672 --> 00:31:25,175
LOCATED IN JACKSON, MISSISSIPPI.

754
00:31:25,175 --> 00:31:26,477
WE'RE VERY EXCITED TO BE PART OF

755
00:31:26,477 --> 00:31:27,244
THIS INITIATIVE.

756
00:31:27,244 --> 00:31:32,950
IT'S A COLLABORATIVE, AND IT'S

757
00:31:32,950 --> 00:31:34,251
BEEN THIS FIRST YEAR THAT WE

758
00:31:34,251 --> 00:31:35,352
JUST FINISHED HAS BEEN ONE THAT

759
00:31:35,352 --> 00:31:39,289
HAS HELPED US TO REMEMBER, ONE,

760
00:31:39,289 --> 00:31:40,591
WE ARE IN MISSISSIPPI.

761
00:31:40,591 --> 00:31:41,725
I THINK I DON'T HAVE TO TELL YOU

762
00:31:41,725 --> 00:31:43,227
A LOT ABOUT THE STATE OF

763
00:31:43,227 --> 00:31:43,527
MISSISSIPPI.

764
00:31:43,527 --> 00:31:47,364
WE COME IN KIND OF AT THE BOTTOM

765
00:31:47,364 --> 00:31:47,931
ON ALMOST EVERYTHING.

766
00:31:47,931 --> 00:31:50,234
SO WHAT I CALLED THE TITLE OF

767
00:31:50,234 --> 00:31:51,635
THIS PRESENTATION WAS THE

768
00:31:51,635 --> 00:31:54,271
SITUATION ROOM AS IT RELATES TO

769
00:31:54,271 --> 00:31:55,472
RURAL MISSISSIPPI, THE SPECIFIC

770
00:31:55,472 --> 00:31:57,875
COUNTIES THAT WE'RE FOCUSED ON.

771
00:31:57,875 --> 00:31:59,943
AND I LIKE TO START OFF THE

772
00:31:59,943 --> 00:32:01,812
PRESENTATION BY SIMPLY GIVING

773
00:32:01,812 --> 00:32:03,447
CONTEXT, WHICH IS WHEN YOU'RE IN

774
00:32:03,447 --> 00:32:05,082
MISSISSIPPI, THE REST OF AMERICA

775
00:32:05,082 --> 00:32:06,617
SOMETIMES DOESN'T SEEM QUITE

776
00:32:06,617 --> 00:32:07,618
REAL, AND WHEN YOU'RE IN THE

777
00:32:07,618 --> 00:32:09,486
REST OF AMERICA, MISSISSIPPI

778
00:32:09,486 --> 00:32:12,756
DOESN'T SEEM REAL.

779
00:32:12,756 --> 00:32:14,291
NOW THOSE OF WHO YOU HAVE SPENT

780
00:32:14,291 --> 00:32:16,493
TIME IN MISSISSIPPI KNOW IT'S A

781
00:32:16,493 --> 00:32:17,461
BEAUTIFUL STATE BUT I THINK YOU

782
00:32:17,461 --> 00:32:18,729
ALSO HAVE TO KNOW THAT THERE IS

783
00:32:18,729 --> 00:32:19,763
A HISTORY OF ONE OF THE THINGS

784
00:32:19,763 --> 00:32:20,964
THAT WE'RE SUPPOSED TO BE

785
00:32:20,964 --> 00:32:23,767
ADDRESSING HERE IN THIS SESSION,

786
00:32:23,767 --> 00:32:25,102
WHICH IS THOSE STRUCTURAL

787
00:32:25,102 --> 00:32:26,970
DETERMINANTS OF HEALTH, AND I

788
00:32:26,970 --> 00:32:28,505
THINK IT'S AN EXCELLENT PLACE TO

789
00:32:28,505 --> 00:32:30,374
TALK ABOUT THAT INTERSECTION

790
00:32:30,374 --> 00:32:32,209
BETWEEN SOCIAL DETERMINANTS OF

791
00:32:32,209 --> 00:32:33,544
HEALTH AS WELL AS THE STRUCTURAL

792
00:32:33,544 --> 00:32:37,014
DETERMINANTS OF HEALTH.

793
00:32:37,014 --> 00:32:38,448
SO I'M GOING TO GIVE THIS A SHOT

794
00:32:38,448 --> 00:32:40,083
AND SEE HOW WELL WE CAN DO IT.

795
00:32:40,083 --> 00:32:41,185
THIS IS A COLLABORATIVE, AND I

796
00:32:41,185 --> 00:32:44,922
THINK THE COLLABORATIVE ACTUALLY

797
00:32:44,922 --> 00:32:45,889
LOOKS A LOT LIKE SOME OF THE

798
00:32:45,889 --> 00:32:48,192
ISSUES THAT WE DEAL WITH IN THE

799
00:32:48,192 --> 00:32:48,625
MISSISSIPPI DELTA.

800
00:32:48,625 --> 00:32:53,197
SO THE COLLABORATIVE CONSISTS OF

801
00:32:53,197 --> 00:32:55,299
JACKSON STATE UNIVERSITY HBCU,

802
00:32:55,299 --> 00:32:57,834
MISSISSIPPI STATE DEPARTMENT OF

803
00:32:57,834 --> 00:32:59,703
HEALTH, UMMC, THE LARGE MEDICAL

804
00:32:59,703 --> 00:33:03,307
CENTER WHICH IS LOCATED WHERE WE

805
00:33:03,307 --> 00:33:04,942
ARE, HARVARD UNIVERSITY SCHOOL

806
00:33:04,942 --> 00:33:06,343
OF PUBLIC HEALTH, WHICH THEY

807
00:33:06,343 --> 00:33:07,945
HAVE BEEN JUST REALLY PHENOMENAL

808
00:33:07,945 --> 00:33:11,715
IN WORKING WITH US, AND THEN WE

809
00:33:11,715 --> 00:33:13,016
HAVE A GROUP CALLED CONVERGE,

810
00:33:13,016 --> 00:33:14,985
WHICH IS HELPING US OUT WITH THE

811
00:33:14,985 --> 00:33:16,420
TITLE 10 SERVICES IN

812
00:33:16,420 --> 00:33:17,287
MISSISSIPPI, PARTICULARLY IN THE

813
00:33:17,287 --> 00:33:19,456
RURAL COUNTIES, AND THEN THE

814
00:33:19,456 --> 00:33:20,357
MOST IMPORTANT GROUP IS WHAT

815
00:33:20,357 --> 00:33:23,327
WE'VE REFERRED TO AND ORGANIZED

816
00:33:23,327 --> 00:33:26,263
AS MOMMYCARE POSTPARTUM

817
00:33:26,263 --> 00:33:27,531
COMMUNITY NETWORK.

818
00:33:27,531 --> 00:33:28,865
AND THAT IS STILL BEING FORMED.

819
00:33:28,865 --> 00:33:31,268
SO THE MULTIPLE P.I. LEADERSHIP

820
00:33:31,268 --> 00:33:33,570
STRUCTURE IS WHAT WE ARE USING

821
00:33:33,570 --> 00:33:37,641
IN THIS PARTICULAR PROJECT.

822
00:33:37,641 --> 00:33:41,345
AND IF YOU CAN IMAGINE, WE'VE

823
00:33:41,345 --> 00:33:42,446
GOT FIVE DIFFERENT ENTITIES

824
00:33:42,446 --> 00:33:44,748
COMING TOGETHER.

825
00:33:44,748 --> 00:33:46,083
OURS IS A NEW STARTUP, WE WERE

826
00:33:46,083 --> 00:33:48,118
NOT ALL WORKING TOGETHER

827
00:33:48,118 --> 00:33:48,819
COLLABORATIVELY AROUND MATERNAL

828
00:33:48,819 --> 00:33:50,420
HEALTH WHEN WE STARTED.

829
00:33:50,420 --> 00:33:52,189
SO WE'VE HAD SOME GROWING PAINS,

830
00:33:52,189 --> 00:33:53,590
LIKE ANYONE ELSE, BUT THIS IS

831
00:33:53,590 --> 00:33:56,226
THE MULTIPLE P.I. STRUCTURE THAT

832
00:33:56,226 --> 00:33:59,396
WE HAVE.

833
00:33:59,396 --> 00:34:05,636
DR. HENNING, AND I THINK

834
00:34:05,636 --> 00:34:07,371
DR. MAZOO, I BELIEVE HE'S HERE

835
00:34:07,371 --> 00:34:09,773
TODAY.

836
00:34:09,773 --> 00:34:10,674
DR. POLK, WE'VE HAD SOME CHANGES

837
00:34:10,674 --> 00:34:12,843
IN OUR CORE LEADERSHIP, WE HAVE

838
00:34:12,843 --> 00:34:14,144
ANOTHER DESIGNATED P.I. WHO WILL

839
00:34:14,144 --> 00:34:16,580
BE JOINING US, MYSELF, AND THEN

840
00:34:16,580 --> 00:34:17,781
MS. SAMPLE IS ACTUALLY HOUSED

841
00:34:17,781 --> 00:34:18,849
OUT IN THE DELTA.

842
00:34:18,849 --> 00:34:20,284
I'M GOING TO SHOW YOU A MAP IN A

843
00:34:20,284 --> 00:34:22,386
LITTLE BIT THAT SHOWS WE'RE

844
00:34:22,386 --> 00:34:24,221
ABOUT 2 1/2 HOURS AWAY FROM THE

845
00:34:24,221 --> 00:34:25,656
COUNTIES THAT ARE REALLY THE

846
00:34:25,656 --> 00:34:27,824
FOCUS OF THIS POSTPARTUM CARE

847
00:34:27,824 --> 00:34:29,793
PROJECT.

848
00:34:29,793 --> 00:34:32,863
SO ONE OF THE GOALS, THE PRIMARY

849
00:34:32,863 --> 00:34:33,730
OVERARCHING GOAL OF THIS

850
00:34:33,730 --> 00:34:35,332
PARTICULAR CENTER IS TO DEAL, OF

851
00:34:35,332 --> 00:34:39,202
COURSE, WITH THOSE MATERNAL

852
00:34:39,202 --> 00:34:40,304
MORBIDITIES, THOSE MATERNAL

853
00:34:40,304 --> 00:34:42,239
MORTALITIES THAT YOU READ ABOUT,

854
00:34:42,239 --> 00:34:43,707
THAT YOU HEAR ABOUT IN THE STATE

855
00:34:43,707 --> 00:34:45,876
OF MISSISSIPPI, BUT WE'RE ONLY

856
00:34:45,876 --> 00:34:47,311
FOCUSING IN THE DELTA, AND IT'S

857
00:34:47,311 --> 00:34:49,279
NOT ALL OF THE DELTA, IT'S

858
00:34:49,279 --> 00:34:50,247
SELECTED COUNTIES THAT I'LL SHOW

859
00:34:50,247 --> 00:34:51,448
YOU A MAP OF IN JUST A FEW

860
00:34:51,448 --> 00:34:54,951
MINUTES.

861
00:34:54,951 --> 00:34:57,254
I THINK WE MADE A LOT OF STRIDES

862
00:34:57,254 --> 00:34:58,121
OVER THE YEARS IF YOU KNOW

863
00:34:58,121 --> 00:34:59,222
ANYTHING ABOUT THE HISTORY OF

864
00:34:59,222 --> 00:35:00,057
MISSISSIPPI, WHICH I DON'T HAVE

865
00:35:00,057 --> 00:35:01,491
TIME TO GO INTO, BUT AS WE

866
00:35:01,491 --> 00:35:03,360
STARTED THIS PROJECT, BECAUSE OF

867
00:35:03,360 --> 00:35:04,895
THE FIVE DIFFERENT ENTITIES THAT

868
00:35:04,895 --> 00:35:06,563
WERE INVOLVED, WE HAD TO AGREE

869
00:35:06,563 --> 00:35:07,531
ON SOME THINGS.

870
00:35:07,531 --> 00:35:08,932
AND I ALWAYS WENT BACK TO THE

871
00:35:08,932 --> 00:35:10,267
STATEMENT FROM A FORMER

872
00:35:10,267 --> 00:35:12,903
GOVERNOR, AND WHAT HE SAID WAS,

873
00:35:12,903 --> 00:35:14,104
WHEREVER I'VE GONE, WHETHER IT'S

874
00:35:14,104 --> 00:35:16,306
IN MISSISSIPPI OR WHEREVER,

875
00:35:16,306 --> 00:35:17,374
IRRESPECTIVE OF RACIAL OR

876
00:35:17,374 --> 00:35:18,909
CULTURAL DIFFERENCES, WE CAN

877
00:35:18,909 --> 00:35:20,644
PROBABLY IN THIS ROOM AGREE ON

878
00:35:20,644 --> 00:35:22,079
SEVERAL THINGS.

879
00:35:22,079 --> 00:35:24,147
EVERYBODY WANTS A DECENT

880
00:35:24,147 --> 00:35:26,016
EDUCATION FOR THEIR CHILDREN.

881
00:35:26,016 --> 00:35:27,751
EVERYBODY WANTS A FAIR CHANCE TO

882
00:35:27,751 --> 00:35:29,419
SECURE A JOB THAT WILL SUSTAIN

883
00:35:29,419 --> 00:35:32,255
THEM AND THEIR FAMILY.

884
00:35:32,255 --> 00:35:34,224
AND EVERYBODY WANTS TO LIVE IN A

885
00:35:34,224 --> 00:35:36,293
DECENT HOUSE OR SAFE STREET, AS

886
00:35:36,293 --> 00:35:37,828
MY COLLEAGUES EARLIER MENTIONED,

887
00:35:37,828 --> 00:35:40,564
AND EVERYBODY WANT ACCESS TO

888
00:35:40,564 --> 00:35:41,465
ADEQUATE HEALTHCARE.

889
00:35:41,465 --> 00:35:42,866
AND FINALLY, EVERYBODY WANTS TO

890
00:35:42,866 --> 00:35:44,401
BE TREATED WITH DIGNITY AND

891
00:35:44,401 --> 00:35:45,702
RESPECT.

892
00:35:45,702 --> 00:35:49,773
SO AS WE STARTED OFF THIS

893
00:35:49,773 --> 00:35:50,974
PROCESS, BECAUSE EACH

894
00:35:50,974 --> 00:35:52,275
INSTITUTION IS SO VERY

895
00:35:52,275 --> 00:35:53,477
DIFFERENT, I THINK ONE OF THE

896
00:35:53,477 --> 00:35:55,579
CHALLENGES FOR US HAS BEEN

897
00:35:55,579 --> 00:35:59,383
UNDERSTANDING THE INSTITUTIONAL

898
00:35:59,383 --> 00:36:00,250
CULTURES, AND THAT'S PRETTY MUCH

899
00:36:00,250 --> 00:36:01,752
THE SAME THING WE HAVE TO DO IN

900
00:36:01,752 --> 00:36:03,520
THE DELTA, IS UNDERSTAND THE

901
00:36:03,520 --> 00:36:04,988
CULTURE IN THE DELTA IN WHICH A

902
00:36:04,988 --> 00:36:06,189
LOT OF WHAT WE'RE TRYING TO TALK

903
00:36:06,189 --> 00:36:08,558
ABOUT TODAY HAS HAPPENED.

904
00:36:08,558 --> 00:36:10,394
SO THE CENTER HAS FOUR GOALS,

905
00:36:10,394 --> 00:36:15,899
AND I THINK I MISSED YESTERDAY

906
00:36:15,899 --> 00:36:17,434
BUT SOME OF THESE TOPICS HAVE

907
00:36:17,434 --> 00:36:20,470
BEEN TALKED ABOUT, AND OUR FOCUS

908
00:36:20,470 --> 00:36:22,005
IS POSTPARTUM CARE ONLY.

909
00:36:22,005 --> 00:36:24,207
BECAUSE IN MISSISSIPPI, THE

910
00:36:24,207 --> 00:36:25,409
POSTPARTUM CARE PERIOD IS WHERE

911
00:36:25,409 --> 00:36:27,911
WE HAVE SEEN A LOT OF THE

912
00:36:27,911 --> 00:36:29,913
MORBIDITIES AND MORTALITIES.

913
00:36:29,913 --> 00:36:31,748
WE HAVE A REPRESENTATIVE HERE

914
00:36:31,748 --> 00:36:33,183
FROM PROJECT 1, CLAIRE RIGHT

915
00:36:33,183 --> 00:36:34,384
THERE, THEIR PROJECT IS FOCUSED

916
00:36:34,384 --> 00:36:36,353
ON USING A COMMUNITY HEALTH

917
00:36:36,353 --> 00:36:40,290
WORKER APPROACH TO DELIVER

918
00:36:40,290 --> 00:36:42,159
POSTPARTUM CARE SERVICES WITHIN

919
00:36:42,159 --> 00:36:43,693
7 TO 10 DAYS AFTER THE MOTHER

920
00:36:43,693 --> 00:36:47,063
HAS BEEN DISCHARGED FROM UMMC,

921
00:36:47,063 --> 00:36:48,031
THE MEDICAL CENTER.

922
00:36:48,031 --> 00:36:49,032
THAT'S OUR REIF HE EVERRING

923
00:36:49,032 --> 00:36:49,499
INSTITUTION.

924
00:36:49,499 --> 00:36:51,501
NOW THERE ARE OTHER HOSPITALS IN

925
00:36:51,501 --> 00:36:53,837
THE AREA BUT WE FOCUSED IN ON

926
00:36:53,837 --> 00:36:55,839
UMMC BECAUSE IT'S ONE THAT

927
00:36:55,839 --> 00:36:56,907
HANDLES HIGH RISK PREGNANCIES.

928
00:36:56,907 --> 00:36:58,775
I THINK AS WE GO ALONG, THE PLAN

929
00:36:58,775 --> 00:37:03,046
IS TO EXPAND INTO OTHER

930
00:37:03,046 --> 00:37:03,880
HOSPITALS, THOSE HOSPITALS THAT

931
00:37:03,880 --> 00:37:05,549
ARE BIRTHING HOSPITALS.

932
00:37:05,549 --> 00:37:07,517
SO THEY ARE GOING TO BE USING --

933
00:37:07,517 --> 00:37:09,686
AND I THINK MOST OF YOU KNOW

934
00:37:09,686 --> 00:37:11,354
THAT CHW-BASED PROJECTS, THEY'VE

935
00:37:11,354 --> 00:37:12,856
BEEN USED ALL OVER THE COUNTRY,

936
00:37:12,856 --> 00:37:14,391
BUT WE HAVEN'T REALLY USED THEM

937
00:37:14,391 --> 00:37:16,159
AS EXTENSIVELY AS WE PROBABLY

938
00:37:16,159 --> 00:37:18,562
COULD IN THE MISSISSIPPI DELTA

939
00:37:18,562 --> 00:37:19,563
REGION.

940
00:37:19,563 --> 00:37:21,965
PROJECT 2 IS ONE OF THE PROJECTS

941
00:37:21,965 --> 00:37:23,333
THAT I'M INTIMATELY CONNECTED

942
00:37:23,333 --> 00:37:24,468
WITH AND WE HAVE A

943
00:37:24,468 --> 00:37:31,374
REPRESENTATIVE FROM PROJECT 2,

944
00:37:31,374 --> 00:37:33,109
DR. RAMUNDI IS HERE.

945
00:37:33,109 --> 00:37:34,110
PROJECT 2 WAS STRUCTURED A

946
00:37:34,110 --> 00:37:36,279
LITTLE MORE LOOSELY SO WE HAD

947
00:37:36,279 --> 00:37:41,218
SOME LATITUDE TO USE A CBBR

948
00:37:41,218 --> 00:37:51,061
APPROACH TO UNDERSTAND THOSE

949
00:37:51,061 --> 00:37:53,230
WOMEN IN THE DELTA COUNTIES AND

950
00:37:53,230 --> 00:37:54,130
THOSE HEALTHCARE PROVIDERS THAT

951
00:37:54,130 --> 00:37:55,532
PROVIDE SERVICES AS WELL AS

952
00:37:55,532 --> 00:37:56,066
IMPROVING TRUST.

953
00:37:56,066 --> 00:37:57,934
NOW THAT'S A BIG AGENDA FOR US,

954
00:37:57,934 --> 00:37:59,035
TRUST AND ENGAGEMENT.

955
00:37:59,035 --> 00:38:00,670
TRUST IN MISSISSIPPI, TRUSTING

956
00:38:00,670 --> 00:38:02,339
THE HEALTHCARE SYSTEM BUT ALSO

957
00:38:02,339 --> 00:38:03,507
TRUSTING WITHIN THE COMMUNITY

958
00:38:03,507 --> 00:38:04,407
NETWORKS.

959
00:38:04,407 --> 00:38:05,475
SO OF COURSE THAT LED US TO AIM

960
00:38:05,475 --> 00:38:07,110
THREE, WHICH IS FOCUSED ON

961
00:38:07,110 --> 00:38:08,011
COMMUNITY PARTNERS.

962
00:38:08,011 --> 00:38:09,646
A VERY CRITICAL PART OF OUR

963
00:38:09,646 --> 00:38:10,847
PARTICULAR CENTER IS WHAT DO

964
00:38:10,847 --> 00:38:14,584
THOSE RELATIONSHIPS LOOK LIKE,

965
00:38:14,584 --> 00:38:16,219
AND YOU HAVE TO KEEP IN MIND THE

966
00:38:16,219 --> 00:38:17,554
LONG HISTORY OF RACISM AND

967
00:38:17,554 --> 00:38:18,622
OPPRESSION AND EVERYTHING THAT'S

968
00:38:18,622 --> 00:38:20,156
HAPPENING IN MISSISSIPPI,

969
00:38:20,156 --> 00:38:21,791
LOOKING AT WHAT THOSE

970
00:38:21,791 --> 00:38:23,093
PARTNERSHIPS LOOK LIKE AND

971
00:38:23,093 --> 00:38:26,062
TRYING TO CREATE MEANINGFUL AND

972
00:38:26,062 --> 00:38:26,830
EQUITABLE PARTNERSHIPS.

973
00:38:26,830 --> 00:38:28,265
THE LAST PART OF OUR INITIATIVE

974
00:38:28,265 --> 00:38:29,132
IS, ORVETION THE TRAINING

975
00:38:29,132 --> 00:38:31,535
PROGRAM, WHICH IS BEING LED BY

976
00:38:31,535 --> 00:38:32,402
HARVARD, WHICH THEY HAVE A LOT

977
00:38:32,402 --> 00:38:34,471
OF EXPERIENCE WITH TRAINING

978
00:38:34,471 --> 00:38:35,906
PROGRAMS, SO OUR FOCUS HAS BEEN

979
00:38:35,906 --> 00:38:37,874
ON CREATING SOMETHING THAT'S

980
00:38:37,874 --> 00:38:39,776
VERY RESPONSIVE TO THOSE NEEDS

981
00:38:39,776 --> 00:38:41,044
IN MISSISSIPPI TO UNDERSTAND THE

982
00:38:41,044 --> 00:38:43,880
STRUCTURAL DETERMINANTS OF

983
00:38:43,880 --> 00:38:45,015
HEALTH, AS WELL AS THE SOCIAL

984
00:38:45,015 --> 00:38:47,417
DETERMINANTS OF HEALTH, AND THE

985
00:38:47,417 --> 00:38:51,121
CULTURE WITHIN MISSISSIPPI.

986
00:38:51,121 --> 00:38:52,556
SO HERE'S A MAP YOU SEE HERE,

987
00:38:52,556 --> 00:38:54,291
AND I THINK WE TRIED TO

988
00:38:54,291 --> 00:38:55,725
ILLUSTRATE WHERE THE MATERNAL

989
00:38:55,725 --> 00:38:57,360
HEALTH DESERTS ARE LOCATED, AND

990
00:38:57,360 --> 00:39:00,330
YOU CAN SEE THE AREAS WHERE WE

991
00:39:00,330 --> 00:39:01,965
HAVE THE STARS, WHERE WE HAVE

992
00:39:01,965 --> 00:39:04,034
THE CIRCLES, SO WE HAVE FIVE

993
00:39:04,034 --> 00:39:04,868
COUNTIES THAT ARE THE FOCUS OF

994
00:39:04,868 --> 00:39:05,702
OUR PROJECTS.

995
00:39:05,702 --> 00:39:07,337
AND HOW DID WE CHOOSE THOSE FIVE

996
00:39:07,337 --> 00:39:07,604
COUNTIES?

997
00:39:07,604 --> 00:39:09,072
THOSE OF YOU WHO KNOW

998
00:39:09,072 --> 00:39:09,906
MISSISSIPPI KNOW THAT SOME OF

999
00:39:09,906 --> 00:39:11,241
THE COUNTIES THAT WE INCLUDED

1000
00:39:11,241 --> 00:39:15,545
ARE NOT NECESSARILY THE MOST

1001
00:39:15,545 --> 00:39:17,314
BARREN IN TERMS OF BEING A

1002
00:39:17,314 --> 00:39:18,281
MATERNAL HEALTH DESERT BUT THEY

1003
00:39:18,281 --> 00:39:19,482
HAVE THE HIGHEST NUMBER OF

1004
00:39:19,482 --> 00:39:20,784
BIRTHS FOR THE STATE OF

1005
00:39:20,784 --> 00:39:21,885
MISSISSIPPI, SO WE HAVE FIVE

1006
00:39:21,885 --> 00:39:26,156
COUNTIES THAT WE'RE LOOKING AT.

1007
00:39:26,156 --> 00:39:27,691
SO THOSE FIVE COUNTIES ARE IN

1008
00:39:27,691 --> 00:39:28,792
THE DELTA REGION, EXCEPT FOR ONE

1009
00:39:28,792 --> 00:39:31,328
OF THE COUNTIES, SCOTT COUNTY,

1010
00:39:31,328 --> 00:39:32,629
AND I'M TRYING TO SHOW YOU AN

1011
00:39:32,629 --> 00:39:35,465
EXAMPLE OF HOW WE LAID IT OUT,

1012
00:39:35,465 --> 00:39:37,534
PROJECT 1 IS BEING LED BY THE

1013
00:39:37,534 --> 00:39:38,401
MISSISSIPPI STATE DEPARTMENT OF

1014
00:39:38,401 --> 00:39:39,836
HEALTH BECAUSE THEY, OF COURSE,

1015
00:39:39,836 --> 00:39:41,705
HAVE LINKAGES ALL OVER THE STATE

1016
00:39:41,705 --> 00:39:42,672
OF MISSISSIPPI.

1017
00:39:42,672 --> 00:39:44,774
AND OUR FOCUS IS HIGH RISK BLACK

1018
00:39:44,774 --> 00:39:45,875
WOMEN.

1019
00:39:45,875 --> 00:39:47,277
NOW I DON'T HAVE A LOT OF TIME

1020
00:39:47,277 --> 00:39:49,179
TO TALK TO YOU ABOUT HOW THAT IS

1021
00:39:49,179 --> 00:39:51,381
DETERMINED IN THE MISSISSIPPI

1022
00:39:51,381 --> 00:39:54,417
DELTA, BUT WE KIND OF GROUP THEM

1023
00:39:54,417 --> 00:39:56,152
INTO TWO CATEGORIES, HEALTHY

1024
00:39:56,152 --> 00:39:57,687
PREGNANCIES AND THEN HIGH RISK

1025
00:39:57,687 --> 00:39:57,988
PREGNANCIES.

1026
00:39:57,988 --> 00:39:59,289
THE THE HIGH RISK PREGNANCIES

1027
00:39:59,289 --> 00:40:01,324
ARE THE ONES THAT WE ARE FOCUSED

1028
00:40:01,324 --> 00:40:01,625
ON.

1029
00:40:01,625 --> 00:40:03,493
THOSE ARE THE WOMEN THAT WILL

1030
00:40:03,493 --> 00:40:06,596
MORE THAN LIKELY BE REFERRED

1031
00:40:06,596 --> 00:40:08,632
INTO UMMC, THE MEDICAL CENTER,

1032
00:40:08,632 --> 00:40:10,033
BECAUSE OF THEIR HIGH RISK FOR

1033
00:40:10,033 --> 00:40:12,902
SOME TYPE OF MORTALITY OR

1034
00:40:12,902 --> 00:40:13,570
MORBIDITY ASSOCIATED WITH THE

1035
00:40:13,570 --> 00:40:15,338
PREGNANCY.

1036
00:40:15,338 --> 00:40:19,175
THE SECOND PROJECT IS HOUSED AT

1037
00:40:19,175 --> 00:40:19,909
JACKSON STATE UNIVERSITY WHERE

1038
00:40:19,909 --> 00:40:21,311
WE HAVE BEEN ENGAGED IN WORKING

1039
00:40:21,311 --> 00:40:22,212
WITH THE COMMUNITIES FOR A

1040
00:40:22,212 --> 00:40:22,879
NUMBER OF YEARS.

1041
00:40:22,879 --> 00:40:24,614
WE TRAIN A LOT OF THE STUDENTS

1042
00:40:24,614 --> 00:40:26,149
THAT COME FROM THE DELTA.

1043
00:40:26,149 --> 00:40:28,985
SO MORE OR LESS LOOKING AT THE

1044
00:40:28,985 --> 00:40:31,521
CONTEXT, THE CULTURE, THE NORMS,

1045
00:40:31,521 --> 00:40:32,622
THOSE RELATIONSHIPS THAT EXIST

1046
00:40:32,622 --> 00:40:34,457
WITHIN THE DELTA COUNTIES AN

1047
00:40:34,457 --> 00:40:36,459
THOSE RELATIONSHIPS THAT EXIST

1048
00:40:36,459 --> 00:40:37,193
BETWEEN WOMEN WHO HAVE TO

1049
00:40:37,193 --> 00:40:38,895
COMMUTE IN FROM THE DELTA, WHICH

1050
00:40:38,895 --> 00:40:41,464
I TOLD YOU IS ABOUT 2 1/2 HOURS.

1051
00:40:41,464 --> 00:40:45,402
SO THIS NEXT SLIDE SHOWS YOU THE

1052
00:40:45,402 --> 00:40:46,236
CONCEPTUALIZATION, THIS CAME

1053
00:40:46,236 --> 00:40:47,637
FROM OUR COMMUNITY PARTNERS.

1054
00:40:47,637 --> 00:40:51,741
THIS IS LED BY A YOUNG WOMAN,

1055
00:40:51,741 --> 00:40:53,843
RASHONDA SAMPLE, WHO MAPPED OUT

1056
00:40:53,843 --> 00:40:55,478
WHAT'S REALLY HAPPENING IN EACH

1057
00:40:55,478 --> 00:40:57,347
OF THESE COUNTIES, WHAT'S

1058
00:40:57,347 --> 00:40:58,114
AVAILABLE, WHAT'S NOT AVAILABLE.

1059
00:40:58,114 --> 00:41:01,117
WE WERE INTERESTED IN IS THERE A

1060
00:41:01,117 --> 00:41:02,585
BIRTHING HOSPITAL WITHIN CLOSE

1061
00:41:02,585 --> 00:41:03,887
PROXIMITY, CLOSER THAN COMING IN

1062
00:41:03,887 --> 00:41:05,789
TO UMMC, WHICH I TOLD YOU IS

1063
00:41:05,789 --> 00:41:07,757
2 1/2 HOURS AWAY?

1064
00:41:07,757 --> 00:41:09,759
WHICH KINDS OF OB-GYN SERVICES

1065
00:41:09,759 --> 00:41:10,960
ARE ACTUALLY AVAILABLE IN EACH

1066
00:41:10,960 --> 00:41:11,428
COUNTY?

1067
00:41:11,428 --> 00:41:12,862
SO I THINK THIS KIND OF DEPICTS

1068
00:41:12,862 --> 00:41:13,363
IT FOR US.

1069
00:41:13,363 --> 00:41:14,764
WE GOT A VERY GOOD PICTURE OF

1070
00:41:14,764 --> 00:41:16,199
WHAT IS HAPPENING AND WHAT'S NOT

1071
00:41:16,199 --> 00:41:18,802
AVAILABLE.

1072
00:41:18,802 --> 00:41:20,470
ONE OF THE COUNTIES THAT'S MOST

1073
00:41:20,470 --> 00:41:21,671
LACKING IN TERMS OF MATERNAL

1074
00:41:21,671 --> 00:41:24,741
HEALTH SERVICES IS CARROLL

1075
00:41:24,741 --> 00:41:28,111
COUNTY, AND I THINK -- THIS

1076
00:41:28,111 --> 00:41:29,412
LOOKS A LITTLE -- WHEN I MOVE

1077
00:41:29,412 --> 00:41:30,613
THE SLIDE INTO THIS

1078
00:41:30,613 --> 00:41:31,848
PRESENTATION, THE ARROWS WHERE

1079
00:41:31,848 --> 00:41:36,853
IT'S SHOWING THE DISTANCE

1080
00:41:36,853 --> 00:41:42,692
BEDISTANCESBETWEEN GOT A LITTLE.

1081
00:41:42,692 --> 00:41:45,562
YOU CAN SEE THE WOMEN THAT VISIT

1082
00:41:45,562 --> 00:41:47,764
CLINICS ONCE THEY'RE PREGNANT,

1083
00:41:47,764 --> 00:41:48,798
THEY'RE CATEGORIZED INTO TWO

1084
00:41:48,798 --> 00:41:49,299
GROUPS.

1085
00:41:49,299 --> 00:41:50,400
BUT THERE'S DISCUSSION ABOUT

1086
00:41:50,400 --> 00:41:52,035
HAVING AN INTERMEDIATE LEVEL

1087
00:41:52,035 --> 00:41:52,535
GROUP.

1088
00:41:52,535 --> 00:41:53,803
WE TALKED WITH ONE OF THE

1089
00:41:53,803 --> 00:41:55,405
NEONATAL SPECIALISTS AT UMMC,

1090
00:41:55,405 --> 00:41:57,507
BUT RIGHT NOW WE GROUP THEM AS

1091
00:41:57,507 --> 00:41:58,608
HEALTHY, MEANING YOU DON'T

1092
00:41:58,608 --> 00:42:00,076
NECESSARILY HAVE TO BE REFERRED

1093
00:42:00,076 --> 00:42:02,545
IN TO UMMC OR HIGH RISK.

1094
00:42:02,545 --> 00:42:04,080
AND THEN THESE WOMEN DO HAVE

1095
00:42:04,080 --> 00:42:05,615
OTHER OPTIONS IN THE DELTA.

1096
00:42:05,615 --> 00:42:07,350
BUT THE HIGH RISK ONES ARE THE

1097
00:42:07,350 --> 00:42:09,018
ONES THAT WE'RE PRIMARILY

1098
00:42:09,018 --> 00:42:12,055
FOCUSING IN ON, ON PROJECT ONE.

1099
00:42:12,055 --> 00:42:14,157
SO HEALTH, CULTURE AND PLACE IS

1100
00:42:14,157 --> 00:42:15,692
WHAT I KIND OF WANT TO TALK

1101
00:42:15,692 --> 00:42:16,693
ABOUT, BECAUSE THAT'S WHAT WE'RE

1102
00:42:16,693 --> 00:42:18,695
DEALING WITH IN MISSISSIPPI, THE

1103
00:42:18,695 --> 00:42:22,932
DISPARITIES ARE THERE,.

1104
00:42:22,932 --> 00:42:23,566
THE CULTURE HAS BEEN THE

1105
00:42:23,566 --> 00:42:24,367
CHALLENGE FOR US.

1106
00:42:24,367 --> 00:42:34,410
I'M NI'VE SPENT A LOT OF TIME TG

1107
00:42:34,410 --> 00:42:35,945
TO UNDERSTAND THE CULTURAL

1108
00:42:35,945 --> 00:42:37,614
NORMS, UNDERSTAND THE HISTORICAL

1109
00:42:37,614 --> 00:42:41,017
GRIEF, UND UNDERSTANDING THE

1110
00:42:41,017 --> 00:42:43,319
OPPRESSION AND RACISM, WE HAVE

1111
00:42:43,319 --> 00:42:44,087
SEVERAL DIFFERENT ENTITIES THAT

1112
00:42:44,087 --> 00:42:45,822
WE'RE DEALING WITH.

1113
00:42:45,822 --> 00:42:46,923
SYSTEMS PERVASIVE THAT THEY WERE

1114
00:42:46,923 --> 00:42:49,259
NOT INTENDED TO BE INCLUSIVE.

1115
00:42:49,259 --> 00:42:50,426
NO ONE WANTS TO TALK ABOUT THEM

1116
00:42:50,426 --> 00:42:52,295
BUT THEY EXIST.

1117
00:42:52,295 --> 00:42:54,497
AND THEY'VE ALWAYS OPERATED IN

1118
00:42:54,497 --> 00:42:55,365
MISSISSIPPI AND PROBABLY LAKE

1119
00:42:55,365 --> 00:42:56,900
MANY OTHER STATES, I'M FROM

1120
00:42:56,900 --> 00:42:58,434
TEXAS SO I KNOW IT EXISTS THERE

1121
00:42:58,434 --> 00:42:59,402
TOO, BUT I RAISED THIS QUESTION

1122
00:42:59,402 --> 00:43:00,837
BECAUSE I'VE WORKED IN THE

1123
00:43:00,837 --> 00:43:02,505
EDUCATION SYSTEM, SO

1124
00:43:02,505 --> 00:43:03,239
QUESTIONABLE EDUCATION,

1125
00:43:03,239 --> 00:43:04,140
QUESTIONABLE POLITICS THAT MORE

1126
00:43:04,140 --> 00:43:05,441
OR LESS DO NOT SUPPORT SOME OF

1127
00:43:05,441 --> 00:43:09,078
THE THINGS THAT WE'RE TRYING TO

1128
00:43:09,078 --> 00:43:09,779
DO.

1129
00:43:09,779 --> 00:43:11,080
QUESTIONABLE HEALTHCARE.

1130
00:43:11,080 --> 00:43:12,615
WOMEN OFTENTIMES TALK ABOUT

1131
00:43:12,615 --> 00:43:15,819
DISRESPECT, LACK OF

1132
00:43:15,819 --> 00:43:17,453
COMMUNICATION WITH PROVIDERS --

1133
00:43:17,453 --> 00:43:17,954
POOR COMMUNICATION WITH

1134
00:43:17,954 --> 00:43:18,421
PROVIDERS.

1135
00:43:18,421 --> 00:43:20,490
WE HAVE THE HEALTH LITERACY

1136
00:43:20,490 --> 00:43:21,624
ISSUES, BECAUSE IT LINKS BACK TO

1137
00:43:21,624 --> 00:43:23,159
SOME OF THE -- I SAY MATERNAL

1138
00:43:23,159 --> 00:43:24,360
HEALTH LITERACY, BUT THEN

1139
00:43:24,360 --> 00:43:25,562
THERE'S HEALTH LITERACY IN

1140
00:43:25,562 --> 00:43:26,529
GENERAL.

1141
00:43:26,529 --> 00:43:28,531
AND THEN BASIC SERVICES THAT

1142
00:43:28,531 --> 00:43:29,632
PROBABLY MOST OF US IN CITIES

1143
00:43:29,632 --> 00:43:30,700
TAKE FOR GRANTED, BECAUSE

1144
00:43:30,700 --> 00:43:32,802
REMEMBER WE'RE IN JACKSON, AND

1145
00:43:32,802 --> 00:43:34,337
I'M TALKING 2 1/2 HOURS AWAY.

1146
00:43:34,337 --> 00:43:35,772
WE TAKE CERTAIN THINGS FOR

1147
00:43:35,772 --> 00:43:37,173
GRANTED, BUT IN THE DELTA, YOU

1148
00:43:37,173 --> 00:43:38,274
CAN'T TAKE THOSE THINGS FOR

1149
00:43:38,274 --> 00:43:38,908
GRANTED.

1150
00:43:38,908 --> 00:43:40,243
FOR EXAMPLE, SOME OF THE

1151
00:43:40,243 --> 00:43:41,344
TECHNOLOGIES THAT WE WOULD LIKE

1152
00:43:41,344 --> 00:43:43,112
TO USE IN THIS PARTICULAR

1153
00:43:43,112 --> 00:43:44,314
INTERVENTION IN THE DELTA, IT'S

1154
00:43:44,314 --> 00:43:45,682
NOT GOING TO BE POSSIBLE BECAUSE

1155
00:43:45,682 --> 00:43:47,183
WE HAVE HUGE POCKETS WHERE

1156
00:43:47,183 --> 00:43:48,484
THERE'S NO BROADBAND.

1157
00:43:48,484 --> 00:43:49,919
SO THAT BECOMES A CHALLENGE FOR

1158
00:43:49,919 --> 00:43:53,189
US.

1159
00:43:53,189 --> 00:43:54,624
SO THE TRANSPORTATION, MAJOR,

1160
00:43:54,624 --> 00:43:56,092
MAJOR PROBLEM IN MISSISSIPPI, IN

1161
00:43:56,092 --> 00:43:58,595
THE DELTA REGIONS.

1162
00:43:58,595 --> 00:43:59,229
THERE'S NO PUBLIC

1163
00:43:59,229 --> 00:43:59,896
TRANSPORTATION.

1164
00:43:59,896 --> 00:44:00,930
WE'VE BEEN TALKING WITH CHURCHES

1165
00:44:00,930 --> 00:44:03,933
ABOUT BEING ABLE TO USE THEIR

1166
00:44:03,933 --> 00:44:06,502
CHURCH VANS TO TRANSPORT WOMEN

1167
00:44:06,502 --> 00:44:08,204
TO SERVICES AND SO FORTH, AND I

1168
00:44:08,204 --> 00:44:09,873
CAN'T IGNORE THIS HISTORICAL

1169
00:44:09,873 --> 00:44:10,340
GRIEF.

1170
00:44:10,340 --> 00:44:14,577
AND WHEN I SAY HISTORICAL GRIEF,

1171
00:44:14,577 --> 00:44:15,778
WE'VE ENGAGED FOR THE PAST YEAR

1172
00:44:15,778 --> 00:44:18,448
IN THESE STORYTELLING VENTURES

1173
00:44:18,448 --> 00:44:21,084
WITH ANOTHER COMMUNITY-BASED

1174
00:44:21,084 --> 00:44:26,522
ORGANIZATION CALLED ALLUVIO

1175
00:44:26,522 --> 00:44:28,057
COLLECTIVE AND THEY HAVE WHAT

1176
00:44:28,057 --> 00:44:30,493
THEY CALL A COMMUNITY APPROACH,

1177
00:44:30,493 --> 00:44:33,429
SO WE HAVE STORIES THAT CATALOG

1178
00:44:33,429 --> 00:44:35,298
THE EXPERIENCES THAT WOMEN HAVE

1179
00:44:35,298 --> 00:44:36,699
EITHER DELIVERING POSTPARTUM

1180
00:44:36,699 --> 00:44:38,034
CARE IN THE DELTA COUNTIES OR

1181
00:44:38,034 --> 00:44:39,969
EVEN WHEN THEY COME INTO

1182
00:44:39,969 --> 00:44:41,104
MISSISSIPPI AND ALSO ABOUT THE

1183
00:44:41,104 --> 00:44:42,105
HOSPITAL CLOSURES AND IMPACT

1184
00:44:42,105 --> 00:44:43,573
THAT IT'S HAD ON MATERNAL

1185
00:44:43,573 --> 00:44:43,873
HEALTH.

1186
00:44:43,873 --> 00:44:45,875
I THINK IN THIS EARLIER GROUP

1187
00:44:45,875 --> 00:44:47,377
THEY TALKED ABOUT UNSTABLE

1188
00:44:47,377 --> 00:44:48,678
HOUSING, THAT'S A MAJOR ISSUE IN

1189
00:44:48,678 --> 00:44:49,545
THE DELTA.

1190
00:44:49,545 --> 00:44:50,780
LIMITED TRANSPORTATION I TALKED

1191
00:44:50,780 --> 00:44:52,181
ABOUT, LIMITED BROADBAND ACCESS

1192
00:44:52,181 --> 00:44:53,283
AND FOOD DESERTS.

1193
00:44:53,283 --> 00:44:56,152
SO THESE ARE ALL DETERMINANTS OF

1194
00:44:56,152 --> 00:44:56,653
HEALTH.

1195
00:44:56,653 --> 00:44:58,121
WE ARE USING KIND OF A MODEL

1196
00:44:58,121 --> 00:45:00,523
THAT'S MORE SOCIAL ECOLOGICAL,

1197
00:45:00,523 --> 00:45:01,391
AND THAT'S ALWAYS BEEN A

1198
00:45:01,391 --> 00:45:03,159
CHALLENGE I THINK FOR US AS

1199
00:45:03,159 --> 00:45:04,294
RESEARCHERS IS THE LINKAGES

1200
00:45:04,294 --> 00:45:04,727
BETWEEN THEM.

1201
00:45:04,727 --> 00:45:06,129
WE CAN IDENTIFY WHAT'S HAPPENING

1202
00:45:06,129 --> 00:45:08,865
AT EACH LEVEL.

1203
00:45:08,865 --> 00:45:10,300
BUT I THINK THIS PICTURE DEPICTS

1204
00:45:10,300 --> 00:45:12,702
EXACTLY SOME OF THE KINDS OF

1205
00:45:12,702 --> 00:45:13,937
THINGS THAT WE'VE BEEN BETTER

1206
00:45:13,937 --> 00:45:15,138
TRYING TO UNDERSTAND HOW THEY

1207
00:45:15,138 --> 00:45:16,673
WORK, HOW WE CAN INTERVENE TO

1208
00:45:16,673 --> 00:45:19,509
MAKE AND IMPROVE POSTPARTUM CARE

1209
00:45:19,509 --> 00:45:20,410
SERVICES.

1210
00:45:20,410 --> 00:45:22,378
REMEMBER WE'RE ONLY DEALING WITH

1211
00:45:22,378 --> 00:45:23,579
POSTPARTUM CARE.

1212
00:45:23,579 --> 00:45:24,881
ADVANCING THIS POSTPARTUM CARE

1213
00:45:24,881 --> 00:45:26,115
IN RURAL MISSISSIPPI IS A LITTLE

1214
00:45:26,115 --> 00:45:27,951
BIT DIFFERENT FROM TRYING TO

1215
00:45:27,951 --> 00:45:28,952
ADVANCE POSTPARTUM CARE IF

1216
00:45:28,952 --> 00:45:31,287
YOU'RE IN JA JACKSON OR CLOSER O

1217
00:45:31,287 --> 00:45:32,221
THE UMMC.

1218
00:45:32,221 --> 00:45:35,858
SO UNDER THE MOMMY POSTPARTUM

1219
00:45:35,858 --> 00:45:37,093
CARE NETWORK, WE BEGAN LOOKING

1220
00:45:37,093 --> 00:45:38,294
AT WHAT ARE THE PERCEPTIONS THAT

1221
00:45:38,294 --> 00:45:41,564
THE WOMEN ACTUALLY HAD ABOUT THE

1222
00:45:41,564 --> 00:45:45,168
HEALTHCARE SYSTEMMIN SYSTEM AS S

1223
00:45:45,168 --> 00:45:45,468
DEFINED.

1224
00:45:45,468 --> 00:45:46,602
IF YOU'RE IN THE DELTA WITH ALL

1225
00:45:46,602 --> 00:45:50,039
THE PROGRAMMING, ALL THE -- WHAT

1226
00:45:50,039 --> 00:45:50,907
HOSPITALS ARE AVAILABLE AND ALL

1227
00:45:50,907 --> 00:45:52,008
THE MONEY THAT'S FLOWING IN, YOU

1228
00:45:52,008 --> 00:45:54,844
WOULD THINK THERE WOULD BE THIS

1229
00:45:54,844 --> 00:45:56,612
BETTER COORDINATED SYSTEM OF

1230
00:45:56,612 --> 00:45:57,914
CARE AND NO ONE WOULD GET

1231
00:45:57,914 --> 00:45:58,581
DROPPED IN THE CRACKS.

1232
00:45:58,581 --> 00:46:00,016
SO THAT'S ONE OF THE ISSUES THAT

1233
00:46:00,016 --> 00:46:01,351
WE'RE ACTUALLY DEALING WITH.

1234
00:46:01,351 --> 00:46:04,153
THE SECOND PART IS LOOKING AT

1235
00:46:04,153 --> 00:46:07,790
WHAT INTERVENTIONS WORK.

1236
00:46:07,790 --> 00:46:09,225
PERHAPS IT WORKED OUTSIDE THE

1237
00:46:09,225 --> 00:46:10,860
DELTA, WE CAN LOOK AT RURAL

1238
00:46:10,860 --> 00:46:12,061
COUNTIES IN OTHER PLACES AND SEE

1239
00:46:12,061 --> 00:46:13,596
WHAT WORKS AND THEN MOVING

1240
00:46:13,596 --> 00:46:15,765
TOWARDS WHAT MIGHT NEED TO BE

1241
00:46:15,765 --> 00:46:17,133
APPLIED OR APPROACHED HERE.

1242
00:46:17,133 --> 00:46:18,368
PROJECT 2 IS MUCH MORE OPEN IN

1243
00:46:18,368 --> 00:46:19,235
THAT WE ARE ACTUALLY STARTING

1244
00:46:19,235 --> 00:46:20,737
FROM THE GROUND UP, HAVING THE

1245
00:46:20,737 --> 00:46:24,240
WOMEN ENGAGED IN THE REST OF THE

1246
00:46:24,240 --> 00:46:26,342
CBPR APPROACH, TO REALLY HELP US

1247
00:46:26,342 --> 00:46:28,945
LOOK THROUGH FORMATIVE RESEARCH,

1248
00:46:28,945 --> 00:46:30,380
THEN DESIGNING THE INTERVENTION

1249
00:46:30,380 --> 00:46:31,714
AND THEN EVALUATING THE

1250
00:46:31,714 --> 00:46:32,582
INTERVENTION SO WE'RE USING WHAT

1251
00:46:32,582 --> 00:46:34,417
WE REFER TO AS A COMMUNITY

1252
00:46:34,417 --> 00:46:34,917
ACCOUNTABILITY BOARD.

1253
00:46:34,917 --> 00:46:36,452
WE USE THAT WORD ACCOUNTABILITY

1254
00:46:36,452 --> 00:46:37,387
BECAUSE SOMEWHERE WE HAD BEEN

1255
00:46:37,387 --> 00:46:38,654
SOMEWHERE AND HEARD SOMEONE ELSE

1256
00:46:38,654 --> 00:46:43,526
USING IT AND WE THOUGHT

1257
00:46:43,526 --> 00:46:44,961
ACCOUNTABILITY IS REALLY WHAT WE

1258
00:46:44,961 --> 00:46:47,063
WANT MORE OF IN THE MISSISSIPPI

1259
00:46:47,063 --> 00:46:47,497
DELTA.

1260
00:46:47,497 --> 00:46:48,564
WE'VE GOT LOTS OF THINGS GOING

1261
00:46:48,564 --> 00:46:49,899
ON BUT IT'S NOT WELL

1262
00:46:49,899 --> 00:46:54,070
COORDINATED, SO THE YOUNG LADY

1263
00:46:54,070 --> 00:46:55,204
WHO'S LEADING THIS COMMUNITY

1264
00:46:55,204 --> 00:46:57,106
PARTNERS FOR US, THEY IDENTIFIED

1265
00:46:57,106 --> 00:46:58,674
THE TENETS UNDER WHICH THEY

1266
00:46:58,674 --> 00:46:59,709
WANTED TO OPERATE AND IN THE

1267
00:46:59,709 --> 00:47:00,777
INTEREST OF TIME, I'M GOING TO

1268
00:47:00,777 --> 00:47:03,212
NOT GO THROUGH THOSE IN DETAIL,

1269
00:47:03,212 --> 00:47:05,181
BUT WE'RE EXCITED ABOUT THE

1270
00:47:05,181 --> 00:47:06,349
COMMUNITY ACCOUNTABILITY BOARD.

1271
00:47:06,349 --> 00:47:07,350
ACTUALLY THE FIRST MEETING OF

1272
00:47:07,350 --> 00:47:09,585
THAT BOARD WILL TAKE PLACE ON

1273
00:47:09,585 --> 00:47:09,919
FRIDAY.

1274
00:47:09,919 --> 00:47:12,188
I'LL BE OUT IN THE DELTA FOR

1275
00:47:12,188 --> 00:47:13,756
THAT BOARD MEETING.

1276
00:47:13,756 --> 00:47:14,857
BUT THEY HAVE BEEN WORKING WITH

1277
00:47:14,857 --> 00:47:16,192
OTHER ORGANIZATIONS, LIKE THEY

1278
00:47:16,192 --> 00:47:18,127
HAVE BABY SHOWERS, AND THE BABY

1279
00:47:18,127 --> 00:47:19,762
SHOWERS ARE ABLE TO BRING IN A

1280
00:47:19,762 --> 00:47:22,565
NUMBER OF THE PROVIDES FOR

1281
00:47:22,565 --> 00:47:23,833
SOCIAL SERVICES, MATERNAL

1282
00:47:23,833 --> 00:47:26,469
HEALTHCARE SERVICES UNDER ONE

1283
00:47:26,469 --> 00:47:27,570
UMBRELLA, AND IT HELPS TO

1284
00:47:27,570 --> 00:47:28,805
CONNECT THE WOMEN, CREATING MORE

1285
00:47:28,805 --> 00:47:30,640
OF A SENSE OF COMMUNITY AS WE GO

1286
00:47:30,640 --> 00:47:32,175
THROUGH THIS WORK.

1287
00:47:32,175 --> 00:47:33,276
THIS PARTICULAR DIAGRAM RIGHT

1288
00:47:33,276 --> 00:47:34,811
HERE ACTUALLY CAME FROM THE

1289
00:47:34,811 --> 00:47:37,013
YOUNG LADY WHO LEADS THE -- IS

1290
00:47:37,013 --> 00:47:38,448
THE DIRECTOR OF THE COMMUNITY

1291
00:47:38,448 --> 00:47:39,649
PARTNERS NETWORK, AND WHAT SHE'S

1292
00:47:39,649 --> 00:47:41,584
TRYING TO GET THEM TO DO IS

1293
00:47:41,584 --> 00:47:43,286
FIRST ACKNOWLEDGE, WE HAVE TO

1294
00:47:43,286 --> 00:47:44,287
MAKE SURE WE'RE ACKNOWLEDGING

1295
00:47:44,287 --> 00:47:46,222
THE PROBLEMS THE SAME WAY, OR

1296
00:47:46,222 --> 00:47:47,023
UNDERSTANDING THE PROBLEMS THE

1297
00:47:47,023 --> 00:47:48,124
SAME WAY.

1298
00:47:48,124 --> 00:47:49,525
REFLECT ON WHAT'S REALLY

1299
00:47:49,525 --> 00:47:52,428
HAPPENING IN THE DELTA FROM A

1300
00:47:52,428 --> 00:47:54,397
COMMUNITY MEMBER REPRESENTATIVE

1301
00:47:54,397 --> 00:47:55,598
PERSPECTIVE, AND THEN

1302
00:47:55,598 --> 00:47:56,365
REIMAGINING WHAT THEY WOULD LIKE

1303
00:47:56,365 --> 00:47:59,102
FOR THIS SYSTEM THAT WE'RE

1304
00:47:59,102 --> 00:48:00,002
TRYING TO HELP CREATE THROUGH

1305
00:48:00,002 --> 00:48:01,304
THIS FUNDING FROM NIH.

1306
00:48:01,304 --> 00:48:03,706
WHAT WOULD IT LOOK LIKE?

1307
00:48:03,706 --> 00:48:04,974
ONE OF THE PIECES ABOUT TRUST,

1308
00:48:04,974 --> 00:48:06,042
ONE OF THE QUESTIONS THAT WE'VE

1309
00:48:06,042 --> 00:48:07,810
ASKED IS WHAT DOES TRUST LOOK

1310
00:48:07,810 --> 00:48:08,344
LIKE.

1311
00:48:08,344 --> 00:48:09,912
SO LOOKING AT IT FROM TWO

1312
00:48:09,912 --> 00:48:11,314
PERSPECTIVES, THE PROVIDER

1313
00:48:11,314 --> 00:48:12,315
PERSPECTIVE AS WELL AS THAT

1314
00:48:12,315 --> 00:48:13,516
WOMAN WHO IS HAVING TO

1315
00:48:13,516 --> 00:48:16,486
EXPERIENCE THE HEALTHCARE

1316
00:48:16,486 --> 00:48:17,587
SYSTEM, WHAT SHOULD TRUST LOOK

1317
00:48:17,587 --> 00:48:18,788
LIKE, WHAT SHOULD IT FEEL LIKE,

1318
00:48:18,788 --> 00:48:20,323
WHAT SHOULD IT SOUND LIKE.

1319
00:48:20,323 --> 00:48:21,557
BECAUSE I DON'T THINK WE'VE EVER

1320
00:48:21,557 --> 00:48:24,327
REALLY HAD THAT CONVERSATION IN

1321
00:48:24,327 --> 00:48:25,628
THE DELTA, AND THEN FROM THE

1322
00:48:25,628 --> 00:48:26,762
PROVIDER PERSPECTIVE, WHAT WOULD

1323
00:48:26,762 --> 00:48:27,697
IT LOOK LIKE, FEEL LIKE AND

1324
00:48:27,697 --> 00:48:28,231
SOUND LIKE.

1325
00:48:28,231 --> 00:48:29,332
AND WHAT WE'RE LOOKING FOR IS

1326
00:48:29,332 --> 00:48:33,503
HOW DO WE CHARACTERIZE TRUST IN

1327
00:48:33,503 --> 00:48:34,504
THE MISSISSIPPI DELTA, BECAUSE

1328
00:48:34,504 --> 00:48:36,472
IT MIGHT NOT BE QUITE THE SAME

1329
00:48:36,472 --> 00:48:37,140
AS SOMEWHERE ELSE.

1330
00:48:37,140 --> 00:48:38,541
SO THAT'S BEEN A REAL BIG PIECE

1331
00:48:38,541 --> 00:48:39,509
THAT WE'VE KIND OF FOCUSED IN

1332
00:48:39,509 --> 00:48:39,909
ON.

1333
00:48:39,909 --> 00:48:46,682
THIS WEEK WE HAVE A

1334
00:48:46,682 --> 00:48:49,118
CONJUGATIONAL NETWORK TO HELP US

1335
00:48:49,118 --> 00:48:50,653
WORK WITH THE WOMEN WHO ARE

1336
00:48:50,653 --> 00:48:54,590
GROUNDED, I SAY SPIRITUALLY,

1337
00:48:54,590 --> 00:48:55,458
RELIGION, LOOKING AT THE

1338
00:48:55,458 --> 00:48:56,259
FRAMEWORK AS WELL.

1339
00:48:56,259 --> 00:48:57,226
THEN FINALLY THERE'S A PIECE

1340
00:48:57,226 --> 00:48:59,195
THAT WE'RE DEALING WITH IN

1341
00:48:59,195 --> 00:49:00,730
PROJECT 2 AND PROJECT 1 THAT

1342
00:49:00,730 --> 00:49:01,364
FOCUSES ON THE MENTAL HEALTH

1343
00:49:01,364 --> 00:49:01,864
PIECE.

1344
00:49:01,864 --> 00:49:04,066
VERY BIG CHALLENGE IN THE DELTA.

1345
00:49:04,066 --> 00:49:04,934
VERY FEW MENTAL HEALTH PROVIDERS

1346
00:49:04,934 --> 00:49:05,668
IN THE COUNTIES THAT WE'RE

1347
00:49:05,668 --> 00:49:06,369
LOOKING AT.

1348
00:49:06,369 --> 00:49:10,006
SO WHAT WE'RE HOPING TO DO IS

1349
00:49:10,006 --> 00:49:11,207
BETTER UNDERSTAND, WE FRAMED A

1350
00:49:11,207 --> 00:49:12,942
PROJECT CALL WOULD AIN'T

1351
00:49:12,942 --> 00:49:13,976
NOBODY'S BUSINESS BUT MY OWN,

1352
00:49:13,976 --> 00:49:14,944
BECAUSE WHEN YOU START TALKING

1353
00:49:14,944 --> 00:49:15,845
TO WOMEN ABOUT MENTAL HEALTH,

1354
00:49:15,845 --> 00:49:17,580
THAT IS THE FEELING, IT AIN'T

1355
00:49:17,580 --> 00:49:18,514
NOBODY'S BUSINESS BUT MY OWN.

1356
00:49:18,514 --> 00:49:19,782
SO WE'RE TRYING TO GET PAST SOME

1357
00:49:19,782 --> 00:49:23,819
OF THAT STIGMA ASSOCIATED WITH

1358
00:49:23,819 --> 00:49:25,421
MENTAL HEALTH BECAUSE IT'S A BIG

1359
00:49:25,421 --> 00:49:26,522
PIECE.

1360
00:49:26,522 --> 00:49:28,157
WHEN NIH VISITED US A COUPLE

1361
00:49:28,157 --> 00:49:31,761
WEEKS AGO, WE HAD SOME OF THE

1362
00:49:31,761 --> 00:49:32,895
WOMEN THERE AND THEY TALKED

1363
00:49:32,895 --> 00:49:33,996
ABOUT THE STRUGGLES AND NOT EVEN

1364
00:49:33,996 --> 00:49:35,464
BEING ABLE TO IDENTIFY THAT IT

1365
00:49:35,464 --> 00:49:36,566
WAS POSTPARTUM DEPRESSION OR

1366
00:49:36,566 --> 00:49:40,002
OTHER THINGS.

1367
00:49:40,002 --> 00:49:41,003
SO WE'RE TRYING TO HAVE THOSE

1368
00:49:41,003 --> 00:49:42,872
CONVERSATIONS IN AN INFORMAL

1369
00:49:42,872 --> 00:49:43,739
MANNER SO THAT WOMEN WILL BE

1370
00:49:43,739 --> 00:49:44,740
ABLE TO TALK ABOUT IT.

1371
00:49:44,740 --> 00:49:45,942
WE HAVE TWO PIECES PLANNED.

1372
00:49:45,942 --> 00:49:48,511
ONE OF THEM IS WHAT WE CALL A

1373
00:49:48,511 --> 00:49:49,245
WORKSHOP TO TALK ABOUT THIS

1374
00:49:49,245 --> 00:49:50,479
THING THAT WE DON'T WANT TO TALK

1375
00:49:50,479 --> 00:49:52,348
ABOUT IN OUR COMMUNITY'S MENTAL

1376
00:49:52,348 --> 00:49:53,349
HEALTH, WHAT DOES IT LOOK LIKE,

1377
00:49:53,349 --> 00:49:56,519
WHAT DOES IT FEEL LIKE, AND WHAT

1378
00:49:56,519 --> 00:49:57,720
EXACTLY ARE WE TALKING ABOUT.

1379
00:49:57,720 --> 00:49:59,255
AND I ALWAYS USE THE LANGUAGE

1380
00:49:59,255 --> 00:50:00,690
ALL OF US SHOULD BE SEEING

1381
00:50:00,690 --> 00:50:01,057
SOMEONE.

1382
00:50:01,057 --> 00:50:05,194
YOU KNOW, IN THIS LIFE PIECE.

1383
00:50:05,194 --> 00:50:06,529
THEN THE OTHER LINE IS

1384
00:50:06,529 --> 00:50:07,430
DEVELOPING ONLINE SUPPORT

1385
00:50:07,430 --> 00:50:07,663
GROUPS.

1386
00:50:07,663 --> 00:50:08,731
WE HAVEN'T DONE THOSE IN THE

1387
00:50:08,731 --> 00:50:08,965
DELTA.

1388
00:50:08,965 --> 00:50:11,000
IT'S GOING TO BE OUR FIRST TIME

1389
00:50:11,000 --> 00:50:12,134
TRYING IT, BUT WE HAVE A MODEL

1390
00:50:12,134 --> 00:50:13,135
THAT'S BEEN USED THROUGH THE

1391
00:50:13,135 --> 00:50:14,237
V.A. AND WE HAVE A YOUNG LADY

1392
00:50:14,237 --> 00:50:17,173
WITH THE V.A. HOSPITAL THAT'S

1393
00:50:17,173 --> 00:50:19,575
ACTUALLY DEVELOPING THOSE.

1394
00:50:19,575 --> 00:50:20,810
WE'RE GOING TO BE TRYING IT IN

1395
00:50:20,810 --> 00:50:22,011
YEAR TWO, STARTING IN JANUARY.

1396
00:50:22,011 --> 00:50:26,015
THOSE ARE BEING DEVELOPED NOW.

1397
00:50:26,015 --> 00:50:27,883
AND WE'RE USING THE WORKSHOP TO

1398
00:50:27,883 --> 00:50:29,986
KIND OF BE A PRELUDE TO WHAT

1399
00:50:29,986 --> 00:50:31,187
WOMEN EXPECT AND WHAT THEY'D BE

1400
00:50:31,187 --> 00:50:32,955
LIKE TO BE ABLE TO TALK ABOUT IN

1401
00:50:32,955 --> 00:50:34,924
AN ONLINE SUPPORT GROUP FORMAT.

1402
00:50:34,924 --> 00:50:38,761
THE LAST PIECE IS CALLED WALK A

1403
00:50:38,761 --> 00:50:43,432
MILE IN MY SHOES, A FORMATIVE

1404
00:50:43,432 --> 00:50:47,103
RESEARCH FOR PROJECT 2, WHEN

1405
00:50:47,103 --> 00:50:50,406
WODESIGNEDTO BETTER UNDERSTAND.

1406
00:50:50,406 --> 00:50:52,708
WHEN WOMEN THINK WITH POSTPARTUM

1407
00:50:52,708 --> 00:50:53,809
CARE, WHERE ARE ALL THE PIECES

1408
00:50:53,809 --> 00:50:55,111
THEY THINK ABOUT?

1409
00:50:55,111 --> 00:50:56,512
EVERYBODY HAS A DIFFERENT

1410
00:50:56,512 --> 00:50:56,912
EXPERIENCE.

1411
00:50:56,912 --> 00:50:57,880
SO THAT WORKSHOP IS GOING TO BE

1412
00:50:57,880 --> 00:50:58,547
ABOUT THAT.

1413
00:50:58,547 --> 00:51:03,286
AND THEN FINALLY, I MENTION THIS

1414
00:51:03,286 --> 00:51:05,354
FORHER, INNOVATING FORHER

1415
00:51:05,354 --> 00:51:06,589
MATERNAL MENTAL HEALTH PIECE,

1416
00:51:06,589 --> 00:51:08,124
GIVES YOU A LITTLE BIT OF

1417
00:51:08,124 --> 00:51:10,192
INFORMATION ABOUT HOW IT'S

1418
00:51:10,192 --> 00:51:12,628
DESIGNED, ONCE A WEEK THROUGH

1419
00:51:12,628 --> 00:51:14,463
FORMATIVE RESEARCH, ONE-HOUR

1420
00:51:14,463 --> 00:51:15,331
DURATION, SHE SAID SHE WOULD

1421
00:51:15,331 --> 00:51:16,832
ADJUST THOSE AS NEEDED DEPENDING

1422
00:51:16,832 --> 00:51:17,767
ON WHAT THE WOMEN WANT.

1423
00:51:17,767 --> 00:51:19,869
AND SHE'S GOING TO LEAD THESE

1424
00:51:19,869 --> 00:51:21,504
FOR A 12-WEEK SESSION.

1425
00:51:21,504 --> 00:51:23,906
SO WE BETDER UNDERSTAND SOME OF

1426
00:51:23,906 --> 00:51:24,473
THE TOPICS.

1427
00:51:24,473 --> 00:51:25,908
AND THEY SHE WILL ALSO BE ABLE

1428
00:51:25,908 --> 00:51:26,776
TO ASSESS WHETHER OR NOT A WOMAN

1429
00:51:26,776 --> 00:51:29,745
NEEDS TO BE REFERRED TO A MORE

1430
00:51:29,745 --> 00:51:30,413
SPECIFIC MENTAL HEALTH PROVIDER

1431
00:51:30,413 --> 00:51:33,582
AND THEY HAVE SOME LIFE HELP

1432
00:51:33,582 --> 00:51:34,717
MENTAL HEALTH CENTERS IN THE

1433
00:51:34,717 --> 00:51:35,484
DELTA.

1434
00:51:35,484 --> 00:51:36,352
OTHERWISE WE'D PROBABLY BE

1435
00:51:36,352 --> 00:51:37,353
TALKING ABOUT REFERRING OUT FOR

1436
00:51:37,353 --> 00:51:38,354
A MENTAL HEALTH PROVIDER IN

1437
00:51:38,354 --> 00:51:40,389
JACKSON, SO THEN WE GET INTO THE

1438
00:51:40,389 --> 00:51:44,360
TRAVEL ISSUES OR WHETHER OR NOT

1439
00:51:44,360 --> 00:51:45,261
TELEHEALTH IS BEING PROVIDED.

1440
00:51:45,261 --> 00:51:46,595
SO I WANT TO THANK YOU FOR

1441
00:51:46,595 --> 00:51:47,063
LISTENING.

1442
00:51:47,063 --> 00:51:49,231
I LEFT OUT A LOT OF SLIDES, BUT

1443
00:51:49,231 --> 00:51:51,100
WE ARE VERY EXCITED FOR THE

1444
00:51:51,100 --> 00:51:51,434
WORK.

1445
00:51:51,434 --> 00:51:54,837
WE HAVE A LOT OF WORK AHEAD OF

1446
00:51:54,837 --> 00:51:56,072
US AND SOME CHALLENGES WITHIN

1447
00:51:56,072 --> 00:51:57,239
OUR COLLABORATIVE THAT VERY MUCH

1448
00:51:57,239 --> 00:52:01,544
MIMIC SOME OF THE ISSUES WITHIN

1449
00:52:01,544 --> 00:52:03,179
THE MISSISSIPPI DELTA REGION AND

1450
00:52:03,179 --> 00:52:03,979
MISSISSIPPI IN GENERAL, SO I'M

1451
00:52:03,979 --> 00:52:05,681
GOING TO CONCLUDE WITH THAT.

1452
00:52:05,681 --> 00:52:07,616
>> THANK YOU, DR. SHAW.

1453
00:52:07,616 --> 00:52:09,785
[APPLAUSE]

1454
00:52:09,785 --> 00:52:11,854
>> THE QUESTION WAS, ARE
THERE

1455
00:52:11,854 --> 00:52:13,622
COMMUNITY MIDWIVES IN THE DELTA

1456
00:52:13,622 --> 00:52:14,957
AND HOW ARE THEY INVOLVED IN

1457
00:52:14,957 --> 00:52:15,658
THIS PROJECT?

1458
00:52:15,658 --> 00:52:17,226
>> GOOD QUESTION.

1459
00:52:17,226 --> 00:52:20,296
WE ACTUALLY JUST HAD A --

1460
00:52:20,296 --> 00:52:22,198
THEY'RE NURSE-BASED MIDWIVES IN

1461
00:52:22,198 --> 00:52:23,933
MISSISSIPPI BUT NOT COMMUNITY IN

1462
00:52:23,933 --> 00:52:26,035
THE SENSE OF THAT THEY CAN EXIST

1463
00:52:26,035 --> 00:52:28,337
OR OPERATE OUTSIDE OF A

1464
00:52:28,337 --> 00:52:28,804
HOSPITAL-BASED SYSTEM.

1465
00:52:28,804 --> 00:52:32,341
WE ACTUALLY HAD A DISCUSSION

1466
00:52:32,341 --> 00:52:34,643
ABOUT THIS, I GUESS IT WAS ABOUT

1467
00:52:34,643 --> 00:52:35,644
FOUR OR FIVE WEEKS AGO IN ONE OF

1468
00:52:35,644 --> 00:52:40,049
MY CLASSES, WE HAD A RESEARCHER

1469
00:52:40,049 --> 00:52:41,183
OUT OF THE UNIVERSITY OF

1470
00:52:41,183 --> 00:52:42,585
TENNESSEE CAME AND TALKED ABOUT

1471
00:52:42,585 --> 00:52:43,586
RESPECTFUL MATERNITY CARE AND

1472
00:52:43,586 --> 00:52:45,321
SUCCESS THEY WERE HAVING WITH

1473
00:52:45,321 --> 00:52:46,655
MIDWIVES, BUT RIGHT NOW IN

1474
00:52:46,655 --> 00:52:48,224
MISSISSIPPI, NO, THE

1475
00:52:48,224 --> 00:52:49,091
COMMUNITY-BASED MIDWIFE OPTION

1476
00:52:49,091 --> 00:52:53,796
IS NOT THERE.

1477
00:52:53,796 --> 00:52:56,999
DOULAS, IN MISSISSIPPI WE

1478
00:52:56,999 --> 00:52:57,600
HAVEN'T EXPANDED MEDICAID SO

1479
00:52:57,600 --> 00:52:58,968
THERE ARE A LOT OF BARRIERS TO

1480
00:52:58,968 --> 00:53:00,736
SOME OF THOSE ADDITIONAL

1481
00:53:00,736 --> 00:53:04,240
SUPPORTS FOR MATERNAL

1482
00:53:04,240 --> 00:53:04,540
HEALTHCARE.

1483
00:53:04,540 --> 00:53:04,907
>> THANK YOU.

1484
00:53:04,907 --> 00:53:07,643
WE DON'T HAVE TIME FOR

1485
00:53:07,643 --> 00:53:08,077
QUESTIONS, BUT --

1486
00:53:08,077 --> 00:53:09,044
>> IT'S REALLY IMPORTANT.

1487
00:53:09,044 --> 00:53:12,047
>> OKAY.

1488
00:53:12,047 --> 00:53:12,715
[LAUGHTER ?CHT YOU CAN

1489
00:53:12,715 --> 00:53:16,552
DEFI]YOU CAN DEFINITELY TALK TOR

1490
00:53:16,552 --> 00:53:18,087
AT THE BREAK.

1491
00:53:18,087 --> 00:53:21,323
THANK YOU SO MUCH, DR. SHAW.

1492
00:53:21,323 --> 00:53:23,559
[APPLAUSE]

1493
00:53:23,559 --> 00:53:27,430
NEXT UP WE HAVE DR. RACHEL

1494
00:53:27,430 --> 00:53:29,165
CASKEY FROM THE UNIVERSITY OF

1495
00:53:29,165 --> 00:53:29,732
ILLINOIS-CHICAGO.

1496
00:53:29,732 --> 00:53:38,140
[APPLAUSE]

1497
00:53:38,140 --> 00:53:38,707
>> THANK YOU.

1498
00:53:38,707 --> 00:53:40,042
IT'S A PLEASURE TO BE HERE.

1499
00:53:40,042 --> 00:53:42,011
ON BEHALF OF OUR WHOLE TEAM,

1500
00:53:42,011 --> 00:53:46,348
MYSELF AND KENYA MCGREY ARE HERE

1501
00:53:46,348 --> 00:53:47,082
TODAY.

1502
00:53:47,082 --> 00:53:47,983
WE ARE ONE OF THE SITES THAT WAS

1503
00:53:47,983 --> 00:53:49,051
JUST RECENTLY FUNDED A FEW

1504
00:53:49,051 --> 00:53:51,487
MONTHS AGO, SO I'M GOING TO

1505
00:53:51,487 --> 00:53:52,521
LARGELY SHARE WHAT IS PLANNED TO

1506
00:53:52,521 --> 00:53:53,055
BE DONE.

1507
00:53:53,055 --> 00:53:55,758
WE DON'T HAVE AS MANY OUTCOMES

1508
00:53:55,758 --> 00:53:55,925
YET.

1509
00:53:55,925 --> 00:53:57,326
IN THE FUTURE, WE WILL SHARE

1510
00:53:57,326 --> 00:53:57,593
THOSE.

1511
00:53:57,593 --> 00:54:00,729
BUT I'D LIKE TO TALK ABOUT WHAT

1512
00:54:00,729 --> 00:54:02,698
WE'RE EXCITED ABOUT AND WHY WE

1513
00:54:02,698 --> 00:54:03,933
THINK CHICAGO AND THE STATE OF

1514
00:54:03,933 --> 00:54:05,167
ILLINOIS IS IMPORTANT FOR THIS

1515
00:54:05,167 --> 00:54:06,001
WORK.

1516
00:54:06,001 --> 00:54:07,670
SO I HOPE MANY OF YOU HAVE

1517
00:54:07,670 --> 00:54:08,838
VISITED CHICAGO.

1518
00:54:08,838 --> 00:54:09,772
WE'RE BIASED, IT'S A GREAT PLACE

1519
00:54:09,772 --> 00:54:11,440
TO BE.

1520
00:54:11,440 --> 00:54:14,710
BUT IT'S ALSO A REALLY CRITICAL

1521
00:54:14,710 --> 00:54:18,180
LOCATION FOR THE CENTER OF

1522
00:54:18,180 --> 00:54:18,781
EXCELLENCE.

1523
00:54:18,781 --> 00:54:20,349
SO PEOPLE OFTEN THINK OF CHICAGO

1524
00:54:20,349 --> 00:54:21,317
AS A CITY OF NEIGHBORHOODS, AND

1525
00:54:21,317 --> 00:54:22,518
IT IS.

1526
00:54:22,518 --> 00:54:27,389
IT HAS A LONG HISTORY OF VERY

1527
00:54:27,389 --> 00:54:28,057
DEFINED COMMUNITIES WITHIN THE

1528
00:54:28,057 --> 00:54:29,592
CITY.

1529
00:54:29,592 --> 00:54:31,126
AND EACH COMMUNITY REALLY HAS A

1530
00:54:31,126 --> 00:54:33,796
CULTURE AND ITS OWN VIBRANCY.

1531
00:54:33,796 --> 00:54:34,763
WHICH IS FUN.

1532
00:54:34,763 --> 00:54:37,199
YOU CAN LIVE LOTS OF DIVERSE

1533
00:54:37,199 --> 00:54:39,602
PLACES, ALL WITHIN ONE TOWN.

1534
00:54:39,602 --> 00:54:41,937
HOWEVER, WE ALSO HAVE ANOTHER

1535
00:54:41,937 --> 00:54:43,405
HISTORY.

1536
00:54:43,405 --> 00:54:45,341
A DARKER HISTORY.

1537
00:54:45,341 --> 00:54:49,178
WE ARE CONSIDERED, SADLY, TODAY,

1538
00:54:49,178 --> 00:54:52,047
ONE OF THE MOST SEGREGATED URBAN

1539
00:54:52,047 --> 00:54:54,450
AREAS IN THE U.S.

1540
00:54:54,450 --> 00:54:56,218
WE HAVE A HISTORY OF RED LINING,

1541
00:54:56,218 --> 00:54:58,754
WE HAVE A HISTORY OF THINGS THAT

1542
00:54:58,754 --> 00:55:00,756
REALLY CONTRIBUTED TO THE

1543
00:55:00,756 --> 00:55:02,591
TERRIBLE DISPARITIES WE SEE

1544
00:55:02,591 --> 00:55:05,261
TODAY FOR ALL HEALTH OUTCOMES,

1545
00:55:05,261 --> 00:55:07,329
INCLUDING MATERNAL HEALTH.

1546
00:55:07,329 --> 00:55:09,832
AS SOME OF YOU MAY HAVE READ,

1547
00:55:09,832 --> 00:55:11,700
THIS WAS PUBLISHED ABOUT A YEAR

1548
00:55:11,700 --> 00:55:14,169
OR SO AGO.

1549
00:55:14,169 --> 00:55:15,271
GERNTION THE CITY OF

1550
00:55:15,271 --> 00:55:16,071
NEIGHBORHOODS.

1551
00:55:16,071 --> 00:55:17,873
TWO NEIGHBORHOODS WERE LOOKED

1552
00:55:17,873 --> 00:55:20,643
AT:  GOLD COAST, WHICH IS THE

1553
00:55:20,643 --> 00:55:25,047
NORTHERN RED CIRCLE YOU SEE, A

1554
00:55:25,047 --> 00:55:27,783
HIHISTORICALLY AFFLUENT WHITE

1555
00:55:27,783 --> 00:55:33,255
NEIGHBORHOOD ON THE LAKE, AND

1556
00:55:33,255 --> 00:55:35,624
ENGELWOOD, A HISTORICALLY LOWER

1557
00:55:35,624 --> 00:55:36,258
INCOME BLACK COMMUNITY.

1558
00:55:36,258 --> 00:55:39,428
THERE'S A LIFE EXPECTANCY GAP OF

1559
00:55:39,428 --> 00:55:41,964
30 YEARS.

1560
00:55:41,964 --> 00:55:45,501
THESE TWO COMMUNITIES ARE

1561
00:55:45,501 --> 00:55:47,603
APPROXIMATELY 10 MILES APART.

1562
00:55:47,603 --> 00:55:49,738
AND WE SEE A LIFE GAP OF 30

1563
00:55:49,738 --> 00:55:51,407
YEARS.

1564
00:55:51,407 --> 00:55:52,741
WHICH IS AWFUL.

1565
00:55:52,741 --> 00:55:54,310
AND SO AGAIN, ONE OF THE REASONS

1566
00:55:54,310 --> 00:55:56,045
WHY THOSE OF US DOING THIS WORK

1567
00:55:56,045 --> 00:55:59,815
ARE SO EXCITED TO BE ABLE TO

1568
00:55:59,815 --> 00:56:00,583
BUILD THE CENTER OF EXCELLENCE.

1569
00:56:00,583 --> 00:56:04,186
LIKE MANY OF YOUR STATES,

1570
00:56:04,186 --> 00:56:06,722
ILLINOIS HAS TERRIBLE HEALTH

1571
00:56:06,722 --> 00:56:07,990
DISPARITIES FOR MATERNAL HEALTH.

1572
00:56:07,990 --> 00:56:09,258
BLACK WOMEN ARE THREE TIMES AS

1573
00:56:09,258 --> 00:56:12,428
LIKELY TO DIE WITHIN A YEAR OF

1574
00:56:12,428 --> 00:56:14,096
PREGNANCY, HAVE THE HIGHEST

1575
00:56:14,096 --> 00:56:16,098
RATES OF NOT JUST SEVERE

1576
00:56:16,098 --> 00:56:17,833
MATERNAL MORBIDITY BUT ALL

1577
00:56:17,833 --> 00:56:19,368
MATERNAL MORBIDITY.

1578
00:56:19,368 --> 00:56:21,337
WOMEN THAT ARE PUBLICLY INSURED

1579
00:56:21,337 --> 00:56:23,138
ARE THREE TIMES AS LIKELY TO DIE

1580
00:56:23,138 --> 00:56:25,975
COMPARED TO THOSE COMMERCIALLY

1581
00:56:25,975 --> 00:56:28,944
INSURED, AND LIKE MISSISSIPPI,

1582
00:56:28,944 --> 00:56:30,646
MANY OF OUR BAD OUTCOMES HAPPEN

1583
00:56:30,646 --> 00:56:32,915
IN THE POSTPARTUM PERIOD.

1584
00:56:32,915 --> 00:56:37,620
ABOUT -- ABOUT 70% OF THE

1585
00:56:37,620 --> 00:56:38,654
MORTALITY AS WELL AS NEARLY ALL

1586
00:56:38,654 --> 00:56:41,190
THE MORBIDITY OCCURS DURING THE

1587
00:56:41,190 --> 00:56:42,691
POSTPARTUM PERIOD, AND NEARLY

1588
00:56:42,691 --> 00:56:45,027
ALL HAVE BEEN DETERMINED

1589
00:56:45,027 --> 00:56:46,161
PREVENTABLE.

1590
00:56:46,161 --> 00:56:47,329
 BY OUR REVIEW

1591
00:56:47,329 --> 00:56:48,797
COMMITTEES, OUR MATERNAL

1592
00:56:48,797 --> 00:56:50,466
MORBIDITY AND MORTALITY REVIEW

1593
00:56:50,466 --> 00:56:50,766
COMMITTEES.

1594
00:56:50,766 --> 00:56:54,203
SO IN MY MIND, IN THE STATE OF

1595
00:56:54,203 --> 00:56:55,704
ILLINOIS, IN THE CITY OF

1596
00:56:55,704 --> 00:56:57,940
CHICAGO, NEARLY ALL OF THESE

1597
00:56:57,940 --> 00:57:01,010
DEATHS SHOULD BE NEVER EVENTS IN

1598
00:57:01,010 --> 00:57:02,211
HEALTHCARE.

1599
00:57:02,211 --> 00:57:03,178
THEY SHOULD NOT HAPPEN AND

1600
00:57:03,178 --> 00:57:04,947
THAT'S WHAT WE'RE HOPING TO HELP

1601
00:57:04,947 --> 00:57:07,049
MOVE THE NEEDLE ON.

1602
00:57:07,049 --> 00:57:10,219
UNIVERSITY OF ILLINOIS-CHICAGO

1603
00:57:10,219 --> 00:57:12,755
IS ALSO WELL POSITIONED FOR THIS

1604
00:57:12,755 --> 00:57:12,955
WORK.

1605
00:57:12,955 --> 00:57:14,990
WE ARE A MINORITY-SERVING

1606
00:57:14,990 --> 00:57:16,525
INSTITUTION AS A WHOLE ACROSS

1607
00:57:16,525 --> 00:57:19,028
THE WHOLE UNIVERSITY, AND WE ARE

1608
00:57:19,028 --> 00:57:21,163
ACTUALLY ONE OF THE MOST DIVERSE

1609
00:57:21,163 --> 00:57:22,665
PUBLIC RESEARCH INSTITUTIONS IN

1610
00:57:22,665 --> 00:57:25,534
THE U.S.

1611
00:57:25,534 --> 00:57:27,736
FROM THE HEALTHCARE AND PUBLIC

1612
00:57:27,736 --> 00:57:30,506
HEALTH PERSPECTIVE, UNIVERSITY

1613
00:57:30,506 --> 00:57:31,740
OF ILLINOIS HEALTH, WHICH IS

1614
00:57:31,740 --> 00:57:34,443
PART OF THE LARGER CAMPUS, IS

1615
00:57:34,443 --> 00:57:36,512
THE ONLY ACADEMIC MEDICAL CENTER

1616
00:57:36,512 --> 00:57:38,414
IN CHICAGO THAT IS PUBLIC.

1617
00:57:38,414 --> 00:57:41,250
THERE ARE A LOT OF INCREDIBLE

1618
00:57:41,250 --> 00:57:43,118
ACADEMIC AND NON-ACADEMIC

1619
00:57:43,118 --> 00:57:44,186
MEDICAL CENTERS IN CHICAGO.

1620
00:57:44,186 --> 00:57:46,255
BUT WE ARE THE ONLY ACADEMIC

1621
00:57:46,255 --> 00:57:49,224
MEDICAL CENTER THAT IS A PUBLIC

1622
00:57:49,224 --> 00:57:49,992
INSTITUTION AND A PUBLIC

1623
00:57:49,992 --> 00:57:51,560
HOSPITAL.

1624
00:57:51,560 --> 00:57:54,596
WE PRIORITIZE THE PUBLICLY

1625
00:57:54,596 --> 00:57:54,830
INSURED.

1626
00:57:54,830 --> 00:57:57,466
AND I WILL TELL YOU, AS A

1627
00:57:57,466 --> 00:57:58,701
CLINICIAN, IT IS AN OUTSTANDING

1628
00:57:58,701 --> 00:58:00,235
PLACE TO SIT.

1629
00:58:00,235 --> 00:58:03,205
I NEVER HAVE TO WORRY WHAT

1630
00:58:03,205 --> 00:58:05,808
SOMEONE'S INSURANCE IS, AND IN

1631
00:58:05,808 --> 00:58:09,912
FACT, WE BUILD A ROBUST TERTIARY

1632
00:58:09,912 --> 00:58:11,480
MEDICAL CENTER FOR PRIORITIZING

1633
00:58:11,480 --> 00:58:13,449
THOSE THAT COME IN WITH MEDICAID

1634
00:58:13,449 --> 00:58:16,618
OR ONE OF THE MEDICAID MCOs,

1635
00:58:16,618 --> 00:58:18,187
SO IT'S REALLY A WONDERFUL PLACE

1636
00:58:18,187 --> 00:58:18,821
TO WORK.

1637
00:58:18,821 --> 00:58:20,656
AND THEN WE HAVE THE BENEFIT OF

1638
00:58:20,656 --> 00:58:22,825
RURAL PARTNER CAMPUSES IN PEORIA

1639
00:58:22,825 --> 00:58:24,359
AND ROCKFORD, WHICH IS, OF

1640
00:58:24,359 --> 00:58:25,294
COURSE, ALSO IMPORTANT TO THIS

1641
00:58:25,294 --> 00:58:26,829
WORK.

1642
00:58:26,829 --> 00:58:30,999
SO BRIEFLY, OUR MATERNAL HEALTH

1643
00:58:30,999 --> 00:58:32,201
RESEARCH CENTER OF EXCELLENCE

1644
00:58:32,201 --> 00:58:34,169
BUILDS ON A LARGE DIVERSE TEAM

1645
00:58:34,169 --> 00:58:36,271
THAT HAS WELL OVER A DECADE OF

1646
00:58:36,271 --> 00:58:37,506
EXPERTISE IN THIS AREA.

1647
00:58:37,506 --> 00:58:39,141
I'M GOING TO SHOW YOU JUST A FEW

1648
00:58:39,141 --> 00:58:44,313
AREAS OF EXPERTISE IN A MOMENT.

1649
00:58:44,313 --> 00:58:45,948
AND OF COURSE OUR GOAL LIKE ALL

1650
00:58:45,948 --> 00:58:47,816
OF YOURS IS REALLY TO ADDRESS

1651
00:58:47,816 --> 00:58:49,118
THE MORBIDITY AND MORTALITY

1652
00:58:49,118 --> 00:58:53,355
ACROSS THE STATE.

1653
00:58:53,355 --> 00:58:55,524
SO OUR DESIGN IS USING METHODS

1654
00:58:55,524 --> 00:58:59,094
TO EXAMINE MECHANISMS BY WHICH

1655
00:58:59,094 --> 00:58:59,728
STRUCTURAL INEQUITY CONTRIBUTE

1656
00:58:59,728 --> 00:59:04,466
TO HEALTH DISPARITIES.

1657
00:59:04,466 --> 00:59:05,901
AND WE'RE LOOKING TO USE A

1658
00:59:05,901 --> 00:59:07,035
MULTILEVEL APPROACH, REALLY

1659
00:59:07,035 --> 00:59:08,437
TRYING TO PULL AWAY FROM

1660
00:59:08,437 --> 00:59:09,872
INDIVIDUAL CONTRIBUTORS, AND

1661
00:59:09,872 --> 00:59:12,474
LOOK AT STRUCTURAL AND

1662
00:59:12,474 --> 00:59:13,976
SYSTEM-LEVEL CONTRIBUTORS, AND

1663
00:59:13,976 --> 00:59:18,547
WAYS WE CAN CHANGE THOSE IN THE

1664
00:59:18,547 --> 00:59:24,119
CITY AND STATE.

1665
00:59:24,119 --> 00:59:27,623
OUR TEAM COMES FROM OVER 14

1666
00:59:27,623 --> 00:59:28,490
DISCIPLINES, ALL WORKING WITHIN

1667
00:59:28,490 --> 00:59:29,758
THE MATERNAL HEALTH SPACE FOR

1668
00:59:29,758 --> 00:59:30,192
MANY YEARS.

1669
00:59:30,192 --> 00:59:32,594
WE HAVE EDUCATION, HEALTHCARE,

1670
00:59:32,594 --> 00:59:34,630
PUBLIC HEALTH, WE HAVE BASIC

1671
00:59:34,630 --> 00:59:36,365
SCIENCES AT THE TABLE, COMMUNITY

1672
00:59:36,365 --> 00:59:37,332
GROUPS.

1673
00:59:37,332 --> 00:59:37,800
THE LIST GOES ON.

1674
00:59:37,800 --> 00:59:39,902
SO IT REALLY A ROBUST TEAM THAT

1675
00:59:39,902 --> 00:59:41,436
WE'RE LEARNING A LOT FROM EACH

1676
00:59:41,436 --> 00:59:42,971
OTHER IN THESE FIRST FEW MONTHS

1677
00:59:42,971 --> 00:59:44,740
OF OUR BUILDING FLEURCHLT SO OF

1678
00:59:44,740 --> 00:59:46,642
COURSE LIKE ALL OF YOU, WE HAVE

1679
00:59:46,642 --> 00:59:47,075
CORES.

1680
00:59:47,075 --> 00:59:48,610
I'M JUST GOING TO TOUCH BRIEFLY

1681
00:59:48,610 --> 00:59:49,711
ON THE PREMISE FOR WHICH WE

1682
00:59:49,711 --> 00:59:51,914
DESIGNED OUR CORES.

1683
00:59:51,914 --> 00:59:53,682
FOR OUR TRAINING CORE, AGAIN,

1684
00:59:53,682 --> 00:59:55,984
GETTING BACK TO THE MISSION OF

1685
00:59:55,984 --> 00:59:57,186
OUR INSTITUTION AS A WHOLE.

1686
00:59:57,186 --> 01:00:01,824
WE AR REALLY WANT TO BUILD A

1687
01:00:01,824 --> 01:00:04,359
STRUCTURE FOR ONGOING PIPELINE

1688
01:00:04,359 --> 01:00:07,129
OF MATERNAL HEALTH RESEARCHERS.

1689
01:00:07,129 --> 01:00:09,198
AND SPECIFICALLY DEVELOP A

1690
01:00:09,198 --> 01:00:10,833
DIVERSE PIPELINE OF MATERNAL

1691
01:00:10,833 --> 01:00:13,569
HEALTH RESEARCHERS COMING FROM

1692
01:00:13,569 --> 01:00:15,137
DIVERSE LIVED EXPERIENCE,

1693
01:00:15,137 --> 01:00:17,339
DIVERSE TRAINING BACKGROUNDS AND

1694
01:00:17,339 --> 01:00:17,973
SO FORTH.

1695
01:00:17,973 --> 01:00:19,842
WE HOPE TO GENERATE A LOT OF

1696
01:00:19,842 --> 01:00:21,443
EARLY STAGE INVESTIGATORS WHO GO

1697
01:00:21,443 --> 01:00:24,213
ON TO BECOME INDEPENDENT, AND UP

1698
01:00:24,213 --> 01:00:26,615
WITH OF THE THINGS T -- ONE OF S

1699
01:00:26,615 --> 01:00:28,116
THAT I'M EXCITED ABOUT IS WE ARE

1700
01:00:28,116 --> 01:00:29,952
PULLING IN COMMUNITY-BASED

1701
01:00:29,952 --> 01:00:31,086
CLINICIANS INTO OUR TRAINING

1702
01:00:31,086 --> 01:00:33,789
CORE.

1703
01:00:33,789 --> 01:00:34,890
SO ONE OF THE COMMUNITY GROUPS

1704
01:00:34,890 --> 01:00:36,425
WE'RE PARTNERING WITH HAS A

1705
01:00:36,425 --> 01:00:37,626
CONSORTIUM OF FEDERALLY

1706
01:00:37,626 --> 01:00:38,861
QUALIFIED HEALTH CENTERS ACROSS

1707
01:00:38,861 --> 01:00:39,528
THE STATE.

1708
01:00:39,528 --> 01:00:41,263
WE'RE ACTUALLY LOOKING FOR

1709
01:00:41,263 --> 01:00:43,899
CLINICIANS WHO WORK ON THE

1710
01:00:43,899 --> 01:00:45,801
GROUND IN COMMUNITY FQHCs TO

1711
01:00:45,801 --> 01:00:48,003
COME AND BE A PART OF OUR

1712
01:00:48,003 --> 01:00:48,871
TRAINING CORE.

1713
01:00:48,871 --> 01:00:50,973
PEOPLE WHO WANT TO LEARN A BIT

1714
01:00:50,973 --> 01:00:52,207
ABOUT RESEARCH.

1715
01:00:52,207 --> 01:00:55,577
MAYBE LEARN HOW TO USE DATA

1716
01:00:55,577 --> 01:00:59,081
WITHIN THEIR FQHC FOR CHANGE OR

1717
01:00:59,081 --> 01:00:59,581
FOR EVALUATION.

1718
01:00:59,581 --> 01:01:00,916
AND THESE ARE COMMUNITIES THAT

1719
01:01:00,916 --> 01:01:04,519
ARE UNDERSTUDIED BECAUSE SO MANY

1720
01:01:04,519 --> 01:01:06,989
OF OUR COMMUNITY FQHCs ARE

1721
01:01:06,989 --> 01:01:08,290
DOING SO MUCH GREAT CLINICAL

1722
01:01:08,290 --> 01:01:09,591
WORK, THEY DON'T HAVE TIME FOR

1723
01:01:09,591 --> 01:01:10,259
THIS, RIGHT?

1724
01:01:10,259 --> 01:01:13,362
THEY OFTEN DON'T HAVE TIME,

1725
01:01:13,362 --> 01:01:14,263
RESOURCES OR INFRASTRUCTURE FOR

1726
01:01:14,263 --> 01:01:14,529
RESEARCH.

1727
01:01:14,529 --> 01:01:16,098
SO WE'RE HOPING TO PROVIDE SOME

1728
01:01:16,098 --> 01:01:18,433
SUPPORT TO GET THEM INVOLVED.

1729
01:01:18,433 --> 01:01:21,069
AND THEN WE HAVE A TEAM OF

1730
01:01:21,069 --> 01:01:22,504
EXPERT MENTORS.

1731
01:01:22,504 --> 01:01:24,339
THESE ARE PEOPLE WHO SPENT THEIR

1732
01:01:24,339 --> 01:01:27,809
CAREER FIGURING OUT HOW TO MOST

1733
01:01:27,809 --> 01:01:28,911
EFFECTIVELY MENTOR ADULT

1734
01:01:28,911 --> 01:01:29,778
LEARNERS.

1735
01:01:29,778 --> 01:01:32,514
AND THEY'RE GOING TO HELP CREATE

1736
01:01:32,514 --> 01:01:37,152
A JOURNEYMEN T JOURNEY MENTORINR

1737
01:01:37,152 --> 01:01:38,587
EVERYONE REGARDLESS OF

1738
01:01:38,587 --> 01:01:39,688
BACKGROUND AND TRAINING.

1739
01:01:39,688 --> 01:01:41,823
WE'RE LEVERAGING SOME OF OUR

1740
01:01:41,823 --> 01:01:43,091
EXISTING TRAINING PROGRAMS AT

1741
01:01:43,091 --> 01:01:43,592
UNIVERSITY OF ILLINOIS.

1742
01:01:43,592 --> 01:01:53,268
WE HAVE A BIRCWH, WHICH IS NIH

1743
01:01:53,268 --> 01:01:54,903
FUNDED, WHICH IS AGAIN FOCUSED

1744
01:01:54,903 --> 01:01:56,471
ON JUNIOR FACILITY WHO STUDY

1745
01:01:56,471 --> 01:02:04,446
ISSUES RELATED TO WOMEN AND

1746
01:02:04,446 --> 01:02:04,913
GENDER.

1747
01:02:04,913 --> 01:02:06,782
WE HAVE A T32 PROGRAM ON

1748
01:02:06,782 --> 01:02:08,450
PRECISION MEDICINE AND WE ARE

1749
01:02:08,450 --> 01:02:09,451
RECRUITING POSTDOCS INTO THAT

1750
01:02:09,451 --> 01:02:10,986
PROGRAM WITH AN INTEREST IN

1751
01:02:10,986 --> 01:02:13,055
MATERNAL HEALTH RESEARCHMENT AND

1752
01:02:13,055 --> 01:02:14,856
OUR SCHOOL OF PUBLIC HEALTH HAS

1753
01:02:14,856 --> 01:02:17,626
AN ACE PROGRAM, AGAIN A JUNIOR

1754
01:02:17,626 --> 01:02:19,027
FACULTY PROGRAM TO BUILD

1755
01:02:19,027 --> 01:02:19,795
INDEPENDENT RESEARCHERS.

1756
01:02:19,795 --> 01:02:21,296
I MENTIONED THE COMMUNITY

1757
01:02:21,296 --> 01:02:22,931
CLINICIANS AT FQHCs, AND WE

1758
01:02:22,931 --> 01:02:24,733
ARE ALSO ENSURING THAT EVERYONE

1759
01:02:24,733 --> 01:02:27,235
WE HIRE TO SUPPORT THE CENTER

1760
01:02:27,235 --> 01:02:28,570
HAS ACCESS TO THE TRAINING CORE.

1761
01:02:28,570 --> 01:02:31,273
WE HIRE RESEARCH ASSISTANTS,

1762
01:02:31,273 --> 01:02:33,208
GRADUATE STUDENTS, COMMUNITY

1763
01:02:33,208 --> 01:02:33,642
MEMBERS.

1764
01:02:33,642 --> 01:02:35,410
ALL SORTS OF THE STAFF THAT

1765
01:02:35,410 --> 01:02:37,346
REALLY MAKE THESE THINGS

1766
01:02:37,346 --> 01:02:37,612
POSSIBLE.

1767
01:02:37,612 --> 01:02:39,181
WE ALSO WANT TO MAKE SURE THEY

1768
01:02:39,181 --> 01:02:40,382
HAVE AN OPPORTUNITY FOR THEIR

1769
01:02:40,382 --> 01:02:42,250
OWN CAREER DEVELOPMENT, SO

1770
01:02:42,250 --> 01:02:44,219
THEY'RE ACTUALLY A GROUP WITHIN

1771
01:02:44,219 --> 01:02:45,320
THIS TRAINING CORE THAT WE'RE

1772
01:02:45,320 --> 01:02:47,656
GOING TO FOCUS ON, AND AGAIN,

1773
01:02:47,656 --> 01:02:50,959
BASED ON THEIR BACKGROUND AND

1774
01:02:50,959 --> 01:02:53,028
NEEDS WILL BE TAILORED.

1775
01:02:53,028 --> 01:02:54,730
OUR COMMUNITY PARTNERSHIP CORE

1776
01:02:54,730 --> 01:02:56,898
ADDRESSES CRITICAL NEED FOR

1777
01:02:56,898 --> 01:02:58,000
STRUCTURED SYSTEM LEVELS

1778
01:02:58,000 --> 01:03:01,236
APPROACH TO ENGAGE COMMUNITIES.

1779
01:03:01,236 --> 01:03:02,871
WE HAVE THE OPPORTUNITY NOW TO

1780
01:03:02,871 --> 01:03:06,441
REALLY EXPAND ON EXISTING

1781
01:03:06,441 --> 01:03:09,111
PARTNERSHIPS WITH EVERTHRIVE

1782
01:03:09,111 --> 01:03:11,346
ILLINOIS, WHICH IS A INCREDIBLE

1783
01:03:11,346 --> 01:03:13,882
NON-PRO FUCT FOCUSED ON

1784
01:03:13,882 --> 01:03:16,151
REPRODUCTIVE JUSTICE AND BIRTH

1785
01:03:16,151 --> 01:03:18,520
EQUITY, AND THEN

1786
01:03:18,520 --> 01:03:20,589
ALLIANCECHICAGO, WHICH IS THE

1787
01:03:20,589 --> 01:03:22,024
GROUP OF FEDERALLY QUALIFIED

1788
01:03:22,024 --> 01:03:23,291
HEALTH CENTERS I MENTIONED.

1789
01:03:23,291 --> 01:03:24,926
WE HAVE ALREADY STARTED TO

1790
01:03:24,926 --> 01:03:26,461
DEVELOP OUR COMMUNITY ADVISORY

1791
01:03:26,461 --> 01:03:27,796
BOARD, EVERTHRIVE IS TAKING THE

1792
01:03:27,796 --> 01:03:29,798
LEAD AND THEY SENT OUT SOME

1793
01:03:29,798 --> 01:03:31,133
INITIAL INVITATIONS LAST WEEK SO

1794
01:03:31,133 --> 01:03:31,767
THAT'S EXCITING.

1795
01:03:31,767 --> 01:03:32,768
THEY'RE GOING TO BE SCHEDULING

1796
01:03:32,768 --> 01:03:34,136
THEIR FIRST MEETING IN A MONTH

1797
01:03:34,136 --> 01:03:34,569
OR SO.

1798
01:03:34,569 --> 01:03:38,273
AND WE'RE REALLY HOPING TO DRAW

1799
01:03:38,273 --> 01:03:39,775
AN EXPERTISE OF OUR COMMUNITY

1800
01:03:39,775 --> 01:03:40,876
MEMBERS ACROSS ALL AREAS OF THE

1801
01:03:40,876 --> 01:03:41,309
CENTER.

1802
01:03:41,309 --> 01:03:43,045
WE BUILT THIS WITH A HUMAN

1803
01:03:43,045 --> 01:03:45,047
CENTERED DESIGN FRAMEWORK

1804
01:03:45,047 --> 01:03:45,547
APPROACH.

1805
01:03:45,547 --> 01:03:49,151
WE REALLY TRY TO ENSURE EVERYONE

1806
01:03:49,151 --> 01:03:50,352
HAS AN OPPORTUNITY TO HAVE A

1807
01:03:50,352 --> 01:03:52,320
VOICE AT THE TABLE.

1808
01:03:52,320 --> 01:03:55,457
AND THEN WE WILL ALSO ANTICIPATE

1809
01:03:55,457 --> 01:03:57,159
BARRIERS AND BURDENS AS WE PRO

1810
01:03:57,159 --> 01:04:05,267
SATISFIED.

1811
01:04:05,267 --> 01:04:10,238
A FEW ACTIVITY EXAMPLES OF OUR

1812
01:04:10,238 --> 01:04:11,573
COMMUNITY ADVISORY BOARD.

1813
01:04:11,573 --> 01:04:13,975
AGAIN BIDIRECTIONAL, WE WANT TO

1814
01:04:13,975 --> 01:04:14,910
HELP BRING RESEARCH TO THE

1815
01:04:14,910 --> 01:04:15,777
COMMUNITY, PROVIDE OPPORTUNITIES

1816
01:04:15,777 --> 01:04:17,112
FOR INTRODUCTION TO WHAT OUR

1817
01:04:17,112 --> 01:04:18,647
RESEARCH METHODS, APPROACHES, SO

1818
01:04:18,647 --> 01:04:21,216
FORTH, FOR OUR COMMUNITY

1819
01:04:21,216 --> 01:04:21,883
STAKEHOLDERS AND COMMUNITY

1820
01:04:21,883 --> 01:04:24,086
GROUPS ACROSS THE STATE.

1821
01:04:24,086 --> 01:04:25,587
LIKEWISE WE WANT TO BRING THE

1822
01:04:25,587 --> 01:04:27,289
COMMUNITY VOICE TO OUR

1823
01:04:27,289 --> 01:04:28,824
RESEARCHERS AND MAKE SURE

1824
01:04:28,824 --> 01:04:30,358
THEY'RE MAKING THE COMMUNITIES

1825
01:04:30,358 --> 01:04:32,861
INVOLVED WITH DESIGN, BUT ALSO

1826
01:04:32,861 --> 01:04:34,463
THAT THEY MAKE RESULTS

1827
01:04:34,463 --> 01:04:35,797
DIGESTIBLE AND UNDERSTANDABLE

1828
01:04:35,797 --> 01:04:36,865
AND MEANINGFUL TO COMMUNITIES

1829
01:04:36,865 --> 01:04:38,266
THEY MAY IMPACT.

1830
01:04:38,266 --> 01:04:40,435
LOTS OF COMMUNITY DIALOGUES

1831
01:04:40,435 --> 01:04:41,770
PLANNED, AND WE ALSO ARE

1832
01:04:41,770 --> 01:04:43,505
PLANNING A CITIZEN SCIENTIST

1833
01:04:43,505 --> 01:04:44,673
PROGRAM, WHERE COMMUNITY

1834
01:04:44,673 --> 01:04:45,640
PARTNERS WILL WORK TOGETHER WITH

1835
01:04:45,640 --> 01:04:49,044
SOME OF OUR TRAINED QUALITATIVE

1836
01:04:49,044 --> 01:04:51,446
STAFF TO GATHER NARRATIVES

1837
01:04:51,446 --> 01:04:53,582
THROUGH STORY CIRCLES,

1838
01:04:53,582 --> 01:04:54,583
PHOTOVOICE, INTERGENERATIONAL

1839
01:04:54,583 --> 01:04:56,885
FAMILY HISTORIES, AND THEN

1840
01:04:56,885 --> 01:04:59,354
ACTUALLY USE A RESEARCH

1841
01:04:59,354 --> 01:05:01,656
FRAMEWORK TO ANALYZE THEIR OWN

1842
01:05:01,656 --> 01:05:02,757
QUALITATIVE DATA AND PRESENT

1843
01:05:02,757 --> 01:05:04,926
THAT BACK TO EACH OTHER AND THE

1844
01:05:04,926 --> 01:05:06,361
COMMUNITIES, AS WELL AS TO OUR

1845
01:05:06,361 --> 01:05:11,800
RESEARCHERS.

1846
01:05:11,800 --> 01:05:13,435
AND FINALLY OUR RESEARCH CORE IS

1847
01:05:13,435 --> 01:05:15,036
FOCUSED ON A PROJECT WHICH IS A

1848
01:05:15,036 --> 01:05:16,505
MULTILEVEL EXPOSURE TO ADVERSITY

1849
01:05:16,505 --> 01:05:18,106
ACROSS THE LIFECOURSE.

1850
01:05:18,106 --> 01:05:19,975
LOOKING AT BIOLOGICAL

1851
01:05:19,975 --> 01:05:24,079
IMPLICATIONS IN POSTPARTUM

1852
01:05:24,079 --> 01:05:24,479
WOMEN.

1853
01:05:24,479 --> 01:05:28,216
SO WE'RE LOOKING TO DESCRIBE

1854
01:05:28,216 --> 01:05:30,318
EXPOSURE TO MULTILEVEL BOTH

1855
01:05:30,318 --> 01:05:31,052
NEIGHBORHOOD, FAMILY AND

1856
01:05:31,052 --> 01:05:32,654
INDIVIDUAL ADVERSE FACTORS AMONG

1857
01:05:32,654 --> 01:05:34,456
POSTPARTUM PEOPLE, ASSESS THE

1858
01:05:34,456 --> 01:05:35,957
EFFECT OF THOSE EXPOSURES ON

1859
01:05:35,957 --> 01:05:37,392
PREGNANCY AND BIRTH OUTCOMES,

1860
01:05:37,392 --> 01:05:39,427
AND DO SOME QUALITATIVE WORK

1861
01:05:39,427 --> 01:05:41,163
USING PHOTOVOICE TO GET EVEN

1862
01:05:41,163 --> 01:05:45,967
RICHER INFORMATION.

1863
01:05:45,967 --> 01:05:46,935
AND OF COURSE OUR COMMUNITY

1864
01:05:46,935 --> 01:05:48,136
MEMBERS WILL BE INVOLVED IN

1865
01:05:48,136 --> 01:05:49,538
EVERY STEP OF THE PROCESS.

1866
01:05:49,538 --> 01:05:52,174
HERE'S JUST SOME EXAMPLES OF THE

1867
01:05:52,174 --> 01:05:54,976
PLANNED DATA TO BE COLLECTED AS

1868
01:05:54,976 --> 01:05:55,877
THIS PROJECT GETS OFF THE

1869
01:05:55,877 --> 01:05:59,581
GROUND.

1870
01:05:59,581 --> 01:06:01,416
AND FINALLY, WE HAVE STRUCTURED

1871
01:06:01,416 --> 01:06:02,918
OUR OWN DATA COMMITTEE, GIVEN

1872
01:06:02,918 --> 01:06:04,653
THE SIZE OF THESE PROJECTS, WE

1873
01:06:04,653 --> 01:06:05,987
THOUGHT IT WAS IMPORTANT TO HAVE

1874
01:06:05,987 --> 01:06:10,425
A UNIFYING STRUCTURE ACROSS THE

1875
01:06:10,425 --> 01:06:12,727
CENTER TO WORK WITH THE DATA

1876
01:06:12,727 --> 01:06:14,162
INNOVATION AND COORDINATING HUB,

1877
01:06:14,162 --> 01:06:15,297
OF COURSE, BUT ALSO TO ENSURE WE

1878
01:06:15,297 --> 01:06:17,165
ARE COLLECTING GOOD DATA ACROSS

1879
01:06:17,165 --> 01:06:20,335
ALL OF OUR CORES, AND DOING IT

1880
01:06:20,335 --> 01:06:21,102
AHEAD OF TIME.

1881
01:06:21,102 --> 01:06:22,837
SO WE DON'T -- WE'RE NOT TWO

1882
01:06:22,837 --> 01:06:24,606
YEARS IN, AND WONDERING WHY

1883
01:06:24,606 --> 01:06:25,807
DIDN'T WE COLLECT THIS, THAT OR

1884
01:06:25,807 --> 01:06:26,441
THE OTHER.

1885
01:06:26,441 --> 01:06:28,076
SO THIS GROUP IS WORKING ACROSS

1886
01:06:28,076 --> 01:06:30,245
ALL THE CORES REALLY, ENSURING

1887
01:06:30,245 --> 01:06:32,280
THAT WE'RE GETTING GOOD ROBUST

1888
01:06:32,280 --> 01:06:33,715
BOTH QUANTITATIVE AND

1889
01:06:33,715 --> 01:06:36,351
QUALITATIVE DATA AS APPROPRIATE.

1890
01:06:36,351 --> 01:06:38,687
AND THEY'RE ALSO SERVING AS A

1891
01:06:38,687 --> 01:06:40,021
MENTORSHIP GROUP TO TRAIN AND

1892
01:06:40,021 --> 01:06:41,456
EDUCATE THE WORKFORCE, AND THEN

1893
01:06:41,456 --> 01:06:42,691
THIS DATA WILL BE AVAILABLE NOT

1894
01:06:42,691 --> 01:06:44,593
JUST TO SHARE WITH PARTNERS

1895
01:06:44,593 --> 01:06:46,795
OUTSIDE OF UIC, BUT TO SHARE

1896
01:06:46,795 --> 01:06:48,496
ACROSS UIC AND WITH COMMUNITY

1897
01:06:48,496 --> 01:06:49,364
PARTNERS.

1898
01:06:49,364 --> 01:06:50,565
AND I'M GOING TO STOP THERE AND

1899
01:06:50,565 --> 01:06:51,299
TAKE YOUR QUESTIONS.

1900
01:06:51,299 --> 01:06:51,666
THANK YOU.

1901
01:06:51,666 --> 01:06:58,907
[APPLAUSE]

1902
01:06:58,907 --> 01:07:00,475
>> THANK YOU SO MUCH.

1903
01:07:00,475 --> 01:07:01,910
DO WE HAVE ANY QUESTIONS IN THE

1904
01:07:01,910 --> 01:07:12,087
AUDIENCE?

1905
01:07:13,121 --> 01:07:14,122
SO I HAVE A QUESTION FOR YOU.

1906
01:07:14,122 --> 01:07:15,757
IN TERMS OF ANALYZING THAT

1907
01:07:15,757 --> 01:07:18,727
REALLY RICH QUALITATIVE DATA,

1908
01:07:18,727 --> 01:07:25,667
FROM PHOTOVOICE, LISTENING

1909
01:07:25,667 --> 01:07:27,636
SESSIONS, DO YOU SEE TOOLS LIKE

1910
01:07:27,636 --> 01:07:29,271
A.I. BEING USEFUL IN THAT, AND

1911
01:07:29,271 --> 01:07:32,741
IF SO, WHAT ARE THE POTENTIAL

1912
01:07:32,741 --> 01:07:34,843
BIASES THAT WE KNOW A.I. HAS,

1913
01:07:34,843 --> 01:07:38,546
WHAT COULD THAT BRING TO THAT

1914
01:07:38,546 --> 01:07:38,847
SPECIFIC --

1915
01:07:38,847 --> 01:07:39,681
>> THAT'S A REALLY GOOD

1916
01:07:39,681 --> 01:07:40,048
QUESTION.

1917
01:07:40,048 --> 01:07:41,683
I'M SURE MANY OF US ARE

1918
01:07:41,683 --> 01:07:45,387
STRUGGLING TO FIGURE OUT HOW TO

1919
01:07:45,387 --> 01:07:46,588
INCORPORATE A.I. THESE DAYS.

1920
01:07:46,588 --> 01:07:48,857
WE HAVE A LOT OF BURGEONING A.I.

1921
01:07:48,857 --> 01:07:49,924
RESEARCHERS AT UNIVERSITY OF

1922
01:07:49,924 --> 01:07:53,862
ILLINOIS, WHICH WE CAN LEAN ON,

1923
01:07:53,862 --> 01:07:55,830
AND SO THE SHORT ANSWER IS, I

1924
01:07:55,830 --> 01:07:58,133
THINK THERE'S A ROLE, THE LONG

1925
01:07:58,133 --> 01:08:00,468
ANSWER IS, I DON'T THINK WE KNOW

1926
01:08:00,468 --> 01:08:02,437
YET, BECAUSE OF COURSE THERE'S

1927
01:08:02,437 --> 01:08:03,538
INTRINSIC BIAS IN EVERYTHING,

1928
01:08:03,538 --> 01:08:04,205
RIGHT?

1929
01:08:04,205 --> 01:08:06,941
A.I. IS TRAINED ON DATA AND

1930
01:08:06,941 --> 01:08:09,778
SCIENCE WITHIN THE LARGER

1931
01:08:09,778 --> 01:08:11,179
INTERNET, AND THOSE COULD BE

1932
01:08:11,179 --> 01:08:13,248
BIASED IN AND OF ITSELF, SO I

1933
01:08:13,248 --> 01:08:14,749
DON'T KNOW HOW WE'RE GOING TO DO

1934
01:08:14,749 --> 01:08:16,184
THIS, BUT WE HAVE A LOT OF SMART

1935
01:08:16,184 --> 01:08:17,218
PEOPLE THINKING ABOUT IT, SO IT

1936
01:08:17,218 --> 01:08:23,358
A GREAT QUESTION.

1937
01:08:23,358 --> 01:08:24,492
>> WE HAVE A QUESTION IN
THE

1938
01:08:24,492 --> 01:08:24,759
AUDIENCE.

1939
01:08:24,759 --> 01:08:32,133
>> HELLO, THANK YOU FOR
YOUR

1940
01:08:32,133 --> 01:08:33,335
PRESENTATION.

1941
01:08:33,335 --> 01:08:34,536
I'M FROM NATURE.

1942
01:08:34,536 --> 01:08:36,271
I LOVE EVERYTHING I SEE.

1943
01:08:36,271 --> 01:08:37,906
I'M FROM ST. LOUIS AND I HAVE

1944
01:08:37,906 --> 01:08:43,778
CLOSE TIES TO CHICAGO.

1945
01:08:43,778 --> 01:08:46,081
TOWARDS THE SYSTEMIC ANGLE OF

1946
01:08:46,081 --> 01:08:47,716
PRIORITIES AND STRATEGY, I SAW

1947
01:08:47,716 --> 01:08:48,683
THERE'S MULTIPLE DIFFERENT

1948
01:08:48,683 --> 01:08:50,085
SECTORS EVEN WITHIN UIC THAT

1949
01:08:50,085 --> 01:08:52,721
WOULD BE INVOLVED, SO HOW WILL

1950
01:08:52,721 --> 01:08:55,457
THE ENGAGEMENT BE IN TERMS OF,

1951
01:08:55,457 --> 01:08:58,059
LIKE, SYSTEMIC CHANGE IN TERMS

1952
01:08:58,059 --> 01:09:03,064
OF POLICY CHANGES, IMPROVING

1953
01:09:03,064 --> 01:09:05,633
ACCESS TO DIFFERENT RESOURCES,

1954
01:09:05,633 --> 01:09:08,403
AND EVEN THE BIGGER FACTORS OF,

1955
01:09:08,403 --> 01:09:11,473
LIKE, THE RACIAL AND ECONOMIC

1956
01:09:11,473 --> 01:09:13,141
DISPARITIES, MCDADEING THAT

1957
01:09:13,141 --> 01:09:15,176
LEVEL OF SYSTEMIC CHANGE?

1958
01:09:15,176 --> 01:09:16,811
>> THAT'S REALLY THE
CRITICAL

1959
01:09:16,811 --> 01:09:19,447
END GAME, RIGHT?

1960
01:09:19,447 --> 01:09:22,283
IS WE NEED TO REALLY MAKE THE

1961
01:09:22,283 --> 01:09:23,451
SUSTAINABLE CHANGE, WE NEED TO

1962
01:09:23,451 --> 01:09:25,320
GO ALL THE WAY UP TO THE

1963
01:09:25,320 --> 01:09:27,889
POLICYMAKERS, THE LEGISLATORS.

1964
01:09:27,889 --> 01:09:29,891
SO WE HAVE STRATEGICALLY

1965
01:09:29,891 --> 01:09:32,060
INCLUDED PEOPLE ON THE TEAM THAT

1966
01:09:32,060 --> 01:09:35,196
HAVE A LOT OF EXPERIENCE IN THAT

1967
01:09:35,196 --> 01:09:36,197
SPACE, POLICY DEVELOPMENT AT THE

1968
01:09:36,197 --> 01:09:38,266
STATE LEVEL, ADVOCACY, AND WE

1969
01:09:38,266 --> 01:09:40,001
WORK VERY CLOSELY WITH OUR STATE

1970
01:09:40,001 --> 01:09:41,836
PARTNERS AT BOTH CHICAGO

1971
01:09:41,836 --> 01:09:43,905
DEPARTMENT OF PUBLIC HEALTH AND

1972
01:09:43,905 --> 01:09:45,373
ILLINOIS DEPARTMENT OF PUBLIC

1973
01:09:45,373 --> 01:09:46,241
HEALTH, AS WELL AS SOME OF OUR

1974
01:09:46,241 --> 01:09:47,742
ELECTED OFFICIALS.

1975
01:09:47,742 --> 01:09:50,245
I WOULD HAVE LOVED TO, YOU KNOW,

1976
01:09:50,245 --> 01:09:51,413
BELIEVE THAT EVERYTHING WE DO

1977
01:09:51,413 --> 01:09:55,583
WILL MAKE IT ALL THE WAY UP, BUT

1978
01:09:55,583 --> 01:09:59,187
I DO FIND THAT IN ILLINOIS, IF

1979
01:09:59,187 --> 01:10:01,189
YOU HAVE A THOUGHTFUL APPROACH

1980
01:10:01,189 --> 01:10:02,824
AND YOU CAN SHOW YOU'VE DONE A

1981
01:10:02,824 --> 01:10:04,526
GOOD JOB LOOKING AT THE ISSUE,

1982
01:10:04,526 --> 01:10:05,627
RIGHT, YOU'VE STUDIED IT

1983
01:10:05,627 --> 01:10:06,928
PROPERLY, YOU'VE ENGAGED THE

1984
01:10:06,928 --> 01:10:10,965
RIGHT VOICES, I HAVE BEEN VERY

1985
01:10:10,965 --> 01:10:12,500
PLEASANTLY SURPRISED AT HOW WELL

1986
01:10:12,500 --> 01:10:14,002
PEOPLE LISTEN.

1987
01:10:14,002 --> 01:10:15,203
WHERE IT GOES FROM THERE IS HARD

1988
01:10:15,203 --> 01:10:16,070
TO SAY.

1989
01:10:16,070 --> 01:10:19,040
BUT I THINK WE'VE SEEN SOME GOOD

1990
01:10:19,040 --> 01:10:19,541
SUCCESS.

1991
01:10:19,541 --> 01:10:21,309
WE'RE QUICK TO EXPAND MEDICAID.

1992
01:10:21,309 --> 01:10:23,812
WE EXPANDED THE MEDICAID

1993
01:10:23,812 --> 01:10:25,013
POSTPARTUM COVERAGE UP TO 12

1994
01:10:25,013 --> 01:10:26,614
MONTHS EARLY ON, WE WERE ONE OF

1995
01:10:26,614 --> 01:10:27,715
THE FIRST STATES TO DO THAT, SO

1996
01:10:27,715 --> 01:10:29,684
WE HAVE A STATE VERY INTERESTED

1997
01:10:29,684 --> 01:10:33,321
IN SUPPORTING THESE OUTCOMES, SO

1998
01:10:33,321 --> 01:10:37,225
I'M CAUTIOUSLY OPTIMISTIC.

1999
01:10:37,225 --> 01:10:38,526
WE HAD ACTUALLY SOME OF OUR

2000
01:10:38,526 --> 01:10:39,627
STATE ELECTED REPRESENTATIVES AT

2001
01:10:39,627 --> 01:10:41,763
OUR KICKOFF EVENT AFTER WE WERE

2002
01:10:41,763 --> 01:10:43,631
FUNDED, AND THAT WAS ON -- WE

2003
01:10:43,631 --> 01:10:44,632
DIDN'T INVITE THEM, THEY OFFERED

2004
01:10:44,632 --> 01:10:48,670
TO COME, WHICH I FEEL WAS

2005
01:10:48,670 --> 01:10:48,970
MEANINGFUL.

2006
01:10:48,970 --> 01:10:49,404
>> THANK YOU.

2007
01:10:49,404 --> 01:10:52,273
>> THANK YOU.

2008
01:10:52,273 --> 01:10:53,441
>> GREAT, THANK YOU SO
MUCH.

2009
01:10:53,441 --> 01:11:00,782
[APPLAUSE]

2010
01:11:00,782 --> 01:11:04,285
NOW I'D LIKE TO INTRODUCE OUR

2011
01:11:04,285 --> 01:11:07,989
LAST GROUP OF SPEAKERS,

2012
01:11:07,989 --> 01:11:14,762
DR. MCKENNAN, DR. ELLIOTT AND

2013
01:11:14,762 --> 01:11:16,598
DR. MCCORMACK FROM SOUTH DAKOTA,

2014
01:11:16,598 --> 01:11:18,132
ON IMPROVING RURAL MATERNAL

2015
01:11:18,132 --> 01:11:19,434
HEALTH, PERSPECTIVES FROM SOUTH

2016
01:11:19,434 --> 01:11:19,734
DAKOTA.

2017
01:11:19,734 --> 01:11:21,736
>> GOOD MORNING, PRESSURE
TO BE

2018
01:11:21,736 --> 01:11:22,370
HERE.

2019
01:11:22,370 --> 01:11:26,875
I'M AMY ELLIOTT, CHIEF RESEARCH

2020
01:11:26,875 --> 01:11:30,345
OFFICER AT AVERA, ALSO PROFESSOR

2021
01:11:30,345 --> 01:11:31,246
AND DIVISION CHIEF IN THE

2022
01:11:31,246 --> 01:11:32,714
UNIVERSITY OF SOUTH DAKOTA

2023
01:11:32,714 --> 01:11:35,650
SCHOOL OF MEDICINE.

2024
01:11:35,650 --> 01:11:37,185
UNLIKE A LOT OF AREAS AND MANY

2025
01:11:37,185 --> 01:11:40,388
OF YOUR LOCATIONS, OUR CLINICAL

2026
01:11:40,388 --> 01:11:41,556
RESEARCH TENDS TO EXIST WITHIN

2027
01:11:41,556 --> 01:11:43,625
COMMUNITY HOSPITALS RATHER THAN

2028
01:11:43,625 --> 01:11:44,626
ACADEMIC MEDICAL CENTERS.

2029
01:11:44,626 --> 01:11:47,395
SO THAT GIVES US SOME DISTINCT

2030
01:11:47,395 --> 01:11:48,496
ADVANTAGES AND POSES SOME

2031
01:11:48,496 --> 01:11:50,698
CHALLENGES AS WELL.

2032
01:11:50,698 --> 01:11:52,033
SO WE'RE HAPPY TO LET YOU KNOW A

2033
01:11:52,033 --> 01:11:53,868
LITTLE ABOUT OUR AREA.

2034
01:11:53,868 --> 01:11:55,303
SO SOUTH DAKOTA, FOR THOSE OF

2035
01:11:55,303 --> 01:11:57,372
WHO YOU AREN'T FAMILIAR, IS YOU

2036
01:11:57,372 --> 01:11:59,073
SEE ON THE ONE MAP, THERE'S SOME

2037
01:11:59,073 --> 01:12:00,508
SHADED AREAS THAT SHOW YOU THE

2038
01:12:00,508 --> 01:12:02,043
NINE TRIBAL NATIONS THAT EXIST

2039
01:12:02,043 --> 01:12:03,678
WITHIN OUR STATE.

2040
01:12:03,678 --> 01:12:05,513
ON THE OTHER SIDE, THE BLUE AND

2041
01:12:05,513 --> 01:12:08,716
THE YELLOW, SHOWS THE RURALITY

2042
01:12:08,716 --> 01:12:09,651
OF THE STATE.

2043
01:12:09,651 --> 01:12:14,489
OUR STATE IS FLANKED BY CITIES

2044
01:12:14,489 --> 01:12:15,290
ON THE EAST AND WEST SIDE.

2045
01:12:15,290 --> 01:12:16,858
I DID HAVE TO SMILE THIS MORNING

2046
01:12:16,858 --> 01:12:18,593
WHEN OUR COLLEAGUES FROM

2047
01:12:18,593 --> 01:12:20,094
MISSISSIPPI DESCRIBED THE NUMBER

2048
01:12:20,094 --> 01:12:22,063
OF HOURS IT TAKES TO DRIVE

2049
01:12:22,063 --> 01:12:22,730
SOMEWHERE.

2050
01:12:22,730 --> 01:12:24,132
I THINK THAT'S A TRUE LITMUS OF

2051
01:12:24,132 --> 01:12:25,133
SOMEONE WHO LIVES IN A RURAL

2052
01:12:25,133 --> 01:12:27,168
AREA.

2053
01:12:27,168 --> 01:12:28,236
TO GET FROM ONE SIDE OF THE

2054
01:12:28,236 --> 01:12:31,239
STATE TO THE OTHER IS SIX HOURS.

2055
01:12:31,239 --> 01:12:33,374
AND WE HAVE AN 80-MILE AN HOUR

2056
01:12:33,374 --> 01:12:38,079
SPEED LIMIT.

2057
01:12:38,079 --> 01:12:41,916
SO THE AVERA HEALTH SYSTEM

2058
01:12:41,916 --> 01:12:43,251
COVERS QUITE A BIT, ABOUT TWO

2059
01:12:43,251 --> 01:12:44,185
THIRDS OF THE STATE.

2060
01:12:44,185 --> 01:12:45,820
37 ACUTE CARE HOSPITALS, OVER

2061
01:12:45,820 --> 01:12:47,255
200 OUTPATIENT CLINICS, SO THE

2062
01:12:47,255 --> 01:12:48,856
CLINICAL PARTNERSHIPS OF THIS

2063
01:12:48,856 --> 01:12:50,391
ARE SOMETHING THAT WE'RE VERY

2064
01:12:50,391 --> 01:12:51,392
EXCITED ABOUT INCORPORATING

2065
01:12:51,392 --> 01:12:53,461
WITHIN OUR CENTER OF EXCELLENCE.

2066
01:12:53,461 --> 01:13:00,435
THE STARS ON THIS DETECT WHERE E

2067
01:13:00,435 --> 01:13:01,736
OUR RESEARCH OFFICES ARE.

2068
01:13:01,736 --> 01:13:03,605
SO WE HAVE ONE ON THE EAST SIDE

2069
01:13:03,605 --> 01:13:07,442
OF THE STATE, RAPID CITY, PINE

2070
01:13:07,442 --> 01:13:10,044
RIDGE, WHICH IS OUR LARGEST

2071
01:13:10,044 --> 01:13:11,245
AMERICAN INDIAN TRIBAL NATION,

2072
01:13:11,245 --> 01:13:16,284
AND THEN ALSO IN PEERE, IN THE

2073
01:13:16,284 --> 01:13:17,719
MIDDLE OF THE STATE.

2074
01:13:17,719 --> 01:13:21,489
HERE'S OUR LEAPER SHIP.

2075
01:13:21,489 --> 01:13:22,590
FOR MATERNAL HEALTH OUTCOMES,

2076
01:13:22,590 --> 01:13:24,892
OUR POPULATION OF OUR STATE IS

2077
01:13:24,892 --> 01:13:27,028
LARGELY WHITE WITH ABOUT 76.9%

2078
01:13:27,028 --> 01:13:29,330
OF WOMEN OF CHILD BEARING AGE

2079
01:13:29,330 --> 01:13:30,865
FALLING INTO THAT CATEGORY, AND

2080
01:13:30,865 --> 01:13:33,234
OUR AMERICAN INDIAN RATE FOR

2081
01:13:33,234 --> 01:13:35,236
WOMEN OF CHILD BEARING AGE IS

2082
01:13:35,236 --> 01:13:36,537
9.3%.

2083
01:13:36,537 --> 01:13:39,374
THE SEVERE MATERNAL MORTALITY,

2084
01:13:39,374 --> 01:13:41,976
ABOUT 79 -- 72.9 PER THOUSAND

2085
01:13:41,976 --> 01:13:42,577
DELIVERIES.

2086
01:13:42,577 --> 01:13:44,278
AND WHAT YOU CAN SEE FROM THE

2087
01:13:44,278 --> 01:13:45,780
BAR GRAPH ON HERE IS THAT HAS

2088
01:13:45,780 --> 01:13:47,048
BEEN STEADILY INCREASING OVER

2089
01:13:47,048 --> 01:13:56,591
THE PAST FEW YEARS.

2090
01:13:56,591 --> 01:13:59,961
SO IN TERMS OF OUR PREGNANCY-ROW

2091
01:13:59,961 --> 01:14:00,728
PREGNANCY-RELATED DEATHS, THIS

2092
01:14:00,728 --> 01:14:01,796
IS WHERE THE HEALTH DISPARITIES

2093
01:14:01,796 --> 01:14:02,864
START TO COME SCREAMING OFF OF

2094
01:14:02,864 --> 01:14:03,364
THE PAGE.

2095
01:14:03,364 --> 01:14:04,666
ON THE GREEN CHART THAT YOU SEE,

2096
01:14:04,666 --> 01:14:06,401
IF THERE WAS NO HEALTH

2097
01:14:06,401 --> 01:14:07,035
DISPARITIES, THOSE LINES WOULD

2098
01:14:07,035 --> 01:14:10,004
BE STRAIGHT.

2099
01:14:10,004 --> 01:14:11,205
MEANING THAT THE PROPORTION OF

2100
01:14:11,205 --> 01:14:12,306
BIRTHS WITHIN THE STATE WAS

2101
01:14:12,306 --> 01:14:13,174
EQUAL TO THE OUTCOME.

2102
01:14:13,174 --> 01:14:14,809
AND WHAT YOU CAN SEE FROM THE

2103
01:14:14,809 --> 01:14:18,613
MIDDLE GREEN LINE IS THAT OUR

2104
01:14:18,613 --> 01:14:19,714
AMERICAN INDIAN MATERNAL

2105
01:14:19,714 --> 01:14:23,551
MORTALITY RATE IS ABOUT 4 TIMES

2106
01:14:23,551 --> 01:14:24,986
WHAT YOU WOULD EXPECT FOR THE

2107
01:14:24,986 --> 01:14:25,987
PERCENT OF BIRTHS WITHIN OUR

2108
01:14:25,987 --> 01:14:29,457
AREA.

2109
01:14:29,457 --> 01:14:30,825
SO WE'VE TALKED A LOT ABOUT

2110
01:14:30,825 --> 01:14:34,328
BARRIERS TO ACCESS AND WE'RE NO

2111
01:14:34,328 --> 01:14:35,630
DIFFERENT THAN MANY OF YOUR

2112
01:14:35,630 --> 01:14:37,365
STATES, WHERE WE HAVE A LARGE

2113
01:14:37,365 --> 01:14:40,334
PERCENT OF MATERNITY CARE

2114
01:14:40,334 --> 01:14:42,537
DESERTS, OUR DISTRIBUTION OF

2115
01:14:42,537 --> 01:14:43,571
OBSTETRIC PROVIDERS IS QUITE

2116
01:14:43,571 --> 01:14:45,973
SPARSE, AND ACCESS TO HOSPITALS.

2117
01:14:45,973 --> 01:14:49,043
AND SO THERE'S ACTUALLY 78.8% OF

2118
01:14:49,043 --> 01:14:51,145
OUR COUNTIES THAT HAVE NO

2119
01:14:51,145 --> 01:14:52,747
HOSPITAL OR BIRTH CENTER, SO

2120
01:14:52,747 --> 01:14:54,282
IT'S NOT EVEN A MATTER SOMETIMES

2121
01:14:54,282 --> 01:14:56,350
OF ACCESS, IT'S A MATTER OF THEY

2122
01:14:56,350 --> 01:14:58,986
PHYSICALLY DO NOT EXIST.

2123
01:14:58,986 --> 01:15:00,621
AND HOW IS IT THAT WE CAN GET

2124
01:15:00,621 --> 01:15:01,689
CARE?

2125
01:15:01,689 --> 01:15:03,324
NEARLY 1 IN 4 WOMEN IN OUR AREA

2126
01:15:03,324 --> 01:15:05,326
HAVE NO BIRTHING HOSPITAL WITHIN

2127
01:15:05,326 --> 01:15:07,595
30 MINUTES, COMPARED TO 9.7% OF

2128
01:15:07,595 --> 01:15:11,999
THE UNITED STATES.

2129
01:15:11,999 --> 01:15:13,301
SO WHAT THIS MEANS IS, THERE'S A

2130
01:15:13,301 --> 01:15:15,136
LOT OF TIME ON THE ROAD

2131
01:15:15,136 --> 01:15:15,570
TRAVELING.

2132
01:15:15,570 --> 01:15:21,442
SOME CAN TRAVEL UP TO 118 MILES.

2133
01:15:21,442 --> 01:15:23,311
AGAIN, 128 MINUTES, AND THEN

2134
01:15:23,311 --> 01:15:26,614
UNDER NORMAL TRAFFIC CONDITIONS,

2135
01:15:26,614 --> 01:15:28,783
9.1% OF THE WOMEN LIVE OVER 60

2136
01:15:28,783 --> 01:15:29,317
MINUTES AWAY.

2137
01:15:29,317 --> 01:15:32,353
AND THEN, OF COURSE, IT SOUTH

2138
01:15:32,353 --> 01:15:33,921
DAKOTA.

2139
01:15:33,921 --> 01:15:36,324
SO I'M GOING TO NOW TURN IT OVER

2140
01:15:36,324 --> 01:15:37,825
TO MY COLLEAGUE AND OUR PROJECT

2141
01:15:37,825 --> 01:15:41,763
DIRECTOR FOR OUR CENTER OF

2142
01:15:41,763 --> 01:15:45,500
EXCELLENCE, DR. LACEY MCCORMACK.

2143
01:15:45,500 --> 01:15:45,933
[APPLAUSE]

2144
01:15:45,933 --> 01:15:48,002
>> THANK YOU.

2145
01:15:48,002 --> 01:15:51,205
SO WE TALK A LOT ABOUT ACCESS IN

2146
01:15:51,205 --> 01:15:52,974
SOUTH DAKOTA WHEN WE TALK ABOUT

2147
01:15:52,974 --> 01:15:54,175
MATERNAL HEALTHCARE, MATERNAL

2148
01:15:54,175 --> 01:15:56,611
HEALTH SERVICES, SO THINGS LIKE

2149
01:15:56,611 --> 01:15:59,213
DOES IT EXIST, CAN I GET THERE,

2150
01:15:59,213 --> 01:16:01,949
HOW LONG DOES IT TAKE TO GET

2151
01:16:01,949 --> 01:16:02,250
THERE.

2152
01:16:02,250 --> 01:16:04,352
WE ALSO HAVE TO CONSIDER THINGS

2153
01:16:04,352 --> 01:16:05,920
LIKE DO I HAVE TO MISS WORK IN

2154
01:16:05,920 --> 01:16:07,188
ORDER TO MAKE THESE

2155
01:16:07,188 --> 01:16:08,389
APPOINTMENTS, HOW CAN I GET

2156
01:16:08,389 --> 01:16:11,325
CHILD CARE ARRANGED, THINGS LIKE

2157
01:16:11,325 --> 01:16:11,993
THAT.

2158
01:16:11,993 --> 01:16:14,362
AS WE CONTINUE TO DIVE INTO THE

2159
01:16:14,362 --> 01:16:16,130
SOCIAL AND STRUCTURAL

2160
01:16:16,130 --> 01:16:18,633
DETERMINANTS OF HEALTH AROUND

2161
01:16:18,633 --> 01:16:20,601
HEALTHCARE AND SUPPORT SERVICES

2162
01:16:20,601 --> 01:16:23,404
IN SOUTH DAKOTA, IT ALSO BECOMES

2163
01:16:23,404 --> 01:16:25,940
AN ISSUE OF WHAT IS AVAILABLE.

2164
01:16:25,940 --> 01:16:28,442
IS IT A SPECIALTY SERVICE?

2165
01:16:28,442 --> 01:16:30,645
HOW LONG DO I HAVE TO TRAVEL FOR

2166
01:16:30,645 --> 01:16:33,614
ROUTINE CARE OR HIGH RISK CARE?

2167
01:16:33,614 --> 01:16:35,116
AND I'LL JUST GIVE YOU AN

2168
01:16:35,116 --> 01:16:35,750
EXAMPLE.

2169
01:16:35,750 --> 01:16:39,387
SO BEFORE I MOVED TO THE M

2170
01:16:39,387 --> 01:16:42,123
METROPOLIS OF SIOUX FALLS, SOUTH

2171
01:16:42,123 --> 01:16:43,791
DAKOTA, I LIVED IN A TOWN THAT

2172
01:16:43,791 --> 01:16:46,494
HAD ABOUT 24,000 PEOPLE, AND MY

2173
01:16:46,494 --> 01:16:47,662
SECOND PREGNANCY WAS HIGH RISK

2174
01:16:47,662 --> 01:16:49,197
AND THERE WAS NOT AN O.B.

2175
01:16:49,197 --> 01:16:52,033
PROVIDER IN MY TOWN OF 24,000

2176
01:16:52,033 --> 01:16:54,635
PEOPLE TO PROVIDE CARE.

2177
01:16:54,635 --> 01:16:55,970
SO I HAD TWO OPTIONS.

2178
01:16:55,970 --> 01:16:58,172
ONE OF THEM WAS TO DRIVE TWO

2179
01:16:58,172 --> 01:17:01,108
HOURS ROUND TRIP FOR ALL OF MY

2180
01:17:01,108 --> 01:17:02,844
APPOINTMENTS OR WAIT FOR A

2181
01:17:02,844 --> 01:17:05,346
TRAVELING OB PROVIDER TO COME TO

2182
01:17:05,346 --> 01:17:07,949
MY TOWN ON A SPECIFIC DAY, AT A

2183
01:17:07,949 --> 01:17:09,584
SPECIFIC TIME, AND RECEIVED CARE

2184
01:17:09,584 --> 01:17:11,352
IN THAT WAY.

2185
01:17:11,352 --> 01:17:12,987
SO I WAS FORTUNATE ENOUGH TO BE

2186
01:17:12,987 --> 01:17:15,389
ABLE TO GET CARE, AND I

2187
01:17:15,389 --> 01:17:16,591
UNDERSTAND THAT IS A PRIVILEGE

2188
01:17:16,591 --> 01:17:19,126
BUT IT ALSO BEGS THE QUESTION OF

2189
01:17:19,126 --> 01:17:20,761
WHAT HAPPENS IF I HAVE AN ISSUE

2190
01:17:20,761 --> 01:17:22,496
WITH THAT PROVIDER, OR IF I

2191
01:17:22,496 --> 01:17:23,698
DON'T TRUST THEM FOR SOME

2192
01:17:23,698 --> 01:17:26,901
REASON, OR IF MY CARE IS NOT OF

2193
01:17:26,901 --> 01:17:28,936
QUALITY FOR SOME REASON.

2194
01:17:28,936 --> 01:17:30,471
THERE WOULD BE NO OTHER OPTION

2195
01:17:30,471 --> 01:17:33,507
FOR ME, I WOULD THEN HAVE TO

2196
01:17:33,507 --> 01:17:33,841
TRAVEL.

2197
01:17:33,841 --> 01:17:36,010
SO IT'S NOT JUST ABOUT IF IT

2198
01:17:36,010 --> 01:17:37,578
EXISTS AND IF I CAN GET TO IT.

2199
01:17:37,578 --> 01:17:38,512
IT'S REALLY ABOUT THE CHOICE

2200
01:17:38,512 --> 01:17:39,714
THAT I HAVE IN THAT MATTER.

2201
01:17:39,714 --> 01:17:42,116
AND SO THERE ARE INDIVIDUALS WHO

2202
01:17:42,116 --> 01:17:44,318
HAVE ISSUES WITH THE CARE SYSTEM

2203
01:17:44,318 --> 01:17:46,621
AND THE QUALITY, AND WILL CHOOSE

2204
01:17:46,621 --> 01:17:48,356
NO CARE OVER THE CHOICES THAT

2205
01:17:48,356 --> 01:17:52,393
THEY HAVE AVAILABLE TO THEM.

2206
01:17:52,393 --> 01:17:55,563
I LIKE TO PUT CONTEXT UP HERE AS

2207
01:17:55,563 --> 01:17:56,030
WELL.

2208
01:17:56,030 --> 01:17:57,765
ALONG WITH THIS BEAUTIFUL

2209
01:17:57,765 --> 01:17:59,800
PICTURE OF A SMALL TOWN IN SOUTH

2210
01:17:59,800 --> 01:18:00,434
DAKOTA, BECAUSE IT'S IMPORTANT

2211
01:18:00,434 --> 01:18:03,871
TO KEEP IN MIND IF PEOPLE CAN DO

2212
01:18:03,871 --> 01:18:06,674
THE THINGS WE ARE TELLING THEM

2213
01:18:06,674 --> 01:18:07,141
TO DO.

2214
01:18:07,141 --> 01:18:08,542
SO IF WE ARE TELLING PEOPLE TO

2215
01:18:08,542 --> 01:18:10,411
EAT MORE FRUITS AND VEGETABLING

2216
01:18:10,411 --> 01:18:11,379
DURING PREGNANCY, ARE THOSE

2217
01:18:11,379 --> 01:18:13,214
KINDS OF THINGS AVAILABLE IN THE

2218
01:18:13,214 --> 01:18:14,882
COMMUNITIES THAT THEY LIVE IN?

2219
01:18:14,882 --> 01:18:17,385
I CAN TELL YOU THAT IN THIS

2220
01:18:17,385 --> 01:18:19,153
TOWN, YOU WOULD HAVE TO DRIVE AN

2221
01:18:19,153 --> 01:18:21,322
HOUR TO GET TO THE NEAREST

2222
01:18:21,322 --> 01:18:22,857
GROCERY STORE, AND THAT SORT OF

2223
01:18:22,857 --> 01:18:24,392
CHANGES HOW YOU SHOP AND HOW YOU

2224
01:18:24,392 --> 01:18:25,893
MEAL PLAN AND THINGS LIKE THAT.

2225
01:18:25,893 --> 01:18:28,062
SO BEING AWARE OF THE

2226
01:18:28,062 --> 01:18:32,533
ENVIRONMENTS IN WHICH PEOPLE

2227
01:18:32,533 --> 01:18:33,567
LIVE, AND ASKS THAT WE'RE MAKING

2228
01:18:33,567 --> 01:18:34,101
OF THEM.

2229
01:18:34,101 --> 01:18:35,836
THE OTHER THING THAT I WANTED TO

2230
01:18:35,836 --> 01:18:38,005
POINT OUT ABOUT DETERMINANTS IS

2231
01:18:38,005 --> 01:18:39,674
THAT IS NOT JUST FOR OUR

2232
01:18:39,674 --> 01:18:40,975
PATIENTS OR THOSE THAT ARE

2233
01:18:40,975 --> 01:18:42,510
SEEKING CARE, IT'S ALSO FOR OUR

2234
01:18:42,510 --> 01:18:43,911
PROVIDERS.

2235
01:18:43,911 --> 01:18:46,013
SO FOR THE PROVIDERS THAT ARE IN

2236
01:18:46,013 --> 01:18:47,748
THE SMALL COMMUNITIES, THEY'RE

2237
01:18:47,748 --> 01:18:49,050
USUALLY TRAINED IN

2238
01:18:49,050 --> 01:18:50,017
INTERDISCIPLINARY SETTINGS, BUT

2239
01:18:50,017 --> 01:18:51,319
THEN GO OFF AND PRACTICE ON

2240
01:18:51,319 --> 01:18:52,119
THEIR OWN.

2241
01:18:52,119 --> 01:18:54,422
AND DON'T NECESSARILY HAVE A

2242
01:18:54,422 --> 01:18:56,157
SUPPORT NETWORK THAT THEY CAN

2243
01:18:56,157 --> 01:18:57,058
LEAN ON.

2244
01:18:57,058 --> 01:18:58,592
THEY'RE NOT NECESSARILY SEEING

2245
01:18:58,592 --> 01:19:00,428
THINGS ALL OF THE TIME AND

2246
01:19:00,428 --> 01:19:01,529
KEEPING THEIR SKILLS UP TO DATE,

2247
01:19:01,529 --> 01:19:03,931
AND THEY DON'T NECESSARILY HAVE

2248
01:19:03,931 --> 01:19:06,067
ACCESS TO TRAINING OPPORTUNITIES

2249
01:19:06,067 --> 01:19:09,904
TO STAY UP TO DATE.

2250
01:19:09,904 --> 01:19:11,672
OR IF THEY DO, THEY CAN'T LEAVE

2251
01:19:11,672 --> 01:19:12,673
THEIR CLINIC BECAUSE THREAR THE

2252
01:19:12,673 --> 01:19:13,841
ONLY PROVIDER AND IT'S JUST NOT

2253
01:19:13,841 --> 01:19:14,108
POSSIBLE.

2254
01:19:14,108 --> 01:19:15,309
SO THOSE ARE THE KINDS OF THINGS

2255
01:19:15,309 --> 01:19:18,446
THAT WE ARE WORKING WITH IN

2256
01:19:18,446 --> 01:19:23,250
SOUTH DAKOTA.

2257
01:19:23,250 --> 01:19:24,151
OUR CENTER OF EXCELLENCE IS

2258
01:19:24,151 --> 01:19:28,723
REALLY FOCUSED ON ACCESS AND NOT

2259
01:19:28,723 --> 01:19:31,258
JUST BARRIERS TO ACCESS BUT ALSO

2260
01:19:31,258 --> 01:19:31,559
SOLUTIONS.

2261
01:19:31,559 --> 01:19:33,394
AND SOLUTIONS THAT WORK FOR

2262
01:19:33,394 --> 01:19:35,963
PATIENTS, PROVIDERS AND

2263
01:19:35,963 --> 01:19:36,297
POLICYMAKERS.

2264
01:19:36,297 --> 01:19:38,666
AND THAT IS WOVEN INTO ALL OF

2265
01:19:38,666 --> 01:19:39,633
OUR DIFFERENT COMPONENTS,

2266
01:19:39,633 --> 01:19:40,968
INCLUDING COMMUNITY

2267
01:19:40,968 --> 01:19:43,104
PARTNERSHIPS, TRAINING, AS WELL

2268
01:19:43,104 --> 01:19:44,872
AS OUR RESEARCH PROJECT.

2269
01:19:44,872 --> 01:19:47,575
WE ARE FOCUSING OUR CENTER ON

2270
01:19:47,575 --> 01:19:49,977
RURAL AND AMERICAN INDIAN

2271
01:19:49,977 --> 01:19:51,278
POPULATIONS, AND THIS REALLY

2272
01:19:51,278 --> 01:19:54,148
BUILDS ON DECADES OF WORK IN OUR

2273
01:19:54,148 --> 01:19:55,583
COMMUNITIES WITH THESE

2274
01:19:55,583 --> 01:19:57,351
POPULATIONS.

2275
01:19:57,351 --> 01:20:00,388
SO WE CAME INTO OUR CENTER OF

2276
01:20:00,388 --> 01:20:01,489
EXCELLENCE WITH A LOT OF

2277
01:20:01,489 --> 01:20:03,324
COMMUNITY PARTNERSHIPS ALREADY

2278
01:20:03,324 --> 01:20:04,959
BUILT, AND WE'RE SEEING

2279
01:20:04,959 --> 01:20:08,029
OURSELVES AS A PLATFORM FOR

2280
01:20:08,029 --> 01:20:08,896
BRINGING PEOPLE TOGETHER,

2281
01:20:08,896 --> 01:20:11,198
LEVERAGING RESOURCES AND

2282
01:20:11,198 --> 01:20:13,167
EXPERTISE, AND MOVING THE NEEDLE

2283
01:20:13,167 --> 01:20:14,969
IN THE MATERNAL HEALTH SPACE IN

2284
01:20:14,969 --> 01:20:16,437
SOUTH DAKOTA IN A MEANINGFUL AND

2285
01:20:16,437 --> 01:20:16,871
SUSTAINABLE WAY.

2286
01:20:16,871 --> 01:20:18,072
AND THIS IS ESPECIALLY IMPORTANT

2287
01:20:18,072 --> 01:20:20,041
TO US BECAUSE AS YOU CAN

2288
01:20:20,041 --> 01:20:21,342
IMAGINE, THE MATERNAL HEALTH

2289
01:20:21,342 --> 01:20:23,110
SPACE IN SOUTH DAKOTA IS

2290
01:20:23,110 --> 01:20:24,645
RELATIVELY SMALL, AND PEOPLE ARE

2291
01:20:24,645 --> 01:20:27,281
ASKED TO DO A LOT OF THINGS, SO

2292
01:20:27,281 --> 01:20:29,683
WE WANT TO OPTIMIZE PEOPLE'S

2293
01:20:29,683 --> 01:20:31,419
TIME AND KEEP PEOPLE FROM

2294
01:20:31,419 --> 01:20:34,622
BURNING OUT.

2295
01:20:34,622 --> 01:20:37,558
SO IN ADDITION TO REGULARLY

2296
01:20:37,558 --> 01:20:39,960
MEETING WITH PARTNERS

2297
01:20:39,960 --> 01:20:41,262
INDIVIDUALLY, WE BRING THEM ALL

2298
01:20:41,262 --> 01:20:45,266
TOGETHER EACH YEAR AT A SUMMIT.

2299
01:20:45,266 --> 01:20:46,700
THIS HAS BEEN A REALLY GREAT WAY

2300
01:20:46,700 --> 01:20:49,837
FOR PEOPLE TO MEET EACH OTHER,

2301
01:20:49,837 --> 01:20:52,273
AND FOR US TO BRING PEOPLE

2302
01:20:52,273 --> 01:20:58,379
TOGETHER THAT WE KNOW SHOULD

2303
01:20:58,379 --> 01:20:59,346
MEET AND SHOULD TALK.

2304
01:20:59,346 --> 01:21:00,915
OF COURSE THERE ARE BARRIERS TO

2305
01:21:00,915 --> 01:21:01,982
GETTING PEOPLE TO A SUMMIT LIKE

2306
01:21:01,982 --> 01:21:04,919
THIS AND WE HAVE WORKED TO

2307
01:21:04,919 --> 01:21:05,586
ADDRESS THOSE IN A COUPLE

2308
01:21:05,586 --> 01:21:06,253
DIFFERENT WAYS.

2309
01:21:06,253 --> 01:21:07,788
SO WE HOLD THIS ON ALTERNATING

2310
01:21:07,788 --> 01:21:08,522
SIDES OF THE STATE.

2311
01:21:08,522 --> 01:21:09,757
WE PROVIDE TRAVEL SCHOLARSHIPS

2312
01:21:09,757 --> 01:21:11,158
FOR PEOPLE TO ATTEND.

2313
01:21:11,158 --> 01:21:12,827
WE OFFER CONTINUING EDUCATION

2314
01:21:12,827 --> 01:21:16,530
FOR PEOPLE TO ATTEND.

2315
01:21:16,530 --> 01:21:17,731
OUR FIRST SUMMIT WAS REALLY

2316
01:21:17,731 --> 01:21:18,265
GREAT.

2317
01:21:18,265 --> 01:21:21,035
WE FOCUSED SORT OF ON SETTING

2318
01:21:21,035 --> 01:21:22,303
THE LANDSCAPE FOR MATERNAL

2319
01:21:22,303 --> 01:21:23,871
HEALTH IN SOUTH DAKOTA, AND WHAT

2320
01:21:23,871 --> 01:21:26,740
IT WILL LOOK LIKE THROUGHOUT THE

2321
01:21:26,740 --> 01:21:29,243
SEVEN YEARS OF THIS CENTER OF

2322
01:21:29,243 --> 01:21:29,543
EXCELLENCE.

2323
01:21:29,543 --> 01:21:31,912
WE FOCUSED ON SHARING

2324
01:21:31,912 --> 01:21:33,247
PERSPECTIVES, BOTH PROVIDER AND

2325
01:21:33,247 --> 01:21:35,349
PATIENT PERSPECTIVES, SHARING

2326
01:21:35,349 --> 01:21:38,486
DATA AND SHARING STORIES, AND I

2327
01:21:38,486 --> 01:21:39,987
AM PROUD TO SAY THAT WE ASKED

2328
01:21:39,987 --> 01:21:41,622
HARD QUESTIONS, AND WE TALKED

2329
01:21:41,622 --> 01:21:44,091
ABOUT UNCOMFORTABLE THINGS, BUT

2330
01:21:44,091 --> 01:21:46,026
WHAT WE SAW COME OUT OF THIS IS

2331
01:21:46,026 --> 01:21:47,328
PEOPLE REALLY HAVING AN

2332
01:21:47,328 --> 01:21:48,195
UNDERSTANDING OF WHAT'S

2333
01:21:48,195 --> 01:21:49,430
HAPPENING IN THEIR COMMUNITY

2334
01:21:49,430 --> 01:21:50,831
THAT THEY DIDN'T HAVE BEFORE.

2335
01:21:50,831 --> 01:21:53,501
SO WE HAD A LOT OF ATTENDEES

2336
01:21:53,501 --> 01:21:54,668
SAYING THAT I DIDN'T KNOW THAT

2337
01:21:54,668 --> 01:21:56,203
MY NEIGHBORS WERE EXPERIENCING

2338
01:21:56,203 --> 01:21:57,738
THIS, OR THAT THINGS WERE THIS

2339
01:21:57,738 --> 01:22:00,007
BAD.

2340
01:22:00,007 --> 01:22:01,208
WE ALSO HEARD A LOT OF PEOPLE

2341
01:22:01,208 --> 01:22:02,343
SAYING THEY MADE CONNECTIONS

2342
01:22:02,343 --> 01:22:03,277
WITH FACILITIES THAT THEY

2343
01:22:03,277 --> 01:22:04,311
WOULDN'T HAVE OTHERWISE.

2344
01:22:04,311 --> 01:22:08,315
YOU HAVE TO GET IN-PERSON, HEAR

2345
01:22:08,315 --> 01:22:09,416
THOSE THINGS AND MEET THOSE

2346
01:22:09,416 --> 01:22:11,719
PEOPLE TO MAKE THOSE

2347
01:22:11,719 --> 01:22:12,586
CONNECTIONS.

2348
01:22:12,586 --> 01:22:15,623
EXAMPLE BEING WORKING AT A LOCAL

2349
01:22:15,623 --> 01:22:16,323
FACILITY TO CREATE A BIRTH PLAN

2350
01:22:16,323 --> 01:22:17,725
THAT CAN BE TAKEN TO A

2351
01:22:17,725 --> 01:22:18,192
DELIVERING FACILITY.

2352
01:22:18,192 --> 01:22:19,326
THAT WAS SOMETHING THAT CAME OUT

2353
01:22:19,326 --> 01:22:23,197
OF THE SUMMIT.

2354
01:22:23,197 --> 01:22:24,398
ONE OF THE OTHER THINGS WE'VE

2355
01:22:24,398 --> 01:22:26,934
BEEN HEARING A LOT IS AROUND THE

2356
01:22:26,934 --> 01:22:29,436
NEED FOR PROVIDER TRAINING.

2357
01:22:29,436 --> 01:22:31,105
THIS WAS COMING UP IN

2358
01:22:31,105 --> 01:22:32,139
CONVERSATIONS AT OUR SUMMIT, AS

2359
01:22:32,139 --> 01:22:35,042
WELL AS OUR INDIVIDUAL

2360
01:22:35,042 --> 01:22:35,643
CONVERSATIONS, AND SOMETHING

2361
01:22:35,643 --> 01:22:37,645
THAT WE HEAR ALL THE TIME IS

2362
01:22:37,645 --> 01:22:39,847
THAT IF YOU ARE A HOSPITAL THAT

2363
01:22:39,847 --> 01:22:41,916
DOES NOT DO DELIVERIES, YOU DO

2364
01:22:41,916 --> 01:22:43,017
DELIVERIES.

2365
01:22:43,017 --> 01:22:45,286
AND SO WE'VE GOT AN EXAMPLE OF

2366
01:22:45,286 --> 01:22:46,520
THAT HERE, SO THESE ARE A COUPLE

2367
01:22:46,520 --> 01:22:51,125
OF PICTURES FROM WAGNER, SOUTH

2368
01:22:51,125 --> 01:22:51,425
DAKOTA.

2369
01:22:51,425 --> 01:22:53,227
THIS IS A PLACE WHERE PRENATAL

2370
01:22:53,227 --> 01:22:54,061
CARE IS PROVIDED BUT THE

2371
01:22:54,061 --> 01:22:55,162
DELIVERING HOSPITAL IS AN HOUR

2372
01:22:55,162 --> 01:22:56,163
AWAY.

2373
01:22:56,163 --> 01:22:58,432
THERE IS THIS COMMUNITY

2374
01:22:58,432 --> 01:23:00,634
HOSPITAL, AND THEY DO EMERGENCY

2375
01:23:00,634 --> 01:23:02,369
DELIVERIES WHEN THEY HAVE TO.

2376
01:23:02,369 --> 01:23:05,439
THEY ACTUALLY DO THE MOST OR

2377
01:23:05,439 --> 01:23:07,308
NEARLY THE MOST EMERGENCY

2378
01:23:07,308 --> 01:23:11,011
DELIVERIES IN OUR HEALTHCARE

2379
01:23:11,011 --> 01:23:12,880
FOOTPRINT.

2380
01:23:12,880 --> 01:23:14,882
AND SO WHAT THIS MEANS IS THAT

2381
01:23:14,882 --> 01:23:17,218
WE HAVE MANY TIMES PRETERM OR

2382
01:23:17,218 --> 01:23:21,355
HIGH RISK PREGNANCIES SHOW UP IN

2383
01:23:21,355 --> 01:23:22,323
OUR EMERGENCY ROOM FOR

2384
01:23:22,323 --> 01:23:22,623
DELIVERIES.

2385
01:23:22,623 --> 01:23:25,159
WE ALSO HAVE INDIAN HEALTH

2386
01:23:25,159 --> 01:23:25,726
SERVICE PATIENTS THAT ARE

2387
01:23:25,726 --> 01:23:28,762
SHOWING UP AT THIS COMMUNITY

2388
01:23:28,762 --> 01:23:30,030
HOSPITAL, AND NEED TO WORK ON

2389
01:23:30,030 --> 01:23:31,699
THE RELATIONSHIP BETWEEN THOSE

2390
01:23:31,699 --> 01:23:34,134
TWO FACILITIES SO THAT EVERYONE

2391
01:23:34,134 --> 01:23:37,404
CAN BEST SERVE THEIR PATIENTS.

2392
01:23:37,404 --> 01:23:39,173
SO WE RAN INTO A SITUATION WHERE

2393
01:23:39,173 --> 01:23:41,775
IHS WAS REQUESTING SORT OF

2394
01:23:41,775 --> 01:23:43,544
TRAINING AROUND CULTURALLY

2395
01:23:43,544 --> 01:23:44,712
COMPETENT CARE SO THAT THEIR

2396
01:23:44,712 --> 01:23:46,614
PATIENTS COULD RECEIVE THAT WHEN

2397
01:23:46,614 --> 01:23:47,681
THEY WERE AT THE HOSPITAL, AND

2398
01:23:47,681 --> 01:23:49,116
THEN WE WERE ALSO HAVING

2399
01:23:49,116 --> 01:23:50,417
HOSPITAL STAFF TELL US THAT THEY

2400
01:23:50,417 --> 01:23:53,487
NEEDED TRAINING ON THESE

2401
01:23:53,487 --> 01:23:54,688
EMERGENCY DELIVERIES THAT THEY

2402
01:23:54,688 --> 01:23:58,859
WERE DOING.

2403
01:23:58,859 --> 01:24:03,330
SO WHAT CAME OUT OF THIS WAS

2404
01:24:03,330 --> 01:24:06,934
REALLY A VERY NICE, ORGANIZED

2405
01:24:06,934 --> 01:24:10,671
AND VERY REALISTIC MANNEQUINS

2406
01:24:10,671 --> 01:24:11,639
SORT OF SIMULATION TRAINING.

2407
01:24:11,639 --> 01:24:13,941
SO THE GOAL OF OUR TRAINING WAS

2408
01:24:13,941 --> 01:24:16,243
TO SIMULATE MATERNAL AND NEWBORN

2409
01:24:16,243 --> 01:24:18,178
EMERGENCY DELIVERY SITUATIONS,

2410
01:24:18,178 --> 01:24:21,615
SO PEOPLE WERE ABLE TO DO A

2411
01:24:21,615 --> 01:24:23,250
DELIVERY, THEN ALSO INTUBATE THE

2412
01:24:23,250 --> 01:24:26,120
BABY AND THEN THERE WAS A SECOND

2413
01:24:26,120 --> 01:24:26,987
SCENARIO WHERE THE STAFF HAD TO

2414
01:24:26,987 --> 01:24:29,023
DEAL WITH A POSTPARTUM

2415
01:24:29,023 --> 01:24:30,224
HEMORRHAGE IN THE EMERGENCY

2416
01:24:30,224 --> 01:24:33,193
DEPARTMENT.

2417
01:24:33,193 --> 01:24:36,163
IN ADDITION TO JUST GETTING

2418
01:24:36,163 --> 01:24:37,665
PRACTICE WITH THESE SKILLS, THE

2419
01:24:37,665 --> 01:24:40,067
GOALS WERE ALSO TO EMPROVE

2420
01:24:40,067 --> 01:24:43,570
PRACTICES RELATED TO QUALITY OF

2421
01:24:43,570 --> 01:24:45,439
CARE, SAFETY OF CARE AND THEN

2422
01:24:45,439 --> 01:24:46,040
AGAIN CULTURALLY APPROPRIATE

2423
01:24:46,040 --> 01:24:46,407
CARE.

2424
01:24:46,407 --> 01:24:49,109
SO IN ADDITION TO THE SIMULATION

2425
01:24:49,109 --> 01:24:52,680
TRAINING WITH THE MANNEQUINS,

2426
01:24:52,680 --> 01:24:56,050
OUR IHS PARTNERS WERE ALSO THERE

2427
01:24:56,050 --> 01:24:57,818
TO DELIVER SORT OF A LITTLE

2428
01:24:57,818 --> 01:25:00,487
WORKSHOP ON CULTURALLY COMPETENT

2429
01:25:00,487 --> 01:25:02,623
CARE AND PRACTICES, WHICH LED TO

2430
01:25:02,623 --> 01:25:04,591
SOME REALLY GREAT DISCUSSIONS

2431
01:25:04,591 --> 01:25:05,959
BETWEEN THESE TWO ORGANIZATIONS,

2432
01:25:05,959 --> 01:25:07,661
AND AGAIN, HOW TO BEST SERVE

2433
01:25:07,661 --> 01:25:12,833
PATIENTS.

2434
01:25:12,833 --> 01:25:15,336
SO WE HAD AMAZING PARTICIPATION

2435
01:25:15,336 --> 01:25:17,604
IN THIS SIMULATION TRAINING

2436
01:25:17,604 --> 01:25:19,273
EVENT IN WAGNER, SOUTH DAKOTA.

2437
01:25:19,273 --> 01:25:23,644
AGAIN, ABOUT 1500 PEOPLE ARE IN

2438
01:25:23,644 --> 01:25:25,245
WAGNER, AND THEY HAVE ABOUT 8 TO

2439
01:25:25,245 --> 01:25:27,114
10 OF THESE EMERGENCY DELIVERIES

2440
01:25:27,114 --> 01:25:29,216
PER YEAR, BUT WE SAW REALLY

2441
01:25:29,216 --> 01:25:31,518
GREAT PARTICIPATION IN STAFF

2442
01:25:31,518 --> 01:25:33,520
FROM BOTH IHS AND THE WAGNER

2443
01:25:33,520 --> 01:25:38,726
COMMUNITY HOSPITAL.

2444
01:25:38,726 --> 01:25:40,060
AGAIN, WE WORKED REALLY HARD TO

2445
01:25:40,060 --> 01:25:41,495
MAKE THIS TRAINING AS EASY AS

2446
01:25:41,495 --> 01:25:42,463
POSSIBLE FOR PEOPLE TO ATTEND,

2447
01:25:42,463 --> 01:25:44,331
SO WE TOOK THE TRAINING TO THEM.

2448
01:25:44,331 --> 01:25:48,469
WAGNER IS ABOUT 2 1/2 HOURS FROM

2449
01:25:48,469 --> 01:25:49,203
SIOUX FALLS, WHERE WE ARE

2450
01:25:49,203 --> 01:25:51,004
LOCATED, BUT WE'RE ABLE TO GET

2451
01:25:51,004 --> 01:25:55,275
THIS ORGANIZED, GET CONTINUING

2452
01:25:55,275 --> 01:25:56,710
EDUCATION UNITS FOR IT, BRING

2453
01:25:56,710 --> 01:25:57,478
THE MANNEQUINS, BRING THE

2454
01:25:57,478 --> 01:26:00,314
TRAINERS TO WAGNER AND THEN ALSO

2455
01:26:00,314 --> 01:26:01,648
HAVE DIFFERENT SESSIONS

2456
01:26:01,648 --> 01:26:02,516
THROUGHOUT THE DAY SO THAT

2457
01:26:02,516 --> 01:26:05,586
EVERYBODY COULD ATTEND.

2458
01:26:05,586 --> 01:26:07,321
AND WE ENDED UP TRAINING OVER

2459
01:26:07,321 --> 01:26:08,422
90% OF THE STAFF AT THESE

2460
01:26:08,422 --> 01:26:11,825
FACILITIES.

2461
01:26:11,825 --> 01:26:13,227
WE HAVE HELD TWO OF THESE

2462
01:26:13,227 --> 01:26:15,095
TRAININGS NOW IN TWO DIFFERENT

2463
01:26:15,095 --> 01:26:17,097
LOCATIONS, AND WE'VE TRAINED

2464
01:26:17,097 --> 01:26:19,833
ALMOST 100 INDIVIDUALS.

2465
01:26:19,833 --> 01:26:20,701
AND IN ADDITION TO THE TRAINING

2466
01:26:20,701 --> 01:26:22,002
THAT IS BEING PROVIDED, IT'S

2467
01:26:22,002 --> 01:26:23,637
REALLY THIS RELATIONSHIP

2468
01:26:23,637 --> 01:26:25,739
BUILDING BETWEEN ORGANIZATIONS.

2469
01:26:25,739 --> 01:26:27,274
PEOPLE HAVE MET EACH OTHER.

2470
01:26:27,274 --> 01:26:29,343
THEY HAVE PUT A FACE TO A PHONE

2471
01:26:29,343 --> 01:26:30,644
CALL, AND THEY NOW KNOW THAT

2472
01:26:30,644 --> 01:26:33,046
THEY CAN WORK TOGETHER IN THESE

2473
01:26:33,046 --> 01:26:35,149
DIFFERENT WAYS.

2474
01:26:35,149 --> 01:26:39,386
I DO HAVE SOME EXCITING UPDATES

2475
01:26:39,386 --> 01:26:41,155
FROM OUR SIMULATION TRAINING

2476
01:26:41,155 --> 01:26:42,122
THAT WAS HELD JUST A COUPLE OF

2477
01:26:42,122 --> 01:26:42,890
MONTHS AGO.

2478
01:26:42,890 --> 01:26:45,626
IT'S NOT JUST ABOUT THE TRAINING

2479
01:26:45,626 --> 01:26:48,028
AND THE SKILLS AND

2480
01:26:48,028 --> 01:26:49,029
RELATIONSHIPS, IT'S ALSO PUTTING

2481
01:26:49,029 --> 01:26:50,230
THIS TO USE IN DIFFERENT WAYS.

2482
01:26:50,230 --> 01:26:53,734
SO AFTER THE TRAINING, THE

2483
01:26:53,734 --> 01:26:57,805
WAGNER HOSPITAL ORDERED A COUPLE

2484
01:26:57,805 --> 01:26:59,640
OF THE -- I'M GOING TO GET THE

2485
01:26:59,640 --> 01:27:03,811
NAMES WRONG -- THE JADA DEVICE

2486
01:27:03,811 --> 01:27:05,179
FOR POSTPARTUM HEMORRHAGE AND

2487
01:27:05,179 --> 01:27:06,647
ONE OF THE NICU BEDS THAT THEY

2488
01:27:06,647 --> 01:27:10,584
HAD USED IN THE SIMULATION

2489
01:27:10,584 --> 01:27:12,553
TRAINING SO THEY COULD HAVE THAT

2490
01:27:12,553 --> 01:27:13,420
DURING THEIR EMERGENCY

2491
01:27:13,420 --> 01:27:13,787
DELIVERIES.

2492
01:27:13,787 --> 01:27:16,256
THEY WERE REALLY EXCITED ABOUT

2493
01:27:16,256 --> 01:27:16,924
THAT, UNFORTUNATELY THERE HAD

2494
01:27:16,924 --> 01:27:18,158
BEEN AN EMERGENCY DELIVERY

2495
01:27:18,158 --> 01:27:19,426
BEFORE THE EQUIPMENT HAD BEEN

2496
01:27:19,426 --> 01:27:19,760
DELIVERED.

2497
01:27:19,760 --> 01:27:20,994
HOWEVER, BECAUSE OF THE

2498
01:27:20,994 --> 01:27:22,095
TRAINING, THEY KNEW WHO TO

2499
01:27:22,095 --> 01:27:23,163
COMMUNICATE WITH, HOW TO

2500
01:27:23,163 --> 01:27:24,264
COMMUNICATE WITH THEM AND FELT

2501
01:27:24,264 --> 01:27:25,799
AS GOOD AS THEY POSSIBLY COULD

2502
01:27:25,799 --> 01:27:27,768
IN THAT SITUATION, EVEN THOUGH

2503
01:27:27,768 --> 01:27:29,203
IT WAS A REALLY HIGH STRESS

2504
01:27:29,203 --> 01:27:31,271
SITUATION.

2505
01:27:31,271 --> 01:27:34,007
THERE ARE ALSO SOME OTHER

2506
01:27:34,007 --> 01:27:35,442
POLICIES THAT HAVE CHANGED AS A

2507
01:27:35,442 --> 01:27:36,977
RESULT OF THIS TRAINING.

2508
01:27:36,977 --> 01:27:38,879
WE SPENT A LOT OF TIME TALKING

2509
01:27:38,879 --> 01:27:41,582
ABOUT THE IMPORTANCE OF THE

2510
01:27:41,582 --> 01:27:43,984
PLACENTA TO OUR AMERICAN INDIAN

2511
01:27:43,984 --> 01:27:49,656
PATIENTS, AND WANTING TO GET

2512
01:27:49,656 --> 01:27:51,124
THAT IF AT ALL POSSIBLE SO THE

2513
01:27:51,124 --> 01:27:52,526
HOSPITAL WAS ABLE TO CHANGE

2514
01:27:52,526 --> 01:27:53,494
POLICIES RELATED TO RELEASE OF

2515
01:27:53,494 --> 01:27:55,362
THE PLACENTA IF A PATIENT WAS

2516
01:27:55,362 --> 01:27:57,564
NOT BEING TRANSFERRED.

2517
01:27:57,564 --> 01:27:59,500
THERE'S ALSO ONGOING TALKS ABOUT

2518
01:27:59,500 --> 01:28:02,269
HOW IHS AND THE WAGNER HOSPITAL

2519
01:28:02,269 --> 01:28:04,037
CAN COMMUNICATE BETTER ABOUT

2520
01:28:04,037 --> 01:28:06,139
THESE HIGH RISK PATIENTS, AND

2521
01:28:06,139 --> 01:28:07,374
THEY'RE IN THE PROCESS OF

2522
01:28:07,374 --> 01:28:08,942
SETTING UP DIFFERENT CARE

2523
01:28:08,942 --> 01:28:11,945
CONFERENCES TO ENSURE THE

2524
01:28:11,945 --> 01:28:13,447
HIGHEST POSSIBLE CARE AND THE

2525
01:28:13,447 --> 01:28:15,782
MOST INFORMATION BEING SHARED

2526
01:28:15,782 --> 01:28:19,686
BETWEEN THOSE TWO FACILITIES.

2527
01:28:19,686 --> 01:28:21,455
I REALLY LIKED THIS PIECE OF

2528
01:28:21,455 --> 01:28:23,857
FEEDBACK FROM ONE OF OUR

2529
01:28:23,857 --> 01:28:24,324
ATTENDEES.

2530
01:28:24,324 --> 01:28:25,959
IT SAYS I THINK THIS ACTIVITY

2531
01:28:25,959 --> 01:28:27,594
WILL INCREASE EVERYONE'S

2532
01:28:27,594 --> 01:28:28,028
PERFORMANCE.

2533
01:28:28,028 --> 01:28:29,229
IT WAS GOOD TO BRING STAFF

2534
01:28:29,229 --> 01:28:30,230
TOGETHER AND DISCUSS HOW WE CAN

2535
01:28:30,230 --> 01:28:31,098
BETTER OURSELVES AND OUR

2536
01:28:31,098 --> 01:28:32,966
THINKING TO HELP UNDERSTAND OUR

2537
01:28:32,966 --> 01:28:34,635
PATIENTS SO THEY CAN GET THE

2538
01:28:34,635 --> 01:28:37,571
BEST POSSIBLE OUTCOMES.

2539
01:28:37,571 --> 01:28:38,872
IT ALSO CREATED A GOOD

2540
01:28:38,872 --> 01:28:39,806
DISCUSSION BETWEEN THE TWO

2541
01:28:39,806 --> 01:28:41,275
FACILITIES ON HOW WE CAN WORK

2542
01:28:41,275 --> 01:28:42,276
TOGETHER INSTEAD OF FEELING LIKE

2543
01:28:42,276 --> 01:28:43,477
WE'RE COMPETING WITH ONE

2544
01:28:43,477 --> 01:28:43,877
ANOTHER.

2545
01:28:43,877 --> 01:28:45,145
AND I THINK THIS IS REALLY WHAT

2546
01:28:45,145 --> 01:28:48,315
WE WERE HOPING TO SEE WITH THIS

2547
01:28:48,315 --> 01:28:49,650
TRAINING, AND BECAUSE OF ITS

2548
01:28:49,650 --> 01:28:52,786
SUCCESS, WE HAVE QUITE A FEW OF

2549
01:28:52,786 --> 01:28:54,154
THESE LINED UP IN DIFFERENT

2550
01:28:54,154 --> 01:28:55,088
RURAL COMMUNITIES, BRINGING

2551
01:28:55,088 --> 01:28:56,490
DIFFERENT FACILITIES OR

2552
01:28:56,490 --> 01:28:58,592
DIFFERENT COMMUNITIES TOGETHER

2553
01:28:58,592 --> 01:28:59,493
TO WORK TOGETHER AND RECEIVE

2554
01:28:59,493 --> 01:29:02,429
THIS TRAINING ON BOTH SKILLS AND

2555
01:29:02,429 --> 01:29:06,033
CULTURAL COMPETENCY.

2556
01:29:06,033 --> 01:29:08,902
SO WE KNOW WE ARE CHANGING

2557
01:29:08,902 --> 01:29:10,103
PATIENT AND PROVIDER LIVES AND

2558
01:29:10,103 --> 01:29:12,839
HAVING AN IMPACT ON POLICIES IN

2559
01:29:12,839 --> 01:29:13,407
ORGANIZATIONS.

2560
01:29:13,407 --> 01:29:14,274
BUT THAT'S NOT GOOD ENOUGH FOR

2561
01:29:14,274 --> 01:29:15,776
US.

2562
01:29:15,776 --> 01:29:17,978
WE HAVE TO DO MORE AND WE HAVE

2563
01:29:17,978 --> 01:29:19,079
TO DO BIGGER THINGS AND ONE OF

2564
01:29:19,079 --> 01:29:21,048
THE WAYS WE ENVISION DOING THIS

2565
01:29:21,048 --> 01:29:22,182
IS THROUGH OUR TRANSFORMATION

2566
01:29:22,182 --> 01:29:22,549
BOARD.

2567
01:29:22,549 --> 01:29:24,918
SO THIS IS PART OF OUR COMMUNITY

2568
01:29:24,918 --> 01:29:27,321
PARTNER COMPONENT, AND IT BRINGS

2569
01:29:27,321 --> 01:29:29,957
TOGETHER LEADERS AND

2570
01:29:29,957 --> 01:29:30,557
ORGANIZATIONAL CHANGE MAKERS

2571
01:29:30,557 --> 01:29:32,693
THAT CAN HELP US TAKE WHAT WE'RE

2572
01:29:32,693 --> 01:29:34,361
LEARNING THROUGH OUR CENTER OF

2573
01:29:34,361 --> 01:29:35,662
EXCELLENCE AND THROUGH ITS

2574
01:29:35,662 --> 01:29:37,097
RESEARCH, AND TURN IT INTO

2575
01:29:37,097 --> 01:29:38,732
POLICY AND SYSTEMS LEVEL

2576
01:29:38,732 --> 01:29:39,466
CHANGES.

2577
01:29:39,466 --> 01:29:44,171
SO THESE ARE PEOPLE WHO CAN TELL

2578
01:29:44,171 --> 01:29:45,639
US NO, THIS WON'T WORK AND THIS

2579
01:29:45,639 --> 01:29:47,608
IS WHY, OR YES, WE WANT TO MAKE

2580
01:29:47,608 --> 01:29:51,111
THIS HAPPEN, HOW CAN WE GET

2581
01:29:51,111 --> 01:29:51,445
THERE.

2582
01:29:51,445 --> 01:29:53,647
WE ARE IN A REALLY UNIQUE SPACE,

2583
01:29:53,647 --> 01:29:55,048
I THINK, BECAUSE OF THE

2584
01:29:55,048 --> 01:29:55,782
COMMUNITY-BASED WORK WE DO

2585
01:29:55,782 --> 01:29:56,817
WITHIN THE HEALTH SYSTEM AND

2586
01:29:56,817 --> 01:30:01,321
WHERE WE SIT IN HEALTHCARE AND

2587
01:30:01,321 --> 01:30:01,855
RESEARCH.

2588
01:30:01,855 --> 01:30:03,624
AND ALSO BECAUSE WE HAVE SUCH

2589
01:30:03,624 --> 01:30:04,391
MOTIVATED PARTNERS WHO ARE

2590
01:30:04,391 --> 01:30:07,027
REALLY INTERESTED IN FINDING

2591
01:30:07,027 --> 01:30:08,328
SOLUTIONS TO THESE ISSUES WE ARE

2592
01:30:08,328 --> 01:30:09,329
FACING IN SOUTH DAKOTA.

2593
01:30:09,329 --> 01:30:10,964
SO WITH THAT, I WOULD LIKE TO

2594
01:30:10,964 --> 01:30:12,833
LEAVE YOU WITH THE SAVE THE DATE

2595
01:30:12,833 --> 01:30:15,235
FOR OUR MARCH SUMMIT IN MARCH.

2596
01:30:15,235 --> 01:30:17,537
WE WOULD LOVE TO HAVE YOU THERE

2597
01:30:17,537 --> 01:30:19,072
SO YOU CAN LEARN MORE ABOUT

2598
01:30:19,072 --> 01:30:19,840
SOUTH DAKOTA AND WHAT WE'RE

2599
01:30:19,840 --> 01:30:20,841
DOING WITH OUR CENTER OF

2600
01:30:20,841 --> 01:30:21,808
EXCELLENCE.

2601
01:30:21,808 --> 01:30:22,275
THANK YOU.

2602
01:30:22,275 --> 01:30:24,311
[APPLAUSE]

2603
01:30:24,311 --> 01:30:30,484
>> THANK YOU SO MUCH.

2604
01:30:30,484 --> 01:30:32,219
WE HAVE TIME FOR MAYBE ONE QUICK

2605
01:30:32,219 --> 01:30:32,786
QUESTION.

2606
01:30:32,786 --> 01:30:35,322
DOES ANYONE HAVE A QUESTION IN

2607
01:30:35,322 --> 01:30:36,757
THE AUDIENCE WHO'D LIKE TO COME

2608
01:30:36,757 --> 01:30:37,090
UP?

2609
01:30:37,090 --> 01:30:44,297
GOING ONCE, GOING TWICE.

2610
01:30:44,297 --> 01:30:48,835
OKAY.

2611
01:30:48,835 --> 01:30:49,302
>> THANK YOU.

2612
01:30:49,302 --> 01:30:52,873
THANK YOU FOR YOUR PRESENTATION.

2613
01:30:52,873 --> 01:30:57,077
I'M FROM M NEVADA AND WE HAVE A

2614
01:30:57,077 --> 01:30:58,612
HUGE RURAL POPULATION IN OUR

2615
01:30:58,612 --> 01:31:02,315
STATE AS WELL.

2616
01:31:02,315 --> 01:31:03,784
IT'S SOMETHING ALL OF OUR

2617
01:31:03,784 --> 01:31:05,385
LEGISLATORS TALK ABOUT AND OUR

2618
01:31:05,385 --> 01:31:06,553
PROVIDERS, AND IT'S SOMETHING

2619
01:31:06,553 --> 01:31:07,788
THAT WE HAVEN'T QUITE FIGURED

2620
01:31:07,788 --> 01:31:10,991
OUT HOW TO GET THROUGH AND THE

2621
01:31:10,991 --> 01:31:11,758
TRAINING COMPONENT IS HUGE.

2622
01:31:11,758 --> 01:31:14,594
SO I'M CURIOUS AS TO WHAT KIND

2623
01:31:14,594 --> 01:31:15,929
OF COLLABORATION YOU'RE

2624
01:31:15,929 --> 01:31:17,998
INTERESTED IN FOR OTHER STATES

2625
01:31:17,998 --> 01:31:20,634
THAT EXPERIENCE A LOT OF RURAL

2626
01:31:20,634 --> 01:31:22,936
CHALLENGES AND HOW TO BRING

2627
01:31:22,936 --> 01:31:24,705
TRAININGS LIKE THIS TO OUR

2628
01:31:24,705 --> 01:31:29,076
COMMUNITIES AS WELL.

2629
01:31:29,076 --> 01:31:30,043
>> I LOVE THAT.

2630
01:31:30,043 --> 01:31:31,311
I'M GUESSING YOU DESCRIBE

2631
01:31:31,311 --> 01:31:32,379
DISTANCE IN TERMS OF HOURS TOO.

2632
01:31:32,379 --> 01:31:36,550
>> MANY, MANY HOURS.

2633
01:31:36,550 --> 01:31:37,551
>> WE LOVE TO COLLABORATE
AND

2634
01:31:37,551 --> 01:31:38,985
WOULD BE HAPPY TO SHARE HOW

2635
01:31:38,985 --> 01:31:41,421
WE'RE ACCOMPLISHING IT AND THE

2636
01:31:41,421 --> 01:31:41,988
PIECES THAT WE'VE BROUGHT

2637
01:31:41,988 --> 01:31:44,591
TOGETHER TO BE ABLE TO SEE WHAT

2638
01:31:44,591 --> 01:31:47,794
PIECINGSPIECES YOU MAY HAVE.

2639
01:31:47,794 --> 01:31:48,929
EVERYTHING WE DO IS IN

2640
01:31:48,929 --> 01:31:49,663
COLLABORATION, SO LET'S CONNECT

2641
01:31:49,663 --> 01:31:55,135
AND SEE IF WE CAN HELP AT LEAST

2642
01:31:55,135 --> 01:31:56,036
SHARE YOU OUR STORY.

2643
01:31:56,036 --> 01:31:58,638
>> THANKS.

2644
01:31:58,638 --> 01:32:00,173
>> GREAT, THANK YOU SO
MUCH.

2645
01:32:00,173 --> 01:32:01,074
GIVE EVERYBODY A HAND.

2646
01:32:01,074 --> 01:32:07,080
[APPLAUSE]

2647
01:32:07,080 --> 01:32:08,615
SO WE ARE NOW DONE WITH THE

2648
01:32:08,615 --> 01:32:11,251
FOURTH SESSION OF THE MEETING.

2649
01:32:11,251 --> 01:32:12,719
WE WERE GOING TO GO ON BREAK FOR

2650
01:32:12,719 --> 01:32:14,187
10 MINUTES, SO WE WILL START

2651
01:32:14,187 --> 01:32:15,722
BACK UP AGAIN AT 10:50.

2652
01:32:15,722 --> 01:32:18,458
IF YOU ARE PRESENTING IN SESSION

2653
01:32:18,458 --> 01:32:23,196
5, PART 1, PLEASE MEET DOWN HERE

2654
01:32:23,196 --> 01:32:23,964
ABOUT THREE MINUTES BEFORE WE

2655
01:32:23,964 --> 01:32:24,164
START.

2656
01:32:24,164 --> 01:32:32,172
THANK YOU.

2657
01:32:32,172 --> 01:32:33,673
>> SO YOU DIDN'T COME HERE
TO

2658
01:32:33,673 --> 01:32:34,274
HEAR ME TALK.

2659
01:32:34,274 --> 01:32:36,242
YOU CAME HERE TO HEAR OTHER

2660
01:32:36,242 --> 01:32:37,544
PEOPLE, SUPER AWESOME PEOPLE

2661
01:32:37,544 --> 01:32:38,578
TALK.

2662
01:32:38,578 --> 01:32:41,081
FIRST UP, WE'RE GOING TO HEAR

2663
01:32:41,081 --> 01:32:41,848
FROM STANFORD PRIHSM.

2664
01:32:41,848 --> 01:32:45,785
WE'RE GOING TO HEAR FROM DRS.

2665
01:32:45,785 --> 01:32:47,554
IGBINOSA AND LYELLE, AND I'M

2666
01:32:47,554 --> 01:32:49,522
GOING TO TURN IT RIGHT OVER TO

2667
01:32:49,522 --> 01:32:58,064
YOU TO JUMP IN.

2668
01:32:58,064 --> 01:33:00,266
>> THANK YOU, CAN YOU HEAR
ME?

2669
01:33:00,266 --> 01:33:01,701
HI.

2670
01:33:01,701 --> 01:33:05,738
I'M DR. DEIRDRE LYELL, PROFESSOR

2671
01:33:05,738 --> 01:33:10,443
OF MATERNAL FETAL MEDICINE AT

2672
01:33:10,443 --> 01:33:20,620
STANFORD AS WELL AS NEW CHAIR,

2673
01:33:20,620 --> 01:33:23,356
PREVENTING INEQUITIES IN

2674
01:33:23,356 --> 01:33:24,491
HEMORRHAGE-RELATED SEVERE

2675
01:33:24,491 --> 01:33:25,859
MATERNAL MORBIDITY.

2676
01:33:25,859 --> 01:33:29,095
>> GOOD MORNING.

2677
01:33:29,095 --> 01:33:30,864
I'M IRO IGBINOSA, WOMEN'S

2678
01:33:30,864 --> 01:33:31,931
REPRODUCTIVE HEALTH RESEARCH

2679
01:33:31,931 --> 01:33:36,536
SCHOLAR IN MATERNAL FETAL

2680
01:33:36,536 --> 01:33:36,803
MEDICINE.

2681
01:33:36,803 --> 01:33:37,537
>> I'LL GET STARTED.

2682
01:33:37,537 --> 01:33:38,738
I WOULD LIKE TO FIRST

2683
01:33:38,738 --> 01:33:39,606
ACKNOWLEDGE THAT WE ARE

2684
01:33:39,606 --> 01:33:40,707
PRESENTING BUT ONE PIECE OF

2685
01:33:40,707 --> 01:33:42,175
LARGER BODY OF WORK AND OUR GOAL

2686
01:33:42,175 --> 01:33:43,943
AND OUR VISION IS TO IMPROVE

2687
01:33:43,943 --> 01:33:45,044
MATERNAL HEALTH BY REDUCING THE

2688
01:33:45,044 --> 01:33:55,755
ILL PIMPACT OF POSTPARTUM -- SON

2689
01:33:55,755 --> 01:33:56,990
DEFICIENCY ANEMIA IN PREGNANCY

2690
01:33:56,990 --> 01:33:58,057
IS A PUBLIC HEALTH ISSUE.

2691
01:33:58,057 --> 01:34:00,894
IT AFFECTS ABOUT 40% OF

2692
01:34:00,894 --> 01:34:01,361
PREGNANCIES WORLDWIDE.

2693
01:34:01,361 --> 01:34:02,996
THE LIGHT PINK SHOWS AREAS WHERE

2694
01:34:02,996 --> 01:34:04,964
THE PREVALENCE IS LESS THAN 20%

2695
01:34:04,964 --> 01:34:07,167
AND THE DARKER MAROON SHOWS

2696
01:34:07,167 --> 01:34:08,501
AREAS WHERE THE PREVALENCE IS

2697
01:34:08,501 --> 01:34:09,502
GREATER THAN 40%, AND SOME OF

2698
01:34:09,502 --> 01:34:12,438
THIS IS DUE TO SOCIAL

2699
01:34:12,438 --> 01:34:13,439
DETERMINANTS OF HEALTH AND

2700
01:34:13,439 --> 01:34:19,245
ACCESS IN THOSE COUNTRIES.

2701
01:34:19,245 --> 01:34:20,346
HOWEVER THAT DOESN'T TELL A

2702
01:34:20,346 --> 01:34:21,414
COMPLETE STORY.

2703
01:34:21,414 --> 01:34:24,184
WWE KNOW IRON DEFICIENCY, THE

2704
01:34:24,184 --> 01:34:26,953
PRECURSOR TO IRON DEFICIENCY

2705
01:34:26,953 --> 01:34:32,392
ANEMIA IS VERY COMMON IN AREAS

2706
01:34:32,392 --> 01:34:34,427
WITH HIGH RESOURCE SETTINGS.

2707
01:34:34,427 --> 01:34:36,496
SO FOR EXAMPLE IN THE STUDY OF

2708
01:34:36,496 --> 01:34:38,031
OVER 40 PREGNANCIES, WE SAW IRON

2709
01:34:38,031 --> 01:34:39,032
DEFICIENCY AFFECTED MORE THAN

2710
01:34:39,032 --> 01:34:40,333
50% OF PREGNANCIES IN A HIGH

2711
01:34:40,333 --> 01:34:41,768
RESOURCE SETTING.

2712
01:34:41,768 --> 01:34:43,169
25% OF PREGNANCIES WERE

2713
01:34:43,169 --> 01:34:44,504
COMPLICATE BID SEVERE IRON

2714
01:34:44,504 --> 01:34:46,372
DEFICIENCY AND PROBABLY MORE

2715
01:34:46,372 --> 01:34:47,574
STRIKINGLY, 40% OF PREGNANCIES

2716
01:34:47,574 --> 01:34:53,580
WEREN'T EVEN SCREEN DOLLARS.

2717
01:34:53,580 --> 01:34:54,547
SO WHY IS THIS IMPORTANT?

2718
01:34:54,547 --> 01:34:56,849
WE KNOW IN PREGNANCY, ANEMIA,

2719
01:34:56,849 --> 01:34:58,851
ONE OF THE MOST COMMON CAUSES IS

2720
01:34:58,851 --> 01:35:00,587
IRON DEFICIENCY, AND THAT IRON

2721
01:35:00,587 --> 01:35:02,021
HELPS BUILD RED BLOOD CELLS,

2722
01:35:02,021 --> 01:35:03,556
WHICH THEN ARE IMPORTANT TO

2723
01:35:03,556 --> 01:35:05,792
DELIVER OXYGEN AND NUTRIENTS SO

2724
01:35:05,792 --> 01:35:06,326
MOM AND BABY.

2725
01:35:06,326 --> 01:35:07,961
AND THERE'S A LOT OF OTHER

2726
01:35:07,961 --> 01:35:10,029
FUNCTIONS, BUT WE WON'T GO INTO

2727
01:35:10,029 --> 01:35:10,830
DETAIL.

2728
01:35:10,830 --> 01:35:13,800
AND CONSEQUENCES OF IRON

2729
01:35:13,800 --> 01:35:15,635
DEFICIENCY AND/OR IRON

2730
01:35:15,635 --> 01:35:17,837
DEFICIENCY ANEMIA CAN BE FOR MOM

2731
01:35:17,837 --> 01:35:19,405
OR FOR BABY.

2732
01:35:19,405 --> 01:35:21,140
SO FOR THE MOTHER, WE MIGHT SEE

2733
01:35:21,140 --> 01:35:23,910
FATIGUE, SHORTNESS OF BREATH,

2734
01:35:23,910 --> 01:35:28,281
DEPRESSION, FOO TEA.

2735
01:35:28,281 --> 01:35:30,383
WE MIGHT SEE DELIVERY RELATED

2736
01:35:30,383 --> 01:35:31,918
COMPLICATIONS, PARTICULARLY

2737
01:35:31,918 --> 01:35:32,986
HEMORRHAGE, POSTPARTUM

2738
01:35:32,986 --> 01:35:34,220
HEMORRHAGE, BLOOD TRANSFUSION,

2739
01:35:34,220 --> 01:35:38,258
HIGHER RISK FOR PREECLAMPSIA AND

2740
01:35:38,258 --> 01:35:39,392
CESAREAN DELIVERY.

2741
01:35:39,392 --> 01:35:40,560
ALONG THE INFANT FETAL SPECTRUM,

2742
01:35:40,560 --> 01:35:42,895
WE CAN SEE STILLBIRTH, PRETERM

2743
01:35:42,895 --> 01:35:44,764
BIRTH, LOW INFANT BIRTH WEIGHT

2744
01:35:44,764 --> 01:35:47,600
AND NEURODEVELOPMENTAL ISSUES.

2745
01:35:47,600 --> 01:35:50,036
SO WHO DOES THIS IMPACT IN

2746
01:35:50,036 --> 01:35:51,104
PREGNANCY?

2747
01:35:51,104 --> 01:35:51,971
IN SHORT, EVERYONE.

2748
01:35:51,971 --> 01:35:54,440
THIS IS DATA OUT OF CALIFORNIA

2749
01:35:54,440 --> 01:35:57,277
FROM OUR TEAM WHERE WE LOOKED AT

2750
01:35:57,277 --> 01:35:58,611
OVER 4 MILLION BIRTHS, BIRTHS

2751
01:35:58,611 --> 01:35:59,479
ADMISSIONS LINKED TO BIRTH

2752
01:35:59,479 --> 01:36:00,747
CERTIFICATE DATA, AND WE LOOKED

2753
01:36:00,747 --> 01:36:03,650
AT THE RATES OF ANEMIA AT THE

2754
01:36:03,650 --> 01:36:06,519
TIME OF BIRTH ADMISSION AND WE

2755
01:36:06,519 --> 01:36:07,520
STRATIFY THAT BY RACE AND

2756
01:36:07,520 --> 01:36:07,820
ETHNICITY.

2757
01:36:07,820 --> 01:36:09,722
SO A FEW THINGS WE SAW OVER THE

2758
01:36:09,722 --> 01:36:11,591
PAST ALMOST 10 YEARS, THAT

2759
01:36:11,591 --> 01:36:13,159
ANEMIA INCREASED FOR EVERYONE,

2760
01:36:13,159 --> 01:36:15,328
AND THAT BLACK PREGNANT

2761
01:36:15,328 --> 01:36:16,129
PEOPLE/BIRTHING PEOPLE HAVE THE

2762
01:36:16,129 --> 01:36:17,530
HIGHEST RATES OF ANEMIA, AND

2763
01:36:17,530 --> 01:36:19,465
THEN THAT DISPARITY BETWEEN

2764
01:36:19,465 --> 01:36:21,701
BLACK AND WHITE WAS PERSISTENT

2765
01:36:21,701 --> 01:36:24,771
AND INCREASE DOLLARS OVER TIME.

2766
01:36:24,771 --> 01:36:25,438
 INCREASED OVER TIME.

2767
01:36:25,438 --> 01:36:26,739
AND SO THE OTHER THING THAT WE

2768
01:36:26,739 --> 01:36:29,309
ASK OURSELVES IS THAT HOW DO

2769
01:36:29,309 --> 01:36:31,511
DIFFERENCES IN THESE DISPARITIES

2770
01:36:31,511 --> 01:36:33,479
IN ANEMIA CONTRIBUTE TO

2771
01:36:33,479 --> 01:36:35,248
DIFFERENCES IN DISPARITIES IN

2772
01:36:35,248 --> 01:36:39,419
SEVERE MATERNAL MORBIDITY, ALSO

2773
01:36:39,419 --> 01:36:41,254
KNOWN AS A NEAR MISS OR ALMOST

2774
01:36:41,254 --> 01:36:42,588
NEAR MISS EVENT IN PREGNANCY.

2775
01:36:42,588 --> 01:36:44,590
FOR THIS DATA WE USE THE CDC

2776
01:36:44,590 --> 01:36:44,924
INDEX.

2777
01:36:44,924 --> 01:36:46,559
SO WHAT WE FOUND WAS THAT ANEMIA

2778
01:36:46,559 --> 01:36:49,996
MAY BE RESPONSIBLE FOR ABOUT

2779
01:36:49,996 --> 01:36:51,864
1 IN 5 CASES OF SEVERE MATERNAL

2780
01:36:51,864 --> 01:36:54,367
MORBIDITY AMONG BLACK PREGNANT

2781
01:36:54,367 --> 01:36:56,669
INDIVIDUALS, AND HISPANIC OR

2782
01:36:56,669 --> 01:37:00,206
LATINX PREGNANT INDIVIDUALS.

2783
01:37:00,206 --> 01:37:06,112
AND IN UP TO 1 IN 9 IN ASIAN

2784
01:37:06,112 --> 01:37:06,546
PREGNANT PEOPLE.

2785
01:37:06,546 --> 01:37:08,748
SO WHAT WE FIND IS THAT ANEMIA

2786
01:37:08,748 --> 01:37:09,649
CONTRIBUTES TO MATERNAL

2787
01:37:09,649 --> 01:37:10,750
MORBIDITY AND THERE ARE

2788
01:37:10,750 --> 01:37:12,618
VARIANCES BY RACE AND ETHNICITY.

2789
01:37:12,618 --> 01:37:17,990
AND SO YOU MIGHT ASK YOURSELF,

2790
01:37:17,990 --> 01:37:19,425
WHY IS THIS AN ISSUE, THESE

2791
01:37:19,425 --> 01:37:23,896
PEOPLE HAVE HAD PRENATAL CARE

2792
01:37:23,896 --> 01:37:25,331
AND WE'VE ADJUSTED FOR COMMON

2793
01:37:25,331 --> 01:37:28,735
SOCIAL DETERMINANTS BUT IT STILL

2794
01:37:28,735 --> 01:37:31,137
EXISTS.

2795
01:37:31,137 --> 01:37:33,539
SCREENING FOR IRON DEFICIENCY IS

2796
01:37:33,539 --> 01:37:35,341
OFTEN INADEQUATE, IT'S

2797
01:37:35,341 --> 01:37:36,109
UNRECOGNIZED AS A PROBLEM BY

2798
01:37:36,109 --> 01:37:37,643
PROVIDERS IN OUR PATIENTS.

2799
01:37:37,643 --> 01:37:38,745
THERE'S A LOT OF DIFFERENT

2800
01:37:38,745 --> 01:37:40,179
APPROACHES TO EVALUATION AND

2801
01:37:40,179 --> 01:37:41,280
TREATMENT, AND THE TREATMENTS,

2802
01:37:41,280 --> 01:37:43,149
THE MOST COMMON BEING ORAL IRON,

2803
01:37:43,149 --> 01:37:44,584
IS NOT THE MOST EASY TO TAKE.

2804
01:37:44,584 --> 01:37:46,119
THERE'S A LOT OF SIDE EFFECTS,

2805
01:37:46,119 --> 01:37:46,753
PARTICULARLY G.I.

2806
01:37:46,753 --> 01:37:49,088
AND THEN WE ALSO HAVE TO TALK

2807
01:37:49,088 --> 01:37:52,592
ABOUT THE PRESENCE OF STRUCTURAL

2808
01:37:52,592 --> 01:37:54,160
RISM, AND AS EVIDENCED IN

2809
01:37:54,160 --> 01:37:55,795
HISTORICAL RACE-BASED CUTOFFS

2810
01:37:55,795 --> 01:37:56,562
FOR ANEMIA.

2811
01:37:56,562 --> 01:37:59,198
SO FOR EXAMPLE, PRIOR TO 2021,

2812
01:37:59,198 --> 01:38:02,368
WE SEE THAT A BLACK PREGNANT

2813
01:38:02,368 --> 01:38:05,671
PATIENT NEEDED A HEMOGLOBIN LESS

2814
01:38:05,671 --> 01:38:06,773
THAN 10.2 AND IN THE THIRD

2815
01:38:06,773 --> 01:38:08,408
TRIMESTER RECEIVED TREATMENT FOR

2816
01:38:08,408 --> 01:38:09,976
ANEMIA AS OPPOSED TO A NON-BLACK

2817
01:38:09,976 --> 01:38:11,177
PATIENT WHO WOULD RECEIVE

2818
01:38:11,177 --> 01:38:12,812
TREATMENT FOR ANEMIA WITH A

2819
01:38:12,812 --> 01:38:16,315
HEMOGLOBIN LESS THAN 11 IN THE

2820
01:38:16,315 --> 01:38:17,450
FIRST OR THIRD.

2821
01:38:17,450 --> 01:38:18,851
SO THESE KIND OF CUTOFFS AND

2822
01:38:18,851 --> 01:38:19,986
THESE DISPARITIES CONTRIBUTE TO

2823
01:38:19,986 --> 01:38:21,053
KIND OF THE DISPARITIES THAT WE

2824
01:38:21,053 --> 01:38:25,892
SEE TODAY.

2825
01:38:25,892 --> 01:38:28,294
WE SAW LOOKING AT DATA,

2826
01:38:28,294 --> 01:38:33,332
SECONDARY LOOK OF A TRIAL OF

2827
01:38:33,332 --> 01:38:34,133
I.V. IRON.

2828
01:38:34,133 --> 01:38:35,234
WE SAW BLACK PATIENTS WERE MORE

2829
01:38:35,234 --> 01:38:36,536
LIKELY TO PRESENT AT DELIVERY

2830
01:38:36,536 --> 01:38:38,504
WITH ANEMIA, COMPARED TO

2831
01:38:38,504 --> 01:38:39,205
NON-WHITE PATIENTS.

2832
01:38:39,205 --> 01:38:40,773
AND THEN THAT ANEMIA INCREASED

2833
01:38:40,773 --> 01:38:44,143
THE ODDS OF BLOOD TRANSFUSION.

2834
01:38:44,143 --> 01:38:46,012
AND SO WHY DOES THIS MATTER?

2835
01:38:46,012 --> 01:38:47,013
WHY DOES THIS TREATMENT AND

2836
01:38:47,013 --> 01:38:50,082
THESE CUTOFFS MATTER?

2837
01:38:50,082 --> 01:38:52,452
BECAUSE IRON THERAPY IMPROVES

2838
01:38:52,452 --> 01:38:53,386
OUTCOMES.

2839
01:38:53,386 --> 01:38:55,221
AND JUST AT A BASIC LEVEL, WE

2840
01:38:55,221 --> 01:38:56,456
KNOW ORAL IRON IMPROVES

2841
01:38:56,456 --> 01:38:56,756
OUTCOMES.

2842
01:38:56,756 --> 01:39:01,527
THIS STUDY OUT OF BAYLOR COLLEGE

2843
01:39:01,527 --> 01:39:04,897
OF MEDICINE, TEXAS HAD ABOUT

2844
01:39:04,897 --> 01:39:05,698
7400 PATIENTS, RETROSPECTIVELY

2845
01:39:05,698 --> 01:39:07,166
OUT OF THEIR REGISTRY.

2846
01:39:07,166 --> 01:39:09,001
SO A FEW KEY FINDINGS WERE THAT

2847
01:39:09,001 --> 01:39:10,336
ONLY 36% WERE SUCCESSFULLY

2848
01:39:10,336 --> 01:39:11,971
TREATED, SO IT GIVES OPTIONS FOR

2849
01:39:11,971 --> 01:39:14,173
US TO CONSIDER WHAT ELSE ARE WE

2850
01:39:14,173 --> 01:39:15,608
CONSIDERING IN OUR BAG, IN OUR

2851
01:39:15,608 --> 01:39:18,277
TOOLKIT OF HOW WE APPROACH

2852
01:39:18,277 --> 01:39:21,113
TREATMENT OF ANEMIA, AND THEN

2853
01:39:21,113 --> 01:39:22,515
PERHAPS MORE WHAT STOOD OUT TO

2854
01:39:22,515 --> 01:39:25,184
ME WAS 46% WERE UNTREATED AND

2855
01:39:25,184 --> 01:39:27,353
THAT WAS MOST LIKELY TO BE

2856
01:39:27,353 --> 01:39:28,354
UNDERREPRESENTED MINORITIES.

2857
01:39:28,354 --> 01:39:30,323
AND IN THIS SAMPLE SIZE, THAT

2858
01:39:30,323 --> 01:39:31,891
GROUP WAS IN PARTICULAR HISPANIC

2859
01:39:31,891 --> 01:39:35,161
OR LATINX.

2860
01:39:35,161 --> 01:39:36,362
THEN THERE WAS A LACK OF

2861
01:39:36,362 --> 01:39:37,797
CONFIRMATION OF THE CAUSE OF

2862
01:39:37,797 --> 01:39:38,564
ANEMIA.

2863
01:39:38,564 --> 01:39:40,333
OUR ABSENCE -- AND ABSENCE OF

2864
01:39:40,333 --> 01:39:41,534
PROTOCOLS TO TREAT AND MONITOR

2865
01:39:41,534 --> 01:39:42,835
THE RESPONSE.

2866
01:39:42,835 --> 01:39:44,871
MEANING THAT YOU STARTED ON A

2867
01:39:44,871 --> 01:39:45,972
TREATMENT, DID YOU GET BETTER,

2868
01:39:45,972 --> 01:39:48,040
DID YOU NOT, HOW DID WE MEASURE

2869
01:39:48,040 --> 01:39:49,041
THAT.

2870
01:39:49,041 --> 01:39:50,176
WE DON'T HAVE THAT WELL

2871
01:39:50,176 --> 01:39:55,648
OUTLINED.

2872
01:39:55,648 --> 01:39:56,816
WHAT I WANTED TO KIND OF ALSO

2873
01:39:56,816 --> 01:39:58,451
SHOW YOU IS THAT WE HAVE THREE

2874
01:39:58,451 --> 01:39:59,151
CATEGORIES.

2875
01:39:59,151 --> 01:40:03,222
THOSE WHO WERE UNTREATED,

2876
01:40:03,222 --> 01:40:04,891
UNSUCCESSFULLY TREATED MEANING

2877
01:40:04,891 --> 01:40:06,092
THEY RECEIVED SOME TREATMENT BUT

2878
01:40:06,092 --> 01:40:07,627
THEY DIDN'T RESOLVE THEIR ANEMIA

2879
01:40:07,627 --> 01:40:09,829
BY THE TIME THEY DELIVERED OR

2880
01:40:09,829 --> 01:40:11,330
SUCCESSFULLY TREATED, THEIR

2881
01:40:11,330 --> 01:40:12,365
ANEMIA WAS CORRECTED BEFORE THEY

2882
01:40:12,365 --> 01:40:12,632
DELIVERED.

2883
01:40:12,632 --> 01:40:14,367
SO WE SEE THAT POSTPARTUM

2884
01:40:14,367 --> 01:40:15,902
HEMORRHAGE, BLOOD TRANSFUSION,

2885
01:40:15,902 --> 01:40:18,437
CESAREAN DELIVERY, AND

2886
01:40:18,437 --> 01:40:19,872
HYSTERECTOMY HAVE PRETTY HIGH

2887
01:40:19,872 --> 01:40:22,708
ODDS IN UNTREATED AND

2888
01:40:22,708 --> 01:40:27,313
UNSUCCESSFULLY TREATED G TREATE.

2889
01:40:27,313 --> 01:40:28,748
BY THE TIME WE GET TO

2890
01:40:28,748 --> 01:40:29,849
SUCCESSFULLY TREATED, THE ODDS

2891
01:40:29,849 --> 01:40:30,283
GO DOWN.

2892
01:40:30,283 --> 01:40:31,517
IT DOESN'T GO AWAY COMPLETELY

2893
01:40:31,517 --> 01:40:33,486
BECAUSE THERE ARE ALSO OTHER

2894
01:40:33,486 --> 01:40:34,587
CONTRIBUTING FACTORS TO

2895
01:40:34,587 --> 01:40:35,588
DISPARITIES, BUT WE'RE JUST

2896
01:40:35,588 --> 01:40:37,123
TALKING ABOUT ONE COMPONENT, CAN

2897
01:40:37,123 --> 01:40:38,658
WE PROVIDE EQUITABLE

2898
01:40:38,658 --> 01:40:39,525
EVIDENCE-BASED CARE FOR THE

2899
01:40:39,525 --> 01:40:40,626
TREATMENT OF ANEMIA.

2900
01:40:40,626 --> 01:40:41,994
AND THEN THE OTHER THING WE SEE

2901
01:40:41,994 --> 01:40:46,933
IS FOR PRETERM BIRTH, THAT

2902
01:40:46,933 --> 01:40:49,435
SUCCESSFUL TREATMENT OF ANEMIA

2903
01:40:49,435 --> 01:40:50,803
CAN BE PROTECTIVE ALSO FOR

2904
01:40:50,803 --> 01:40:51,871
PRE-ECLAMPSIA SO WITH THAT, I

2905
01:40:51,871 --> 01:40:54,507
WILL TURN TO MY COLLEAGUE,

2906
01:40:54,507 --> 01:40:55,975
DEIRDRE LYELL, TO KIND OF TALK

2907
01:40:55,975 --> 01:40:56,943
ABOUT WHAT WE'LL BE DOING WITH

2908
01:40:56,943 --> 01:40:57,677
PRIHSM.

2909
01:40:57,677 --> 01:40:59,011
>> GREAT.

2910
01:40:59,011 --> 01:41:02,114
THANK YOU, DR. IGBINOSA.

2911
01:41:02,114 --> 01:41:04,083
SO BASED ON WANTING TO

2912
01:41:04,083 --> 01:41:05,418
UNDERSTAND THIS PROBLEM, WE

2913
01:41:05,418 --> 01:41:07,420
CONDUCTED PILOT WORK WITH OUR

2914
01:41:07,420 --> 01:41:09,956
COMMUNITY PARTNER, BLACKWELLNESS

2915
01:41:09,956 --> 01:41:11,924
AND PROSPERITY CENTER IN FRESNO,

2916
01:41:11,924 --> 01:41:13,459
CALIFORNIA, AN CONDUCTED

2917
01:41:13,459 --> 01:41:14,794
QUALITATIVE WORK INTERVIEWS

2918
01:41:14,794 --> 01:41:17,096
AMONG BLACK AND HISPANIC LATINX

2919
01:41:17,096 --> 01:41:18,965
PREGNANT PEOPLE, IN THIS CASE,

2920
01:41:18,965 --> 01:41:21,167
WOMEN, WITH LIVED EXPERIENCE OF

2921
01:41:21,167 --> 01:41:23,235
ANEMIA IN PREGNANCY.

2922
01:41:23,235 --> 01:41:27,173
AND IDENTIFIED SEVERAL KEY

2923
01:41:27,173 --> 01:41:29,241
THEMES:  A FEELING OF LACK OF

2924
01:41:29,241 --> 01:41:30,376
INFORMATION FROM THE PROVIDER,

2925
01:41:30,376 --> 01:41:32,144
DISMISSAL OF SYMPTOMS, TREATMENT

2926
01:41:32,144 --> 01:41:34,880
CHALLENGES WHEN TAKING

2927
01:41:34,880 --> 01:41:38,317
TREATMENT, AS DR. IGBINOSA

2928
01:41:38,317 --> 01:41:40,086
MENTIONED, AS WELL AS A VERY

2929
01:41:40,086 --> 01:41:44,156
STRONG INTEREST AND DESIRE FOR

2930
01:41:44,156 --> 01:41:45,458
PATIENT-CENTERED CARE AND MUCH

2931
01:41:45,458 --> 01:41:45,891
GREATER INFORMATION.

2932
01:41:45,891 --> 01:41:48,394
WE HAD MANY, MANY QUOTES, AND WE

2933
01:41:48,394 --> 01:41:49,762
PRESENTED THIS WORK AT THE

2934
01:41:49,762 --> 01:41:51,163
SOCIETY FOR MATERNAL FETAL

2935
01:41:51,163 --> 01:41:52,932
MEDICINE ANNUAL MEETING IN 2024.

2936
01:41:52,932 --> 01:41:55,267
I WANT TO READ THE LAST ONE.

2937
01:41:55,267 --> 01:41:56,936
"WE NEED TO FIND A WAY TO

2938
01:41:56,936 --> 01:41:57,803
NAVIGATE CONVERSATIONS AROUND

2939
01:41:57,803 --> 01:42:02,108
THE PROCESS OF BIRTH,, BRINGING

2940
01:42:02,108 --> 01:42:03,542
A CHILD INTO THIS WORLD,

2941
01:42:03,542 --> 01:42:04,310
POSTPARTUM HEALING AND

2942
01:42:04,310 --> 01:42:05,378
DEPRESSION IN A WAY THAT WE

2943
01:42:05,378 --> 01:42:09,382
DON'T INSTILL FEAR BUT GIVE

2944
01:42:09,382 --> 01:42:11,984
INSIGHT."

2945
01:42:11,984 --> 01:42:13,419
SO THIS IS OUR PROJECT OVERVIEW.

2946
01:42:13,419 --> 01:42:14,620
IT'S KIND OF A BUSY SLIDE.

2947
01:42:14,620 --> 01:42:15,888
I'M GOING TO WALK YOU THROUGH

2948
01:42:15,888 --> 01:42:16,288
IT.

2949
01:42:16,288 --> 01:42:19,492
AT THE CORE R. CORE, WE ARE

2950
01:42:19,492 --> 01:42:21,460
DEVELOPING A PATIENT INFORMED

2951
01:42:21,460 --> 01:42:22,928
EVIDENCE-BASED ANEMIA TREATMENT

2952
01:42:22,928 --> 01:42:25,464
AND PREVENTION TOOLKIT IN ORDER

2953
01:42:25,464 --> 01:42:29,502
TO REDUCE ANEMIA AT BIRTH

2954
01:42:29,502 --> 01:42:30,870
ADMISSION AS WELL AS DISPARITIES

2955
01:42:30,870 --> 01:42:31,971
AND IMPROVE OUTCOMES

2956
01:42:31,971 --> 01:42:34,907
PARTICULARLY THOSE RELATED TO

2957
01:42:34,907 --> 01:42:38,644
POSTPARTUM HEMORRHAGE AND SEVERE

2958
01:42:38,644 --> 01:42:40,112
MATERNAL MORBIDITY AND REDUCE

2959
01:42:40,112 --> 01:42:41,947
DISPARITIES IN THOSE OUTCOMES.

2960
01:42:41,947 --> 01:42:44,684
AND WE WILL TEST THE -- FIRST

2961
01:42:44,684 --> 01:42:46,352
OUR AIMS ARE SEQUENTIAL.

2962
01:42:46,352 --> 01:42:49,989
AIM ONE IS REALLY TO CREATE THAT

2963
01:42:49,989 --> 01:42:51,957
TOOLKIT.

2964
01:42:51,957 --> 01:42:53,392
AGAIN IT'S GOING TO BE

2965
01:42:53,392 --> 01:42:55,394
PATIENT-INFORMED AND

2966
01:42:55,394 --> 01:42:56,362
CLINICIAN-INFORMED AS WELL,

2967
01:42:56,362 --> 01:42:57,096
EVIDENCE-BASED.

2968
01:42:57,096 --> 01:42:58,130
IN AIM 2, WE'RE GOING TO TEST

2969
01:42:58,130 --> 01:43:00,866
THE TOOLKIT AT HOSPITALS AMONG

2970
01:43:00,866 --> 01:43:01,967
NINE DIFFERENT -- OR EIGHT

2971
01:43:01,967 --> 01:43:05,471
DIFFERENT PILOT SITES, NINE

2972
01:43:05,471 --> 01:43:06,472
DIFFERENT HOSPITALS, IN ORDER TO

2973
01:43:06,472 --> 01:43:08,774
UNDERSTAND IS IT WORKING.

2974
01:43:08,774 --> 01:43:13,512
THROUGH THE CMQCC MATERNAL DATA

2975
01:43:13,512 --> 01:43:14,980
CENTER, WE CAN ACTUALLY MEASURE

2976
01:43:14,980 --> 01:43:17,483
AT EACH OF THESE SITES THINGS

2977
01:43:17,483 --> 01:43:19,051
LIKE HEMOGLOBIN AT BIRTH

2978
01:43:19,051 --> 01:43:20,352
ADMISSION, QUANTITATIVE BLOOD

2979
01:43:20,352 --> 01:43:25,491
LOSS AT DELIVERY, AS WELL AS

2980
01:43:25,491 --> 01:43:27,493
BLOOD TRANSFUSION, NEARLY

2981
01:43:27,493 --> 01:43:29,095
REALTIME, IT'S DATA THAT ARE 45

2982
01:43:29,095 --> 01:43:34,734
DAYS OLD BUT THROUGH THE SAME

2983
01:43:34,734 --> 01:43:35,868
CMQCC MATERNAL DATA CENTER.

2984
01:43:35,868 --> 01:43:38,170
AND BASED ON HOW WE'RE DOING,

2985
01:43:38,170 --> 01:43:39,739
WHETHER OR NOT WE'RE MOVING THAT

2986
01:43:39,739 --> 01:43:45,111
NEEDLE, ARE WE IMPROVING BIRTH

2987
01:43:45,111 --> 01:43:46,412
ADMISSION AND AIM THREE IS WHERE

2988
01:43:46,412 --> 01:43:48,380
WE REALLY HOPE TO MEASURE AND

2989
01:43:48,380 --> 01:43:49,949
IDENTIFY ANY DIFFERENCES IN

2990
01:43:49,949 --> 01:43:55,988
SEVERE MATERNAL MORBIDITY.

2991
01:43:55,988 --> 01:43:57,356
ACTUALLY WANT TO MENTION ONE

2992
01:43:57,356 --> 01:44:00,826
MORE THING THAT FOR PROVIDERS,

2993
01:44:00,826 --> 01:44:03,462
PART OF THE TOOLKIT IN ADDITION

2994
01:44:03,462 --> 01:44:05,598
TO OUTLINES THROUGH

2995
01:44:05,598 --> 01:44:06,132
EVIDENCE-BASED STREAMLINED

2996
01:44:06,132 --> 01:44:07,733
PRACTICE OF HOW YOU IDENTIFY

2997
01:44:07,733 --> 01:44:09,401
ANEMIA, HOW DO YOU IDENTIFY IRON

2998
01:44:09,401 --> 01:44:11,704
DEFICIENCY, THAT'S A KEY

2999
01:44:11,704 --> 01:44:12,571
COMPONENT, THERE'S A LOT OF

3000
01:44:12,571 --> 01:44:13,506
EDUCATION AS WELL FOR THE

3001
01:44:13,506 --> 01:44:14,173
PROVIDERS.

3002
01:44:14,173 --> 01:44:15,808
I THINK RIGHT NOW, THERE'S CLEAR

3003
01:44:15,808 --> 01:44:18,978
EVIDENCE THAT MANY PROVIDERS DO

3004
01:44:18,978 --> 01:44:19,845
LITTLE MORE THAN JUST SAY HERE

3005
01:44:19,845 --> 01:44:21,981
YOU HAVE ANEMIA, TAKE THIS PILL.

3006
01:44:21,981 --> 01:44:23,382
HOW DO YOU TAKE IT, WHEN DO YOU

3007
01:44:23,382 --> 01:44:24,750
TAKE IT, WHAT MEDS DO YOU TAKE

3008
01:44:24,750 --> 01:44:26,619
IT WITH, WHAT MEDS DO YOU AVOID

3009
01:44:26,619 --> 01:44:27,186
TAKING IT WITH.

3010
01:44:27,186 --> 01:44:28,721
THESE ARE ALL IMPORTANT TOO,

3011
01:44:28,721 --> 01:44:31,157
WHILE PROVIDING EHR ELECTRONIC

3012
01:44:31,157 --> 01:44:33,025
HEALTH RECORD TOOLS, AS WELL AS

3013
01:44:33,025 --> 01:44:34,760
IV IRON GUIDELINES AND

3014
01:44:34,760 --> 01:44:36,562
PROTOCOLS, JUST A WHOLE LOT

3015
01:44:36,562 --> 01:44:39,198
MORE, JUST APPROACHING THIS IN A

3016
01:44:39,198 --> 01:44:40,399
HOLISTIC MANNER, BOTH FROM OUR

3017
01:44:40,399 --> 01:44:45,838
PATIENTS AND FOR OUR PROVIDERS.

3018
01:44:45,838 --> 01:44:47,439
AS I MENTIONED OUR AIMS ARE

3019
01:44:47,439 --> 01:44:50,509
SEQUENTIAL.

3020
01:44:50,509 --> 01:44:53,913
OUR TOP ROW SHOWS YOU THE

3021
01:44:53,913 --> 01:44:54,313
TIMELINE.

3022
01:44:54,313 --> 01:44:55,915
BUT AGAIN THIS IS WORK THAT WE

3023
01:44:55,915 --> 01:44:56,882
NEED CLINICIANS AND COMMUNITY

3024
01:44:56,882 --> 01:44:57,883
WORKING TOGETHER.

3025
01:44:57,883 --> 01:44:59,618
WE CAN'T -- NEITHER OF US CAN DO

3026
01:44:59,618 --> 01:45:01,854
THIS ALONE TO SOLVE THIS.

3027
01:45:01,854 --> 01:45:04,356
OUR COMMUNITY ADVISORY BOARD OR

3028
01:45:04,356 --> 01:45:06,559
ANEMIA COMMUNITY LIEDER SHIP

3029
01:45:06,559 --> 01:45:07,927
GROUP, ACLG, IS WITH US THE

3030
01:45:07,927 --> 01:45:11,430
ENTIRE TEUM AND THEY WILL

3031
01:45:11,430 --> 01:45:13,833
CONTINUOUSLY HELP US TO EVALUATE

3032
01:45:13,833 --> 01:45:16,535
OUR PATIENT-FACING MATERIALS,

3033
01:45:16,535 --> 01:45:18,137
PATIENT EDUCATION TOOLS, AS WELL

3034
01:45:18,137 --> 01:45:21,740
AS WORK ON MESSAGING THROUGHOUT

3035
01:45:21,740 --> 01:45:26,946
THE COMMUNITY AS WELL ON WHY

3036
01:45:26,946 --> 01:45:28,314
ANEMIA MATTERS.

3037
01:45:28,314 --> 01:45:29,982
NOW IN ORDER TO REALLY GET THIS

3038
01:45:29,982 --> 01:45:31,750
RIGHT WE BUILD OUR TOOLKIT, WE

3039
01:45:31,750 --> 01:45:33,185
WANT TO ENSURE WE'RE INCLUDING

3040
01:45:33,185 --> 01:45:33,686
THE RIGHT GROUPS.

3041
01:45:33,686 --> 01:45:36,522
THIS INCLUDES PATIENTS AS I'VE

3042
01:45:36,522 --> 01:45:38,924
MENTIONED, BOTH THROUGH THE

3043
01:45:38,924 --> 01:45:40,226
ANEMIA COMMUNITY LEADERSHIP

3044
01:45:40,226 --> 01:45:41,493
GROUP AND OTHER.

3045
01:45:41,493 --> 01:45:42,595
CLINICIAN, MIDWIVES, BIRTH

3046
01:45:42,595 --> 01:45:43,996
WORKERS AND COMMUNITY-BASED

3047
01:45:43,996 --> 01:45:45,464
ORGANIZATIONS, WHILE

3048
01:45:45,464 --> 01:45:46,532
ACKNOWLEDGING THE ROLE OF SOCIAL

3049
01:45:46,532 --> 01:45:47,666
DETERMINANTS OF HEALTH IN THIS

3050
01:45:47,666 --> 01:45:49,168
PROBLEM AND WHAT WE NEED FOR THE

3051
01:45:49,168 --> 01:45:51,904
SOLUTION.

3052
01:45:51,904 --> 01:45:53,939
TO HELP US TO ACHIEVE THIS,

3053
01:45:53,939 --> 01:45:57,877
WE'RE COMPREHENSIVELY USING

3054
01:45:57,877 --> 01:45:58,744
THESE TWO FRAME WORKS.

3055
01:45:58,744 --> 01:46:00,145
FOR AIM ONE OUR FRAMEWORK

3056
01:46:00,145 --> 01:46:01,847
INCLUDES THE PATHWAYS TO RACIAL

3057
01:46:01,847 --> 01:46:04,783
AND ETHNIC DISPARITIES IN SEVERE

3058
01:46:04,783 --> 01:46:06,051
MATERNAL MORBIDITY AND MORTALITY

3059
01:46:06,051 --> 01:46:07,052
MODEL.

3060
01:46:07,052 --> 01:46:08,587
TO ENSURE THAT WE'RE TALKING TO

3061
01:46:08,587 --> 01:46:10,422
ALL OF THE CORRECT KEY PLAYERS

3062
01:46:10,422 --> 01:46:11,924
AND NOT JUST AT THE CLINIC OR

3063
01:46:11,924 --> 01:46:14,526
THE ACADEMIC LEVEL, BUT ALSO AT

3064
01:46:14,526 --> 01:46:17,730
THE INDIVIDUAL AND COMMUNITY

3065
01:46:17,730 --> 01:46:18,931
LEVEL.

3066
01:46:18,931 --> 01:46:21,267
WE'RE ALSO USING THE NIMH

3067
01:46:21,267 --> 01:46:22,034
FRAMEWORK FOR THE RESEARCH

3068
01:46:22,034 --> 01:46:23,469
COMPONENT, AND THIS FRAMEWORK IS

3069
01:46:23,469 --> 01:46:24,770
REFLECTED IN OUR INTERVIEW

3070
01:46:24,770 --> 01:46:26,338
GUIDES THAT WE'VE CREATED AND IT

3071
01:46:26,338 --> 01:46:27,239
CONSIDERS THESE LEVELS OF

3072
01:46:27,239 --> 01:46:30,943
INFLUENCE THAT YOU SEE AT THE

3073
01:46:30,943 --> 01:46:32,745
TOP, INDIVIDUAL, INTERPERSONAL,

3074
01:46:32,745 --> 01:46:34,380
COMMUNITY AND SOCIETAL.

3075
01:46:34,380 --> 01:46:37,650
AND HEALTH OUT COME LEVELS OR

3076
01:46:37,650 --> 01:46:38,651
HEALTH OUTCOMES THAT ARE SHOWN

3077
01:46:38,651 --> 01:46:41,687
AT THE BOTTOM, THE INDIVIDUAL

3078
01:46:41,687 --> 01:46:42,321
HEALTH, FAMILY AND

3079
01:46:42,321 --> 01:46:43,622
ORGANIZATIONAL HEALTH, COMMUNITY

3080
01:46:43,622 --> 01:46:46,792
HEALTH, AS WELL AS POPULATION

3081
01:46:46,792 --> 01:46:48,227
HEALTH.

3082
01:46:48,227 --> 01:46:49,862
AND THIS IS WHERE WE ARE NOW.

3083
01:46:49,862 --> 01:46:51,263
UNDER THE LEADERSHIP OF

3084
01:46:51,263 --> 01:46:53,933
BLACKWELLNESS AND PROSPERITY

3085
01:46:53,933 --> 01:46:55,768
CENTER, WE HAVE BUILT OUT A

3086
01:46:55,768 --> 01:46:57,469
LARGER ANEMIA COMMUNITY

3087
01:46:57,469 --> 01:46:59,772
LEADERSHIP GROUP, AND THEY HAVE

3088
01:46:59,772 --> 01:47:01,573
CREATED AND WE'VE CO-CREATED

3089
01:47:01,573 --> 01:47:04,643
INTERVIEW AND FOCUS GUIDES, AND

3090
01:47:04,643 --> 01:47:06,178
ULTIMATELY WE WILL -- THEY WILL

3091
01:47:06,178 --> 01:47:08,480
HELP US TO INFORM THE

3092
01:47:08,480 --> 01:47:09,014
PATIENT-CENTERED TOOLS.

3093
01:47:09,014 --> 01:47:11,583
RIGHT NOW ONE CHALLENGE IS WE'RE

3094
01:47:11,583 --> 01:47:13,686
STUCK WITHIN THE STANFORD IRB.

3095
01:47:13,686 --> 01:47:15,454
WE'VE WORKED A LOT ON PROJECT

3096
01:47:15,454 --> 01:47:17,156
TWO SORT OF IN TANDEM, SO THAT

3097
01:47:17,156 --> 01:47:18,257
WE'RE READY TO HIT THE ROAD AS

3098
01:47:18,257 --> 01:47:20,192
SOON AS WE GET THE FINAL IRB

3099
01:47:20,192 --> 01:47:21,460
APPROVAL, WHICH WE ARE EXPECTING

3100
01:47:21,460 --> 01:47:28,801
THIS WEEK.

3101
01:47:28,801 --> 01:47:30,002
THESE ARE MANY OF THE PEOPLE

3102
01:47:30,002 --> 01:47:32,171
INVOLVED AND NOT EVERYBODY ON

3103
01:47:32,171 --> 01:47:33,939
THE LEFT, YOU SEE BLACKWELLNESS

3104
01:47:33,939 --> 01:47:36,008
AND PROSPERITY CENTER LEADERSHIP

3105
01:47:36,008 --> 01:47:39,044
FOUNDED AND LED BY THE

3106
01:47:39,044 --> 01:47:42,147
INDOMITABLE CHANTE DAVIS BULCH

3107
01:47:42,147 --> 01:47:44,149
WHO IS PRESIDENT AND CEO AND HAS

3108
01:47:44,149 --> 01:47:45,117
DONE MANY GREAT THINGS

3109
01:47:45,117 --> 01:47:45,784
THROUGHOUT CALIFORNIA FOR THE

3110
01:47:45,784 --> 01:47:46,118
COMMUNITY.

3111
01:47:46,118 --> 01:47:48,354
ON THE RIGHT ARE SOME OF OUR

3112
01:47:48,354 --> 01:47:51,123
CLINICIAN LEADERS THROUGHOUT

3113
01:47:51,123 --> 01:47:52,291
CALIFORNIA AND OREGON WHO HAVE

3114
01:47:52,291 --> 01:47:53,392
BEEN PASSIONATE ABOUT WORKING

3115
01:47:53,392 --> 01:47:56,095
TOWARD ENDING ANEMIA AT BIRTH

3116
01:47:56,095 --> 01:47:58,731
ADMISSION FOR ACTUALLY WE'VE

3117
01:47:58,731 --> 01:47:59,698
BEEN GATHERING TOGETHER FOR MORE

3118
01:47:59,698 --> 01:48:04,303
THAN THREE YEARS NOW.

3119
01:48:04,303 --> 01:48:05,904
DR. IGBINOSA YOU SEE AND

3120
01:48:05,904 --> 01:48:07,206
DR. SUSAN PEREZ WHO YOU SAW

3121
01:48:07,206 --> 01:48:09,375
YESTERDAY, SHE'S WORKING WITH

3122
01:48:09,375 --> 01:48:10,576
THE NEW ORLEANS GROUP AS WELL

3123
01:48:10,576 --> 01:48:12,077
AND SHE'S LEADING OUR

3124
01:48:12,077 --> 01:48:12,544
QUALITATIVE WORK.

3125
01:48:12,544 --> 01:48:14,346
I KNOW THAT WE'RE LOW ON TIME.

3126
01:48:14,346 --> 01:48:15,948
I'VE ALREADY MENTIONED OUR AIMS

3127
01:48:15,948 --> 01:48:17,950
TWO AND THREE.

3128
01:48:17,950 --> 01:48:21,186
I JUST WANT TO END OR NEARLY END

3129
01:48:21,186 --> 01:48:23,789
COMMENTING ON OUR IMPLEMENTATION

3130
01:48:23,789 --> 01:48:24,690
FRAMEWORK.

3131
01:48:24,690 --> 01:48:27,092
THIS FRAMEWORK, IT'S REALLY

3132
01:48:27,092 --> 01:48:28,627
IMPORTANT BECAUSE WHEN YOU THINK

3133
01:48:28,627 --> 01:48:31,864
ABOUT HOW IN ADDITION TO

3134
01:48:31,864 --> 01:48:32,831
MOTIVATE THE THE COMMUNITY,

3135
01:48:32,831 --> 01:48:34,066
WE'RE ASKING A LOT OF OUR

3136
01:48:34,066 --> 01:48:37,002
PROVIDERS, SO WE'RE USING THE

3137
01:48:37,002 --> 01:48:38,037
COM-B MODEL THAT'S CAPABILITY,

3138
01:48:38,037 --> 01:48:38,804
OPPORTUNITY AND MOTIVATION.

3139
01:48:38,804 --> 01:48:40,773
THIS IS ESSENTIALLY A FRAMEWORK

3140
01:48:40,773 --> 01:48:44,476
FROM IMPLEMENTATION SCIENCE THAT

3141
01:48:44,476 --> 01:48:46,211
IDENTIFIES THREE CRUCIAL FACTORS

3142
01:48:46,211 --> 01:48:47,346
ABOVE THAT GOVERN BEHAVIOR AND

3143
01:48:47,346 --> 01:48:48,947
THAT REALLY NEED TO BE ADDRESSED

3144
01:48:48,947 --> 01:48:50,416
WHEN A NEW CLINICAL PRACTICE, IF

3145
01:48:50,416 --> 01:48:52,484
WE WANT TO BE FULLY IMPLEMENTED.

3146
01:48:52,484 --> 01:48:54,319
WE'RE ALSO USING THE BEHAVIOR

3147
01:48:54,319 --> 01:48:56,588
CHANGE WE'LL THAT BUILDS ON THE

3148
01:48:56,588 --> 01:48:57,923
COM-B FRAMEWORK AND THAT JUST

3149
01:48:57,923 --> 01:48:59,725
OFFERS A NUMBER OF DIFFERENT

3150
01:48:59,725 --> 01:49:02,361
SUGGESTIONS AND STRA STRATEGIES

3151
01:49:02,361 --> 01:49:04,430
THROUGH THE MULTITUDE OF

3152
01:49:04,430 --> 01:49:05,297
DIFFERENT CLINICS WE'LL BE

3153
01:49:05,297 --> 01:49:06,098
WORKING WITH IN ORDER TO MAKE

3154
01:49:06,098 --> 01:49:07,266
THIS CHANGE.

3155
01:49:07,266 --> 01:49:08,467
WE ALSO KIND OF ALWAYS CIRCLE

3156
01:49:08,467 --> 01:49:09,635
BACK TO THE WHY OF THIS PROBLEM,

3157
01:49:09,635 --> 01:49:11,570
WHY DOES IT MATTER, WHY IS IT

3158
01:49:11,570 --> 01:49:12,671
IMPORTANT, WHY SHOULD PROVIDERS

3159
01:49:12,671 --> 01:49:17,709
MAKE CHANGE?

3160
01:49:17,709 --> 01:49:18,677
FINALLY I JUST WANT TO

3161
01:49:18,677 --> 01:49:21,046
ACKNOWLEDGE THE REST OF OUR

3162
01:49:21,046 --> 01:49:22,281
CENTER, PROJECT 2 IS REDUCING

3163
01:49:22,281 --> 01:49:24,883
RACIAL INEQUITIES IN CESAREAN

3164
01:49:24,883 --> 01:49:29,221
BIRTH, THAT'S LED BY DR. ELLIOTT

3165
01:49:29,221 --> 01:49:30,956
MANE, WHO'S HERE.

3166
01:49:30,956 --> 01:49:32,257
WE KNOW CESAREAN IS A MAJOR

3167
01:49:32,257 --> 01:49:35,060
DRIVER OF POSTPARTUM HEMORRHAGE,

3168
01:49:35,060 --> 01:49:36,462
BLOOD TRANSFUSIONS AND

3169
01:49:36,462 --> 01:49:37,896
INEQUITIES IN SEVERE MATERNAL

3170
01:49:37,896 --> 01:49:38,564
MORBIDITIES.

3171
01:49:38,564 --> 01:49:42,000
WE'RE AIMED AT REDUCING CESAREAN

3172
01:49:42,000 --> 01:49:43,102
FURTHER BUT PARTICULARLY

3173
01:49:43,102 --> 01:49:44,970
REDUCING THOSE INEQUITIES, WHICH

3174
01:49:44,970 --> 01:49:46,872
WHILE CESAREAN HAS FALLEN, THE

3175
01:49:46,872 --> 01:49:48,107
EQUITY GAP HAS NOT AND WE'RE

3176
01:49:48,107 --> 01:49:49,641
REALLY DIGGING INTO WHY AND HOW

3177
01:49:49,641 --> 01:49:50,509
DO WE CHANGE THAT.

3178
01:49:50,509 --> 01:49:51,710
AS WELL AS A TRAINING COMPONENT

3179
01:49:51,710 --> 01:49:53,512
AND A COMMUNITY ENGAGEMENT AND

3180
01:49:53,512 --> 01:49:54,947
PARTNERSHIP IMOANT LED BY

3181
01:49:54,947 --> 01:49:56,181
DR. SUSAN CARMICHAEL WHO'S ALSO

3182
01:49:56,181 --> 01:49:56,448
HERE.

3183
01:49:56,448 --> 01:49:59,618
SHE'S ALSO A CO-PI OF THE ENTIRE

3184
01:49:59,618 --> 01:50:05,023
PROJECT WITH DR. YASSER

3185
01:50:05,023 --> 01:50:05,557
AL-SAYEK.

3186
01:50:05,557 --> 01:50:07,326
OUR TEAM IS GROWING ALL THE TIME

3187
01:50:07,326 --> 01:50:08,694
AND WE HAVE PEOPLE NOT REFLECTED

3188
01:50:08,694 --> 01:50:12,097
HERE, BUT WE WANT TO THANK THE

3189
01:50:12,097 --> 01:50:13,098
NIH, AND IMPROVE FOR THE

3190
01:50:13,098 --> 01:50:16,034
OPPORTUNITY TO REALLY WORK

3191
01:50:16,034 --> 01:50:18,170
TOWARD MAKING CHANGE IN SO MANY

3192
01:50:18,170 --> 01:50:19,138
DIFFERENT INCREDIBLE, IMPORTANT

3193
01:50:19,138 --> 01:50:20,172
AREAS THAT YOU'VE HEARD ABOUT

3194
01:50:20,172 --> 01:50:20,772
TODAY AND YESTERDAY.

3195
01:50:20,772 --> 01:50:21,907
THANK YOU.

3196
01:50:21,907 --> 01:50:27,913
[APPLAUSE]

3197
01:50:27,913 --> 01:50:29,281
>> FANTASTIC PRESENTATION.

3198
01:50:29,281 --> 01:50:29,848
THANK YOU SO MUCH.

3199
01:50:29,848 --> 01:50:31,783
LET'S OPEN IT UP FOR QUESTIONS.

3200
01:50:31,783 --> 01:50:33,418
I'M A LITTLE BLINDED HERE, BUT I

3201
01:50:33,418 --> 01:50:34,720
THINK I SEE SOMEONE MAKING THEIR

3202
01:50:34,720 --> 01:50:37,222
WAY TO A MICROPHONE.

3203
01:50:37,222 --> 01:50:37,990
COME ON DOWN!

3204
01:50:37,990 --> 01:50:39,591
YOU'RE THE FIRST CONTESTANT.

3205
01:50:39,591 --> 01:50:41,493
>> AND AS SHE'S COMING
DOWN, I

3206
01:50:41,493 --> 01:50:42,895
INVITE PEOPLE ON ZOOM TO PUT

3207
01:50:42,895 --> 01:50:44,563
INTO THE QA BOX IF YOU HAVE ANY

3208
01:50:44,563 --> 01:50:46,398
QUESTIONS AS WELL.

3209
01:50:46,398 --> 01:50:47,232
>> THANK YOU SO MUCH.

3210
01:50:47,232 --> 01:50:48,667
THIS IS FASCINATING WORK.

3211
01:50:48,667 --> 01:50:52,538
I REALLY APPRECIATE WHAT YOU'RE

3212
01:50:52,538 --> 01:50:53,005
DOING.

3213
01:50:53,005 --> 01:50:54,039
I WAS CURIOUS THAT YOU HAVE A

3214
01:50:54,039 --> 01:50:56,008
SLIDE WHERE IT'S SHOWING THE

3215
01:50:56,008 --> 01:51:01,647
DIFFERENCES IN BLOOD TRANSFUSION

3216
01:51:01,647 --> 01:51:03,482
AND HYSTERECTOMY AMONG THOSE WHO

3217
01:51:03,482 --> 01:51:05,184
ARE TREATED AND THEN THOSE

3218
01:51:05,184 --> 01:51:06,251
UNSUCCESSFULLY TREATED AND

3219
01:51:06,251 --> 01:51:07,319
UNTREATED, AND IT LOOKED LIKE

3220
01:51:07,319 --> 01:51:12,391
THE RISK OF THOSE TWO ARE HIGHER

3221
01:51:12,391 --> 01:51:14,927
IN THOSE WHO WERE UNSUCCESSFULLY

3222
01:51:14,927 --> 01:51:15,561
TREATED.

3223
01:51:15,561 --> 01:51:16,795
DO YOU HAVE ANY IDEA WHY THAT

3224
01:51:16,795 --> 01:51:16,962
IS?

3225
01:51:16,962 --> 01:51:17,462
>> THANK YOU.

3226
01:51:17,462 --> 01:51:20,232
SO I THINK THAT REFRACTORY GROUP

3227
01:51:20,232 --> 01:51:21,667
IS ALSO A WAY WE THINK ABOUT IT,

3228
01:51:21,667 --> 01:51:24,069
AND THERE'S A LOT OF DIFFERENT

3229
01:51:24,069 --> 01:51:25,304
HYPOTHESES, AND I THINK THAT

3230
01:51:25,304 --> 01:51:27,539
LOOKS INTO MORE OF THE SOCIAL

3231
01:51:27,539 --> 01:51:28,307
DETERMINANTS, LIKE WHERE WERE

3232
01:51:28,307 --> 01:51:31,043
THEY STARTING, LIKE THEIR

3233
01:51:31,043 --> 01:51:33,312
HEMOGLOBIN, SO WHAT IS THAT GAP

3234
01:51:33,312 --> 01:51:34,513
THAT YOU'RE TRYING TO ACHIEVE BY

3235
01:51:34,513 --> 01:51:35,714
THE TIME THAT THEY DELIVER?

3236
01:51:35,714 --> 01:51:36,949
SO I THINK A KEY THING ABOUT

3237
01:51:36,949 --> 01:51:38,951
THAT STUDY IS THAT THEY ONLY USE

3238
01:51:38,951 --> 01:51:41,453
ORAL IRON, AND THERE'S SO MANY

3239
01:51:41,453 --> 01:51:43,422
OTHER TOOLS AVAILABLE, AND ARE

3240
01:51:43,422 --> 01:51:45,724
THOSE PATIENTS -- WOULD THEY

3241
01:51:45,724 --> 01:51:47,259
HAVE BEEN BETTER OFF IF THEY

3242
01:51:47,259 --> 01:51:48,460
RECEIVED I.V. IRON?

3243
01:51:48,460 --> 01:51:50,295
ESPECIALLY IF THEY HAD SIDE

3244
01:51:50,295 --> 01:51:51,697
EFFECTS, ET CETERA, SO SOME OF

3245
01:51:51,697 --> 01:51:53,432
OUR FOCUS GROUPS THAT WE'VE DONE

3246
01:51:53,432 --> 01:51:55,500
WITH BLACKWELLNESS AND

3247
01:51:55,500 --> 01:51:56,802
PROSPERITY HAS REALLY POINTED

3248
01:51:56,802 --> 01:51:58,971
OUT, WELL, THEY SAY I WILL HAVE

3249
01:51:58,971 --> 01:52:00,005
DIFFICULTY TAKING THE STANDARD

3250
01:52:00,005 --> 01:52:02,474
OF CARE, WHICH IS ORAL IRON, BUT

3251
01:52:02,474 --> 01:52:03,442
AN ALTERNATIVE OPTION IS NOT

3252
01:52:03,442 --> 01:52:03,809
PROVIDED.

3253
01:52:03,809 --> 01:52:07,679
SO I THINK -- AND THAT

3254
01:52:07,679 --> 01:52:09,014
REFRACTORY GROUP WAS MOSTLY

3255
01:52:09,014 --> 01:52:10,616
UNDER URM, SO I THINK THERE'S

3256
01:52:10,616 --> 01:52:12,718
OTHER OPPORTUNITIES FOR US WHEN

3257
01:52:12,718 --> 01:52:13,485
DEVELOPING THIS TOOLKIT.

3258
01:52:13,485 --> 01:52:14,086
>> THANK YOU.

3259
01:52:14,086 --> 01:52:15,554
THAT'S VERY HELPFUL.

3260
01:52:15,554 --> 01:52:15,954
>> EXCELLENT.

3261
01:52:15,954 --> 01:52:19,324
WE HAVE TIME FOR ONE MORE QUICK

3262
01:52:19,324 --> 01:52:19,925
QUESTION.

3263
01:52:19,925 --> 01:52:22,694
>> JUST WANTED TO ASK A
QUICK

3264
01:52:22,694 --> 01:52:23,695
QUESTION ABOUT THE C-SECTION

3265
01:52:23,695 --> 01:52:24,896
PROJECT BECAUSE RELI THE LEADERS

3266
01:52:24,896 --> 01:52:28,233
IN THAT FIELD, C-SECTION IN

3267
01:52:28,233 --> 01:52:29,001
NEW YORK STATE IS HIGH.

3268
01:52:29,001 --> 01:52:32,037
ARE YOU FOCUSING ON MTSB, WHAT

3269
01:52:32,037 --> 01:52:33,772
ARE YOU FOCUSING ON IN THAT

3270
01:52:33,772 --> 01:52:34,473
PROJECT?

3271
01:52:34,473 --> 01:52:42,014
JUST CURIOUS.

3272
01:52:42,014 --> 01:52:47,185
>> YOU LEADI LEAD THE
C-SECTION.

3273
01:52:47,185 --> 01:52:49,054
WE'RE WORKING WITH A VARIETY OF

3274
01:52:49,054 --> 01:52:50,355
COMMUNITY GROUPS TO IDENTIFY --

3275
01:52:50,355 --> 01:52:51,623
WE HAVE HOSPITALS IN CALIFORNIA

3276
01:52:51,623 --> 01:52:53,725
THAT HAVE DONE VERY WELL WITH

3277
01:52:53,725 --> 01:52:55,460
C-SECTION AND VERY WELL WITH

3278
01:52:55,460 --> 01:52:57,329
BLACK BIRTHING PERSON C-SECTIONS

3279
01:52:57,329 --> 01:53:00,032
AND OTHERS THAT HAVE VERY HIGH

3280
01:53:00,032 --> 01:53:03,435
RATES -- AND THERE'S NO

3281
01:53:03,435 --> 01:53:04,836
DIFFERENCE IN THEIR SOCIAL

3282
01:53:04,836 --> 01:53:05,704
DETERMINANTS, MEDICAL

3283
01:53:05,704 --> 01:53:07,105
COMPLICATION RATES AND SO FORTH,

3284
01:53:07,105 --> 01:53:08,440
SO THAT KIND OF VARIATION IS

3285
01:53:08,440 --> 01:53:11,977
REALLY A OPPORTUNITY TO

3286
01:53:11,977 --> 01:53:14,212
INVESTIGATE WHY, WHY DO SOME

3287
01:53:14,212 --> 01:53:15,547
HOSPITALS DO WELL, SOME

3288
01:53:15,547 --> 01:53:16,615
COMMUNITIES DO WELL AND OTHERS

3289
01:53:16,615 --> 01:53:16,848
DO NOT.

3290
01:53:16,848 --> 01:53:17,916
SO WE'RE IN THE MIDDLE OF THAT

3291
01:53:17,916 --> 01:53:19,351
RIGHT NOW, AND THAT'S GOING TO

3292
01:53:19,351 --> 01:53:22,354
LEAD US TO HAVE EXEMPLARS AND TO

3293
01:53:22,354 --> 01:53:24,022
HAVE LEARNINGS THAT WE CAN

3294
01:53:24,022 --> 01:53:26,625
SPREAD TO THE REST OF THE STATE.

3295
01:53:26,625 --> 01:53:28,126
WE FOLLOW THAT WITH THE DATA

3296
01:53:28,126 --> 01:53:32,397
CENTER ON A MONTHLY BASIS, SO

3297
01:53:32,397 --> 01:53:33,598
STRATIFIED BY RACE AND

3298
01:53:33,598 --> 01:53:35,233
ETHNICITY.

3299
01:53:35,233 --> 01:53:36,968
AND WE HAVE A WHOLE SERIES OF

3300
01:53:36,968 --> 01:53:40,472
TOOLS THAT WE'VE DEVELOPED TO

3301
01:53:40,472 --> 01:53:43,675
ADDRESS SOME OF THE STRUCTURAL

3302
01:53:43,675 --> 01:53:44,810
ISSUES IN HOSPITALS SUCH AS THE

3303
01:53:44,810 --> 01:53:46,111
CULTURE, WHICH IS PROBABLY THE

3304
01:53:46,111 --> 01:53:47,512
BIGGEST DRIVER IN THE HOSPITAL

3305
01:53:47,512 --> 01:53:50,582
FOR DIFFERENTIAL RATES OF

3306
01:53:50,582 --> 01:53:55,354
C-SECTION, AND BASICALLY, FOR

3307
01:53:55,354 --> 01:53:58,790
EXAMPLE, A TOOL THAT'S A

3308
01:53:58,790 --> 01:54:01,159
COMMITMENT DOCUMENT THAT ALL THE

3309
01:54:01,159 --> 01:54:02,694
STAFF, THE NURSES AND PHYSICIANS

3310
01:54:02,694 --> 01:54:05,530
COMMIT TO HOW YOU TREAT THEM.

3311
01:54:05,530 --> 01:54:06,732
NEW YORK STATE IS DOING

3312
01:54:06,732 --> 01:54:08,700
SOMETHING LIKE THIS AS WELL, BUT

3313
01:54:08,700 --> 01:54:10,202
THIS IS REALLY A VERY PERSONAL

3314
01:54:10,202 --> 01:54:11,303
DOCUMENT THAT'S POSTED ON THE

3315
01:54:11,303 --> 01:54:13,572
WALL AND IS SIGNED OFF BY EVERY

3316
01:54:13,572 --> 01:54:14,139
PHYSICIAN AND NURSE IN THE

3317
01:54:14,139 --> 01:54:15,040
HOSPITAL.

3318
01:54:15,040 --> 01:54:15,874
SO THOSE ARE SOME OF THE

3319
01:54:15,874 --> 01:54:16,842
INTERVENTIONS THAT WE'RE LOOKING

3320
01:54:16,842 --> 01:54:18,377
AT.

3321
01:54:18,377 --> 01:54:20,545
>> FANTASTIC.

3322
01:54:20,545 --> 01:54:22,481
LET'S THANK AN AWESOME

3323
01:54:22,481 --> 01:54:26,852
PRESENTATION FROM DRS. IGBINOSA

3324
01:54:26,852 --> 01:54:27,319
AND LYELL.

3325
01:54:27,319 --> 01:54:28,920
[APPLAUSE]

3326
01:54:28,920 --> 01:54:39,331
CHRISTINE, COME ON DOWN.

3327
01:55:02,454 --> 01:55:04,689
SO LET ME INTRODUCE CHRISTINE

3328
01:55:04,689 --> 01:55:06,391
GARNER FROM TEXAS TECH

3329
01:55:06,391 --> 01:55:07,492
UNIVERSITY WHO IS WORKING WITH

3330
01:55:07,492 --> 01:55:09,995
ONE OF THE IMPROVE CIP PROGRAMS.

3331
01:55:09,995 --> 01:55:10,629
CHRISTINE, PLEASE TAKE IT AWAY.

3332
01:55:10,629 --> 01:55:11,530
>> THANK YOU VERY MUCH.

3333
01:55:11,530 --> 01:55:13,265
FIRST LET ME SAY, IT IS TRULY A

3334
01:55:13,265 --> 01:55:15,867
PRIVILEGE TO BE HERE AT THE NIH

3335
01:55:15,867 --> 01:55:17,402
WITH ALL OF YOU WHO ARE DOING

3336
01:55:17,402 --> 01:55:21,473
SUCH WONDERFUL WORK TO IMPROVE

3337
01:55:21,473 --> 01:55:23,942
MATERNAL HEALTH IN THIS NATION.

3338
01:55:23,942 --> 01:55:24,476
IT'S GREAT TO BE HERE.

3339
01:55:24,476 --> 01:55:34,085
THANK YOU FOR THE OPPORTUNITY.

3340
01:55:34,085 --> 01:55:36,388
SO I AM AN ASSISTANT PROFESSOR

3341
01:55:36,388 --> 01:55:38,223
AT TEXAS TECH UNIVERSITY HEALTH

3342
01:55:38,223 --> 01:55:39,691
SCIENCES CENTER IN THE

3343
01:55:39,691 --> 01:55:41,059
DEPARTMENT OF OBSTETRICS AND

3344
01:55:41,059 --> 01:55:43,328
GYNECOLOGY.

3345
01:55:43,328 --> 01:55:44,896
AND I AM THE PRINCIPAL

3346
01:55:44,896 --> 01:55:49,134
INVESTIGATOR FOR THE VIBRANT

3347
01:55:49,134 --> 01:55:51,870
MOMS COALITION, WHICH IS THE

3348
01:55:51,870 --> 01:55:53,505
IMPROVE GROUP IN THE STATE OF

3349
01:55:53,505 --> 01:55:54,239
TEXAS.

3350
01:55:54,239 --> 01:55:58,176
AND WE HAVE DECIDED AS A

3351
01:55:58,176 --> 01:56:00,712
COALITION TO WORK ON ADDRESSING

3352
01:56:00,712 --> 01:56:03,415
PRE-ECLAMPSIA IN OUR REGION.

3353
01:56:03,415 --> 01:56:04,950
I HAVE NO CONFLICTS OF INTEREST.

3354
01:56:04,950 --> 01:56:06,017
I DO HAVE FUNDING SOURCES

3355
01:56:06,017 --> 01:56:10,489
THROUGH THE IMPROVE PROGRAM.

3356
01:56:10,489 --> 01:56:11,790
AND NIMHD.

3357
01:56:11,790 --> 01:56:14,426
AND BEFORE I REALLY GET INTO

3358
01:56:14,426 --> 01:56:15,627
PRE-ECLAMPSIA, I WOULD LIKE TO

3359
01:56:15,627 --> 01:56:21,433
RECOGNIZE MY FANTASTIC TEAM FOR

3360
01:56:21,433 --> 01:56:23,068
VIBRANT MOMS.

3361
01:56:23,068 --> 01:56:24,903
DR. JULIE ST. JOHN, WHO WAS ON

3362
01:56:24,903 --> 01:56:28,173
THE PANEL YESTERDAY, AND

3363
01:56:28,173 --> 01:56:31,576
DR. STEPHANIE STROEVER WHO'S NOT

3364
01:56:31,576 --> 01:56:33,979
HERE AND OUR COMMUNITY LEADS ARE

3365
01:56:33,979 --> 01:56:36,281
JUST INCREDIBLE.

3366
01:56:36,281 --> 01:56:41,753
CASIE STOUGHTON AND CINDI WYNIA

3367
01:56:41,753 --> 01:56:42,587
WITH AMARILLO PUBLIC HEALTH.

3368
01:56:42,587 --> 01:56:45,056
WE HAVE TWO COALITION CO-CHAIRS,

3369
01:56:45,056 --> 01:56:45,857
SEVERAL OTHER KEY PERSONNEL WITH

3370
01:56:45,857 --> 01:56:49,694
A VARIETY OF BACKGROUND AND

3371
01:56:49,694 --> 01:56:54,065
EXPERIENCE, AND SOME STUDENTS.

3372
01:56:54,065 --> 01:56:55,901
SO WE'LL START WITH A LITTLE BIT

3373
01:56:55,901 --> 01:56:58,303
ABOUT WHAT PRE-ECLAMPSIA IS,

3374
01:56:58,303 --> 01:57:02,007
PREVALENCE, AND PREVENTION,

3375
01:57:02,007 --> 01:57:02,541
SCREENING, BLOOD PRESSURE

3376
01:57:02,541 --> 01:57:03,074
MANAGEMENT AND SOME

3377
01:57:03,074 --> 01:57:05,143
CONSIDERATIONS FOR

3378
01:57:05,143 --> 01:57:09,848
IMPLEMENTATION OF THESE

3379
01:57:09,848 --> 01:57:10,715
PREVENTION AND SCREENING

3380
01:57:10,715 --> 01:57:20,125
RECOMMENDATIONS.

3381
01:57:20,125 --> 01:57:21,793
SO FIRST, WHAT IS PRE-ECLAMPSIA?

3382
01:57:21,793 --> 01:57:24,796
IT IS THE -- WORLDWIDE, IT IS

3383
01:57:24,796 --> 01:57:26,231
THE SECOND LEADING CAUSE OF

3384
01:57:26,231 --> 01:57:28,199
MATERNAL MORTALITY AND

3385
01:57:28,199 --> 01:57:31,503
MORBIDITY, AND IN THE U.S., 4%

3386
01:57:31,503 --> 01:57:33,939
OF PREGNANCIES ARE AFFECTED BY

3387
01:57:33,939 --> 01:57:35,106
PRE-ECLAMPSIA.

3388
01:57:35,106 --> 01:57:38,243
IT'S CHARACTERIZED BY NEW ONSET

3389
01:57:38,243 --> 01:57:39,744
OF HYPERTENSION DURING

3390
01:57:39,744 --> 01:57:43,982
PREGNANCY, AND IT'S A

3391
01:57:43,982 --> 01:57:44,749
HYPERTENSIVE DISORDER OF

3392
01:57:44,749 --> 01:57:47,619
PREGNANCY, AND IT AFFECTS

3393
01:57:47,619 --> 01:57:51,823
MULTIPLE SYSTEMS IN THE BODY,

3394
01:57:51,823 --> 01:57:52,924
WITH INFLAMMATION.

3395
01:57:52,924 --> 01:57:54,793
IT CAN BE VERY SEVERE.

3396
01:57:54,793 --> 01:57:57,095
CONSEQUENCES FOR THE MOTHER

3397
01:57:57,095 --> 01:58:00,098
INCLUDE CESAREAN DELIVERY,

3398
01:58:00,098 --> 01:58:01,866
STROKE, ECLAMPSIA, WHICH IS THE

3399
01:58:01,866 --> 01:58:03,101
SEVEREST FORM OF PRE-ECLAMPSIA

3400
01:58:03,101 --> 01:58:06,538
THAT OCCURS WITH SEIZURE, ORGAN

3401
01:58:06,538 --> 01:58:08,406
FAILURE, PRETERM BIRTH,

3402
01:58:08,406 --> 01:58:09,507
INTRAUTERINE GROWTH FAILURE FOR

3403
01:58:09,507 --> 01:58:11,576
THE INFANT, LOW BIRTH WEIGHT AND

3404
01:58:11,576 --> 01:58:14,145
STILLBIRTH.

3405
01:58:14,145 --> 01:58:15,814
SO THERE ARE REALLY SUBSTANTIAL

3406
01:58:15,814 --> 01:58:20,051
CONSEQUENCES TO THIS.

3407
01:58:20,051 --> 01:58:22,354
THE EXACT PATHOPHYSIOLOGY OF

3408
01:58:22,354 --> 01:58:24,022
PRE-ECLAMPSIA REMAINS SOMEWHAT

3409
01:58:24,022 --> 01:58:27,792
ILL LOU SIEVE, BUT THERE HAS

3410
01:58:27,792 --> 01:58:28,560
ELUSIVE, BUT THERE HAS BEEN A

3411
01:58:28,560 --> 01:58:29,761
LOT OF RESEARCH IN THIS AREA TO

3412
01:58:29,761 --> 01:58:31,363
TRY TO FIGURE OUT WHAT THIS IS

3413
01:58:31,363 --> 01:58:33,798
ALL ABOUT.

3414
01:58:33,798 --> 01:58:35,533
SO WHAT THEY FIGURED OUT IS THAT

3415
01:58:35,533 --> 01:58:41,306
THERE'S SOMETHING ABNORMAL WITH

3416
01:58:41,306 --> 01:58:42,307
THE PRESENTATION THAT'S HAPPENS

3417
01:58:42,307 --> 01:58:44,943
AND IT'S PROPOSED THAT SOME --

3418
01:58:44,943 --> 01:58:48,380
THAT THE TROPHOBLAST IS NOT

3419
01:58:48,380 --> 01:58:50,915
EMBEDDING INTO THE UTERINE WALL

3420
01:58:50,915 --> 01:58:54,519
PROPERLY AND SO THE BLOOD

3421
01:58:54,519 --> 01:58:56,721
PERFUSION IS RATHER POOR, WHICH

3422
01:58:56,721 --> 01:59:00,425
RESULTS IN PLACENTAL FACTORS

3423
01:59:00,425 --> 01:59:02,060
BEING CREATED THAT GOES OUT INTO

3424
01:59:02,060 --> 01:59:07,065
THE BLOODSTREAM, AND CAUSING

3425
01:59:07,065 --> 01:59:08,500
SYSTEMIC ENDOTHELIAL DYSFUNCTION

3426
01:59:08,500 --> 01:59:13,638
AND SYSTEMIC VASCULAR PROBLEMS.

3427
01:59:13,638 --> 01:59:14,973
UNFORTUNATELY THERE ARE NO

3428
01:59:14,973 --> 01:59:16,508
PREDICTIVE TESTS FOR

3429
01:59:16,508 --> 01:59:17,876
PREECLAMPSIA, AT LEAST NOT YET.

3430
01:59:17,876 --> 01:59:19,878
THEY'RE MAKING SOME PROGRESS IN

3431
01:59:19,878 --> 01:59:25,116
IDENTIFYING SOME POTENTIAL

3432
01:59:25,116 --> 01:59:28,486
FACTORS LIKE SFLT 1 THAT MAY

3433
01:59:28,486 --> 01:59:33,091
PREDIPREDICT SEVERITY OF

3434
01:59:33,091 --> 01:59:35,360
PRE-ECLAMPSIA BUT IT DOES NOT

3435
01:59:35,360 --> 01:59:37,328
PREDICT WHO WILL GET

3436
01:59:37,328 --> 01:59:37,896
PRE-ECLAMPSIA.

3437
01:59:37,896 --> 01:59:39,197
IT'S REALLY UNPREDICTABLE.

3438
01:59:39,197 --> 01:59:40,799
SOMEONE MAY HAVE GESTATIONAL

3439
01:59:40,799 --> 01:59:42,000
HYPERTENSION THROUGHOUT

3440
01:59:42,000 --> 01:59:43,768
PREGNANCY AND IT REMAINS SORT OF

3441
01:59:43,768 --> 01:59:47,038
STABLE, AND OTHERS MAY RAPIDLY

3442
01:59:47,038 --> 01:59:49,007
WORSEN, RESULTING IN SEVERE

3443
01:59:49,007 --> 01:59:50,075
HEALTH CONSEQUENCES FOR BOTH THE

3444
01:59:50,075 --> 01:59:53,912
MOTHER AND INFANT.

3445
01:59:53,912 --> 01:59:55,580
ADDITIONALLY, IT CAN EVEN OCCUR

3446
01:59:55,580 --> 01:59:56,081
POSTPARTUM.

3447
01:59:56,081 --> 01:59:57,716
SO SOMEONE MAY NOT HAVE SYMPTOMS

3448
01:59:57,716 --> 01:59:58,683
OF PREECLAMPSIA DURING

3449
01:59:58,683 --> 02:00:02,287
PREGNANCY, BUT THEN IN THE FIRST

3450
02:00:02,287 --> 02:00:05,890
ESPECIALLY 7 TO 10 DAYS AFTER

3451
02:00:05,890 --> 02:00:08,760
DELIVERY, THEY MAY DEVELOP

3452
02:00:08,760 --> 02:00:11,830
PRE-ECLAMPSIA.

3453
02:00:11,830 --> 02:00:14,132
SO GESTATIONAL HYPERTENSION IS

3454
02:00:14,132 --> 02:00:15,500
SOMETHING NOT TO BE IGNORED

3455
02:00:15,500 --> 02:00:17,669
DURING PREGNANCY.

3456
02:00:17,669 --> 02:00:19,571
IT'S DIAGNOSED WITH SYSTOLIC

3457
02:00:19,571 --> 02:00:21,473
BLOOD PRESSURE OF GREATER THAN

3458
02:00:21,473 --> 02:00:24,542
140 AND DIASTOLIC GREATER THAN

3459
02:00:24,542 --> 02:00:24,709
90.

3460
02:00:24,709 --> 02:00:26,845
PRE-ECLAMPSIA IS THAT

3461
02:00:26,845 --> 02:00:28,580
HYPERTENSION ALONG WITH ANOTHER

3462
02:00:28,580 --> 02:00:30,448
SYMPTOM OF ORGAN DYSFUNCTION,

3463
02:00:30,448 --> 02:00:35,553
AND THOSE INCLUDE PROTEINURIA,

3464
02:00:35,553 --> 02:00:36,554
THROMBOCYTOPENIA, RENAL

3465
02:00:36,554 --> 02:00:37,856
INSUFFICIENCY, IMPAIRED LIVER

3466
02:00:37,856 --> 02:00:39,591
FUNCTION, PULMONARY EDEMA, AND

3467
02:00:39,591 --> 02:00:41,326
CEREBRAL OR VISUAL SYMPTOMS, AND

3468
02:00:41,326 --> 02:00:43,328
THEN SEVERE PRE-ECLAMPSIA IS

3469
02:00:43,328 --> 02:00:45,163
WHEN THAT HYPERTENSION IS

3470
02:00:45,163 --> 02:00:47,332
HIGHER.

3471
02:00:47,332 --> 02:00:50,935
SO EXCEEDING 160 SYSTOLIC OR 110

3472
02:00:50,935 --> 02:00:52,036
DIASTOLIC, ALONG WITH ANOTHER

3473
02:00:52,036 --> 02:00:54,105
ONE OF THOSE SYMPTOMS.

3474
02:00:54,105 --> 02:00:57,375
SO OVER THE PAST 20 YEARS,

3475
02:00:57,375 --> 02:00:58,143
HYPERTENSIVE DISORDERS OF

3476
02:00:58,143 --> 02:01:01,412
PREGNANCY HAVE INCREASED PRETTY

3477
02:01:01,412 --> 02:01:02,447
SUBSTANTIALLY.

3478
02:01:02,447 --> 02:01:03,948
SO ON THE LEFT FIGURE, IN THE

3479
02:01:03,948 --> 02:01:08,086
BLUE LINE, WE SEE THE -- WE SEE

3480
02:01:08,086 --> 02:01:11,256
INCREASES IN CHRONIC

3481
02:01:11,256 --> 02:01:13,691
HYPERTENSION OVER THE PAST 20

3482
02:01:13,691 --> 02:01:15,059
YEARS, AND IN THAT BLACK LINE

3483
02:01:15,059 --> 02:01:18,029
ABOVE IT, THAT'S THE PREVALENCE

3484
02:01:18,029 --> 02:01:20,265
OF HYPERTENSIVE DISORDERS OF

3485
02:01:20,265 --> 02:01:22,801
PREGNANCY.

3486
02:01:22,801 --> 02:01:27,739
SO ON AN ANNUAL AVERAGE BASIS,

3487
02:01:27,739 --> 02:01:28,740
HYPERTENSIVE DISORDERS OF

3488
02:01:28,740 --> 02:01:31,209
PREGNANCY HAVE INCREASED 4.1%

3489
02:01:31,209 --> 02:01:34,813
PER YEAR OVER THE PAST 20 YEARS.

3490
02:01:34,813 --> 02:01:36,347
A LITTLE GOOD NEWS IS THAT

3491
02:01:36,347 --> 02:01:38,349
ECLAMPSIA HAS DECREASED OVER

3492
02:01:38,349 --> 02:01:41,486
THIS TIME, PROBABLY BECAUSE

3493
02:01:41,486 --> 02:01:43,021
WE'RE IDENTIFYING PRE-ECLAMPSIA

3494
02:01:43,021 --> 02:01:44,756
AND POSSIBLY MANAGING IT BET E

3495
02:01:44,756 --> 02:01:47,725
BUT WE STILL HAVE A VERY LARGE

3496
02:01:47,725 --> 02:01:51,462
INCREASE IN PRE-ECLAMPSIA.

3497
02:01:51,462 --> 02:01:54,966
SO THERE ARE NUMEROUS RISK

3498
02:01:54,966 --> 02:01:58,036
FACTORS FOR PRE-ECLAMPSIA, AND

3499
02:01:58,036 --> 02:01:59,971
I'M NOT GOING TO STATE THEM ALL,

3500
02:01:59,971 --> 02:02:04,475
BUT I THINK IT'S IMPORTANT THAT

3501
02:02:04,475 --> 02:02:07,478
ACOG IN THEIR PRACTICE BULLETIN

3502
02:02:07,478 --> 02:02:11,015
ABOUT GESTATIONAL HYPERTENSIVE

3503
02:02:11,015 --> 02:02:11,883
DISORDERS STATES THAT IT'S

3504
02:02:11,883 --> 02:02:13,751
IMPORTANT TO REMEMBER THAT MOST

3505
02:02:13,751 --> 02:02:17,922
CASES OF PRE-ECLAMPSIA OCCUR IN

3506
02:02:17,922 --> 02:02:23,795
HEALTHY NULLIPARIS WOMEN WITH NO

3507
02:02:23,795 --> 02:02:25,196
OBVIOUS RISK FACTORS.

3508
02:02:25,196 --> 02:02:26,931
SO WHILE THERE ARE MANY RISK

3509
02:02:26,931 --> 02:02:29,667
FACTORS, THEY AREN'T NECESSARY

3510
02:02:29,667 --> 02:02:30,869
TO DEVELOP PRE-ECLAMPSIA.

3511
02:02:30,869 --> 02:02:31,836
HERE ARE SOME OF THE WARNING

3512
02:02:31,836 --> 02:02:32,537
SIGNS.

3513
02:02:32,537 --> 02:02:33,805
THIS IS AN INFOGRAPHIC PUT OUT

3514
02:02:33,805 --> 02:02:34,472
BY ACOG.

3515
02:02:34,472 --> 02:02:36,107
AND IF A PATIENT EXPERIENCES ANY

3516
02:02:36,107 --> 02:02:39,110
OF THESE THINGS DURING

3517
02:02:39,110 --> 02:02:40,678
PREGNANCY, THEY SHOULD

3518
02:02:40,678 --> 02:02:42,380
IMMEDIATELY CONTACT THEIR

3519
02:02:42,380 --> 02:02:50,188
PHYSICIAN AND SEEK MEDICAL HELP.

3520
02:02:50,188 --> 02:02:51,289
GOOD NEWS IS THAT PRE-ECLAMPSIA

3521
02:02:51,289 --> 02:02:54,926
MAY BE PREVENTED WITH USE OF

3522
02:02:54,926 --> 02:02:55,693
LOW-DOSE ASPIRIN DURING

3523
02:02:55,693 --> 02:02:57,228
PREGNANCY.

3524
02:02:57,228 --> 02:02:59,397
SO IN 2021, THE U.S. PREVENTIVE

3525
02:02:59,397 --> 02:03:01,900
SERVICES TASK FORCE PUBLISHED A

3526
02:03:01,900 --> 02:03:04,869
RECOMMENDATION FOR USE OF

3527
02:03:04,869 --> 02:03:07,138
81 MILLIGRAMS OF ASPIRIN DAILY

3528
02:03:07,138 --> 02:03:09,574
STARTING AFTER 12 WEEKS OF

3529
02:03:09,574 --> 02:03:10,308
PREGNANCY TO PREVENT

3530
02:03:10,308 --> 02:03:13,578
PRE-ECLAMPSIA.

3531
02:03:13,578 --> 02:03:17,215
EVIDENCE ALSO SUGGESTS THAT

3532
02:03:17,215 --> 02:03:18,116
LOW-DOSE ASPIRIN SHOULD

3533
02:03:18,116 --> 02:03:19,350
POTENTIALLY BE STARTED BEFORE 16

3534
02:03:19,350 --> 02:03:20,818
WEEKS TO BE THE MOST EFFECTIVE.

3535
02:03:20,818 --> 02:03:22,120
THIS ISN'T PART OF THEIR

3536
02:03:22,120 --> 02:03:23,021
RECOMMENDATION YET.

3537
02:03:23,021 --> 02:03:25,089
AND RESEARCH IS ONGOING TO

3538
02:03:25,089 --> 02:03:27,158
EXAMINE EFFICACY OF DIFFERENT

3539
02:03:27,158 --> 02:03:28,993
DOSES OF ASPIRIN, AS WELL AS

3540
02:03:28,993 --> 02:03:31,429
VARIATIONS IN TIMING AND

3541
02:03:31,429 --> 02:03:37,101
DURATION OF ASPIRIN USE.

3542
02:03:37,101 --> 02:03:39,504
SO LOW-DOSE ASPIRIN INHIBITS THE

3543
02:03:39,504 --> 02:03:41,105
COX-1 ENZYME, I'M NOT GOING TO

3544
02:03:41,105 --> 02:03:42,640
GO INTO DETAIL ON THIS, BUT IT

3545
02:03:42,640 --> 02:03:47,979
INHIBITS THE COX-1 ENZYME WHICH

3546
02:03:47,979 --> 02:03:57,588
LEADS TO A REDUCTION IN

3547
02:03:57,588 --> 02:03:59,691
THROMBOXANE A2, IT REDUCES

3548
02:03:59,691 --> 02:04:00,758
PLATELET PRODUCTION AND

3549
02:04:00,758 --> 02:04:01,960
AGGREGATION, IT DECREASES

3550
02:04:01,960 --> 02:04:04,696
INFLAMMATION AND MAY HELP WITH

3551
02:04:04,696 --> 02:04:11,469
ENDOTHELIAL FUNCTION.

3552
02:04:11,469 --> 02:04:13,571
SO LOW-DOSE ASPIRIN IS

3553
02:04:13,571 --> 02:04:15,740
RECOMMENDED FOR ANYONE WITH ONE

3554
02:04:15,740 --> 02:04:19,344
HIGH LEVEL RISK FACTOR OR TWO OR

3555
02:04:19,344 --> 02:04:21,312
MORE MODERATE RISK FACTOR.

3556
02:04:21,312 --> 02:04:25,350
SO HIGH LEVEL RISK FACTORS FOR

3557
02:04:25,350 --> 02:04:26,884
PRE-ECLAMPSIA INCLUDE A PREVIOUS

3558
02:04:26,884 --> 02:04:29,620
HISTORY OF PRE-ECLAMPSIA,

3559
02:04:29,620 --> 02:04:30,588
MULTI-FETAL GESTATION, SO TWINS

3560
02:04:30,588 --> 02:04:33,224
OR TRIPLETS, CHRONIC

3561
02:04:33,224 --> 02:04:35,393
HYPERTENSION, HAVING TYPE 1 OR

3562
02:04:35,393 --> 02:04:37,362
TYPE 2 DIABETES, KIDNEY DISEASE

3563
02:04:37,362 --> 02:04:38,997
OR AN AUTOIMMUNE DISEASE.

3564
02:04:38,997 --> 02:04:42,600
SO ANY OF THOSE THINGS, IF YOU

3565
02:04:42,600 --> 02:04:43,701
ENTER PREGNANCY WITH ANY OF

3566
02:04:43,701 --> 02:04:46,404
THOSE THINGS, YOU SHOULD BE

3567
02:04:46,404 --> 02:04:47,538
TAKING LOW-DOSE ASPIRIN AFTER 12

3568
02:04:47,538 --> 02:04:49,907
WEEKS OF PREGNANCY.

3569
02:04:49,907 --> 02:04:51,776
MODERATE RISK FACTORS INCLUDE

3570
02:04:51,776 --> 02:04:56,347
OBESITY, FAMILY HISTORY OF

3571
02:04:56,347 --> 02:04:57,115
PRE-ECLAMPSIA, BLACK INDIVIDUALS

3572
02:04:57,115 --> 02:05:00,952
AND INDIVIDUALS WITH LOW INCOME,

3573
02:05:00,952 --> 02:05:03,154
THOSE ARE RISK FACTORS, AS WELL

3574
02:05:03,154 --> 02:05:08,693
AS BEING OVER THE AGE OF 35.

3575
02:05:08,693 --> 02:05:10,428
SO -- OH, AND A PREVIOUS ADVERSE

3576
02:05:10,428 --> 02:05:11,129
PREGNANCY OUT COME.

3577
02:05:11,129 --> 02:05:14,465
SO YOU CAN IMAGINE THAT THERE

3578
02:05:14,465 --> 02:05:20,972
ARE LOTS OF PEOPLE WHO MAY

3579
02:05:20,972 --> 02:05:22,673
BENEFIT FROM TAKING LOW-DOSE

3580
02:05:22,673 --> 02:05:27,178
ASPIRIN DURING PREGNANCY.

3581
02:05:27,178 --> 02:05:31,482
SO IN THINKING ABOUT WHO MAY BE

3582
02:05:31,482 --> 02:05:32,617
AT RISK FOR PRE-ECLAMPSIA AND

3583
02:05:32,617 --> 02:05:36,320
HOW THOSE PEOPLE MAY LEARN ABOUT

3584
02:05:36,320 --> 02:05:41,125
THEIR RISK FOR PRE-ECLAMPSIA OR

3585
02:05:41,125 --> 02:05:49,233
LEARN ABOUT LOW-DOSE ASPIRIN,

3586
02:05:49,233 --> 02:05:50,435
WE'VE SEEN A COUPLE TIMES WITHIN

3587
02:05:50,435 --> 02:05:51,869
THE LAST DAY AND A HALF, BUT

3588
02:05:51,869 --> 02:05:53,805
THIS IS IMPORTANT BECAUSE IF

3589
02:05:53,805 --> 02:05:55,640
THEY'RE NOT ABLE TO ACCESS CARE

3590
02:05:55,640 --> 02:05:57,642
OR HAVE THEIR RISK ASSESSED,

3591
02:05:57,642 --> 02:06:03,714
THIS IS GOING TO BE DIFFICULT,

3592
02:06:03,714 --> 02:06:05,817
AND IT SOMETHING WE NEED TO BE

3593
02:06:05,817 --> 02:06:08,886
ABLE TO OVERCOME.

3594
02:06:08,886 --> 02:06:10,421
PREGNANT INDIVIDUALS WHO LIVE IN

3595
02:06:10,421 --> 02:06:14,325
MATERNITY CARE DESERTS USUALLY

3596
02:06:14,325 --> 02:06:16,627
ENTER PREGNANCY WITH POOR

3597
02:06:16,627 --> 02:06:17,962
HEALTH, THEY RECEIVE LESS

3598
02:06:17,962 --> 02:06:19,997
PRENATAL CARE, THEY HAVE HIGHER

3599
02:06:19,997 --> 02:06:23,634
PRETERM BIRTH RATES, AND IN OUR

3600
02:06:23,634 --> 02:06:26,671
EXPERIENCE, IN OUR RESEARCH IN

3601
02:06:26,671 --> 02:06:28,272
RURAL TEXAS, THEY OFTEN HAVE

3602
02:06:28,272 --> 02:06:30,308
DELAYED TIMING OF ENTRY INTO

3603
02:06:30,308 --> 02:06:31,609
PRENATAL CARE DUE TO A VARIETY

3604
02:06:31,609 --> 02:06:35,780
OF FACTORS BETWEEN DISTANCE TO

3605
02:06:35,780 --> 02:06:37,081
ACCESS -- ACCESS PRENATAL VISITS

3606
02:06:37,081 --> 02:06:38,583
OR DELAYS IN GETTING ON TO

3607
02:06:38,583 --> 02:06:47,892
MEDICAID.

3608
02:06:47,892 --> 02:06:48,993
SO PRE-ECLAMPSIA SCREENING IS

3609
02:06:48,993 --> 02:06:49,894
DONE THROUGH BLOOD PRESSURE

3610
02:06:49,894 --> 02:06:51,629
SCREENING, AND THIS IS REALLY

3611
02:06:51,629 --> 02:06:53,831
CRUCIAL FOR DETECTION OF HIGH

3612
02:06:53,831 --> 02:06:55,233
BLOOD PRESSURE, SO THAT IT CAN

3613
02:06:55,233 --> 02:06:56,300
BE MANAGED.

3614
02:06:56,300 --> 02:06:57,602
SO HIGH PRESSURE CAN BE MANAGED

3615
02:06:57,602 --> 02:07:00,905
DURING PREGNANCY.

3616
02:07:00,905 --> 02:07:03,074
BECAUSE ALL WOMEN ARE AT RISK OF

3617
02:07:03,074 --> 02:07:04,942
DEVELOPING HIGH BLOOD PRESSURE

3618
02:07:04,942 --> 02:07:05,810
OR PRE-ECLAMPSIA DURING

3619
02:07:05,810 --> 02:07:06,577
PREGNANCY, IT'S RECOMMENDED THAT

3620
02:07:06,577 --> 02:07:08,880
ALL WOMEN IS BLOOD PRESSURE

3621
02:07:08,880 --> 02:07:09,947
SCREENED DURING PREGNANCY, AND

3622
02:07:09,947 --> 02:07:11,582
THIS IS DONE WITH STANDARD BLOOD

3623
02:07:11,582 --> 02:07:14,652
PRESSURE MEASUREMENTS, AND IT

3624
02:07:14,652 --> 02:07:16,821
SHOULD BE DONE AT EACH PRENATAL

3625
02:07:16,821 --> 02:07:18,256
VISIT SO THERE ARE TYPICALLY

3626
02:07:18,256 --> 02:07:24,162
ABOUT 14 STANDARD VISITS DURING

3627
02:07:24,162 --> 02:07:24,595
PRENATAL CARE.

3628
02:07:24,595 --> 02:07:26,764
SO HERE ARE THE GUIDELINES OF

3629
02:07:26,764 --> 02:07:28,065
HOW BLOOD PRESSURE SHOULD BE

3630
02:07:28,065 --> 02:07:31,035
CHECKED, AND SO I JUST WOULD

3631
02:07:31,035 --> 02:07:35,173
LIKE US TO CONSIDER HOW THESE

3632
02:07:35,173 --> 02:07:37,241
THINGS -- HOW THESE THINGS ARE

3633
02:07:37,241 --> 02:07:39,343
CARRIED OUT IN PRACTICE.

3634
02:07:39,343 --> 02:07:40,645
IF THE PATIENT IS SUPPOSED TO BE

3635
02:07:40,645 --> 02:07:42,713
SITTING AT REST FOR 5 MINUTES

3636
02:07:42,713 --> 02:07:43,915
PRIOR TO THAT BLOOD PRESSURE

3637
02:07:43,915 --> 02:07:46,784
CHECK, IS THAT HAPPENING?

3638
02:07:46,784 --> 02:07:47,752
IF THEY'RE SUPPOSED TO BE

3639
02:07:47,752 --> 02:07:49,387
SITTING WITH THEIR BACK

3640
02:07:49,387 --> 02:07:51,022
SUPPORTED, THAT MEANS NOT ON AN

3641
02:07:51,022 --> 02:07:52,123
EXAM TABLE.

3642
02:07:52,123 --> 02:07:57,695
SO THINKING ABOUT HOW ACCURATE

3643
02:07:57,695 --> 02:08:02,066
OUR BLOOD PRESSURE CHECKS ARE.

3644
02:08:02,066 --> 02:08:04,669
ADDITIONALLY, HOW DOES THIS

3645
02:08:04,669 --> 02:08:05,903
TRANSLATE TO MONITORING IN

3646
02:08:05,903 --> 02:08:08,940
DIFFERENT SETTINGS?

3647
02:08:08,940 --> 02:08:11,676
WHETHER AT HOME OR IN -- FOR

3648
02:08:11,676 --> 02:08:12,944
VIRTUAL CARE, DIFFERENT THINGS,

3649
02:08:12,944 --> 02:08:21,285
SO JUST THINGS TO THINK ABOUT.

3650
02:08:21,285 --> 02:08:22,820
SO THE GOAL FOR BLOOD PRESSURE

3651
02:08:22,820 --> 02:08:24,121
MANAGEMENT DURING PREGNANCY IS

3652
02:08:24,121 --> 02:08:25,856
TO KEEP BLOOD PRESSURE, THE

3653
02:08:25,856 --> 02:08:27,625
SYSTOLIC BETWEEN 140 AND THE

3654
02:08:27,625 --> 02:08:31,896
DIASTOLIC MEASUREMENT BELOW 90.

3655
02:08:31,896 --> 02:08:36,901
AND GUIDELINES FROM THE CHAP

3656
02:08:36,901 --> 02:08:43,241
TRIAL GAVE US EVIDENCE THAT

3657
02:08:43,241 --> 02:08:46,110
ADDRESSING MILD HYPERTENSION

3658
02:08:46,110 --> 02:08:49,146
DURING PREGNANCY WAS BENEFICIAL

3659
02:08:49,146 --> 02:08:50,681
OVER ONLY ADDRESSING IT WHEN IT

3660
02:08:50,681 --> 02:08:52,149
GET TO A SEVERE LEVEL.

3661
02:08:52,149 --> 02:08:53,251
SO ADDRESSING AND TREATING BLOOD

3662
02:08:53,251 --> 02:08:54,418
PRESSURE TO MAINTAIN THESE

3663
02:08:54,418 --> 02:08:56,153
LEVELS IS ASSOCIATED WITH

3664
02:08:56,153 --> 02:08:58,122
REDUCED RISK OF SEVERE AND ANY

3665
02:08:58,122 --> 02:08:59,023
PRE-ECLAMPSIA, AS WELL AS

3666
02:08:59,023 --> 02:09:02,627
REDUCED RISK OF MEDICALLY

3667
02:09:02,627 --> 02:09:04,362
INDICATED PRETERM BIRTH OR ANY

3668
02:09:04,362 --> 02:09:07,632
PRETERM BIRTH.

3669
02:09:07,632 --> 02:09:13,170
SO IF SOMEONE ENTERS PREGNANCY

3670
02:09:13,170 --> 02:09:15,373
WITH HYPERTENSION, THEY SHOULD

3671
02:09:15,373 --> 02:09:15,906
CONTINUE ANTIHYPERTENSIVE

3672
02:09:15,906 --> 02:09:17,908
THERAPY DURING THEIR PREGNANCY,

3673
02:09:17,908 --> 02:09:23,247
OR THEY SHOULD BE THEIR

3674
02:09:23,247 --> 02:09:24,015
ANTIHYPERTENSIVE SHOULD BE

3675
02:09:24,015 --> 02:09:25,783
CHANGED TO BE COMPATIBLE WITH

3676
02:09:25,783 --> 02:09:26,050
PREGNANCY.

3677
02:09:26,050 --> 02:09:28,085
ANYONE WITH NEW ONSET MILD

3678
02:09:28,085 --> 02:09:29,053
HYPERTENSION DURING PREGNANCY

3679
02:09:29,053 --> 02:09:32,323
SHOULD BE INITIATED WITH

3680
02:09:32,323 --> 02:09:33,724
ANTIHYPERTENSIVE MEDICATIONS,

3681
02:09:33,724 --> 02:09:37,061
AND ANYONE WITH SEVERE

3682
02:09:37,061 --> 02:09:41,465
HYPERTENSION THAT IS 160 OVER

3683
02:09:41,465 --> 02:09:43,401
110 THAT'S CONFIRMED AFTER 15

3684
02:09:43,401 --> 02:09:44,869
MINUTES SHOULD INITIATE AS SOON

3685
02:09:44,869 --> 02:09:48,939
AS POSSIBLE OR WITHIN AN HOUR OF

3686
02:09:48,939 --> 02:09:51,442
IDENTIFYING THIS LEVEL OF BLOOD

3687
02:09:51,442 --> 02:09:55,179
PRESSURE MEASUREMENTS.

3688
02:09:55,179 --> 02:09:57,615
THESE ARE THE RECOMMENDATIONS

3689
02:09:57,615 --> 02:09:59,216
FROM ACOG FOR TREATMENT OF

3690
02:09:59,216 --> 02:10:02,820
SEVERE HYPERTENSION DURING

3691
02:10:02,820 --> 02:10:05,656
PREGNANCY, AND TWO OF THESE

3692
02:10:05,656 --> 02:10:07,725
MEDICATIONS ARE INTRAVENOUS

3693
02:10:07,725 --> 02:10:08,926
INFUSIONS AND ONE IS AN

3694
02:10:08,926 --> 02:10:09,493
IMMEDIATE RELEASE.

3695
02:10:09,493 --> 02:10:11,996
THERE ARE NO SUCH SPECIFIC

3696
02:10:11,996 --> 02:10:13,864
RECOMMENDATIONS FOR TREATMENT OF

3697
02:10:13,864 --> 02:10:16,033
MILD HYPERTENSION DURING

3698
02:10:16,033 --> 02:10:17,234
PREGNANCY, BUT THERE ARE A

3699
02:10:17,234 --> 02:10:21,839
COUPLE OF THINGS THAT ARE PRETTY

3700
02:10:21,839 --> 02:10:28,179
COMMON LIKE LABETALOL AND

3701
02:10:28,179 --> 02:10:30,715
EXTENDED RELEASE -- SO IN

3702
02:10:30,715 --> 02:10:31,782
THINKING ABOUT HOW THESE

3703
02:10:31,782 --> 02:10:32,950
RECOMMENDATIONS CAN REASONABLY

3704
02:10:32,950 --> 02:10:34,085
BE CARRIED OUT IN THE U.S., I'D

3705
02:10:34,085 --> 02:10:35,419
LIKE US TO CONSIDER WHAT SOME OF

3706
02:10:35,419 --> 02:10:38,789
OUR NEEDS ARE, WHAT IS THE

3707
02:10:38,789 --> 02:10:43,694
CURRENT STATE OF THINGS.

3708
02:10:43,694 --> 02:10:45,563
SO SOCIAL DETERMINANTS OF HEALTH

3709
02:10:45,563 --> 02:10:48,499
IMPACT MANY ASPECTS OF ACCESS

3710
02:10:48,499 --> 02:10:53,571
AND UPTAKE OF PRENATAL CARE.

3711
02:10:53,571 --> 02:10:54,772
INCLUDING PRE-ECLAMPSIA

3712
02:10:54,772 --> 02:10:55,973
PREVENTION THROUGH LOW-DOSE

3713
02:10:55,973 --> 02:10:57,375
ASPIRIN, SCREENING AND BLOOD

3714
02:10:57,375 --> 02:11:01,011
PRESSURE MANAGEMENT.

3715
02:11:01,011 --> 02:11:03,347
TO INITIATE LOW-DOSE ASPIRIN,

3716
02:11:03,347 --> 02:11:05,282
TIMELY ENTRY INTO PRENATAL CARE

3717
02:11:05,282 --> 02:11:09,420
IN THE FIRST TRIMESTER IS REALLY

3718
02:11:09,420 --> 02:11:09,987
IMPORTANT.

3719
02:11:09,987 --> 02:11:14,358
IF WE'RE EXPECTING AND

3720
02:11:14,358 --> 02:11:16,794
RECOMMENDING THAT PREGNANT

3721
02:11:16,794 --> 02:11:17,962
INDIVIDUALS START LOW-DOSE

3722
02:11:17,962 --> 02:11:19,163
ASPIRIN AFTER 12 WEEKS, IN ORDER

3723
02:11:19,163 --> 02:11:20,131
TO GET THAT INFORMATION, THEY

3724
02:11:20,131 --> 02:11:24,301
WOULD HAVE NEEDED TO RECEIVE

3725
02:11:24,301 --> 02:11:24,902
THAT RECOMMENDATION PRIOR TO

3726
02:11:24,902 --> 02:11:28,239
THAT TIME.

3727
02:11:28,239 --> 02:11:31,742
ADDITIONALLY, AN ADEQUATE NUMBER

3728
02:11:31,742 --> 02:11:33,110
OF PRENATAL CARE VISITS IS

3729
02:11:33,110 --> 02:11:35,880
NEEDED FOR ADEQUATE FREQUENCY OF

3730
02:11:35,880 --> 02:11:36,580
BLOOD PRESSURE CHECKS, AS WELL

3731
02:11:36,580 --> 02:11:38,549
AS MONITORING OF

3732
02:11:38,549 --> 02:11:39,483
ANTIHYPERTENSIVE THERAPIES.

3733
02:11:39,483 --> 02:11:44,321
SO A QUARTER OF PREGNANT

3734
02:11:44,321 --> 02:11:47,925
INDIVIDUALS IN THE U.S. RECEIVE

3735
02:11:47,925 --> 02:11:50,094
LESS THAN AN ADEQUATE NUMBER OF

3736
02:11:50,094 --> 02:11:52,396
RENATAL VISITS, SO THAT'S A LOT

3737
02:11:52,396 --> 02:11:58,035
OF PEOPLE WHO MAY NOT BE GETTING

3738
02:11:58,035 --> 02:11:59,103
THE RECOMMENDATION, SCREENING

3739
02:11:59,103 --> 02:12:03,574
AND MONITORING THAT THEY NEED.

3740
02:12:03,574 --> 02:12:05,042
ADDITIONALLY, TYPICALLY THE ONE

3741
02:12:05,042 --> 02:12:05,843
POSTPARTUM VISIT THAT MOST

3742
02:12:05,843 --> 02:12:08,579
PEOPLE ARE ABLE TO GET OCCURS

3743
02:12:08,579 --> 02:12:11,348
AROUND SIX WEEKS POSTPARTUM.

3744
02:12:11,348 --> 02:12:12,650
WHICH IS SORT OF AT THE END OF

3745
02:12:12,650 --> 02:12:16,387
THAT RISK PERIOD FOR WHEN

3746
02:12:16,387 --> 02:12:18,122
PRE-ECLAMPSIA, POSTPARTUM

3747
02:12:18,122 --> 02:12:20,691
PRE-ECLAMPSIA MAY DEVELOP, AND

3748
02:12:20,691 --> 02:12:22,393
OF COURSE IMPROVED HEALTH OF

3749
02:12:22,393 --> 02:12:27,565
WOMEN PRIOR TO PREGNANCY WOULD

3750
02:12:27,565 --> 02:12:29,533
CERTAINLY HELP REDUCE RISK

3751
02:12:29,533 --> 02:12:30,401
FACTORS FOR PRE-ECLAMPSIA AND

3752
02:12:30,401 --> 02:12:31,402
IMPROVE OVERALL OUTCOMES.

3753
02:12:31,402 --> 02:12:35,940
I KNOW THAT THERE ARE A COUPLE

3754
02:12:35,940 --> 02:12:39,009
OF GROUPS ADDRESSING

3755
02:12:39,009 --> 02:12:40,010
PRECONCEPTION HEALTH AND OTHER

3756
02:12:40,010 --> 02:12:44,415
LIFESTYLE FACTORS.

3757
02:12:44,415 --> 02:12:45,816
SO I APPLAUD THAT WORK.

3758
02:12:45,816 --> 02:12:47,418
SO JUST TO SUMMARIZE,

3759
02:12:47,418 --> 02:12:48,652
PRE-ECLAMPSIA IS A MAJOR

3760
02:12:48,652 --> 02:12:50,054
CONTRIBUTOR TO MATERNAL

3761
02:12:50,054 --> 02:12:54,458
MORBIDITY AND MORTALITY, AND ITS

3762
02:12:54,458 --> 02:12:55,759
PREVALENCE IS INCREASING.

3763
02:12:55,759 --> 02:12:57,528
LOW-DOSE ASPIRIN AFTER 12 WEEKS

3764
02:12:57,528 --> 02:13:00,130
OF PREGNANCY MAY BE EFFECTIVE AT

3765
02:13:00,130 --> 02:13:01,332
PREVENTING PRE-ECLAMPSIA.

3766
02:13:01,332 --> 02:13:03,033
BLOOD PRESSURE MONITORING IS

3767
02:13:03,033 --> 02:13:06,036
IMPORTANT TO DETECT -- DETECT

3768
02:13:06,036 --> 02:13:09,640
AND THEN START TREATMENT FOR

3769
02:13:09,640 --> 02:13:10,674
HYPERTENSION, AND IMPROVED

3770
02:13:10,674 --> 02:13:12,276
ACCESS AND EQUITY TO PRENATAL

3771
02:13:12,276 --> 02:13:18,649
AND POSTPARTUM CARE IS NEEDED.

3772
02:13:18,649 --> 02:13:19,083
THANK YOU.

3773
02:13:19,083 --> 02:13:24,855
[APPLAUSE]

3774
02:13:24,855 --> 02:13:25,923
>> THANK YOU SO MUCH.

3775
02:13:25,923 --> 02:13:27,925
WE'RE RUNNING A LITTLE BEHIND SO

3776
02:13:27,925 --> 02:13:29,293
WE'RE GOING TO HAVE TIME FOR ONE

3777
02:13:29,293 --> 02:13:30,761
QUESTION, I BELIEVE WE HAVE ONE

3778
02:13:30,761 --> 02:13:30,995
ONLINE.

3779
02:13:30,995 --> 02:13:32,763
>> WE HAVE TWO ONLINE AND
I'LL

3780
02:13:32,763 --> 02:13:34,398
GET TO THE ONE THAT WAS ENTERED

3781
02:13:34,398 --> 02:13:36,133
FIRST.

3782
02:13:36,133 --> 02:13:40,204
SO HOW IS RACE/ETHNICITY A RISK

3783
02:13:40,204 --> 02:13:41,405
FACTOR FOR DISEASE IF IT IS A

3784
02:13:41,405 --> 02:13:45,876
SOCIAL CONSTRUCT?

3785
02:13:45,876 --> 02:13:48,345
IT SAYS SINCE RACE/ETHNICITY IS

3786
02:13:48,345 --> 02:13:49,914
A SOCIAL CONSTRUCT, HOW ARE WE

3787
02:13:49,914 --> 02:13:52,016
STRATIFYING AS A RISK FACTOR FOR

3788
02:13:52,016 --> 02:13:52,249
DISEASE?

3789
02:13:52,249 --> 02:13:57,021
>> SO BLACK INDIVIDUALS
ARE AT

3790
02:13:57,021 --> 02:14:00,958
HIGHER RISK FOR PRE-ECLAMPSIA.

3791
02:14:00,958 --> 02:14:02,826
AND I THINK WE DON'T KNOW

3792
02:14:02,826 --> 02:14:08,198
ENTIRELY WHY THAT IS.

3793
02:14:08,198 --> 02:14:14,772
BUT THEY ARE.

3794
02:14:14,772 --> 02:14:15,539
SO THAT'S DEFINITELY SOMETHING

3795
02:14:15,539 --> 02:14:19,009
THAT NEEDS TO BE CONSIDERED ON

3796
02:14:19,009 --> 02:14:20,878
THAT LIST OF MODERATE RISK

3797
02:14:20,878 --> 02:14:24,281
FACTORS FOR PRE-ECLAMPSIA, BEING

3798
02:14:24,281 --> 02:14:27,451
BLACK IS ONE OF THOSE RISK

3799
02:14:27,451 --> 02:14:32,790
FACTORS.

3800
02:14:32,790 --> 02:14:34,325
SO I THINK THAT'S REALLY

3801
02:14:34,325 --> 02:14:38,062
IMPORTANT TO CONSIDER NATIONWIDE

3802
02:14:38,062 --> 02:14:44,301
AND I KNOW THAT THERE ARE GROUPS

3803
02:14:44,301 --> 02:14:45,703
SPECIFICALLY LOOKING AT

3804
02:14:45,703 --> 02:14:46,503
ADDRESSING PRE-ECLAMPSIA AMONG

3805
02:14:46,503 --> 02:14:47,104
BLACK INDIVIDUALS.

3806
02:14:47,104 --> 02:14:49,640
>> THANK YOU SO MUCH.

3807
02:14:49,640 --> 02:14:55,212
[APPLAUSE]

3808
02:14:55,212 --> 02:14:56,747
>> THANKS SO MUCH,
CHRISTINE.

3809
02:14:56,747 --> 02:14:57,281
GREAT PRESENTATION.

3810
02:14:57,281 --> 02:14:58,282
AND THEN FOR THE LAST OF THE

3811
02:14:58,282 --> 02:15:01,452
SESSION BEFORE WE GO TO BREAK,

3812
02:15:01,452 --> 02:15:05,055
WE HAVE UMA REDDY AND -- HOLD

3813
02:15:05,055 --> 02:15:08,859
ON, CHEAT SHEET -- VICTORIA

3814
02:15:08,859 --> 02:15:09,126
ST. CLAIR.

3815
02:15:09,126 --> 02:15:10,461
SO I'M GOING TO TURN IT STRAIGHT

3816
02:15:10,461 --> 02:15:14,031
OVER TO YOU GUYS.

3817
02:15:14,031 --> 02:15:14,698
>> THANK YOU.

3818
02:15:14,698 --> 02:15:16,533
WE'RE THRILLED TO BE PRESENTING

3819
02:15:16,533 --> 02:15:19,069
ON BEHALF OF NEW YORK CHAMP.

3820
02:15:19,069 --> 02:15:20,904
IT'S AN HONOR TO BE HERE AMONG

3821
02:15:20,904 --> 02:15:23,440
ALL OF YOU AT THIS WONDERFUL

3822
02:15:23,440 --> 02:15:24,208
MEETING SO FAR.

3823
02:15:24,208 --> 02:15:28,912
SO I'M UMA READY, PROFESSOR OF

3824
02:15:28,912 --> 02:15:30,481
OB-GYN, VICE CHAIR OF RESEARCH,

3825
02:15:30,481 --> 02:15:31,815
PROFESSOR OF POPULATION AND

3826
02:15:31,815 --> 02:15:33,751
FAMILY HEALTH AT COLUMBIA

3827
02:15:33,751 --> 02:15:34,385
UNIVERSITY.

3828
02:15:34,385 --> 02:15:37,221
>> AND I'M VICTORIA ST.
CLAIR,

3829
02:15:37,221 --> 02:15:39,623
I'M AN MPI FOR THE NEW YORK

3830
02:15:39,623 --> 02:15:40,557
CHAMP CENTER OF EXCELLENCE, AND

3831
02:15:40,557 --> 02:15:42,393
I AM THE WOMEN'S HEALTH DIRECTOR

3832
02:15:42,393 --> 02:15:44,461
AT A COMMUNITY-BASED

3833
02:15:44,461 --> 02:15:46,630
ORGANIZATION CALLED CARIBBEAN

3834
02:15:46,630 --> 02:15:47,765
WOMEN'S HEALTH ASSOCIATION, IN

3835
02:15:47,765 --> 02:15:51,001
WHICH WE PROVIDE MATERNAL

3836
02:15:51,001 --> 02:15:52,836
HEALTHCARE AND OTHER

3837
02:15:52,836 --> 02:15:54,171
INTERVENTIONS AND RESOURCES TO

3838
02:15:54,171 --> 02:15:55,272
ADDRESS THE SOCIAL DETERMINANTS

3839
02:15:55,272 --> 02:15:57,574
OF HEALTH TO THE POPULATION MOST

3840
02:15:57,574 --> 02:16:02,613
AT RISK IN NEW YORK CITY.

3841
02:16:02,613 --> 02:16:04,148
>> SO WE WERE ASKED
SPECIFICALLY

3842
02:16:04,148 --> 02:16:06,750
TO TALK ABOUT OUR PROJECT CALLED

3843
02:16:06,750 --> 02:16:07,851
LIVING HEALTHY FOR MOMS.

3844
02:16:07,851 --> 02:16:09,186
BUT BEFORE I DO THAT, I WANT TO

3845
02:16:09,186 --> 02:16:12,356
GIVE YOU THE BACKGROUND FOR NY

3846
02:16:12,356 --> 02:16:13,657
CHAMP.

3847
02:16:13,657 --> 02:16:15,192
WE'RE UNIQUE IN THAT WE HAVE

3848
02:16:15,192 --> 02:16:17,161
NINE PRINCIPAL INVESTIGATORS,

3849
02:16:17,161 --> 02:16:19,897
AND SO WE'RE A TEAM, THERE'S

3850
02:16:19,897 --> 02:16:22,199
MYSELF, I'M IN MATERNAL FETAL

3851
02:16:22,199 --> 02:16:25,269
MEDICINE SPECIALIST OB-GYN.

3852
02:16:25,269 --> 02:16:28,972
KELLY HALL RECENTLY MOVED TO

3853
02:16:28,972 --> 02:16:30,941
TULANE BUT SHE'S PART OF OUR

3854
02:16:30,941 --> 02:16:33,110
TEAM OF MPIs, JACQUELINE

3855
02:16:33,110 --> 02:16:34,378
TAYLOR, WHO REPRESENTS THE

3856
02:16:34,378 --> 02:16:38,816
SCHOOL OF NURSING, CORNELL.

3857
02:16:38,816 --> 02:16:41,351
WE HAVE LAUREN OSBOURNE, AND

3858
02:16:41,351 --> 02:16:42,453
MONICA SAFFORD.

3859
02:16:42,453 --> 02:16:45,622
AND THEN WE HAVE FOUR ESTEEMED

3860
02:16:45,622 --> 02:16:49,226
COMMUNITY ORGANIZATIONS WHO

3861
02:16:49,226 --> 02:16:50,661
PROVIDE A HUGE AMOUNT OF THE

3862
02:16:50,661 --> 02:16:52,396
PERINATAL SERVICES AND PROGRAMS

3863
02:16:52,396 --> 02:16:53,297
TO OUR BIRTHING PEOPLE IN NEW

3864
02:16:53,297 --> 02:16:55,566
YORK CITY.

3865
02:16:55,566 --> 02:16:56,767
INCLUDING CARIBBEAN WOMEN'S

3866
02:16:56,767 --> 02:17:00,404
HEALTH ASSOCIATION, VICTORIA

3867
02:17:00,404 --> 02:17:03,974
ST. CLAIR, MADELINE

3868
02:17:03,974 --> 02:17:05,843
DORVAL-MOLLER, NORTHERN MA HA

3869
02:17:05,843 --> 02:17:11,548
TAN PERINATAL PROJECT, SAVANNAH

3870
02:17:11,548 --> 02:17:13,283
BROWN, BLACK WOMEN'S BLUEPRINT,

3871
02:17:13,283 --> 02:17:14,518
AND EMILY RODRIGUEZ, WHO'S AT

3872
02:17:14,518 --> 02:17:15,252
THE BRIDGE DIRECTORY.

3873
02:17:15,252 --> 02:17:17,354
SO THE NINE OF US ARE AT THE

3874
02:17:17,354 --> 02:17:19,656
TABLE TOGETHER WEEK AFTER WEEK,

3875
02:17:19,656 --> 02:17:21,825
MAKING DECISIONS TOGETHER,

3876
02:17:21,825 --> 02:17:25,262
MAKING DECISIONS ON HOW WE'RE

3877
02:17:25,262 --> 02:17:28,565
GOING TO MAKE PROGRESS ON THE

3878
02:17:28,565 --> 02:17:29,700
TWO CORES AND TWO PROJECTS.

3879
02:17:29,700 --> 02:17:31,568
AND THE REASON I BRING IT UP IS,

3880
02:17:31,568 --> 02:17:33,137
IT'S NINE PEOPLE, NINE OPINIONS,

3881
02:17:33,137 --> 02:17:35,405
BUT WE FELT VERY STRONGLY, WE'RE

3882
02:17:35,405 --> 02:17:36,607
NOT JUST GOING TO BRING

3883
02:17:36,607 --> 02:17:37,708
COMMUNITY INPUT TO THESE

3884
02:17:37,708 --> 02:17:38,909
PROJECTS AND EXPERTISE.

3885
02:17:38,909 --> 02:17:40,010
WE WANT THEM AT THE TABLE.

3886
02:17:40,010 --> 02:17:46,116
SO WE'RE AT THE TABLE.

3887
02:17:46,116 --> 02:17:47,551
SO NOW I'LL JUST GET TO THE

3888
02:17:47,551 --> 02:17:48,952
BACKGROUND OF LIVING HEALTHY FOR

3889
02:17:48,952 --> 02:17:49,686
MOMS, THE INVESTIGATORS FOR

3890
02:17:49,686 --> 02:17:50,621
THIS.

3891
02:17:50,621 --> 02:17:55,259
SO LAUREN OSBORNE IS THE LEAD

3892
02:17:55,259 --> 02:17:56,760
FOR THIS, SHE'S AT CORNELL,

3893
02:17:56,760 --> 02:18:00,697
SHE'S A PSYCHIATRIST, EXPERT IN

3894
02:18:00,697 --> 02:18:01,365
PERINATAL MENTAL HEALTH.

3895
02:18:01,365 --> 02:18:02,232
SHE HAS DONE WORK WITH THIS

3896
02:18:02,232 --> 02:18:05,736
PROGRAM CALLED THINKING HEALTHY

3897
02:18:05,736 --> 02:18:07,404
PROGRAM IN LOW INCOME COUNTRY,

3898
02:18:07,404 --> 02:18:09,773
WHICH LIVING HEALTHY FOR MOMS IS

3899
02:18:09,773 --> 02:18:12,976
ADAPTED BY -- IT INVOLVES

3900
02:18:12,976 --> 02:18:14,945
COGNITIVE BEHAVIORAL THERAPY,

3901
02:18:14,945 --> 02:18:16,713
CBT, AND HAS BEEN SHOWN TO

3902
02:18:16,713 --> 02:18:20,284
DECREASE DRAMATICALLY THE

3903
02:18:20,284 --> 02:18:22,152
INCIDENCE OF POSTPARTUM

3904
02:18:22,152 --> 02:18:23,120
DEPREPTION.

3905
02:18:23,120 --> 02:18:25,122
I MYSELF AS I SAID AM A MATERNAL

3906
02:18:25,122 --> 02:18:27,624
FETAL MEDICINE SPECIALIST AND

3907
02:18:27,624 --> 02:18:29,092
RANDOMIZED CONTROL TRIALS IS MY

3908
02:18:29,092 --> 02:18:30,060
AREA OF EXPERTISE.

3909
02:18:30,060 --> 02:18:35,199
MAN KA SAFFORD WHO IS AN

3910
02:18:35,199 --> 02:18:36,934
INTERNIST SPECIALIZED IN

3911
02:18:36,934 --> 02:18:37,401
CARDIOVASCULAR HEALTH.

3912
02:18:37,401 --> 02:18:40,938
SHE ALSO USED THIS THINKING

3913
02:18:40,938 --> 02:18:42,806
HEALTHY PROGRAM, THIS COGNITIVE

3914
02:18:42,806 --> 02:18:43,574
BEHAVIORAL THERAPY IN A

3915
02:18:43,574 --> 02:18:44,775
DIFFERENT SETTING IN RURAL

3916
02:18:44,775 --> 02:18:46,109
ALABAMA AMONG A PREDOMINANTLY

3917
02:18:46,109 --> 02:18:48,078
BLACK POPULATION TO IMPROVE

3918
02:18:48,078 --> 02:18:49,913
CARDIOVASCULAR OUTCOMES.

3919
02:18:49,913 --> 02:18:54,518
HEATHER LIPKIND, MATERNAL FETAL

3920
02:18:54,518 --> 02:18:56,153
MEDICINE EXPERTISE IN POSTPARTUM

3921
02:18:56,153 --> 02:18:59,456
CARDIOVASCULAR HEALTH, VICTORIA

3922
02:18:59,456 --> 02:19:03,627
ST. CLAIR WHO'S CO-ING WITH ME

3923
02:19:03,627 --> 02:19:07,231
AND MADELINE DORVAL-MSM OLLER,

3924
02:19:07,231 --> 02:19:08,565
PROVIDES A SIGNIFICANT AMOUNT OF

3925
02:19:08,565 --> 02:19:10,534
DOULA SERVICES FOR OUR CITY.

3926
02:19:10,534 --> 02:19:11,401
>> THANK YOU.

3927
02:19:11,401 --> 02:19:15,105
SO I'LL TALK A BIT ABOUT WHAT IS

3928
02:19:15,105 --> 02:19:17,641
LIVING HEALTHY FOR MOMS OR LH

3929
02:19:17,641 --> 02:19:17,841
MOMS.

3930
02:19:17,841 --> 02:19:19,409
IT IS A RANDOMIZED CONTROL TRIAL

3931
02:19:19,409 --> 02:19:20,844
RESEARCH STUDY THAT IS AIMED TO

3932
02:19:20,844 --> 02:19:23,146
ADDRESS THE LEADING CAUSES OF

3933
02:19:23,146 --> 02:19:24,481
SHORT-TERM MATERNAL MORBIDITY

3934
02:19:24,481 --> 02:19:25,983
AND LONG TERM MATERNAL

3935
02:19:25,983 --> 02:19:27,718
MORBIDITY, SO IT'S INTENDED TO

3936
02:19:27,718 --> 02:19:28,952
ADDRESS BOTH SHORT AND LONG-TERM

3937
02:19:28,952 --> 02:19:30,921
AS WE SEE PARTICULARLY IN THE

3938
02:19:30,921 --> 02:19:32,689
POSTPARTUM PERIOD OF ONCE

3939
02:19:32,689 --> 02:19:33,657
MATERNAL HEALTH JOURNEY.

3940
02:19:33,657 --> 02:19:36,960
WE'LL BE DOING THIS BY

3941
02:19:36,960 --> 02:19:38,595
ADDRESSING MENTAL HEALTH, MORE

3942
02:19:38,595 --> 02:19:39,363
SPECIFICALLY POSTPARTUM

3943
02:19:39,363 --> 02:19:41,265
DEPREPTION, AND CARDIOVASCULAR

3944
02:19:41,265 --> 02:19:42,699
CONDITIONS, AND HOW WILL WE BE

3945
02:19:42,699 --> 02:19:43,533
DOING THIS?

3946
02:19:43,533 --> 02:19:44,968
WE'RE COMPARING THE

3947
02:19:44,968 --> 02:19:46,603
EFFECTIVENESS OF OUR LIVING

3948
02:19:46,603 --> 02:19:50,240
HEALTHY FOR MOMS INTERVENTION

3949
02:19:50,240 --> 02:19:51,441
AGAINST THE ATTENTION CONTROL.

3950
02:19:51,441 --> 02:19:53,277
THE LIVING HEALTHY FOR MOMS

3951
02:19:53,277 --> 02:19:54,511
INTERVENTION UTILIZES THE

3952
02:19:54,511 --> 02:19:55,712
PRINCIPLES OF COGNITIVE

3953
02:19:55,712 --> 02:19:58,015
BEHAVIORAL THERAPY OR CBT, AS

3954
02:19:58,015 --> 02:19:59,983
WELL AS HEALTHY LIFESTYLE

3955
02:19:59,983 --> 02:20:02,953
PROGRAM, AND THIS WILL BE DONE

3956
02:20:02,953 --> 02:20:04,254
THROUGH PATIENT ACTIVATED

3957
02:20:04,254 --> 02:20:06,990
LEARNING SYSTEM OR PALS AS WE

3958
02:20:06,990 --> 02:20:08,659
REFER TO IT, WHICH IS A SERIES

3959
02:20:08,659 --> 02:20:12,996
OF PATIENT-CENTERED, PATIENT

3960
02:20:12,996 --> 02:20:14,331
LANGUAGE VIBL VIDEOS THAT WILL

3961
02:20:14,331 --> 02:20:19,937
BE DEVELOPED BY OUR DOULA,

3962
02:20:19,937 --> 02:20:20,737
AGAINST THE ATTENTION CONTROL,

3963
02:20:20,737 --> 02:20:23,674
WHICH IS STANDARD DOULA CARE.

3964
02:20:23,674 --> 02:20:25,208
BOTH THE ATTENTION CONTROL AND

3965
02:20:25,208 --> 02:20:27,144
THE INTERVENTION WILL BE

3966
02:20:27,144 --> 02:20:28,912
DELIVERED BY DOULAS, AND WHEN I

3967
02:20:28,912 --> 02:20:30,580
SAY DOULAS, I MEAN

3968
02:20:30,580 --> 02:20:36,153
COMMUNITY-BASED DOULAS THAT WORK

3969
02:20:36,153 --> 02:20:39,323
WITH CARIBBEAN WOMEN'S HEALTH

3970
02:20:39,323 --> 02:20:41,858
ASSOCIATION AND NORTHERN

3971
02:20:41,858 --> 02:20:46,496
MANHATTAN PERINATAL -- IT MEANS

3972
02:20:46,496 --> 02:20:47,764
THE DOULAS ARE REPRESENTATIVE OF

3973
02:20:47,764 --> 02:20:48,665
THE COMMUNITIES THEY SERVE, THEY

3974
02:20:48,665 --> 02:20:50,100
ARE MEMBERS OF THE COMMUNITIES

3975
02:20:50,100 --> 02:20:52,602
THEY SERVE, AND THEY HAVE THE

3976
02:20:52,602 --> 02:20:54,037
CULTURAL HUMILITY AND

3977
02:20:54,037 --> 02:20:55,439
COMPETENCIES IN ORDER TO BEST --

3978
02:20:55,439 --> 02:20:57,574
THAT BEST EQUIP THEM TO SUPPORT

3979
02:20:57,574 --> 02:20:59,309
THE POPULATION OR THE

3980
02:20:59,309 --> 02:21:04,214
PARTICIPANTS IN THE STUDY.

3981
02:21:04,214 --> 02:21:05,549
THE THREE HOSPITAL SITES IN

3982
02:21:05,549 --> 02:21:07,317
WHICH PARTICIPANTS WILL BE

3983
02:21:07,317 --> 02:21:11,154
RECRUITED FROM ARE NEW YORK

3984
02:21:11,154 --> 02:21:12,789
PRESBYTERIAN BROOKLYN METHODIST

3985
02:21:12,789 --> 02:21:14,124
HOSPITAL IN BROOKLYN, QUEENS

3986
02:21:14,124 --> 02:21:16,093
HOSPITAL, WHICH IS A NEW YORK

3987
02:21:16,093 --> 02:21:17,427
CITY HEALTH AND HOSPITALS PUBLIC

3988
02:21:17,427 --> 02:21:20,130
HOSPITAL IN QUEENS, AND THE

3989
02:21:20,130 --> 02:21:21,798
NEW YORK PRESBYTERIAN ALLEN

3990
02:21:21,798 --> 02:21:25,402
HOSPITAL IN UPPER MANHATTAN.

3991
02:21:25,402 --> 02:21:27,037
THE AIMS FOR LIVING HEALTHY FOR

3992
02:21:27,037 --> 02:21:28,472
MOMS IS TO TEST THE

3993
02:21:28,472 --> 02:21:33,910
EFFECTIVENESS IN A HYBRID TYPE H

3994
02:21:33,910 --> 02:21:35,612
APPROXIMATELY 600 PARTICIPANTS.

3995
02:21:35,612 --> 02:21:38,915
THE PARTICIPANTS WILL BE 18 OR

3996
02:21:38,915 --> 02:21:41,985
OLDER WHO HAVE GIVEN BIRTH TO A

3997
02:21:41,985 --> 02:21:44,087
SINGLETON, SO SINGLE BIRTH, NO

3998
02:21:44,087 --> 02:21:45,522
MULTIPLES AT BIRTH.

3999
02:21:45,522 --> 02:21:48,058
THEY WILL BE SELF-IDENTIFIED AS

4000
02:21:48,058 --> 02:21:50,761
BLACK AND/OR HISPANIC AND BE

4001
02:21:50,761 --> 02:21:52,496
RECIPIENTS OF MEDICAID.

4002
02:21:52,496 --> 02:21:54,698
THE AIM IS TO LOWER THE

4003
02:21:54,698 --> 02:21:57,667
INCIDENCE OF POSTPARTUM

4004
02:21:57,667 --> 02:21:59,202
DEPRESSION, IMPROVEMENT IN

4005
02:21:59,202 --> 02:22:00,737
CARDIOVASCULAR HEALTH, AND

4006
02:22:00,737 --> 02:22:02,739
BETTER QUALITY OF LIFE.

4007
02:22:02,739 --> 02:22:04,341
THE SECOND AIM IS TO ANALYZE THE

4008
02:22:04,341 --> 02:22:05,876
EFFECTS ON HEALTHCARE

4009
02:22:05,876 --> 02:22:07,511
UTILIZATION, INCLUDING EARLY

4010
02:22:07,511 --> 02:22:09,780
POSTPARTUM PROVIDER CONTACT, SO

4011
02:22:09,780 --> 02:22:12,115
SEVEN DAYS IN THE POSTPARTUM

4012
02:22:12,115 --> 02:22:13,550
PERIOD, AS WELL AS SIX-WEEK

4013
02:22:13,550 --> 02:22:17,054
VISITS, AND MEASURE PARTICIPANT

4014
02:22:17,054 --> 02:22:18,288
SATISFACTION WITH POSTPARTUM

4015
02:22:18,288 --> 02:22:18,488
CARE.

4016
02:22:18,488 --> 02:22:19,689
AND THE THIRD AIM IS TO

4017
02:22:19,689 --> 02:22:21,391
INVESTIGATE THE IMPLEMENTATION

4018
02:22:21,391 --> 02:22:23,760
PROCESS AND THE OUTCOMES OF THE

4019
02:22:23,760 --> 02:22:27,164
LH MOMS INTERVENTION.

4020
02:22:27,164 --> 02:22:30,934
THE OUTCOMES ARE TO REDUCE OR

4021
02:22:30,934 --> 02:22:35,172
ELIMINATE POSTPARTUM DEPRESSION

4022
02:22:35,172 --> 02:22:41,645
UTILIZING THE MEASURE OF THE

4023
02:22:41,645 --> 02:22:42,913
EDINBURGH POSTNATAL DEPRESSION

4024
02:22:42,913 --> 02:22:44,481
SCORE WHICH THE VALUE OF GREATER

4025
02:22:44,481 --> 02:22:47,451
THAN OR EQUAL TO 9, AND IMPROVE

4026
02:22:47,451 --> 02:22:49,519
CARDIOVASCULAR HEALTH USING THE

4027
02:22:49,519 --> 02:22:54,491
A HSM AHA'S HEART SCORE, AND SEY

4028
02:22:54,491 --> 02:22:55,459
OUTCOMES ARE INCLUDING BUT NOT

4029
02:22:55,459 --> 02:22:57,661
LIMITED TO RESILIENCE, SOCIAL

4030
02:22:57,661 --> 02:22:59,096
SUPPORT, REDUCTION OF ANXIETY

4031
02:22:59,096 --> 02:23:01,832
AND POSTPARTUM DEPRESSION.

4032
02:23:01,832 --> 02:23:03,366
OR PTSD.

4033
02:23:03,366 --> 02:23:05,569
HEALTHCARE UTILIZATION AND

4034
02:23:05,569 --> 02:23:07,204
SATISFACTION WITH POSTPARTUM

4035
02:23:07,204 --> 02:23:08,238
CARE IN THE IMPLEMENTATION

4036
02:23:08,238 --> 02:23:11,408
PROCESS.

4037
02:23:11,408 --> 02:23:12,909
WE WANT TO FOCUS A BIT MORE ON

4038
02:23:12,909 --> 02:23:15,112
WHAT DOES AIM THREE MEAN IN THIS

4039
02:23:15,112 --> 02:23:15,979
RESEARCH STUDY.

4040
02:23:15,979 --> 02:23:19,716
WE WANT TO MAKE SURE THAT WE ARE

4041
02:23:19,716 --> 02:23:21,685
EVALUATING OUR INTERVENTION IN

4042
02:23:21,685 --> 02:23:25,555
THE IMPLEMENTATION PHASE ACROSS

4043
02:23:25,555 --> 02:23:26,957
THE SIX-MONTH PERIOD.

4044
02:23:26,957 --> 02:23:29,359
SIX MONTHS, 18 MONTHS OF RCT

4045
02:23:29,359 --> 02:23:31,661
RECRUITMENT.

4046
02:23:31,661 --> 02:23:34,331
WE WILL BE RECRUITING

4047
02:23:34,331 --> 02:23:35,432
PARTICIPANTS FROM THE RANDOMIZED

4048
02:23:35,432 --> 02:23:36,867
CONTROL TRIAL, HEALTHCARE

4049
02:23:36,867 --> 02:23:38,368
PROVIDERS, AND DOULAS AT EACH OF

4050
02:23:38,368 --> 02:23:42,239
THE RESPECTIVE SITES.

4051
02:23:42,239 --> 02:23:45,876
AND WAIL W WE'LL WORK WITH OUR B

4052
02:23:45,876 --> 02:23:47,944
TO FINALIZE PLANS FOR DATA

4053
02:23:47,944 --> 02:23:48,512
COLLECTION INSTRUMENTS.

4054
02:23:48,512 --> 02:23:49,713
AND THIS WILL BE DONE OVER THE

4055
02:23:49,713 --> 02:23:51,681
COURSE OF SURVEYS, FOCUS GROUPS

4056
02:23:51,681 --> 02:23:57,087
AND KEY INFORMANT INTERVIEWS.

4057
02:23:57,087 --> 02:24:00,223
>> SO THE STUDY DESIGN IS
A TYPE

4058
02:24:00,223 --> 02:24:01,458
1 HYBRID EFFECTIVENESS

4059
02:24:01,458 --> 02:24:02,526
IMPLEMENTATION DESIGN, SO WHAT

4060
02:24:02,526 --> 02:24:03,193
IS THAT?

4061
02:24:03,193 --> 02:24:06,129
SO WE'RE ASSESSING THE

4062
02:24:06,129 --> 02:24:07,264
INTERVENTIONS' EFFECTIVENESS,

4063
02:24:07,264 --> 02:24:09,900
LIVING HEALTHY FOR MOMS, AND ITS

4064
02:24:09,900 --> 02:24:11,001
EFFECT ON THE OUTCOMES, BUT

4065
02:24:11,001 --> 02:24:13,537
WE'RE ALSO GOING TO EXAMINE THE

4066
02:24:13,537 --> 02:24:18,141
IMPLEMENTATION PROCESSES.

4067
02:24:18,141 --> 02:24:19,676
SO THIS SHOWS WHAT THE LIVING

4068
02:24:19,676 --> 02:24:21,011
HEALTHY FOR MOMS INTERVENTION

4069
02:24:21,011 --> 02:24:21,178
IS.

4070
02:24:21,178 --> 02:24:23,313
IT'S A NOVEL POSTPARTUM

4071
02:24:23,313 --> 02:24:24,748
EMERGENCY DETECTION SYSTEM FOR

4072
02:24:24,748 --> 02:24:26,149
THE FIRST SEVEN DAYS POST

4073
02:24:26,149 --> 02:24:29,119
DISCHARGE.

4074
02:24:29,119 --> 02:24:30,020
THEN STRUCTURAL BEHAVIORAL

4075
02:24:30,020 --> 02:24:32,322
INTERVENTION DESIGNED TO PREVENT

4076
02:24:32,322 --> 02:24:33,190
POSTPARTUM DEPRESSION SYMPTOMS

4077
02:24:33,190 --> 02:24:36,893
AND IMPROVE CARDIOVASCULAR

4078
02:24:36,893 --> 02:24:37,894
HEALTH THROUGH THE LIVING

4079
02:24:37,894 --> 02:24:39,095
HEALTHY FOR MOMS PROGRAM, AND

4080
02:24:39,095 --> 02:24:41,731
THEN WE'RE LEVERAGING EXISTING

4081
02:24:41,731 --> 02:24:42,933
INFRASTRUCTURE AND RELATIONSHIPS

4082
02:24:42,933 --> 02:24:45,035
BY TRAINING COMMUNITY DOULAS TO

4083
02:24:45,035 --> 02:24:46,570
DELIVER THE INTERVENTION.

4084
02:24:46,570 --> 02:24:49,306
SO IN THE FIRST YEAR, THESE

4085
02:24:49,306 --> 02:24:50,941
ARE -- WE'VE ALREADY REFINED THE

4086
02:24:50,941 --> 02:24:52,175
INTERVENTION WITH FOCUS GROUPS

4087
02:24:52,175 --> 02:24:54,144
AND DOULA WORKING GROUPS.

4088
02:24:54,144 --> 02:24:56,546
WE'VE HAD WORKING FOCUS GROUPS

4089
02:24:56,546 --> 02:24:59,716
WITH BIRTHING PEOPLE, HEALTHCARE

4090
02:24:59,716 --> 02:25:01,284
PROFESSIONALS, WIDE VARIETY OF

4091
02:25:01,284 --> 02:25:03,320
HEALTHCARE PROFESSIONALS, WITH

4092
02:25:03,320 --> 02:25:04,354
DOULAS, WITH HOSPITAL

4093
02:25:04,354 --> 02:25:04,688
STAKEHOLDERS.

4094
02:25:04,688 --> 02:25:06,523
WE'RE TRAINING AND CERTIFYING

4095
02:25:06,523 --> 02:25:08,291
THE INITIAL -- WE TRAINED THE

4096
02:25:08,291 --> 02:25:09,859
INITIAL GROUP OF DOULAS TO

4097
02:25:09,859 --> 02:25:12,128
DELIVER THE INTERVENTION.

4098
02:25:12,128 --> 02:25:16,199
SO WE ARE POISED TO ENROLL AND

4099
02:25:16,199 --> 02:25:17,000
RANDOMIZE 200 BIRTHING

4100
02:25:17,000 --> 02:25:17,734
INDIVIDUALS AT THE FIRST

4101
02:25:17,734 --> 02:25:19,069
HOSPITAL, WHICH IS BROOKLYN

4102
02:25:19,069 --> 02:25:19,836
METHODIST.

4103
02:25:19,836 --> 02:25:22,472
EACH INDIVIDUAL WILL BE ENROLLED

4104
02:25:22,472 --> 02:25:23,373
FOR SIX MONTHS.

4105
02:25:23,373 --> 02:25:25,108
THAT'S WHERE WE GET TO PRIMARY

4106
02:25:25,108 --> 02:25:26,109
FOLLOW-UP, AND EACH HOSPITAL

4107
02:25:26,109 --> 02:25:28,712
WILL BE ENROLLING PATIENTS OVER

4108
02:25:28,712 --> 02:25:31,181
THE FIRST -- OVER 18 MONTHS, AND

4109
02:25:31,181 --> 02:25:33,783
THEN AFTER THEY'RE DONE WITH

4110
02:25:33,783 --> 02:25:35,218
ENROLLING AND FOLLOW-UP, WE'LL

4111
02:25:35,218 --> 02:25:38,121
THEN DO AN IMPLEMENTATION

4112
02:25:38,121 --> 02:25:39,623
EVALUATION OVER SIX MONTHS AT

4113
02:25:39,623 --> 02:25:44,194
EACH SITE.

4114
02:25:44,194 --> 02:25:46,229
AND THIS IS JUST OUR TIMELINE

4115
02:25:46,229 --> 02:25:46,963
OVER THE SEVEN YEARS.

4116
02:25:46,963 --> 02:25:51,134
SO THE FIRST YEAR WAS A DEVELOP

4117
02:25:51,134 --> 02:25:52,002
MEANT PHASE.

4118
02:25:52,002 --> 02:25:55,839
I. ALSO WANT TO MENTION, WE HAVE

4119
02:25:55,839 --> 02:25:57,474
A CHARGE BOARD, SO THIS IS THE

4120
02:25:57,474 --> 02:25:58,908
COMMUNITY HOSPITAL ACADEMIC

4121
02:25:58,908 --> 02:26:02,412
RESEARCH GOVERNANCE ADVISORY

4122
02:26:02,412 --> 02:26:03,847
BOARD, AND SO LIVING HEALTHY FOR

4123
02:26:03,847 --> 02:26:07,550
MOMS WAS PRESENTED TO THEM TWICE

4124
02:26:07,550 --> 02:26:10,220
FOR THEIR INPUT.

4125
02:26:10,220 --> 02:26:12,455
SO THIS BOARD HAS A NEW YORK

4126
02:26:12,455 --> 02:26:13,523
STATE DEPARTMENT OF HEALTH, THE

4127
02:26:13,523 --> 02:26:15,392
CITY DEPARTMENT OF HEALTH, ACOG

4128
02:26:15,392 --> 02:26:16,493
DISTRICT 2, SO THERE'S A SAFE

4129
02:26:16,493 --> 02:26:18,595
MOTHER INITIATIVE IN OUR STATE.

4130
02:26:18,595 --> 02:26:22,599
WHICH INVOLVES, OUT OF 123

4131
02:26:22,599 --> 02:26:23,833
HOSPITALS IN NEW YORK STATE, 117

4132
02:26:23,833 --> 02:26:26,569
OF THEM, AND THEY'VE BEEN

4133
02:26:26,569 --> 02:26:27,804
INSTRUMENTAL IN IMPLEMENTING

4134
02:26:27,804 --> 02:26:32,642
SAFETY BUNDLES ON HEMORRHAGE,

4135
02:26:32,642 --> 02:26:33,510
PRE-ECLAMPSIA, SO THEY'RE PART

4136
02:26:33,510 --> 02:26:33,943
OF THE BOARD.

4137
02:26:33,943 --> 02:26:39,115
AND WE'VE ENGAGED MAJOR HEALTH

4138
02:26:39,115 --> 02:26:43,086
SYSTEMS, MOUNT SINAI, IT'S ALSO

4139
02:26:43,086 --> 02:26:46,489
A SITE FOR OUR INTERVENTION.

4140
02:26:46,489 --> 02:26:48,692
SO THEY'RE THE LARGEST MUNICIPAL

4141
02:26:48,692 --> 02:26:49,726
DELIVERY SYSTEM IN THE COUNTRY,

4142
02:26:49,726 --> 02:26:54,798
AND THEY DELIVER 50% OF BLACK

4143
02:26:54,798 --> 02:26:57,934
BIRTHING PEOPLE IN NEW YORK

4144
02:26:57,934 --> 02:27:00,403
CITY, AND A MAJORITY OF MEDICAID

4145
02:27:00,403 --> 02:27:02,305
RECIPIENTS IN NEW YORK CITY OF

4146
02:27:02,305 --> 02:27:03,239
TWO PERINATAL PROGRAMS

4147
02:27:03,239 --> 02:27:03,873
THROUGHOUT THE STATE.

4148
02:27:03,873 --> 02:27:07,410
AND WE'RE INTERESTED ALSO IN NOT

4149
02:27:07,410 --> 02:27:12,649
JUST URBAN SETTINGS, BUT RURAL

4150
02:27:12,649 --> 02:27:13,550
SETTINGS, UNIVERSITY OF

4151
02:27:13,550 --> 02:27:15,118
ROCHESTER IS A PARTNER, IN YEAR

4152
02:27:15,118 --> 02:27:16,853
5 AND 6, WE'LL BE LOOKING AT

4153
02:27:16,853 --> 02:27:18,621
ADAPTATIONS OF THIS PROGRAM FOR

4154
02:27:18,621 --> 02:27:21,024
MORE RURAL SETTING.

4155
02:27:21,024 --> 02:27:24,327
AND THEN IN YEAR 7, OBVIOUSLY

4156
02:27:24,327 --> 02:27:25,428
BESIDES ANALYSIS, WE'LL USE THIS

4157
02:27:25,428 --> 02:27:28,064
CHARGE BOARD TO HELP DISSEMINATE

4158
02:27:28,064 --> 02:27:29,599
THE RESEARCH FINDINGS AND

4159
02:27:29,599 --> 02:27:32,869
IMPLEMENTATION.

4160
02:27:32,869 --> 02:27:34,704
SO THIS JUST SHOWS A SCHEMATIC

4161
02:27:34,704 --> 02:27:36,873
OF THE LIVING HEALTHY FOR MOMS

4162
02:27:36,873 --> 02:27:39,175
ARM AND THE ATTENTION CONTROL

4163
02:27:39,175 --> 02:27:39,609
ARM.

4164
02:27:39,609 --> 02:27:40,577
SO THE ATTENTION CONTROL ARM

4165
02:27:40,577 --> 02:27:42,579
THAT IS DOULA CARE, ROUTINE

4166
02:27:42,579 --> 02:27:44,347
DOULA CARE, BUT THERE'S NOT THE

4167
02:27:44,347 --> 02:27:45,382
COGNITIVE -- IT'S NOT EMBEDDED

4168
02:27:45,382 --> 02:27:47,317
IN COGNITIVE BEHAVIORAL THERAPY

4169
02:27:47,317 --> 02:27:48,418
AND THE MOTIVATIONAL

4170
02:27:48,418 --> 02:27:51,087
INTERVIEWING THAT HAPPENS IN THE

4171
02:27:51,087 --> 02:27:54,324
LIVING HEALTHY FOR MOMS ARM.

4172
02:27:54,324 --> 02:27:57,093
SO ON THE POSTPARTUM BOARD,

4173
02:27:57,093 --> 02:27:59,062
BLOOD PRESSURE CUFFS WILL BE

4174
02:27:59,062 --> 02:28:00,597
GIVEN, GIVEN EDUCATION ABOUT

4175
02:28:00,597 --> 02:28:01,464
POSTPARTUM COMPLICATIONS AND

4176
02:28:01,464 --> 02:28:03,032
INTRODUCTION TO THE DOULA.

4177
02:28:03,032 --> 02:28:07,203
AND THEN AFTERWARDS, ONE TO

4178
02:28:07,203 --> 02:28:08,338
SEVEN DAYS, BOTH ARMS WILL BE

4179
02:28:08,338 --> 02:28:10,306
DOING DAILY HOME BLOOD PRESSURE

4180
02:28:10,306 --> 02:28:11,941
MONITORING BUT THERE WILL BE

4181
02:28:11,941 --> 02:28:22,452
DAILY DOULA OUTREACH FOR, BUT

4182
02:28:24,154 --> 02:28:25,622
THESE SESSION TOPICS FOR LIVING

4183
02:28:25,622 --> 02:28:29,459
HEALTHY FOR MOMS WAS -- IT WAS

4184
02:28:29,459 --> 02:28:31,327
DEVISED IN CONJUNCTION WITH

4185
02:28:31,327 --> 02:28:36,733
BIRTHING PEOPLE DOULAS, AND SO

4186
02:28:36,733 --> 02:28:38,001
THESE SESSIONS, THE TIMING OF

4187
02:28:38,001 --> 02:28:40,437
THEM, THEIR CONTENT, AND AS

4188
02:28:40,437 --> 02:28:42,439
VICTORIA MENTIONED, A KEY

4189
02:28:42,439 --> 02:28:45,175
COMPONENT IS PALS, PATIENT

4190
02:28:45,175 --> 02:28:46,209
ACTIVATED LEARNING SYSTEM, SO

4191
02:28:46,209 --> 02:28:49,312
THIS ACTUALLY, MONICA SAFFORD

4192
02:28:49,312 --> 02:28:52,115
CAME UP WITH DEVICE AND WE'RE

4193
02:28:52,115 --> 02:28:53,850
OPTING IN FOR PERINATAL FOR THIS

4194
02:28:53,850 --> 02:28:56,653
USE BUT IT REALLY TARGETS LOW

4195
02:28:56,653 --> 02:28:59,389
LITERACY MARGINALIZED

4196
02:28:59,389 --> 02:29:01,024
POPULATIONS, AB SO THROUGH

4197
02:29:01,024 --> 02:29:03,159
INTERACTIVE VIDEOS, ACTIVITIES,

4198
02:29:03,159 --> 02:29:05,762
CBT, REALLY REFRAMING AND

4199
02:29:05,762 --> 02:29:10,266
EMBEDDING THIS EDUCATION TO

4200
02:29:10,266 --> 02:29:10,667
IMPROVE OUTCOMES.

4201
02:29:10,667 --> 02:29:12,068
THE DATA COLLECTION POINTS,

4202
02:29:12,068 --> 02:29:13,503
HEALTH SURVEYS, BLOOD PRESSURE,

4203
02:29:13,503 --> 02:29:15,405
HEIGHT, WEIGHT, POINT-OF-CARE

4204
02:29:15,405 --> 02:29:17,474
TESTING WILL BE DONE AT

4205
02:29:17,474 --> 02:29:19,342
BASELINE, SIX WEEKS POSTPARTUM

4206
02:29:19,342 --> 02:29:22,712
AND SIX MONTHS POSTPARTUM.

4207
02:29:22,712 --> 02:29:24,214
WE HAVE DATA AND SAFETY

4208
02:29:24,214 --> 02:29:27,150
MONITORING BOARD, WHICH IS --

4209
02:29:27,150 --> 02:29:30,954
GAVE US EXCELLENT INPUT TO

4210
02:29:30,954 --> 02:29:33,289
REFINE ALSO THE STUDY.

4211
02:29:33,289 --> 02:29:34,757
IN TERMS OF IMPLEMENTATION

4212
02:29:34,757 --> 02:29:37,560
EVALUATION, WE'RE GOING TO USE A

4213
02:29:37,560 --> 02:29:39,262
RE-AIM FRAMEWORK, SO WHO ARE THE

4214
02:29:39,262 --> 02:29:40,563
PATIENTS INTENDED TO PARTICIPATE

4215
02:29:40,563 --> 02:29:41,865
AND BENEFIT FROM LIVING HEALTHY

4216
02:29:41,865 --> 02:29:43,399
FOR MOMS, WHAT ARE THE MOST

4217
02:29:43,399 --> 02:29:45,635
IMPORTANT BENEFITS WE'RE TRYING

4218
02:29:45,635 --> 02:29:46,636
TO ACHIEVE, WHAT IS THE

4219
02:29:46,636 --> 02:29:47,937
LIKELIHOOD OF A NEGATIVE OUT

4220
02:29:47,937 --> 02:29:49,506
COME, WHERE WAS LIVING HEALTHY

4221
02:29:49,506 --> 02:29:52,709
FOR MOMS APPLIED AND BY WHOM,

4222
02:29:52,709 --> 02:29:53,776
HOW CONSISTENTLY WAS IT

4223
02:29:53,776 --> 02:29:54,677
DELIVERED, HOW MUCH DID IT COST,

4224
02:29:54,677 --> 02:29:57,213
WHY DID THE RESULTS HAPPEN THAT

4225
02:29:57,213 --> 02:29:58,882
WE GOT, AND THEN MAINTENANCE,

4226
02:29:58,882 --> 02:30:01,050
WHEN DID LIVING HEALTHY FOR MOMS

4227
02:30:01,050 --> 02:30:02,552
BECOME OPERATIONAL, HOW WAS IT

4228
02:30:02,552 --> 02:30:03,820
SUSTAINED, AND HOW ARE

4229
02:30:03,820 --> 02:30:06,022
INDIVIDUAL RESULTS SUSTAINED.

4230
02:30:06,022 --> 02:30:10,326
WE'RE ALSO USING THE CIFR

4231
02:30:10,326 --> 02:30:11,661
CONSTRUCT, SO WHAT ARE THE

4232
02:30:11,661 --> 02:30:12,862
ADVANTAGES TO LIVING HEALTHY FOR

4233
02:30:12,862 --> 02:30:15,298
MOMS VERSUS USUAL CARE, DO WE

4234
02:30:15,298 --> 02:30:15,932
HAVE SUFFICIENT PARTNERSHIPS AND

4235
02:30:15,932 --> 02:30:17,700
CONNECTIONS TO CARRY IT OUT, HOW

4236
02:30:17,700 --> 02:30:20,236
HARD WILL IT BE TO IMPLEMENT

4237
02:30:20,236 --> 02:30:21,304
COMMUNICATION BETWEEN PROVIDERS

4238
02:30:21,304 --> 02:30:23,406
AND THE HOSPITAL SYSTEM, AND THE

4239
02:30:23,406 --> 02:30:26,943
LIVING FOR HEALTHY MOMS PROGRAM.

4240
02:30:26,943 --> 02:30:28,411
THE INDIVIDUAL LEVEL, IS THE

4241
02:30:28,411 --> 02:30:30,146
HOSPITAL LEADERSHIP GOING TO BE

4242
02:30:30,146 --> 02:30:32,282
ENTHUSIASTIC ABOUT THIS PROGRAM,

4243
02:30:32,282 --> 02:30:35,385
AND WILL IT BE HARD TO FIND

4244
02:30:35,385 --> 02:30:39,289
STRATEGIES TO FIX -- TO TAILOR

4245
02:30:39,289 --> 02:30:40,490
THIS TO THE IMPLEMENTATION

4246
02:30:40,490 --> 02:30:41,224
PROCESS.

4247
02:30:41,224 --> 02:30:44,527
WE'RE GOOD.

4248
02:30:44,527 --> 02:30:46,095
I TALK QUICKLY BECAUSE I'M FROM

4249
02:30:46,095 --> 02:30:49,399
NEW YORK ORIGINALLY, SO -- IN

4250
02:30:49,399 --> 02:30:51,301
TERMS OF -- SO WE FINISHED,

4251
02:30:51,301 --> 02:30:53,236
WE'RE STARTING YEAR TWO, WE'RE

4252
02:30:53,236 --> 02:30:55,338
THRILLED WE FINISHED THE DOULA

4253
02:30:55,338 --> 02:30:57,206
TRAINING AND CERTIFICATION, WE

4254
02:30:57,206 --> 02:30:59,108
TRAINED ATTENTION CONTROL

4255
02:30:59,108 --> 02:31:00,743
DOULAS, HIRED A RECRUITER FROM

4256
02:31:00,743 --> 02:31:03,780
THE COMMUNITY AT BROOKLYN

4257
02:31:03,780 --> 02:31:05,315
METHODIST, FINALIZED AND

4258
02:31:05,315 --> 02:31:07,350
TRANSLATED ALL THE INTERVENTION

4259
02:31:07,350 --> 02:31:08,484
MATERIALS SO THERE'S A

4260
02:31:08,484 --> 02:31:09,986
PARTICIPANT ACTIVITY BOOK, THE

4261
02:31:09,986 --> 02:31:11,654
DOULA REFERENCE MANUAL, THE

4262
02:31:11,654 --> 02:31:14,824
PATIENT ACTIVATED LEARNING

4263
02:31:14,824 --> 02:31:15,692
CONTENT.

4264
02:31:15,692 --> 02:31:17,460
WE'VE OBTAINED IRB APPROVAL TO

4265
02:31:17,460 --> 02:31:19,495
DO THE STUDY, AND THEN THE

4266
02:31:19,495 --> 02:31:21,998
LATEST THING IS COMMON DATA

4267
02:31:21,998 --> 02:31:23,933
ELEMENTS, SO WE HAD A MEETING

4268
02:31:23,933 --> 02:31:25,802
AND NIH HELD A MEETING ABOUT THE

4269
02:31:25,802 --> 02:31:27,270
DESIRE TO IMPLEMENT THE COMMON

4270
02:31:27,270 --> 02:31:30,106
DATA ELEMENTS ACROSS ALL THE

4271
02:31:30,106 --> 02:31:31,741
STUDIES, SO THOSE FORMS AND

4272
02:31:31,741 --> 02:31:33,676
ELEMENTS ARE BEING EMBEDDED, SO

4273
02:31:33,676 --> 02:31:37,046
WE'RE ABOUT TO -- I SAID

4274
02:31:37,046 --> 02:31:38,181
OCTOBER, IT'S GOING TO BE

4275
02:31:38,181 --> 02:31:39,282
NOVEMBER, BUT WE'RE READY TO

4276
02:31:39,282 --> 02:31:41,584
RECRUIT AT BROOKLYN METHODIST.

4277
02:31:41,584 --> 02:31:47,423
AND I JUST WANT TO SAY ON BEHALF

4278
02:31:47,423 --> 02:31:49,626
OF NEW YORK CHAMP, WE CALL

4279
02:31:49,626 --> 02:31:50,827
OURSELVES NEW YORK CHAMPIONS,

4280
02:31:50,827 --> 02:31:52,729
WE'RE JUST SO THANKFUL TO BE A

4281
02:31:52,729 --> 02:31:54,564
PART OF THIS INITIATIVE AND HAVE

4282
02:31:54,564 --> 02:31:55,298
THIS OPPORTUNITY, SO THANK YOU

4283
02:31:55,298 --> 02:31:55,698
SO MUCH.

4284
02:31:55,698 --> 02:32:02,572
[APPLAUSE]

4285
02:32:02,572 --> 02:32:05,408
>> THANK YOU SO MUCH, UMA,
THAT

4286
02:32:05,408 --> 02:32:08,077
WAS FON TAS TICK.

4287
02:32:08,077 --> 02:32:08,378
 FANTASTIC.

4288
02:32:08,378 --> 02:32:10,413
I KNOW WE'RE UP AGAINST THE

4289
02:32:10,413 --> 02:32:11,514
BREAK BUT WE'RE GOING TO OPEN IT

4290
02:32:11,514 --> 02:32:12,949
UP FOR ONE QUESTION IF ANYONE IN

4291
02:32:12,949 --> 02:32:14,250
THE AUDIENCE WANTS TO STEP

4292
02:32:14,250 --> 02:32:15,385
FORWARD?

4293
02:32:15,385 --> 02:32:16,252
NO PRESSURE BECAUSE IT'S THE

4294
02:32:16,252 --> 02:32:21,157
ONLY QUESTION.

4295
02:32:21,157 --> 02:32:21,758
WE HAVE A TAKER.

4296
02:32:21,758 --> 02:32:24,360
>> VERY QUICK QUESTION AND
I MAY

4297
02:32:24,360 --> 02:32:27,263
HAVE MISSED IT WHEN I DARTED OUT

4298
02:32:27,263 --> 02:32:28,031
FOR THE RESTROOM.

4299
02:32:28,031 --> 02:32:30,199
CAN YOU SHARE FOR YOUR

4300
02:32:30,199 --> 02:32:31,467
INTERVENTION WHEN YOU'RE

4301
02:32:31,467 --> 02:32:31,768
RECRUITING?

4302
02:32:31,768 --> 02:32:34,170
IS IT DURING LATE PREGNANCY,

4303
02:32:34,170 --> 02:32:34,637
POSTPARTUM?

4304
02:32:34,637 --> 02:32:36,205
CAN YOU SHARE A LITTLE ABOUT THE

4305
02:32:36,205 --> 02:32:39,075
RECRUITMENT PROCESS?

4306
02:32:39,075 --> 02:32:40,576
>> EXCELLENT QUESTION.

4307
02:32:40,576 --> 02:32:41,778
WE'RE RECRUISING POSTPARTUM,

4308
02:32:41,778 --> 02:32:42,845
RIGHT AFTER DELIVERY, IN THE

4309
02:32:42,845 --> 02:32:46,049
HOSPITAL.

4310
02:32:46,049 --> 02:32:48,951
>> WELL, LET'S THANK UMA
AND

4311
02:32:48,951 --> 02:32:50,153
VICTORIA FOR A FANTASTIC

4312
02:32:50,153 --> 02:32:50,687
PRESENTATION.

4313
02:32:50,687 --> 02:32:51,554
IT WAS AWESOME.

4314
02:32:51,554 --> 02:32:55,224
ALSO AGAIN THANKS TO CHRISTINE

4315
02:32:55,224 --> 02:32:56,959
GARNER AND IRO AND DEIRDRE FOR

4316
02:32:56,959 --> 02:32:57,727
THEIR PRESENTATIONS.

4317
02:32:57,727 --> 02:32:58,928
WE DO HAVE TWO MORE

4318
02:32:58,928 --> 02:32:59,929
PRESENTATIONS AFTER THE BREAK,

4319
02:32:59,929 --> 02:33:01,597
SO WE WILL BE STARTING UP AGAIN

4320
02:33:01,597 --> 02:33:04,400
PROMPTLY AT 1:30, AND PRESUMING

4321
02:33:04,400 --> 02:33:08,738
THAT THERE'S NO OTHER

4322
02:33:08,738 --> 02:33:11,741
HOUSEKEEPING, BON APPETIT, ENJOY

4323
02:33:11,741 --> 02:33:13,476
THE POSTER AND DEMO SESSION AND

4324
02:33:13,476 --> 02:33:15,280
WE'LL BE BACK AT 1:30 EASTERN
TIME.

4325
02:33:15,280 --> 02:33:16,682
FANTASTIC!  ALL RIGHT.

4326
02:33:16,682 --> 02:33:19,318
SO WE HAVE TWO -- TO CLOSE THE

4327
02:33:19,318 --> 02:33:22,254
SESSION WE HAVE TWO MORE AWESOME

4328
02:33:22,254 --> 02:33:23,355
PRESENTATIONS, FIRST UP, SAMEER,

4329
02:33:23,355 --> 02:33:25,224
COME ON DOWN.

4330
02:33:25,224 --> 02:33:27,626
SAMEER IS FROM CARDIEX, IS GOING

4331
02:33:27,626 --> 02:33:31,130
TO TALK ABOUT DETECTING THE

4332
02:33:31,130 --> 02:33:32,231
UNDETECTED. 

4333
02:33:32,231 --> 02:33:37,169
COME ON DOWN. 

4334
02:33:37,169 --> 02:33:37,636
>> GOOD AFTERNOON.

4335
02:33:37,636 --> 02:33:39,538
CAN YOU HEAR ME?

4336
02:33:39,538 --> 02:33:40,005
AWESOME.

4337
02:33:40,005 --> 02:33:46,011
I'M  SAMEER MOLVI, TODAY

4338
02:33:46,011 --> 02:33:47,646
INTRODUCING YOU TO OUR

4339
02:33:47,646 --> 02:33:50,582
INNOVATIVE SOLUTIONS FOR EARLY

4340
02:33:50,582 --> 02:33:53,585
DETECTION AND INTERVENTION OF

4341
02:33:53,585 --> 02:33:54,053
PREECLAMPSIA.

4342
02:33:54,053 --> 02:33:55,754
PREECLAMPSIA AFFECTS

4343
02:33:55,754 --> 02:33:56,755
APPROXIMATELY 8% OF PREGNANCIES,

4344
02:33:56,755 --> 02:33:59,958
AND WHICH CAN ALSO LEAD TO FETAL

4345
02:33:59,958 --> 02:34:01,693
AND MATERNAL MORBIDITY.

4346
02:34:01,693 --> 02:34:06,598
AT CARDIEX WE BELIEVE ADVANCE

4347
02:34:06,598 --> 02:34:07,933
THE VASCULAR BIOMARKERS CAN

4348
02:34:07,933 --> 02:34:10,636
PROVIDE DEEPER INSIGHTS INTO

4349
02:34:10,636 --> 02:34:12,971
THIS CONDITION, MORE PRECISE

4350
02:34:12,971 --> 02:34:17,543
MONITORING AND INTERVENTION IN

4351
02:34:17,543 --> 02:34:25,851
CLINICS AND REMOTELY. 

4352
02:34:25,851 --> 02:34:26,952
THERE WE GO.

4353
02:34:26,952 --> 02:34:28,153
ALL RIGHT.

4354
02:34:28,153 --> 02:34:30,656
SO OUR CONNECT VASCULAR MELT

4355
02:34:30,656 --> 02:34:33,192
MONITORING PLATFORM IS DESIGNED

4356
02:34:33,192 --> 02:34:36,028
TO DIAGNOSE, INTERVENE, MANAGE

4357
02:34:36,028 --> 02:34:39,064
ARTERIAL HEALTH, CONTINUOUS AND

4358
02:34:39,064 --> 02:34:41,066
COMPREHENSIVE MONITORING, BUILD

4359
02:34:41,066 --> 02:34:42,734
ON THE TECHNOLOGY WHICH PROVIDES

4360
02:34:42,734 --> 02:34:50,375
INSIGHT INTO CENTRAL BLOOD

4361
02:34:50,375 --> 02:34:58,283
PRESSURE AND ARTERIAL, TWO CRE

4362
02:34:58,283 --> 02:34:59,585
MANAGEMENTS IN PREECLAMPSIA AND

4363
02:34:59,585 --> 02:35:04,189
OTHER CARDIAC CONDITIONS. 

4364
02:35:04,189 --> 02:35:05,724
THE SEAMLESS INTEGRATION MAKES

4365
02:35:05,724 --> 02:35:08,127
THIS UNIQUE, CAN BE INCORPORATED

4366
02:35:08,127 --> 02:35:14,266
INTO EXISTING CARE PATHWAYS FOR

4367
02:35:14,266 --> 02:35:14,867
PREGNANT WOMEN, REIMBURSEMENT

4368
02:35:14,867 --> 02:35:17,002
THROUGH CODE, THUS MAKING IT

4369
02:35:17,002 --> 02:35:20,472
PRACTICAL AND FINANCIALLY

4370
02:35:20,472 --> 02:35:21,006
BENEFICIAL FOR HEALTHCARE

4371
02:35:21,006 --> 02:35:23,575
PROVIDERS.

4372
02:35:23,575 --> 02:35:32,251
NOW, AT THE HEART OF OUR CONNECT

4373
02:35:32,251 --> 02:35:35,754
PLATFORM IS OUR CONNEQT PULSE

4374
02:35:35,754 --> 02:35:39,224
VASCULAR BIOMETRIC MONITORING,

4375
02:35:39,224 --> 02:35:40,826
WE GOT APPROVAL, COMPRISE HENCE

4376
02:35:40,826 --> 02:35:44,630
SIV AND BRACHIAL BLOOD PRESSURE,

4377
02:35:44,630 --> 02:35:46,365
INSIGHT INTO ARTERIAL STIFFNESS

4378
02:35:46,365 --> 02:35:53,005
AND CARDIAC PROFUSION

4379
02:35:53,005 --> 02:35:53,705
EFFICIENCY.

4380
02:35:53,705 --> 02:35:54,606
OVER 2500 PEER-REVIEWED

4381
02:35:54,606 --> 02:35:55,707
PUBLICATIONS, TECHNOLOGIES LIKE

4382
02:35:55,707 --> 02:35:59,211
THIS ARE VALIDATED AND TRUSTED

4383
02:35:59,211 --> 02:36:01,847
BY EXPERTS WORLDWIDE.

4384
02:36:01,847 --> 02:36:03,582
 

4385
02:36:03,582 --> 02:36:10,255
LET ME TELL YOU MORE ABOUT THE

4386
02:36:10,255 --> 02:36:13,225
CONNECT PULSE, WE CAN MEASURE

4387
02:36:13,225 --> 02:36:13,892
VASCULAR BIOMARKERS LIKE CENTRAL

4388
02:36:13,892 --> 02:36:15,961
BLOOD PRESSURE WHICH IS THE

4389
02:36:15,961 --> 02:36:19,665
PRESSURE AT YOUR HEART AND

4390
02:36:19,665 --> 02:36:24,136
ASCENDING AORTIC VALVE AND

4391
02:36:24,136 --> 02:36:27,439
AUGMENTATION INDEX, KEY

4392
02:36:27,439 --> 02:36:28,840
INDICATOR OF ARTERIAL STIFFNESS

4393
02:36:28,840 --> 02:36:29,908
IDENTIFYING EARLY SIGNS OF

4394
02:36:29,908 --> 02:36:31,710
CARDIOVASCULAR STRESS, SIGNAL TO

4395
02:36:31,710 --> 02:36:35,080
THE ONSET OF CONDITIONS SUCH AS

4396
02:36:35,080 --> 02:36:37,282
PREECLAMPSIA.

4397
02:36:37,282 --> 02:36:38,517
 

4398
02:36:38,517 --> 02:36:40,786
ONE OF THE MOST EXCITING

4399
02:36:40,786 --> 02:36:42,521
APPLICATIONS OF THIS TECHNOLOGY

4400
02:36:42,521 --> 02:36:47,559
IS THE UTILITY IN PREGNANCY CARE

4401
02:36:47,559 --> 02:36:49,094
IN GENERAL, REMOTELY MONITORING

4402
02:36:49,094 --> 02:36:50,429
KEY CARDIOVASCULAR METRICS CAN

4403
02:36:50,429 --> 02:36:53,465
DETECT EARLY SIGNS OF

4404
02:36:53,465 --> 02:36:54,466
HYPERTENSIVE DISORDERS LONG

4405
02:36:54,466 --> 02:36:58,937
BEFORE THAT  -- TRADITIONAL MIGT

4406
02:36:58,937 --> 02:37:02,741
PICK THEM UP ALLOWING FOR TIMELY

4407
02:37:02,741 --> 02:37:04,042
INTERVENTION, GIVING PROVIDERS

4408
02:37:04,042 --> 02:37:07,212
ABILITY TO EFFECTIVELY MANAGE

4409
02:37:07,212 --> 02:37:07,713
HIGHER RISK PREGNANCIES.

4410
02:37:07,713 --> 02:37:11,049
ALL RIGHT.

4411
02:37:11,049 --> 02:37:12,584
NEXT SLIDE.

4412
02:37:12,584 --> 02:37:13,919
STUDIES HAVE SHOWN SIGNIFICANT

4413
02:37:13,919 --> 02:37:16,388
IMPACT ON PREGNANCY OUTCOMES.

4414
02:37:16,388 --> 02:37:21,893
FOR EXAMPLE RESEARCH INDICATES

4415
02:37:21,893 --> 02:37:25,831
HAVING HAD PREECLAMPSIA ADDS SIX

4416
02:37:25,831 --> 02:37:28,133
YEARS TO VASCULAR AGING,

4417
02:37:28,133 --> 02:37:30,202
DETECTING THESE CHANGES EARLY AS

4418
02:37:30,202 --> 02:37:34,506
POSSIBLE IS SO CRUCIAL.

4419
02:37:34,506 --> 02:37:37,075
BY TRACKING, WE CAN PREDICT

4420
02:37:37,075 --> 02:37:40,245
PREECLAMPSIA, IMPROVE OUTCOMES

4421
02:37:40,245 --> 02:37:46,518
FOR MOTHERS AND BABIES.

4422
02:37:46,518 --> 02:37:46,852
 

4423
02:37:46,852 --> 02:37:48,453
SO OUR COMPREHENSIVE

4424
02:37:48,453 --> 02:37:52,057
PREECLAMPSIA RISK ASSESSMENT AND

4425
02:37:52,057 --> 02:37:53,158
MONITORING WORKFLOW INCLUDES IN

4426
02:37:53,158 --> 02:37:55,994
CLINIC AND AT HOME MONITORING.

4427
02:37:55,994 --> 02:37:57,763
THROUGHOUT PREGNANCY REGULAR

4428
02:37:57,763 --> 02:38:01,066
VISITS AND ONGOING MONITORING

4429
02:38:01,066 --> 02:38:03,568
ALLOWS TRACKING OF CHANGES,

4430
02:38:03,568 --> 02:38:04,903
ENABLING TIMELY INTERVENTIONS,

4431
02:38:04,903 --> 02:38:06,538
ENSURING MOTHERS AND HEALTHCARE

4432
02:38:06,538 --> 02:38:11,610
PROVIDERS ARE WELL EQUIPPED TO

4433
02:38:11,610 --> 02:38:14,980
MANAGE PREGNANCY-RELATED RISKS.

4434
02:38:14,980 --> 02:38:16,048
FOR PROVIDERS, OUR SOLUTIONS

4435
02:38:16,048 --> 02:38:19,885
OFFER EARLY DETECTION AND

4436
02:38:19,885 --> 02:38:21,086
ONGOING MONITORING WHILE

4437
02:38:21,086 --> 02:38:22,721
PROVIDING VITAL DATA THAT ALLOWS

4438
02:38:22,721 --> 02:38:24,156
FOR EARLIER AND MORE PRECISE

4439
02:38:24,156 --> 02:38:28,960
ENTER 

4440
02:38:28,960 --> 02:38:29,861
INTERVENTION, IDENTIFYING

4441
02:38:29,861 --> 02:38:32,030
CHANGES EARLIER AND CAN OFFER

4442
02:38:32,030 --> 02:38:33,765
MORE PERSONALIZED CARE AND

4443
02:38:33,765 --> 02:38:35,734
IMPROVE PATIENT OUTCOMES WHILE

4444
02:38:35,734 --> 02:38:40,772
BENEFITING FROM CPE CODES FOR

4445
02:38:40,772 --> 02:38:43,408
REIMBURSEMENT. 

4446
02:38:43,408 --> 02:38:46,044
NOW, FOR EXPECTING MOMS, THE

4447
02:38:46,044 --> 02:38:47,913
PLATFORM OFFERS EASY ACCESS TO

4448
02:38:47,913 --> 02:38:49,748
PERSONALIZE THE HEALTH DATA WITH

4449
02:38:49,748 --> 02:38:51,516
CONTINUOUS MONITORING OF CENTRAL

4450
02:38:51,516 --> 02:38:52,718
BLOOD PRESSURE, ARTERIAL

4451
02:38:52,718 --> 02:38:53,685
STIFFNESS, MOTHERS CAN STAY

4452
02:38:53,685 --> 02:38:55,320
INFORMED ABOUT THEIR HEART

4453
02:38:55,320 --> 02:38:58,290
HEALTH THROUGHOUT PREGNANCY

4454
02:38:58,290 --> 02:38:59,791
GIVING PEACE OF MIND THAT THEY

4455
02:38:59,791 --> 02:39:01,226
HAVE ADDITIONAL LAYER OF CARE

4456
02:39:01,226 --> 02:39:07,132
BEYOND STANDARD BLOOD PRESSURE

4457
02:39:07,132 --> 02:39:08,533
MONITORING.

4458
02:39:08,533 --> 02:39:18,443
AND NOW A SNEAK PEEK, WE'RE

4459
02:39:18,443 --> 02:39:21,179
WORKING ON THE CONNEQT BAND,

4460
02:39:21,179 --> 02:39:21,847
MONITORING KEY METRICS-LIKE

4461
02:39:21,847 --> 02:39:23,915
CENTRAL BLOOD PRESSURE AND

4462
02:39:23,915 --> 02:39:25,417
ARTERIAL STIFFNESS, AND WHICH

4463
02:39:25,417 --> 02:39:26,218
ARE IMPORTANT DURING PREGNANCY

4464
02:39:26,218 --> 02:39:28,620
AS I MENTIONED BEFORE.

4465
02:39:28,620 --> 02:39:32,991
THE BAND IS BUILT ON OUR

4466
02:39:32,991 --> 02:39:34,292
VALIDATED PLATFORM AND OFFERS

4467
02:39:34,292 --> 02:39:36,695
24/7 MONITORING IN THE

4468
02:39:36,695 --> 02:39:38,764
COMFORTABLE WEARABLE FORMAT

4469
02:39:38,764 --> 02:39:44,469
MAKING IT  EASIER TO MANAGE

4470
02:39:44,469 --> 02:39:46,238
HEALTH THROUGHOUT PREGNANCY.

4471
02:39:46,238 --> 02:39:49,508
AND WE'VE HAD SOME RECOGNITIONS

4472
02:39:49,508 --> 02:39:54,880
ALONG THE WAY, WE ALSO WERE

4473
02:39:54,880 --> 02:39:58,617
THANKFULLY WON THE RADx

4474
02:39:58,617 --> 02:40:00,318
MATERNAL HEALTH CHALLENGE,

4475
02:40:00,318 --> 02:40:01,653
RECOGNITIONS ALONG THE WAY.

4476
02:40:01,653 --> 02:40:04,723
THANK YOU FOR YOUR TIME.

4477
02:40:04,723 --> 02:40:07,125
WE'RE DRIVEN TO IMPROVE MATERNAL

4478
02:40:07,125 --> 02:40:08,660
HEALTH THROUGH ADVANCE THE

4479
02:40:08,660 --> 02:40:14,800
ARTERIAL HEALTH MONITORING AND

4480
02:40:14,800 --> 02:40:18,403
OFFER BETTER TOOLS FOR

4481
02:40:18,403 --> 02:40:20,272
MONITORING CONDITIONS SUCH AS

4482
02:40:20,272 --> 02:40:23,442
PREECLAMPSIA AND AIM  -- I'M

4483
02:40:23,442 --> 02:40:29,681
HAPPY TO ANSWER QUESTIONS.

4484
02:40:29,681 --> 02:40:30,348
>> EXCITING TECHNOLOGY,
PLEASE

4485
02:40:30,348 --> 02:40:33,285
GO AHEAD.

4486
02:40:33,285 --> 02:40:43,328
 

4487
02:40:47,833 --> 02:40:48,266
>> OKAY.

4488
02:40:48,266 --> 02:40:49,701
I THINK IT'S REMARKABLE THAT

4489
02:40:49,701 --> 02:40:52,671
YOU'VE BEEN ABLE TO CRACK THE

4490
02:40:52,671 --> 02:40:54,739
REIMBURSEMENT PATH SO WELL.

4491
02:40:54,739 --> 02:40:56,374
MY QUESTION IS, IF YOU COULD

4492
02:40:56,374 --> 02:41:00,011
EXPAND UPON THAT, ESPECIALLY

4493
02:41:00,011 --> 02:41:00,979
WITH YOUR CONNECT BAND COMING

4494
02:41:00,979 --> 02:41:04,916
OUT IF YOU THINK THE DEVICE WILL

4495
02:41:04,916 --> 02:41:06,151
BE FULLY REIMBURSABLE DOES THE

4496
02:41:06,151 --> 02:41:07,919
PATIENT HAVE ANY COSTS AT ALL

4497
02:41:07,919 --> 02:41:09,054
AND HOW COMPELLING FOR A

4498
02:41:09,054 --> 02:41:10,722
PROVIDER TO JUMP ON BOARD AND

4499
02:41:10,722 --> 02:41:12,991
START USING YOUR TECHNOLOGY.

4500
02:41:12,991 --> 02:41:14,993
>> YEAH, ABSOLUTELY GOOD

4501
02:41:14,993 --> 02:41:15,527
QUESTION.

4502
02:41:15,527 --> 02:41:18,096
SO, WE ARE WORKING OUT OUR

4503
02:41:18,096 --> 02:41:19,664
PRICING MODELS AT THE MOMENT AS

4504
02:41:19,664 --> 02:41:20,665
WELL.

4505
02:41:20,665 --> 02:41:21,766
IT'S SOMETHING WE'RE LOOKING

4506
02:41:21,766 --> 02:41:24,169
INTO. 

4507
02:41:24,169 --> 02:41:25,937
WE'RE LOOKING INTO PROVIDING

4508
02:41:25,937 --> 02:41:28,573
MORE HEALTH SERVICES AS OUR WAY

4509
02:41:28,573 --> 02:41:31,543
OF PROVIDING THE SERVICE TO

4510
02:41:31,543 --> 02:41:31,877
USERS.

4511
02:41:31,877 --> 02:41:35,680
THIS INCLUDES, YOU KNOW,

4512
02:41:35,680 --> 02:41:37,315
PROVIDING ANYONE THAT A HEART IS

4513
02:41:37,315 --> 02:41:41,686
ABLE TO TAKE THE ASSESSMENT, NOT

4514
02:41:41,686 --> 02:41:42,687
JUST PREGNANT WOMEN IN THIS

4515
02:41:42,687 --> 02:41:43,989
CASE, FOR EXAMPLE, RIGHT?

4516
02:41:43,989 --> 02:41:45,090
WE'RE LOOKING TO PROVIDE A

4517
02:41:45,090 --> 02:41:46,858
SERVICE AT THE PRICE RANGE OF

4518
02:41:46,858 --> 02:41:48,159
TWO TO THREE HUNDRED DOLLARS AT

4519
02:41:48,159 --> 02:41:53,632
THE MOMENT SO IT'S AVAILABLE TO

4520
02:41:53,632 --> 02:41:56,334
EVERYONE.

4521
02:41:56,334 --> 02:41:57,068
>> FANTASTIC.

4522
02:41:57,068 --> 02:42:01,940
ANY OTHER QUESTIONS FOR SAMEER? 

4523
02:42:01,940 --> 02:42:05,443
IT WAS SO CLEAR AND EXACTLY

4524
02:42:05,443 --> 02:42:05,944
CONCISE.

4525
02:42:05,944 --> 02:42:07,546
OH, ONE MORE, SORRY.

4526
02:42:07,546 --> 02:42:08,513
PLEASE GO AHEAD.

4527
02:42:08,513 --> 02:42:09,748
>> FOR THE BANDS, ARE THEY

4528
02:42:09,748 --> 02:42:12,217
REUSABLE AND HOW LONG WOULD IT

4529
02:42:12,217 --> 02:42:12,450
LAST?

4530
02:42:12,450 --> 02:42:15,287
IF I'M A PERSON NOT PREGNANT AND

4531
02:42:15,287 --> 02:42:17,155
WANTS TO MONITOR MY BLOOD

4532
02:42:17,155 --> 02:42:20,559
PRESSURE BECAUSE I HAVE CHRONIC

4533
02:42:20,559 --> 02:42:20,892
HYPERTENSION.

4534
02:42:20,892 --> 02:42:21,760
>> WE'RE LOOKING FOR IT TO
LAST

4535
02:42:21,760 --> 02:42:28,233
ABOUT FIVE DAYS AT THE MOMENT.

4536
02:42:28,233 --> 02:42:29,000
IT'S RECHARGEABLE.

4537
02:42:29,000 --> 02:42:31,503
>> DO WE HAVE TIME FOR ONE

4538
02:42:31,503 --> 02:42:32,270
QUESTION FROM ONLINE?

4539
02:42:32,270 --> 02:42:34,339
SO THE QUESTION FROM ONLINE IS

4540
02:42:34,339 --> 02:42:35,707
FROM SUSAN HAHN, HOW DOES THE

4541
02:42:35,707 --> 02:42:37,742
DATA GET TO THE TREATING

4542
02:42:37,742 --> 02:42:39,611
CLINICIAN, DOES IT REQUIRE WI-FI

4543
02:42:39,611 --> 02:42:41,346
AND INTERNET?

4544
02:42:41,346 --> 02:42:44,115
>> YES, SO OUR DATA IS

4545
02:42:44,115 --> 02:42:45,984
TRANSFERRED FROM HARDWARE TO

4546
02:42:45,984 --> 02:42:50,655
MOBILE APPLICATION OR TABLET

4547
02:42:50,655 --> 02:42:52,090
APPLICATION VIA BLUETOOTH, WENT

4548
02:42:52,090 --> 02:42:54,492
VIA WI-FI TO THE BACK END, THE

4549
02:42:54,492 --> 02:42:54,726
PORTAL.

4550
02:42:54,726 --> 02:42:57,462
WHEN YOU TAKE THE READING THE

4551
02:42:57,462 --> 02:42:59,297
DATA IS SENT ACROSS, ONCE YOU

4552
02:42:59,297 --> 02:43:01,399
CONNECT YOUR MOBILE APPLICATION

4553
02:43:01,399 --> 02:43:03,702
IT'S RIGHT THERE WITH TRANSIS

4554
02:43:03,702 --> 02:43:05,437
ANALYSIS READY FOR THE PHYSICIAN

4555
02:43:05,437 --> 02:43:06,504
OR HEALTHCARE PROVIDER.

4556
02:43:06,504 --> 02:43:13,445
THANK YOU VERY MUCH, EVERYBODY.

4557
02:43:13,445 --> 02:43:21,853
 

4558
02:43:21,853 --> 02:43:23,955
>> COME ON DOWN, WILL.

4559
02:43:23,955 --> 02:43:34,499
NEXT PRESENTATION IS FROM WILL,

4560
02:43:36,701 --> 02:43:37,636
PYRAMES.

4561
02:43:37,636 --> 02:43:38,603
>> WILL SUTHERLAND FROM
PYRAMES,

4562
02:43:38,603 --> 02:43:39,571
CHIEF OPERATING OFFICER WHICH

4563
02:43:39,571 --> 02:43:41,006
MEANS THEY DON'T LET ME OUT IN

4564
02:43:41,006 --> 02:43:42,073
PUBLIC OFTEN TO TALK TO PEOPLE

4565
02:43:42,073 --> 02:43:43,508
LIKE YOU.

4566
02:43:43,508 --> 02:43:46,578
I'LL DO MY BEST AND SEE IF I CAN

4567
02:43:46,578 --> 02:43:47,345
FILL THE SHOES.

4568
02:43:47,345 --> 02:43:50,448
I WANTED TO START OUT BY

4569
02:43:50,448 --> 02:43:55,787
THANKING NIH AND PARTICULARLY

4570
02:43:55,787 --> 02:43:57,122
THE RADx PROGRAM FOR THIS

4571
02:43:57,122 --> 02:43:59,958
PROGRAM THAT WE PARTICIPATED IN.

4572
02:43:59,958 --> 02:44:02,160
THE AWARDS ARE VERY IMPORTANT TO

4573
02:44:02,160 --> 02:44:04,329
SMALL START-UP COMPANIES LIKE

4574
02:44:04,329 --> 02:44:05,130
OURS WHERE THE FINANCIAL

4575
02:44:05,130 --> 02:44:06,331
RESOURCES ARE PRECIOUS AND THIS

4576
02:44:06,331 --> 02:44:08,400
GIVES US AN EXTRA BOOST TO FOCUS

4577
02:44:08,400 --> 02:44:11,036
IN ON A CRITICAL AREA OF HEALTH.

4578
02:44:11,036 --> 02:44:14,305
BUT THE PROGRAM ITSELF GAVE US

4579
02:44:14,305 --> 02:44:16,741
MUCH MORE THAN JUST FINANCIAL

4580
02:44:16,741 --> 02:44:17,008
SUPPORT.

4581
02:44:17,008 --> 02:44:19,244
THE PROGRAM PROVIDED SOME GREAT

4582
02:44:19,244 --> 02:44:21,212
RESOURCES AND FEEDBACK AND

4583
02:44:21,212 --> 02:44:23,048
DIRECTION THAT REALLY HELPED

4584
02:44:23,048 --> 02:44:24,816
ADVANCE OUR EFFORTS ON OUR

4585
02:44:24,816 --> 02:44:27,886
PRODUCTS WHILE FOCUSING IN ON

4586
02:44:27,886 --> 02:44:29,287
THE MATERNAL HEALTH CHALLENGE,

4587
02:44:29,287 --> 02:44:36,961
IT'S BEEN VALUABLE AND I THANK

4588
02:44:36,961 --> 02:44:42,067
RADx FOR THAT PROGRAM.

4589
02:44:42,067 --> 02:44:44,869
A LITTLE BIT ABOUT PYRAMES AS A

4590
02:44:44,869 --> 02:44:47,539
COMPANY, WE'VE GOT AN ALWAYS-ON

4591
02:44:47,539 --> 02:44:48,173
BLOOD PRESSURE MONITORING

4592
02:44:48,173 --> 02:44:48,773
TECHNOLOGY.

4593
02:44:48,773 --> 02:44:52,177
THE CORE OF THE TECHNOLOGY CAME

4594
02:44:52,177 --> 02:44:58,750
OUT OF A LAB AT STANFORD, A

4595
02:44:58,750 --> 02:44:59,751
SENSOR THAT'S ULTRA SENSITIVE,

4596
02:44:59,751 --> 02:45:03,021
WORN ON THE WRIST OR OVER ANY

4597
02:45:03,021 --> 02:45:04,222
ARTERIAL PULSE POINT.

4598
02:45:04,222 --> 02:45:06,291
WE'RE ABLE TO PICK UP DEFLECTION

4599
02:45:06,291 --> 02:45:11,996
OF THE SKIN AND USING MACHINE

4600
02:45:11,996 --> 02:45:13,064
LEARNING AND ARTIFICIAL

4601
02:45:13,064 --> 02:45:15,600
INTELLIGENCE METHODS DEVELOPED

4602
02:45:15,600 --> 02:45:16,601
ALGORITHMS THAT CAN EXTRACT THE

4603
02:45:16,601 --> 02:45:18,002
BLOOD PRESSURE OF THE PATIENT

4604
02:45:18,002 --> 02:45:19,437
FROM THAT.

4605
02:45:19,437 --> 02:45:21,272
AND THAT PROCESSING OF DATA IS

4606
02:45:21,272 --> 02:45:24,008
DONE ON A MOBILE DEVICE SO THE

4607
02:45:24,008 --> 02:45:25,877
WRIST JUST COLLECTS THE SENSOR

4608
02:45:25,877 --> 02:45:27,412
DATA, AND THEN TRANSFERS IT TO

4609
02:45:27,412 --> 02:45:29,280
THE MOBILE DEVICE.

4610
02:45:29,280 --> 02:45:32,450
WE'VE BEEN IN EXISTENCE SINCE

4611
02:45:32,450 --> 02:45:32,917
2016.

4612
02:45:32,917 --> 02:45:34,319
AND LAST YEAR WE WERE CLEARED

4613
02:45:34,319 --> 02:45:37,589
FOR OUR VERY FIRST PRODUCT,

4614
02:45:37,589 --> 02:45:40,658
TARGETED AT NEONATAL INFANTS, IN

4615
02:45:40,658 --> 02:45:42,594
THE NICU, WHERE REALLY THE STATE

4616
02:45:42,594 --> 02:45:44,929
OF CARE IF YOU NEEDS TO MONITOR

4617
02:45:44,929 --> 02:45:46,865
BLOOD PRESSURE IS AN ARTERIAL

4618
02:45:46,865 --> 02:45:48,533
LINE AND MORE NEEDLES BEING

4619
02:45:48,533 --> 02:45:49,434
STUCK INTO THESE LITTLE PRECIOUS

4620
02:45:49,434 --> 02:45:51,369
BABIES IS NOT A VERY GOOD

4621
02:45:51,369 --> 02:45:51,770
SOLUTION.

4622
02:45:51,770 --> 02:45:53,638
SO WE'RE CLEARED ON THAT AND

4623
02:45:53,638 --> 02:45:54,773
CURRENTLY WORKING ON THE

4624
02:45:54,773 --> 02:45:55,774
COMMERCIALIZATION OF THAT

4625
02:45:55,774 --> 02:45:56,007
PRODUCT.

4626
02:45:56,007 --> 02:46:00,578
AND WE WANTED TO TURN OUR

4627
02:46:00,578 --> 02:46:01,913
ATTENTION TO ADULT MONITORING

4628
02:46:01,913 --> 02:46:07,252
AND BECAUSE OF THIS PROGRAM WE

4629
02:46:07,252 --> 02:46:10,755
STARTED WITH MATERNAL HEALTH IN

4630
02:46:10,755 --> 02:46:12,590
THE POSTPARTUM PERIOD, EASILY

4631
02:46:12,590 --> 02:46:14,125
EXTENDSABLE IN THE PERINATAL

4632
02:46:14,125 --> 02:46:16,094
OPPORTUNITIES, BUT THEY'VE THEN

4633
02:46:16,094 --> 02:46:20,932
FOLLOWING THAT WOULD BE ELDER

4634
02:46:20,932 --> 02:46:21,800
CARE, GENERAL HYPERTENSION

4635
02:46:21,800 --> 02:46:22,567
MARKET, ADULT OPPORTUNITIES

4636
02:46:22,567 --> 02:46:25,403
WITHIN THE HOSPITALS AND CLINICS

4637
02:46:25,403 --> 02:46:27,038
FOR EMERGENCY RARE AND OPERATING

4638
02:46:27,038 --> 02:46:27,605
ROOMS.

4639
02:46:27,605 --> 02:46:29,574
SO WE'VE GOT A NICE ROAD MAP OF

4640
02:46:29,574 --> 02:46:34,379
PRODUCTS TO ROLL OUT OVER TIME.

4641
02:46:34,379 --> 02:46:34,712
OKAY.

4642
02:46:34,712 --> 02:46:37,115
I DIDN'T REALIZE MY SLIDE IS A

4643
02:46:37,115 --> 02:46:40,251
PROGRESSIVE ONE HERE.

4644
02:46:40,251 --> 02:46:43,655
SO, ALWAYS ON BLOOD PRESSURE

4645
02:46:43,655 --> 02:46:45,089
MONITORING IS VALUABLE AT ALL

4646
02:46:45,089 --> 02:46:49,260
STAGES OF LIFE STARTING WITH

4647
02:46:49,260 --> 02:46:50,795
INFANTS, GOING THROUGH

4648
02:46:50,795 --> 02:46:54,299
CHILDHOOD, THROUGHOUT -- WITH

4649
02:46:54,299 --> 02:46:55,066
EMERGENCIES, MATERNAL HEALTH

4650
02:46:55,066 --> 02:46:57,802
OPPORTUNITY, AND WE GET TO THE

4651
02:46:57,802 --> 02:46:58,703
GENERAL HYPERTENSION MARKET.

4652
02:46:58,703 --> 02:47:01,206
THERE'S A LOT OF NEED FOR BLOOD

4653
02:47:01,206 --> 02:47:02,507
PRESSURE MONITORING TO IMPROVE

4654
02:47:02,507 --> 02:47:05,677
OVER WHAT WE'VE GOT TODAY.

4655
02:47:05,677 --> 02:47:09,480
AND I THINK CHRISTINE DID A VERY

4656
02:47:09,480 --> 02:47:12,116
GOOD JOB OUTLINING THE CHALLENGE

4657
02:47:12,116 --> 02:47:14,185
TODAY OF PREECLAMPSIA AND

4658
02:47:14,185 --> 02:47:15,420
HYPERTENSION IN GENERAL, BUT ONE

4659
02:47:15,420 --> 02:47:18,590
OF THE THINGS THAT WE FOUND IN

4660
02:47:18,590 --> 02:47:22,493
THE -- GOING IN THIS PROGRAM IS

4661
02:47:22,493 --> 02:47:24,295
THAT THE CURRENT SOLUTION FOR

4662
02:47:24,295 --> 02:47:25,597
POSTPARTUM WOMEN IF THEY REALLY

4663
02:47:25,597 --> 02:47:28,466
NEED IT IS TO SEND THEM HOME

4664
02:47:28,466 --> 02:47:33,371
WITH A CUFF, AND THE CUFFS ARE

4665
02:47:33,371 --> 02:47:34,038
JUST -- THEY ARE UNCOMFORTABLE,

4666
02:47:34,038 --> 02:47:34,906
THEY ARE INCONVENIENT.

4667
02:47:34,906 --> 02:47:37,475
THEY ARE NOT -- THE ACCURACY IS

4668
02:47:37,475 --> 02:47:38,843
A LITTLE SUSPECT AT TIMES

4669
02:47:38,843 --> 02:47:40,111
ESPECIALLY FOR PEOPLE NOT

4670
02:47:40,111 --> 02:47:42,347
FAMILIAR WITH USING BLOOD

4671
02:47:42,347 --> 02:47:42,714
PRESSURE CUFFS.

4672
02:47:42,714 --> 02:47:45,950
AND ONE OF THE BIGGEST FEEDBACKS

4673
02:47:45,950 --> 02:47:47,518
WE GOT WAS USER COMPLIANCE IS

4674
02:47:47,518 --> 02:47:48,353
VERY POOR.

4675
02:47:48,353 --> 02:47:50,388
WHILE THEY ARE SENDING PATIENTS

4676
02:47:50,388 --> 02:47:51,956
HOME, THEY REALLY WANT TO KNOW

4677
02:47:51,956 --> 02:47:53,524
HOW THEY ARE DOING, ARE THEY

4678
02:47:53,524 --> 02:47:55,059
TRENDING UP, IS THE CONDITION

4679
02:47:55,059 --> 02:47:57,328
STABLE, WHAT'S GOING ON WITH THE

4680
02:47:57,328 --> 02:47:59,964
PATIENT, THEY OFTEN FOUND THEY

4681
02:47:59,964 --> 02:48:02,500
HAVE TO CALL TWICE A DAY TO GET

4682
02:48:02,500 --> 02:48:03,902
TWO MEASUREMENTS A DAY AND EVEN

4683
02:48:03,902 --> 02:48:05,436
THEN THAT WAS A STRETCH OF

4684
02:48:05,436 --> 02:48:09,040
TRYING TO GET COMPLIANCE FROM

4685
02:48:09,040 --> 02:48:09,908
THE PATIENTS.

4686
02:48:09,908 --> 02:48:11,976
AND AS WE'VE HEARD OVER THE LAST

4687
02:48:11,976 --> 02:48:15,380
TWO DAYS, VISITS TO THE DOCTORS

4688
02:48:15,380 --> 02:48:18,116
ARE DIFFICULT IN THESE CARE

4689
02:48:18,116 --> 02:48:21,419
DESERTS, AND SO IF YOU'RE LUCKY

4690
02:48:21,419 --> 02:48:24,022
YOU'LL GET A FOLLOW-UP TWO WEEKS

4691
02:48:24,022 --> 02:48:25,890
AFTER BIRTH, OFTEN IT'S SIX

4692
02:48:25,890 --> 02:48:27,959
WEEKS, SO YOU'RE NOT GETTING

4693
02:48:27,959 --> 02:48:29,394
MONITORING DURING THIS CRITICAL

4694
02:48:29,394 --> 02:48:30,728
PERIOD SIX WEEKS AFTER BIRTH.

4695
02:48:30,728 --> 02:48:32,230
AND AS I MENTIONED, THE TWO

4696
02:48:32,230 --> 02:48:34,532
MEASUREMENTS A DAY IS WHEN

4697
02:48:34,532 --> 02:48:36,301
YOU'RE LUCKY OFTEN IT'S ONE OR

4698
02:48:36,301 --> 02:48:41,306
TWO A WEEK, IF THAT AT ALL.

4699
02:48:41,306 --> 02:48:44,175
AND SO WE COME TO THE BOSIMI

4700
02:48:44,175 --> 02:48:44,442
SOLUTION.

4701
02:48:44,442 --> 02:48:46,144
THERE'S THREE ELEMENTS OF IT.

4702
02:48:46,144 --> 02:48:48,880
ONE IS THE SENSOR BAND WHICH AS

4703
02:48:48,880 --> 02:48:50,615
I SAID IS A FOAM BAND WORN ON

4704
02:48:50,615 --> 02:48:52,050
THE WRIST.

4705
02:48:52,050 --> 02:48:53,685
IT'S VERY LIGHT, COMFORTABLE,

4706
02:48:53,685 --> 02:48:54,419
EASY TO USE.

4707
02:48:54,419 --> 02:48:57,388
IN FACT SOME OF THE FEEDBACK WE

4708
02:48:57,388 --> 02:49:00,158
GOT FROM THE HOME LABS GROUP LED

4709
02:49:00,158 --> 02:49:01,025
TO USABILITY IMPROVEMENTS OF

4710
02:49:01,025 --> 02:49:01,559
THAT BAND.

4711
02:49:01,559 --> 02:49:03,094
WE FIND YOU CAN PUT IT ON AND

4712
02:49:03,094 --> 02:49:05,063
JUST WEAR IT AND GO ABOUT LIVING

4713
02:49:05,063 --> 02:49:06,965
LIFE, AND NOT REALLY PAY ANY

4714
02:49:06,965 --> 02:49:07,899
ATTENTION TO IT.

4715
02:49:07,899 --> 02:49:09,767
THE APP IS WORKING IN THE

4716
02:49:09,767 --> 02:49:12,637
BACKGROUND ON THE USER'S MOBILE

4717
02:49:12,637 --> 02:49:14,906
DEVICE, WHICH EVERYBODY HAS A

4718
02:49:14,906 --> 02:49:17,775
MOBILE DEVICE, CELL PHONE OR

4719
02:49:17,775 --> 02:49:19,410
TABLET OR SOMETHING LIKE THAT.

4720
02:49:19,410 --> 02:49:23,414
AND THERE'S A LOT YOU CAN DO

4721
02:49:23,414 --> 02:49:26,951
THERE, BUT ONE OF THE THINGS WE

4722
02:49:26,951 --> 02:49:28,820
LEARNED FROM OUR KOLs, WE PUT

4723
02:49:28,820 --> 02:49:30,154
EFFORT IN, STILL WORKING ON,

4724
02:49:30,154 --> 02:49:34,058
TRYING TO GIVE MORE THAN JUST A

4725
02:49:34,058 --> 02:49:36,127
NUMBER, THAT PATIENT ENGAGEMENT

4726
02:49:36,127 --> 02:49:37,895
EMPOWERMENT BY EDUCATING AND

4727
02:49:37,895 --> 02:49:39,764
GIVING THEM ACCESS TO RESOURCES

4728
02:49:39,764 --> 02:49:40,531
AND HINTS FOR MANAGING BLOOD

4729
02:49:40,531 --> 02:49:42,367
PRESSURE WAS ONE OF THE THINGS

4730
02:49:42,367 --> 02:49:44,235
THAT WAS GOING TO MAKE THE

4731
02:49:44,235 --> 02:49:46,437
PATIENT'S HEALTH COME OUT BETTER

4732
02:49:46,437 --> 02:49:49,073
IN THE LONG RUN, AND WE HAVE

4733
02:49:49,073 --> 02:49:50,608
THIS REMOTE MONITORING LINK TO

4734
02:49:50,608 --> 02:49:53,578
THE CLOUD, WHICH IS INTENDED TO

4735
02:49:53,578 --> 02:49:55,113
WHEN THERE'S ALERTS OR THE

4736
02:49:55,113 --> 02:49:57,048
DOCTOR WANTS TO CHECK IN WITH

4737
02:49:57,048 --> 02:49:58,950
THE PATIENT, HAVING A TELEHEALTH

4738
02:49:58,950 --> 02:50:00,118
CALL, THEY CAN LOOK AND SEE

4739
02:50:00,118 --> 02:50:01,019
WHAT'S HAPPENING WITH THE

4740
02:50:01,019 --> 02:50:04,088
PATIENT OVER THE LAST COUPLE OF

4741
02:50:04,088 --> 02:50:06,491
WEEKS, AND GET -- WHY IS THERE

4742
02:50:06,491 --> 02:50:07,492
AN ALERT, WHAT'S BEEN HAPPENING

4743
02:50:07,492 --> 02:50:10,328
OVER THE LAST FEW HOURS, AND

4744
02:50:10,328 --> 02:50:13,331
THEY CAN RECOMMEND COURSES OF

4745
02:50:13,331 --> 02:50:14,365
ACTION ADJUSTMENTS TO MEDICATION

4746
02:50:14,365 --> 02:50:19,103
OR WE NEED TO SEE YOU, COME IN

4747
02:50:19,103 --> 02:50:20,405
RIGHT AWAY.

4748
02:50:20,405 --> 02:50:23,808
WHERE WE SEE OURSELVES FITTING

4749
02:50:23,808 --> 02:50:24,709
WITH OUR EMERGING TECHNOLOGIES

4750
02:50:24,709 --> 02:50:26,677
IS THAT IT'S VERY COMFORTABLE

4751
02:50:26,677 --> 02:50:28,179
AND IT'S VERY ACCURATE WHICH

4752
02:50:28,179 --> 02:50:29,647
PUTS US IN THE UPPER QUADRANT

4753
02:50:29,647 --> 02:50:31,482
WHERE WE WANT TO BE.

4754
02:50:31,482 --> 02:50:33,985
WE THINK WE'VE GOT A COMPELLING

4755
02:50:33,985 --> 02:50:34,752
SOLUTION THERE.

4756
02:50:34,752 --> 02:50:38,589
AND THEN HERE IS A LOOK AT OUR

4757
02:50:38,589 --> 02:50:40,558
PYRAMES TEAM, A SMALL GROUP OF

4758
02:50:40,558 --> 02:50:41,993
PEOPLE WORKING HARD TOWARDS THIS

4759
02:50:41,993 --> 02:50:42,760
OBJECTIVE.

4760
02:50:42,760 --> 02:50:48,766
THANK YOU VERY MUCH.

4761
02:50:48,766 --> 02:50:52,837
>> VERY COOL TECHNOLOGY. 

4762
02:50:52,837 --> 02:50:54,038
CERTAINLY AN AREA THAT I HAVE

4763
02:50:54,038 --> 02:50:56,207
GREAT INTEREST IN TERMS OF

4764
02:50:56,207 --> 02:50:57,508
ADHERENCE AND DATA COLLECTION.

4765
02:50:57,508 --> 02:50:58,676
DO WE HAVE A QUESTION?

4766
02:50:58,676 --> 02:51:01,345
COME ON DOWN.

4767
02:51:01,345 --> 02:51:03,214
>> I DO.

4768
02:51:03,214 --> 02:51:05,283
CHRIS FROM MIRACLE CENTER,

4769
02:51:05,283 --> 02:51:05,750
MICHIGAN.

4770
02:51:05,750 --> 02:51:08,719
I WAS TALKING TO I GUESS ONE OF

4771
02:51:08,719 --> 02:51:10,588
OUR COMPETITORS YESTERDAY HERE.

4772
02:51:10,588 --> 02:51:12,924
DO YOU WORRY ABOUT THE

4773
02:51:12,924 --> 02:51:17,195
POSSIBILITY OF ACTUALLY, YOU

4774
02:51:17,195 --> 02:51:19,097
KNOW, UNINTENDED CONSEQUENCE,

4775
02:51:19,097 --> 02:51:20,498
YOU KNOW, WITH CONTINUOUS WEAR

4776
02:51:20,498 --> 02:51:22,567
PERHAPS SOMEBODY WITH HIGH BLOOD

4777
02:51:22,567 --> 02:51:24,035
PRESSURE WILL, YOU KNOW, GET

4778
02:51:24,035 --> 02:51:26,671
ANXIOUS AND SORT OF GO INTO MORE

4779
02:51:26,671 --> 02:51:28,639
ANXIETY AND MORE CONSTANTLY

4780
02:51:28,639 --> 02:51:30,475
CHECKING AND LOOKING AT THEIR

4781
02:51:30,475 --> 02:51:31,242
PHONE?

4782
02:51:31,242 --> 02:51:34,112
>> IT'S A VERY GOOD
QUESTION.

4783
02:51:34,112 --> 02:51:36,280
ESPECIALLY A NEW MOTHER WHO HAS

4784
02:51:36,280 --> 02:51:39,016
A LOT GOING ON, YOU KNOW, ONE

4785
02:51:39,016 --> 02:51:40,551
HIGH BLOOD PRESSURE READING

4786
02:51:40,551 --> 02:51:41,752
COULD GET SOMEBODY EVEN MORE

4787
02:51:41,752 --> 02:51:43,488
ANXIOUS AND PUMP UP THE BLOOD

4788
02:51:43,488 --> 02:51:44,055
PRESSURE EVEN HIGHER.

4789
02:51:44,055 --> 02:51:45,556
ONE OF THE THINGS WE'RE TRYING

4790
02:51:45,556 --> 02:51:48,559
TO BUILD IN IS PROGRESSIVE

4791
02:51:48,559 --> 02:51:50,194
ALERTS, TO WHERE THE VERY FIRST

4792
02:51:50,194 --> 02:51:52,263
READING WE MAY OR MAY NOT EVEN

4793
02:51:52,263 --> 02:51:57,568
DISPLAY BUT INSTEAD OF TAKING --

4794
02:51:57,568 --> 02:52:03,541
WE GET SIX WEEKS OF LIGHT

4795
02:52:03,541 --> 02:52:05,076
ONCE AND HOUR, WE MEET CHECK IN

4796
02:52:05,076 --> 02:52:06,511
15 MINUTES TO SEE WHAT'S GOING

4797
02:52:06,511 --> 02:52:08,246
AND ESTABLISH A TREND BEFORE

4798
02:52:08,246 --> 02:52:09,881
ALERTING THE PATIENT THERE'S A

4799
02:52:09,881 --> 02:52:11,048
HIGH BLOOD PRESSURE READING.

4800
02:52:11,048 --> 02:52:14,185
ONE OF THE CHALLENGES THAT I WAS

4801
02:52:14,185 --> 02:52:15,386
HIGHLIGHTING IS JUST GETTING

4802
02:52:15,386 --> 02:52:17,088
FEMUR LOOK AT THE DEVICE AND

4803
02:52:17,088 --> 02:52:18,823
MAKE SURE IT'S ON AND THEY ARE

4804
02:52:18,823 --> 02:52:20,958
WEARING IT AND, YOU KNOW, THAT

4805
02:52:20,958 --> 02:52:22,927
YOU'RE GETTING READINGS IS A

4806
02:52:22,927 --> 02:52:25,429
CHALLENGE WE'RE TRYING TO

4807
02:52:25,429 --> 02:52:25,897
OVERCOME.

4808
02:52:25,897 --> 02:52:27,832
AND WE THINK GETTING MORE DATA

4809
02:52:27,832 --> 02:52:30,468
IS MORE VALUABLE THAN

4810
02:52:30,468 --> 02:52:40,878
SUPPRESSING THAT DATA. 

4811
02:52:41,512 --> 02:52:43,147
>> THANKS AGAIN TO WILL
AND

4812
02:52:43,147 --> 02:52:45,216
SAMEER, BOTH OF OUR AFTERNOON

4813
02:52:45,216 --> 02:52:45,883
PRESENTERS.

4814
02:52:45,883 --> 02:52:48,286
ALSO THANKS AGAIN TO OUR EARLIER

4815
02:52:48,286 --> 02:52:48,686
ROUND PRESENTERS.

4816
02:52:48,686 --> 02:52:50,154
WE'RE GOING TO MOVE TO THE NEXT

4817
02:52:50,154 --> 02:52:50,721
SESSION.

4818
02:52:50,721 --> 02:52:52,657
IF YOU ARE PRESENTING AT THE

4819
02:52:52,657 --> 02:52:54,225
NEXT SESSION, YOU SEE THESE

4820
02:52:54,225 --> 02:52:56,294
CHAIRS UP HERE THAT SAY

4821
02:52:56,294 --> 02:52:57,195
RESERVED?

4822
02:52:57,195 --> 02:52:58,563
THEY ARE RESERVED FOR YOU.

4823
02:52:58,563 --> 02:53:08,806
COME ON DOWN. 

4824
02:53:09,740 --> 02:53:13,578
>> WELCOME TO SESSION 6,
WHICH

4825
02:53:13,578 --> 02:53:16,647
IS USING DATA AND POLICY TO BEND

4826
02:53:16,647 --> 02:53:17,848
THE CURVE OF MATERNAL MORBIDITY

4827
02:53:17,848 --> 02:53:24,222
AND MORTALITY.

4828
02:53:24,222 --> 02:53:27,925
I'M CAMILLE FABIYI, JOINING ME

4829
02:53:27,925 --> 02:53:28,893
IS MEGAN MITCHELL.

4830
02:53:28,893 --> 02:53:33,731
>> ON A PROGRAM OFFICER AT

4831
02:53:33,731 --> 02:53:37,535
NICHD, MEGAN MITCHELL. 

4832
02:53:37,535 --> 02:53:38,869
>> WE'LL HAVE OUR FIRST

4833
02:53:38,869 --> 02:53:40,504
PRESENTER COME ON UP.

4834
02:53:40,504 --> 02:53:42,506
AND INTRODUCE THEMSELVES AND GET

4835
02:53:42,506 --> 02:53:44,742
US STARTED.

4836
02:53:44,742 --> 02:53:45,643
THANK YOU.

4837
02:53:45,643 --> 02:53:46,978
>> THANK YOU.

4838
02:53:46,978 --> 02:53:49,313
GOOD AFTERNOON.

4839
02:53:49,313 --> 02:53:54,752
I'M DARA MENDEZ, ASSOCIATE

4840
02:53:54,752 --> 02:53:57,588
PROFESSOR OF EPIDEMIOLOGY AT

4841
02:53:57,588 --> 02:54:03,661
UNIVERSITY OF PITTSBURGH AND

4842
02:54:03,661 --> 02:54:04,562
CO-P.I. OF EMBRACE.

4843
02:54:04,562 --> 02:54:07,365
I'M GOING TO HONE IN ON THE

4844
02:54:07,365 --> 02:54:09,967
ASPECTS OF DATA AND POLICY,

4845
02:54:09,967 --> 02:54:13,704
PROVIDING AN OVERVIEW OF EMBRACE

4846
02:54:13,704 --> 02:54:17,875
AND THE WORK WE'RE DOING.

4847
02:54:17,875 --> 02:54:20,044
SO I'M THRILLED TO SHARE ABOUT

4848
02:54:20,044 --> 02:54:22,380
EMBRACE AND TALK ABOUT OUR DATA

4849
02:54:22,380 --> 02:54:22,880
TRANSPARENCY WORK.

4850
02:54:22,880 --> 02:54:25,216
AND AT THE VERY END IF I HAVE A

4851
02:54:25,216 --> 02:54:27,151
COUPLE MINUTES, I'M NOT OVER

4852
02:54:27,151 --> 02:54:31,856
TIME, I'LL SHARE ABOUT A

4853
02:54:31,856 --> 02:54:32,523
SEPARATE NINR-FUNDED STUDY UNDER

4854
02:54:32,523 --> 02:54:33,824
THE "IMPROVE" INITIATIVE THAT

4855
02:54:33,824 --> 02:54:36,994
HAS A DATA CHALLENGE, I WOULD

4856
02:54:36,994 --> 02:54:39,530
LIKE TO SHARE WITH THE AUDIENCE.

4857
02:54:39,530 --> 02:54:40,798
SO EMBRACE INCLUDES RESEARCHERS

4858
02:54:40,798 --> 02:54:42,500
ACROSS MULTIPLE DIVISIONS AT THE

4859
02:54:42,500 --> 02:54:44,435
UNIVERSITY OF PITTSBURGH AS WELL

4860
02:54:44,435 --> 02:54:46,937
AS MULTIPLE COMMUNITY PARTNERED

4861
02:54:46,937 --> 02:54:49,240
ORGANIZATIONS, WE'RE A WIDE

4862
02:54:49,240 --> 02:54:49,473
NETWORK.

4863
02:54:49,473 --> 02:54:52,009
THIS INCLUDES PITT SCHOOL OF

4864
02:54:52,009 --> 02:54:53,244
MEDICINE, PUBLIC HEALTH,

4865
02:54:53,244 --> 02:54:56,247
NURSING, EDUCATION, CENTER FOR

4866
02:54:56,247 --> 02:54:57,348
HEALTH EQUITY, CONVERGE CENTER,

4867
02:54:57,348 --> 02:54:59,750
UNIVERSITY OF PITTSBURGH MEDICAL

4868
02:54:59,750 --> 02:55:02,153
CENTER, MIDWIFE CENTER,

4869
02:55:02,153 --> 02:55:04,221
FEDERALLY QUALIFIED HEALTH

4870
02:55:04,221 --> 02:55:05,556
CENTER, HEALTHY START PITTSBURGH

4871
02:55:05,556 --> 02:55:07,191
IS OUR CORE COMMUNITY LEAD,

4872
02:55:07,191 --> 02:55:13,964
JOURNEY LIGHTER WHICH IS A

4873
02:55:13,964 --> 02:55:15,099
COMMUNITY-BASTED EDUCATION,

4874
02:55:15,099 --> 02:55:16,600
BLACK WOMEN'S POLICY CENTER, THE

4875
02:55:16,600 --> 02:55:17,501
COUNTY HEALTH DEPARTMENT AND I

4876
02:55:17,501 --> 02:55:22,873
COULD GO ON.

4877
02:55:22,873 --> 02:55:24,942
A WIDE NETWORK OF BRILLIANCE AND

4878
02:55:24,942 --> 02:55:26,344
WORK FOCUS ON HEALTH EQUITY AND

4879
02:55:26,344 --> 02:55:27,878
REPRODUCTIVE JUSTICE.

4880
02:55:27,878 --> 02:55:29,980
THIS IS OUR CENTER LEADERSHIP.

4881
02:55:29,980 --> 02:55:36,220
I'M HERE ON BEHALF OF A NUMBER

4882
02:55:36,220 --> 02:55:39,724
OF COLLEAGUES AND PARTNERS

4883
02:55:39,724 --> 02:55:42,026
INCLUDING DR. TALABI, DR.

4884
02:55:42,026 --> 02:55:44,528
SIMHAN, CLINICIANS AND LEADERS

4885
02:55:44,528 --> 02:55:46,731
IN OUR REGION RELATED TO

4886
02:55:46,731 --> 02:55:47,932
MATERNAL HEALTH AND JUSTICE,

4887
02:55:47,932 --> 02:55:50,000
ALSO COMMUNITY AND TRAINING AND

4888
02:55:50,000 --> 02:55:52,036
RESEARCH PROJECT CO-LEADS SO OUR

4889
02:55:52,036 --> 02:55:54,171
CENTER IS REALLY BASED ON

4890
02:55:54,171 --> 02:55:56,340
ACADEMIC LEADERSHIP AND

4891
02:55:56,340 --> 02:55:57,007
COMMUNITY LEADERSHIP, REALLY

4892
02:55:57,007 --> 02:56:02,346
CRITICAL AND IMPORTANT FOR OUR

4893
02:56:02,346 --> 02:56:03,681
WORK.

4894
02:56:03,681 --> 02:56:06,450
THAT INCLUDES NGOZI TIBBS, A

4895
02:56:06,450 --> 02:56:09,620
LONG-TERM HISTORY AND EXPERTISE

4896
02:56:09,620 --> 02:56:11,355
AROUND TRAINING AND COMMUNITY

4897
02:56:11,355 --> 02:56:12,790
PARTNERED WORK.

4898
02:56:12,790 --> 02:56:15,726
DR. KATHY HAGGERTY IS A LEAD IN

4899
02:56:15,726 --> 02:56:18,028
TRAINING AND DEVELOPMENT OF

4900
02:56:18,028 --> 02:56:19,997
ACADEMIC RESEARCHERS, AND THEN

4901
02:56:19,997 --> 02:56:22,867
MAIN RESEARCH PROJECT WHICH I'LL

4902
02:56:22,867 --> 02:56:25,569
TALK ABOUT FUNDED INCLUDES OUR

4903
02:56:25,569 --> 02:56:29,206
COMMUNITY HEALTH LEADER STATEY

4904
02:56:29,206 --> 02:56:32,910
BARTLETT AND CINDY SALTER.

4905
02:56:32,910 --> 02:56:34,678
AND COMMUNITY COMPONENT IS

4906
02:56:34,678 --> 02:56:39,817
LEADER FROM HEALTHY START

4907
02:56:39,817 --> 02:56:41,018
PITTSBURGH AND DR. OGHIFIOBIBI

4908
02:56:41,018 --> 02:56:43,521
IN PEDIATRICS AND DR. ASHLEY

4909
02:56:43,521 --> 02:56:44,155
HILL WHO WAS AT UNIVERSITY OF

4910
02:56:44,155 --> 02:56:50,294
PITTSBURGH  BUT NOW AT UIC, WE

4911
02:56:50,294 --> 02:56:53,931
HAVE A BRILLIANT CONNECTION NOW

4912
02:56:53,931 --> 02:56:55,366
BETWEEN OUR TWO CENTERS.

4913
02:56:55,366 --> 02:56:58,469
SIMILAR TO OTHER CENTERS, OUR

4914
02:56:58,469 --> 02:56:59,937
REGION EXPERIENCES TREMENDOUS

4915
02:56:59,937 --> 02:57:03,340
RACIAL AND ECONOMIC INEQUITIES

4916
02:57:03,340 --> 02:57:05,109
IN MATERNAL HEALTH OUTCOMES IN

4917
02:57:05,109 --> 02:57:06,510
ALLEGHENY COUNTY, THE RESULT OF

4918
02:57:06,510 --> 02:57:08,579
A LONG HISTORY OF STRUCTURAL

4919
02:57:08,579 --> 02:57:12,082
RACISM AND OPPRESSION THAT HAS

4920
02:57:12,082 --> 02:57:13,851
REINFORCED TRADITIONAL POWER

4921
02:57:13,851 --> 02:57:15,386
DYNAMICS AND INEQUALITIES.

4922
02:57:15,386 --> 02:57:17,254
ANDS LISTENING TO THE

4923
02:57:17,254 --> 02:57:18,989
PRESENTATION EARLIER FROM

4924
02:57:18,989 --> 02:57:20,524
MISSISSIPPI, LIKE PITTSBURGH IS

4925
02:57:20,524 --> 02:57:22,059
SOMETIMES CONSIDERED THE

4926
02:57:22,059 --> 02:57:23,494
MISSISSIPPI OF THE NORTH.

4927
02:57:23,494 --> 02:57:25,129
IT'S BEEN CLAIMED THE MOST

4928
02:57:25,129 --> 02:57:27,331
LIVABLE CITY BUT THE QUESTION IS

4929
02:57:27,331 --> 02:57:29,733
FOR WHOM, RIGHT?

4930
02:57:29,733 --> 02:57:32,369
SO BEING AN APARTHEID CITY THAT

4931
02:57:32,369 --> 02:57:34,872
HAS REINFORCED INEQUITIES WE SEE

4932
02:57:34,872 --> 02:57:37,274
IN HEALTH AS WELL.

4933
02:57:37,274 --> 02:57:40,444
BUT EMBRACE BUILDS UPON A LONG

4934
02:57:40,444 --> 02:57:42,847
HISTORY OF COMMUNITY PARTNERS

4935
02:57:42,847 --> 02:57:44,148
THROUGH OUR INFANT MORTALITY

4936
02:57:44,148 --> 02:57:44,748
STRATEGIC PLAN COMMITTEE WHICH

4937
02:57:44,748 --> 02:57:46,917
IS NOW KNOWN AS THE BEST

4938
02:57:46,917 --> 02:57:48,552
ALLEGHENY INITIATIVE WHICH HAS

4939
02:57:48,552 --> 02:57:51,622
FUNNED BY CITY MATCH OVER THE

4940
02:57:51,622 --> 02:57:53,824
PAST DECADE, AND IS BEST BABY

4941
02:57:53,824 --> 02:57:54,758
ZONE DESIGNATION.

4942
02:57:54,758 --> 02:57:57,127
THEN ALSO KEY WORK THROUGH OUR

4943
02:57:57,127 --> 02:57:58,562
MATERNAL AND CHILD HEALTH

4944
02:57:58,562 --> 02:57:59,430
STRATEGY TEAM.

4945
02:57:59,430 --> 02:58:02,366
AND THIS LED TO THE DEVELOPMENT

4946
02:58:02,366 --> 02:58:04,134
OF THE BIRTH PLAN, OUR BLUEPRINT

4947
02:58:04,134 --> 02:58:05,769
FOR THE CENTER.

4948
02:58:05,769 --> 02:58:08,272
THE BIRTH PLAN INCLUDES THESE

4949
02:58:08,272 --> 02:58:10,374
FOUR KEY ACTION AREAS WE'VE USED

4950
02:58:10,374 --> 02:58:15,379
AS A FRAMEWORK AS WELL FOR OUR

4951
02:58:15,379 --> 02:58:17,581
WORK FOR THE CENTER.

4952
02:58:17,581 --> 02:58:20,651
THE SITUATION IS TO ADVANCE

4953
02:58:20,651 --> 02:58:21,519
MATERNAL REPRODUCTIVE HEALTH

4954
02:58:21,519 --> 02:58:23,954
EQUITY AND JUSTICE FOR

4955
02:58:23,954 --> 02:58:24,522
MULTI-DISCIPLINARY RESEARCH,

4956
02:58:24,522 --> 02:58:25,923
TRAINING, PRACTICE AND POLICY

4957
02:58:25,923 --> 02:58:27,024
EFFORTS FOCUSED ON BLACK

4958
02:58:27,024 --> 02:58:28,459
BIRTHING PEOPLE IN ALLEGHENY

4959
02:58:28,459 --> 02:58:31,695
COUNTY AND SURROUNDING REGION.

4960
02:58:31,695 --> 02:58:33,697
OUR WORK IS FOUNDATIONAL AROUND

4961
02:58:33,697 --> 02:58:34,899
APPLICATIONS OF REPRODUCTIVE

4962
02:58:34,899 --> 02:58:36,100
JUSTICE, PUBLIC HEALTH CRITICAL

4963
02:58:36,100 --> 02:58:38,269
RACE PRACTICE WHICH IS CENTERING

4964
02:58:38,269 --> 02:58:42,106
ON THE MARGIN, CENTERING THE

4965
02:58:42,106 --> 02:58:42,773
COMMUNITY DISPROPORTIONATELY

4966
02:58:42,773 --> 02:58:45,709
EXCLUDED, OVER TIME AND

4967
02:58:45,709 --> 02:58:47,678
THROUGHOUT HISTORY.

4968
02:58:47,678 --> 02:58:49,446
EMBRACE TAKES A MULTI-LEVEL

4969
02:58:49,446 --> 02:58:51,849
APPROACH SO THAT INCLUDES OUR

4970
02:58:51,849 --> 02:58:53,817
COMMUNITY AND BEHAVIORAL

4971
02:58:53,817 --> 02:58:54,385
HEALTH-RELATED INTERVENTION,

4972
02:58:54,385 --> 02:58:55,786
HEALTH CARE SYSTEMS

4973
02:58:55,786 --> 02:58:57,321
INTERVENTION, AND STRUCTURAL

4974
02:58:57,321 --> 02:58:58,389
POLICY.

4975
02:58:58,389 --> 02:59:00,257
AND WE WERE SPECIFICALLY FUNDED

4976
02:59:00,257 --> 02:59:02,993
UNDER THE CENTER OF EXCELLENCE

4977
02:59:02,993 --> 02:59:05,062
MODEL, FOR OUR HEALTHCARE

4978
02:59:05,062 --> 02:59:08,265
SYSTEMS INTERVENTION, SO THE

4979
02:59:08,265 --> 02:59:09,800
OTHER TWO INTERVENTIONS WERE NOT

4980
02:59:09,800 --> 02:59:11,035
SPECIFICALLY FUNDED UNDER CENTER

4981
02:59:11,035 --> 02:59:12,570
OF EXCELLENCE BUT WE'RE MOVING

4982
02:59:12,570 --> 02:59:16,240
FORWARD WITH A NUMBER OF

4983
02:59:16,240 --> 02:59:17,341
PROJECTS RELATED TO THAT WORK.

4984
02:59:17,341 --> 02:59:20,177
HERE ARE FOUR AIMS FOR THE

4985
02:59:20,177 --> 02:59:21,712
CENTER, TO ADVANCE

4986
02:59:21,712 --> 02:59:23,347
INTERDISCIPLINARY RESEARCH

4987
02:59:23,347 --> 02:59:27,418
GUIDED BY REPRODUCTIVE JUSTICE

4988
02:59:27,418 --> 02:59:29,486
TO HELP US IDENTIFY AND

4989
02:59:29,486 --> 02:59:33,190
AMELIORATE CAUSES AND

4990
02:59:33,190 --> 02:59:36,060
CONSEQUENCES OF ADVERSE MATERNAL

4991
02:59:36,060 --> 02:59:36,594
REPRODUCTIVE HEALTH AND

4992
02:59:36,594 --> 02:59:38,796
WELL-BEING FOR BLACK PEOPLE.

4993
02:59:38,796 --> 02:59:44,802
TWO, DEVELOP, IMPLEMENT, AND

4994
02:59:44,802 --> 02:59:46,170
EVALUATE MULTI LEVEL TRAINING,

4995
02:59:46,170 --> 02:59:49,173
IMPLEMENT TRAINING AND EDUCATION

4996
02:59:49,173 --> 02:59:52,142
FOR EMBRACE PARTNERS, AND

4997
02:59:52,142 --> 02:59:53,444
PROMOTE BIDIRECTIONAL

4998
02:59:53,444 --> 02:59:58,148
COLLABORATIONS WITH ONGOING

4999
02:59:58,148 --> 02:59:59,483
COMMUNITY-LED BLACK-LED AND

5000
02:59:59,483 --> 03:00:01,318
EQUITY-CENTERED EFFORTS, THE

5001
03:00:01,318 --> 03:00:05,255
PREMISE IS NOTHING ABOUT US

5002
03:00:05,255 --> 03:00:07,791
WITHOUT US, A PHRASE WE TALK

5003
03:00:07,791 --> 03:00:10,060
ABOUT, OUR COMMUNITY PARTNERS AS

5004
03:00:10,060 --> 03:00:10,427
WELL.

5005
03:00:10,427 --> 03:00:11,962
WE HAVE THREE PROJECTS IN

5006
03:00:11,962 --> 03:00:13,030
ADDITION TO COMMUNITY COMPONENT

5007
03:00:13,030 --> 03:00:14,498
AND TRAINING COMPONENT FOR OUR

5008
03:00:14,498 --> 03:00:18,502
CENTER, I'M GOING TO HONE IN ON

5009
03:00:18,502 --> 03:00:21,672
THE COMMUNITY, TRAINING, AND

5010
03:00:21,672 --> 03:00:24,074
SPECIFICALLY INTERVENTION FUNDED

5011
03:00:24,074 --> 03:00:25,275
BY EMBRACE, GOING THROUGH THEM

5012
03:00:25,275 --> 03:00:27,044
QUICKLY AND TALK ABOUT THE DATA

5013
03:00:27,044 --> 03:00:29,013
TRANSPARENCY WORK THAT LED TO

5014
03:00:29,013 --> 03:00:30,314
SOME CURRENT WORK.

5015
03:00:30,314 --> 03:00:33,484
SO THE COMMUNITY COMPONENT IN

5016
03:00:33,484 --> 03:00:34,518
OUR COLLABORATOR WILL BE

5017
03:00:34,518 --> 03:00:36,453
INTEGRATING ALL ASPECT OF THE

5018
03:00:36,453 --> 03:00:38,856
RESEARCH LIFE CYCLE AND

5019
03:00:38,856 --> 03:00:42,393
TRAINING, AND ALSO JUST GENERAL

5020
03:00:42,393 --> 03:00:43,727
COMMUNICATION AND ENGAGEMENT

5021
03:00:43,727 --> 03:00:44,895
AROUND DISSEMINATION OF RESEARCH

5022
03:00:44,895 --> 03:00:46,897
AS WELL AS OUR DATA JUSTICE

5023
03:00:46,897 --> 03:00:49,066
WHICH I'LL TALK ABOUT.

5024
03:00:49,066 --> 03:00:50,834
THE TRAINING COMPONENT WILL

5025
03:00:50,834 --> 03:00:52,703
PROVIDE COMMUNITY PARTNER

5026
03:00:52,703 --> 03:00:53,270
RESEARCH, PRACTICE,

5027
03:00:53,270 --> 03:00:55,406
INTERVENTION, THIS IS ALSO

5028
03:00:55,406 --> 03:00:56,073
BIDIRECTIONAL SUPPORT AND

5029
03:00:56,073 --> 03:00:57,741
EDUCATION FOR THOSE WHO ARE IN

5030
03:00:57,741 --> 03:01:00,244
THE ACADEMIC SPACE AND THOSE

5031
03:01:00,244 --> 03:01:01,245
OUTSIDE OF THE ACADEMIC SPACE,

5032
03:01:01,245 --> 03:01:04,715
REALLY LED BY OUR COMMUNITY

5033
03:01:04,715 --> 03:01:06,050
PARTNERS AS WELL, AROUND

5034
03:01:06,050 --> 03:01:08,018
PROVIDING TRAINING AND CAPACITY

5035
03:01:08,018 --> 03:01:10,220
BUILDING AROUND REPRODUCTIVE

5036
03:01:10,220 --> 03:01:11,855
JUSTICE AND ANTI-RACIST

5037
03:01:11,855 --> 03:01:12,322
PRACTICE.

5038
03:01:12,322 --> 03:01:14,591
AND THEN FINALLY OUR KEY

5039
03:01:14,591 --> 03:01:17,761
RESEARCH PROJECT THAT WAS FUNDED

5040
03:01:17,761 --> 03:01:19,930
IS WITHIN THE IMPLICIT NETWORK,

5041
03:01:19,930 --> 03:01:27,805
FOR 15 YEARS EIGHT PITTSBURGH

5042
03:01:27,805 --> 03:01:29,006
SITES IMPLEMENTED INTERCONCEPTAL

5043
03:01:29,006 --> 03:01:31,208
CARE AND TRIMESTER CARE THROUGH

5044
03:01:31,208 --> 03:01:33,377
THE NETWORK INCLUDING 38 SITES

5045
03:01:33,377 --> 03:01:35,145
AND RESIDENCIES THROUGHOUT THE

5046
03:01:35,145 --> 03:01:36,146
REGION.

5047
03:01:36,146 --> 03:01:38,382
AND THIS NETWORK HAS PROVIDED

5048
03:01:38,382 --> 03:01:42,486
CARE AS A PART OF WELL CHILD

5049
03:01:42,486 --> 03:01:44,655
VISITS, WITH THE FOURTH

5050
03:01:44,655 --> 03:01:45,222
TRIMESTER INTERCONCEPTIONAL

5051
03:01:45,222 --> 03:01:47,424
MODEL THE FOCUS HAS BEEN ON

5052
03:01:47,424 --> 03:01:49,793
INFANT OUTCOMES AND THE WELL

5053
03:01:49,793 --> 03:01:56,900
CHILD VISIT TO ENGAGE WITH THE

5054
03:01:56,900 --> 03:01:59,603
POSTPARTUM PERSON TO EXPAND AND

5055
03:01:59,603 --> 03:02:02,840
INTEGRATE REPRODUCTIVE JUSTICE

5056
03:02:02,840 --> 03:02:04,475
WITHIN THE FOURTH TRIMESTER.

5057
03:02:04,475 --> 03:02:06,543
FOUR AIMS, ONE IS PILOT AIMS AS

5058
03:02:06,543 --> 03:02:11,148
WELL, WHICH IS UNDER AIM 3, TO

5059
03:02:11,148 --> 03:02:19,356
ALSO PILOT A CASH TRANSFER

5060
03:02:19,356 --> 03:02:19,690
INTERVENTION.

5061
03:02:19,690 --> 03:02:22,626
SO IN ADDITION TO THE TWO

5062
03:02:22,626 --> 03:02:23,527
COMPONENTS IN OUR RESEARCH STUDY

5063
03:02:23,527 --> 03:02:26,029
WE HAVE A DATA WORKING GROUP OR

5064
03:02:26,029 --> 03:02:28,665
DATA JUSTICE WORKING GROUP AS

5065
03:02:28,665 --> 03:02:29,767
WELL AS COMMUNICATIONS AND

5066
03:02:29,767 --> 03:02:31,068
DISSEMINATION WORKING GROUP.

5067
03:02:31,068 --> 03:02:32,703
I'LL SPEND TIME TALKING ABOUT

5068
03:02:32,703 --> 03:02:34,104
OUR DATA JUSTICE WORK, AND WHAT

5069
03:02:34,104 --> 03:02:36,640
HAS LED TO WHAT WE'RE DOING NOW

5070
03:02:36,640 --> 03:02:39,476
AND MENTION AS WELL WITH OUR

5071
03:02:39,476 --> 03:02:40,244
COMMUNICATIONS AND DISSEMINATION

5072
03:02:40,244 --> 03:02:44,081
WORKING GROUP WE HAVE A NUMBER

5073
03:02:44,081 --> 03:02:45,349
OF ARTISTS, ARTIST IN RESIDENCE,

5074
03:02:45,349 --> 03:02:48,886
AND THOSE IN THE SPACE OF

5075
03:02:48,886 --> 03:02:50,087
DISSEMINATION OF COMMUNICATION

5076
03:02:50,087 --> 03:02:54,358
ABOUT WORK BEYOND SORT OF

5077
03:02:54,358 --> 03:02:56,326
TYPICAL TRADITIONAL RESEARCH

5078
03:02:56,326 --> 03:02:56,894
METHODOLOGIES.

5079
03:02:56,894 --> 03:02:58,395
OUR DATA MEASUREMENT ANALYTICS

5080
03:02:58,395 --> 03:02:59,496
WORKING GROUP WORKING WITH OUR

5081
03:02:59,496 --> 03:03:00,798
PROJECT LEADS AND COMMUNITY

5082
03:03:00,798 --> 03:03:03,433
COMPONENT AS WELL AS TRAINING

5083
03:03:03,433 --> 03:03:04,735
COMPONENT, OUR COMMUNITY

5084
03:03:04,735 --> 03:03:06,003
COMPONENT ALSO INCLUDES

5085
03:03:06,003 --> 03:03:07,371
COMMUNITY HEALTH ADVOCATES WHO

5086
03:03:07,371 --> 03:03:10,340
WILL BE INVOLVED IN DATA JUSTICE

5087
03:03:10,340 --> 03:03:10,974
AND TRANSPARENCY.

5088
03:03:10,974 --> 03:03:14,478
SOME OF THE LEAD FOLKS INVOLVED

5089
03:03:14,478 --> 03:03:16,647
IN THAT WORK INCLUDE BOB, ASHLEY

5090
03:03:16,647 --> 03:03:18,649
HILL, WHO IS BETWEEN BOTH OF OUR

5091
03:03:18,649 --> 03:03:22,486
CENTERS HERE AT PITT, ALSO AT

5092
03:03:22,486 --> 03:03:28,926
UIC, AND THEN THE WESTERN

5093
03:03:28,926 --> 03:03:29,827
PENNSYLVANIA DATA CENTER, TO

5094
03:03:29,827 --> 03:03:30,961
PROVIDE DATA JUSTICE AND

5095
03:03:30,961 --> 03:03:33,964
LITERACY TRAINING TO ALL OF OUR

5096
03:03:33,964 --> 03:03:35,365
PARTNERS, AND THEN PERFORM DATA

5097
03:03:35,365 --> 03:03:38,335
MONITORING AND PUBLIC ACCESS TO

5098
03:03:38,335 --> 03:03:38,936
DATA AND TRAINING.

5099
03:03:38,936 --> 03:03:40,737
AND SOME OF THE WORK THAT LED US

5100
03:03:40,737 --> 03:03:44,441
TO THAT IS OUR DATA TRANSPARENCY

5101
03:03:44,441 --> 03:03:44,675
PROJECT.

5102
03:03:44,675 --> 03:03:48,078
THIS WAS FUNDED BY FIRST STEPS

5103
03:03:48,078 --> 03:03:50,614
AND BEYOND AN INITIATIVE OF

5104
03:03:50,614 --> 03:03:52,249
ALLEGHENY HEALTH NETWORK AND THE

5105
03:03:52,249 --> 03:03:54,484
MAIN OBJECTIVE WAS TO CREATE A

5106
03:03:54,484 --> 03:03:56,753
STRUCTURE TO HOST DATA AS A

5107
03:03:56,753 --> 03:03:58,488
NEUTRAL BROKER FOR A NUMBER OF

5108
03:03:58,488 --> 03:04:01,491
WHAT WE CONSIDER HEALTH METRICS

5109
03:04:01,491 --> 03:04:05,829
AND ALSO SOCIAL DETERMINANTS OF

5110
03:04:05,829 --> 03:04:07,231
HEALTH METRICS.

5111
03:04:07,231 --> 03:04:08,665
ONE MAIN OUTCOME WAS A DATA

5112
03:04:08,665 --> 03:04:10,400
ASSET MAP WHICH I'LL SHOW YOU.

5113
03:04:10,400 --> 03:04:11,835
ONE OF THE KEY LEARNINGS FROM

5114
03:04:11,835 --> 03:04:14,471
THAT PROCESS WAS THAT WE CAN

5115
03:04:14,471 --> 03:04:16,340
BUILD A DATA WAREHOUSE, BUT THE

5116
03:04:16,340 --> 03:04:19,276
ASUM 

5117
03:04:19,276 --> 03:04:20,477
ASSUMPTION IF WE BUILD IT FOLKS

5118
03:04:20,477 --> 03:04:22,446
WILL COME AT A COMMUNITY LEVEL

5119
03:04:22,446 --> 03:04:23,981
IS NOT THE NEEDS OF THE

5120
03:04:23,981 --> 03:04:26,183
COMMUNITY AND WAYS THEY MIGHT

5121
03:04:26,183 --> 03:04:27,150
USE THAT DATA.

5122
03:04:27,150 --> 03:04:29,686
AND SO WITH THIS DATA ASSET MAP

5123
03:04:29,686 --> 03:04:31,889
WHICH IS VERY MUCH IN ALIGNMENT

5124
03:04:31,889 --> 03:04:33,991
WITH THE WORK THAT IS HAPPENING

5125
03:04:33,991 --> 03:04:36,360
WITH OUR DATA HUB FOR THE

5126
03:04:36,360 --> 03:04:42,032
CENTERS, IS REALLY TO DESCRIBE

5127
03:04:42,032 --> 03:04:43,033
THE MCH LANDSCAPE AMONG NINE

5128
03:04:43,033 --> 03:04:45,736
DOMAINS IN THE REGION.

5129
03:04:45,736 --> 03:04:52,109
THIS IS A FEW EXAMPLES, THAT

5130
03:04:52,109 --> 03:04:53,310
INCLUDES PREGNANCY-RELATED

5131
03:04:53,310 --> 03:04:56,380
HYPERTENSION, PRE-CONCEPTIONAL

5132
03:04:56,380 --> 03:05:00,083
HEALTH DOMAIN, ET CETERA.

5133
03:05:00,083 --> 03:05:04,154
AND 

5134
03:05:04,154 --> 03:05:07,424
AND SO, AS A RESULT WE LEARNED

5135
03:05:07,424 --> 03:05:09,393
HAVING DATA AVAILABLE GOES

5136
03:05:09,393 --> 03:05:11,695
BEYOND CREATING A WAREHOUSE AND

5137
03:05:11,695 --> 03:05:13,330
TOOL THAT SOMETIMES LIVES ONLINE

5138
03:05:13,330 --> 03:05:14,932
MAY NOT BE ACCESSIBLE.

5139
03:05:14,932 --> 03:05:16,099
AS A PART OF THAT WORK THROUGH

5140
03:05:16,099 --> 03:05:18,402
THE FIRST STEPS AND BEYOND

5141
03:05:18,402 --> 03:05:19,836
INITIATIVE AND OUR

5142
03:05:19,836 --> 03:05:21,338
COLLABORATION, THE WESTERN

5143
03:05:21,338 --> 03:05:22,105
PENNSYLVANIA REGIONAL DATA

5144
03:05:22,105 --> 03:05:23,540
CENTER THROUGH UNIVERSITY OF

5145
03:05:23,540 --> 03:05:25,309
PITTSBURGH DEVELOPED A LITERACY

5146
03:05:25,309 --> 03:05:26,743
WORKSHOP PARTLY TO SHIFT FOLK

5147
03:05:26,743 --> 03:05:29,146
FROM US CREATING A DATA

5148
03:05:29,146 --> 03:05:30,681
WAREHOUSE TO THE EXPECTATION

5149
03:05:30,681 --> 03:05:33,116
THAT WE ARE CREATING A SPACE FOR

5150
03:05:33,116 --> 03:05:34,284
COMMUNITY PARTNERS TO LEARN

5151
03:05:34,284 --> 03:05:37,354
ABOUT WHAT DATA IS AVAILABLE BUT

5152
03:05:37,354 --> 03:05:38,755
WHAT DATA -- HOW DATA CAN WORK

5153
03:05:38,755 --> 03:05:40,223
FOR THEM.

5154
03:05:40,223 --> 03:05:41,858
WHAT ARE THE DATA POINTS THAT

5155
03:05:41,858 --> 03:05:43,593
EXIST AND WHAT ARE THE ONES THAT

5156
03:05:43,593 --> 03:05:45,562
DO NOT EXIST THAT WOULD BE

5157
03:05:45,562 --> 03:05:51,835
USEFUL FOR THEIR WORK ON THE

5158
03:05:51,835 --> 03:05:52,302
COMMUNITY LEVEL.

5159
03:05:52,302 --> 03:05:54,271
SO JUST SOME OF THE NEXT STEPS

5160
03:05:54,271 --> 03:05:55,339
SPECIFICALLY WITH OUR DATA

5161
03:05:55,339 --> 03:05:58,375
WORKING GROUP THIS IS NOT

5162
03:05:58,375 --> 03:05:59,843
OVERALL FOR EMBRACE, I'M OPEN TO

5163
03:05:59,843 --> 03:06:01,812
ANSWERING ANY QUESTIONS RELATED

5164
03:06:01,812 --> 03:06:03,880
TO THAT, ELEVATE OUR DATA

5165
03:06:03,880 --> 03:06:04,982
JUSTICE LITERACY WORKSHOP AND

5166
03:06:04,982 --> 03:06:05,983
OUR TRAININGS WHICH ONCE AGAIN

5167
03:06:05,983 --> 03:06:08,819
IS A CORE ELEMENT OF OUR

5168
03:06:08,819 --> 03:06:10,354
COMMUNITY COMPONENT WORK FOR THE

5169
03:06:10,354 --> 03:06:12,022
CENTER.

5170
03:06:12,022 --> 03:06:13,223
AND OUR TRAINING COMPONENT

5171
03:06:13,223 --> 03:06:14,391
COLLABORATE ONCE AGAIN OUR DATA

5172
03:06:14,391 --> 03:06:17,561
WORKING GROUP WILL BE WORKING

5173
03:06:17,561 --> 03:06:20,630
ACROSS THE CENTERS SO

5174
03:06:20,630 --> 03:06:22,065
COLLABORATING WITH

5175
03:06:22,065 --> 03:06:22,733
INTERCONCEPTIONAL CARE FOR

5176
03:06:22,733 --> 03:06:24,601
EMBRACER PROJECT AND ENGAGE WITH

5177
03:06:24,601 --> 03:06:25,469
DATA INNOVATION HUB.

5178
03:06:25,469 --> 03:06:28,872
HOW MUCH TIME DO I HAVE?

5179
03:06:28,872 --> 03:06:29,072
OKAY.

5180
03:06:29,072 --> 03:06:32,376
I'M GOING TO TAKE TWO MINUTES TO

5181
03:06:32,376 --> 03:06:33,243
JUST SHARE SOMETHING BRIEF.

5182
03:06:33,243 --> 03:06:36,313
WHICH IS SEPARATE FROM OUR WORK

5183
03:06:36,313 --> 03:06:38,382
FROM EMBRACE BUT IN CONCERT AND

5184
03:06:38,382 --> 03:06:38,715
ALIGNMENT.

5185
03:06:38,715 --> 03:06:40,584
I MENTIONED THE FOURTH

5186
03:06:40,584 --> 03:06:41,885
STRUCTURAL POLICY RELATED

5187
03:06:41,885 --> 03:06:44,721
INTERVENTION THAT WAS NOT

5188
03:06:44,721 --> 03:06:51,828
FUNDED, THE WORK IS SYNERGY

5189
03:06:51,828 --> 03:06:52,029
ISTIC,

5190
03:06:52,029 --> 03:06:54,798
THE STREAMR STUDY TO INVESTIGATE

5191
03:06:54,798 --> 03:06:56,600
THREE CORE MEDICAID POLICIES

5192
03:06:56,600 --> 03:06:57,868
RELATED TO ADDRESSING MATERNAL

5193
03:06:57,868 --> 03:07:00,537
HEALTH IN THE STATE OF

5194
03:07:00,537 --> 03:07:01,905
PENNSYLVANIA.

5195
03:07:01,905 --> 03:07:04,041
TWO OF THOSE POLICIES IN

5196
03:07:04,041 --> 03:07:05,242
PARTICULAR FOCUS ON BLACK

5197
03:07:05,242 --> 03:07:05,842
POPULATIONS.

5198
03:07:05,842 --> 03:07:09,513
SO OUR STATE IS ONE OF I THINK

5199
03:07:09,513 --> 03:07:12,149
THE ONLY STATE IN WHICH THEIR

5200
03:07:12,149 --> 03:07:14,117
HEALTHCARE QUALITY METRICS AND

5201
03:07:14,117 --> 03:07:15,118
SPECIFICALLY FINANCING IS TIED

5202
03:07:15,118 --> 03:07:16,520
TO IMPROVEMENT OF OUTCOMES FOR

5203
03:07:16,520 --> 03:07:18,622
BLACK INDIVIDUALS SO NOT JUST

5204
03:07:18,622 --> 03:07:21,224
ACROSS EVERY POPULATION BUT

5205
03:07:21,224 --> 03:07:22,225
SPECIFICALLY FOR BLACK

5206
03:07:22,225 --> 03:07:24,628
INDIVIDUALS WHO OUR STUDY IS

5207
03:07:24,628 --> 03:07:26,263
FOCUSED ON EVALUATING AND WHAT

5208
03:07:26,263 --> 03:07:27,998
DOES IMPLEMENTATION OF THAT

5209
03:07:27,998 --> 03:07:29,232
ACTUALLY REALLY LOOK LIKE, SO I

5210
03:07:29,232 --> 03:07:32,069
CAN ANSWER QUESTIONS ABOUT THAT.

5211
03:07:32,069 --> 03:07:33,937
THIS IS OUR PROTOCOL FOR ANYONE

5212
03:07:33,937 --> 03:07:36,106
WHO WANTS TO READ A LITTLE BIT

5213
03:07:36,106 --> 03:07:36,907
MORE ABOUT OUR PROTOCOL.

5214
03:07:36,907 --> 03:07:39,309
IT PROVIDES A LITTLE MORE

5215
03:07:39,309 --> 03:07:42,479
DETAILS IN THAT WE ARE -- WE

5216
03:07:42,479 --> 03:07:47,150
ENGAGED IN QUALITATIVE WORK WITH

5217
03:07:47,150 --> 03:07:52,422
ADMINISTRATORS OF BE  OBSTETRICD

5218
03:07:52,422 --> 03:07:53,857
PEDIATRIC PROVIDERS, AND DOULAS.

5219
03:07:53,857 --> 03:07:56,993
THIS GIVES RESULTS FROM OUR

5220
03:07:56,993 --> 03:07:58,995
CONVERSATIONS WITH MCOs WHICH

5221
03:07:58,995 --> 03:07:59,663
IS VERY INTERESTING.

5222
03:07:59,663 --> 03:08:01,064
THE REASON I WANTED TO BRING

5223
03:08:01,064 --> 03:08:03,366
THIS TO YOU TODAY IS BECAUSE

5224
03:08:03,366 --> 03:08:06,837
THERE IS CURRENTLY ON THE TABLE

5225
03:08:06,837 --> 03:08:08,505
CMS IS CONSIDERING THE WAYS IN

5226
03:08:08,505 --> 03:08:09,706
WHICH WE ACCESS THIS DATA, SO

5227
03:08:09,706 --> 03:08:11,341
FOR THOSE WHO MAY NOT BE

5228
03:08:11,341 --> 03:08:15,278
FAMILIAR, YOU CAN HAVE SORT OF

5229
03:08:15,278 --> 03:08:17,814
PHYSICAL ACCESS OF MEDICAID

5230
03:08:17,814 --> 03:08:19,116
CLAIMS, MEDICARE CLAIMS DATA.

5231
03:08:19,116 --> 03:08:21,718
WHAT IS BEING PROPOSED NOW IS TO

5232
03:08:21,718 --> 03:08:24,321
USE WHAT WOULD BE CONSIDERED AN

5233
03:08:24,321 --> 03:08:27,524
ONLINE FORMAT AS THE NUMBER OF

5234
03:08:27,524 --> 03:08:28,959
IMPLICATIONS FOR ACCESS, FOR

5235
03:08:28,959 --> 03:08:32,562
COST, AND SO OUR TEAM HAS SENT A

5236
03:08:32,562 --> 03:08:35,198
RESPONSE TO CMS REQUEST FOR

5237
03:08:35,198 --> 03:08:35,499
INFORMATION.

5238
03:08:35,499 --> 03:08:36,066
MY UNDERSTANDING THAT POLICY

5239
03:08:36,066 --> 03:08:37,968
CHANGE HAS BEEN PUT ON HOLD BUT

5240
03:08:37,968 --> 03:08:40,670
I THINK AT THE BOTTOM, THE END

5241
03:08:40,670 --> 03:08:43,640
OF THE DAY, IT HAS IMPLICATIONS

5242
03:08:43,640 --> 03:08:46,143
FROM PEOPLE USING THIS DATA TO

5243
03:08:46,143 --> 03:08:49,179
UNDERSTAND MATERNAL MORTALITY OR

5244
03:08:49,179 --> 03:08:50,480
MORBIDITY, MORBIDITY

5245
03:08:50,480 --> 03:08:51,748
SPECIFICALLY ACROSS THE U.S.

5246
03:08:51,748 --> 03:08:53,717
I WILL STOP THERE.

5247
03:08:53,717 --> 03:09:00,790
THANK YOU, AND TAKE ANY

5248
03:09:00,790 --> 03:09:01,625
QUESTIONS.

5249
03:09:01,625 --> 03:09:02,859
>> I'D LIKE TO INVITE
ANYONE IN

5250
03:09:02,859 --> 03:09:06,096
PERSON TO COME TO THE MIC AND

5251
03:09:06,096 --> 03:09:07,197
VIRTUAL ATTENDEES PLEASE USE THE

5252
03:09:07,197 --> 03:09:08,965
Q&A BOX TO SUBMIT QUESTIONS

5253
03:09:08,965 --> 03:09:14,971
ONLINE. 

5254
03:09:14,971 --> 03:09:20,677
ARE THERE ANY QUESTIONS?

5255
03:09:20,677 --> 03:09:22,345
>> MIRACLE CENTER
MICHIGAN.

5256
03:09:22,345 --> 03:09:23,446
HAVE YOU GIVEN THOUGHT OR

5257
03:09:23,446 --> 03:09:25,215
PERHAPS THE STREAMR PROJECT TO

5258
03:09:25,215 --> 03:09:27,617
USING MEDICAID, YOU KNOW, BIRTH

5259
03:09:27,617 --> 03:09:30,253
RECORDS, DEATH RECORDS, CLAIMS,

5260
03:09:30,253 --> 03:09:33,523
THESE ARE DATA COLLECTED BY THE

5261
03:09:33,523 --> 03:09:34,958
STATE, LINKABLE IN THEORY, I'M

5262
03:09:34,958 --> 03:09:35,926
WONDERING IF YOU CONSIDER THAT

5263
03:09:35,926 --> 03:09:41,198
AS A SOURCE OF DATA, CMS IS

5264
03:09:41,198 --> 03:09:41,865
PRICY.

5265
03:09:41,865 --> 03:09:44,034
>> THE STREAMR STUDY WE
ARE, SO

5266
03:09:44,034 --> 03:09:47,337
THAT'S THE R01-FUNDED STUDY I

5267
03:09:47,337 --> 03:09:48,071
MENTIONED.

5268
03:09:48,071 --> 03:09:48,805
ANOTHER PCORI-FUNDED STUDY IS

5269
03:09:48,805 --> 03:09:51,041
ACROSS EIGHT STATES THROUGH THE

5270
03:09:51,041 --> 03:09:52,475
MODERN INITIATIVE.

5271
03:09:52,475 --> 03:09:53,243
YES, WE ARE.

5272
03:09:53,243 --> 03:09:54,678
LOCALLY WE'VE NOT LINKED THOSE

5273
03:09:54,678 --> 03:09:55,045
DATASETS.

5274
03:09:55,045 --> 03:09:56,947
RIGHT NOW WE'RE LOOKING AT

5275
03:09:56,947 --> 03:09:58,882
LINKAGE BETWEEN VITAL STATISTICS

5276
03:09:58,882 --> 03:09:59,783
AND MEDICAID DATA.

5277
03:09:59,783 --> 03:10:01,318
WE HAVE A RELATIONSHIP WITH THE

5278
03:10:01,318 --> 03:10:02,752
STATE OF PENNSYLVANIA TO BE ABLE

5279
03:10:02,752 --> 03:10:04,387
TO DO THAT.

5280
03:10:04,387 --> 03:10:09,025
AND THEN THE CENSUS DATA WHICH

5281
03:10:09,025 --> 03:10:10,327
IS VERY EXPENSIVE SO FOR

5282
03:10:10,327 --> 03:10:12,295
COMMUNITY MEMBER OR RESEARCHER

5283
03:10:12,295 --> 03:10:13,830
TO PAY NEXT TO $30,000 A YEAR

5284
03:10:13,830 --> 03:10:16,366
FOR VIRTUAL ACCESS IS VERY

5285
03:10:16,366 --> 03:10:18,735
LIMITED.

5286
03:10:18,735 --> 03:10:19,936
 

5287
03:10:19,936 --> 03:10:22,272
>> CAN YOU EXPLAIN WHAT
YOU MEAN

5288
03:10:22,272 --> 03:10:24,007
BY DATA JUSTICE AND WHAT IN A

5289
03:10:24,007 --> 03:10:25,675
LOOKS LIKE IN PRACTICE?

5290
03:10:25,675 --> 03:10:29,145
>> YEAH, ABSOLUTELY.

5291
03:10:29,145 --> 03:10:31,581
SO, WE ARE WORKING WITH A NUMBER

5292
03:10:31,581 --> 03:10:33,083
OF COMMUNITY PARTNERS THROUGH

5293
03:10:33,083 --> 03:10:34,618
THE HEALTHY START SO THAT

5294
03:10:34,618 --> 03:10:37,821
INCLUDES OUR COMMUNITY HEALTH

5295
03:10:37,821 --> 03:10:39,456
ADVOCATES, WESTERN PENNSYLVANIA

5296
03:10:39,456 --> 03:10:41,324
REGIONAL DATA CENTER, AND THEN A

5297
03:10:41,324 --> 03:10:43,593
NUMBER OF OUR I WOULD SAY

5298
03:10:43,593 --> 03:10:45,795
PARTNERS BOTH IN THE ACADEMIC

5299
03:10:45,795 --> 03:10:49,699
AND NON-ACADEMIC SETTING TO

5300
03:10:49,699 --> 03:10:50,267
REALLY IMPLEMENT PRINCIPLES

5301
03:10:50,267 --> 03:10:53,536
AROUND WHAT ARE THE WAYS IN

5302
03:10:53,536 --> 03:10:54,971
WHICH WE ARTICULATE WHAT IS

5303
03:10:54,971 --> 03:10:57,741
DATA, LIKE WHAT IS VALUED AT

5304
03:10:57,741 --> 03:11:01,011
DATA, WHAT ARE THE WAYS IN WHICH

5305
03:11:01,011 --> 03:11:03,847
BOTH FROM QUANTITATIVE AND

5306
03:11:03,847 --> 03:11:04,948
QUALITATIVE PERSPECTIVES THE

5307
03:11:04,948 --> 03:11:12,389
WAYS IN WHICH WE MIGHT ACCESS

5308
03:11:12,389 --> 03:11:19,596
THAT INFORMATION AND THAT DATA

5309
03:11:19,596 --> 03:11:20,297
AND HOW IT'S DISSEMINATED.

5310
03:11:20,297 --> 03:11:22,499
A KEY ELEMENT WITH THE JUSTICE

5311
03:11:22,499 --> 03:11:24,367
WORKING GROUP, DIDN'T MENTION

5312
03:11:24,367 --> 03:11:26,970
THIS CONTEXT, BUT SOME OF THAT

5313
03:11:26,970 --> 03:11:28,905
WORK ACTUALLY STARTED DURING THE

5314
03:11:28,905 --> 03:11:29,706
PANDEMIC THROUGH THE BLACK

5315
03:11:29,706 --> 03:11:31,341
EQUITY COALITION, WHICH HAS BEEN

5316
03:11:31,341 --> 03:11:34,411
A COALITION OF PARTNERS WHO CAME

5317
03:11:34,411 --> 03:11:35,712
TOGETHER AROUND THE FACT THAT

5318
03:11:35,712 --> 03:11:37,247
THEY COULD NOT GET ACCESS TO

5319
03:11:37,247 --> 03:11:38,782
DATA, COULD NOT UNDERSTAND WHAT

5320
03:11:38,782 --> 03:11:40,050
WAS HAPPENING DURING THE

5321
03:11:40,050 --> 03:11:42,052
PANDEMIC AND SO THAT WORK REALLY

5322
03:11:42,052 --> 03:11:44,054
SORT OF DEVELOPED WITHIN THAT

5323
03:11:44,054 --> 03:11:46,556
SPACE, AND HAS MADE CONNECTIONS

5324
03:11:46,556 --> 03:11:49,392
TO OUR BROADER WORK WITHIN

5325
03:11:49,392 --> 03:11:59,269
EMBRACE AND MATERNAL HEALTH

5326
03:11:59,269 --> 03:12:09,646
SPACE LOCALLY FOR US.

5327
03:12:11,715 --> 03:12:13,817
>> NEXT PRESENTER,
UNIVERSITY OF

5328
03:12:13,817 --> 03:12:23,760
OKLAHOMA PLEASE JOIN US AND

5329
03:12:23,760 --> 03:12:25,428
INTRODUCE YOURSELF.

5330
03:12:25,428 --> 03:12:27,163
>> LEREMY COLF WITH
UNIVERSITY

5331
03:12:27,163 --> 03:12:29,132
OF OKLAHOMA, MORE SPECIFICALLY

5332
03:12:29,132 --> 03:12:29,999
WITH AN ADMINISTRATIVE

5333
03:12:29,999 --> 03:12:32,502
SUPPLEMENT GRANT TO THAT, TO

5334
03:12:32,502 --> 03:12:34,504
CREATE DATA CAPACITY AND DATA

5335
03:12:34,504 --> 03:12:35,672
RESOURCES FOR MATERNAL HEALTH

5336
03:12:35,672 --> 03:12:37,207
RESERVERS FOR CIRCLE AND FOR THE

5337
03:12:37,207 --> 03:12:39,409
REST OF YOU AS WELL.

5338
03:12:39,409 --> 03:12:41,144
AND SO I'M GOING TO BE TALKING

5339
03:12:41,144 --> 03:12:42,712
ABOUT THAT AND WHAT WE'RE

5340
03:12:42,712 --> 03:12:43,113
CREATING.

5341
03:12:43,113 --> 03:12:44,748
SINCE THIS IS USING DATA AND

5342
03:12:44,748 --> 03:12:45,915
POLICY TO BEND THE MATERNAL

5343
03:12:45,915 --> 03:12:47,484
HEALTH CURVE I THOUGHT I WOULD

5344
03:12:47,484 --> 03:12:50,887
TAKE ADVANTAGE OF MY PREVIOUS

5345
03:12:50,887 --> 03:12:55,592
BACKGROUND, AND BEING NEW TO

5346
03:12:55,592 --> 03:12:57,894
ACADEMIA, BEFORE THAT I DID

5347
03:12:57,894 --> 03:13:00,530
HEALTH POLICY AND DATA POLICY,

5348
03:13:00,530 --> 03:13:01,398
AT HOMELAND SECURITY AT HEALTH

5349
03:13:01,398 --> 03:13:03,032
AND HUMAN SERVICES AND THE WHITE

5350
03:13:03,032 --> 03:13:04,667
HOUSE, SO I THOUGHT I DON'T HAVE

5351
03:13:04,667 --> 03:13:06,002
ANY CLASSES TO LECTURE IN THIS

5352
03:13:06,002 --> 03:13:08,405
WEEK SO I GET TO LECTURE TO YOU

5353
03:13:08,405 --> 03:13:10,907
ABOUT DATA POLICY AND HEALTH

5354
03:13:10,907 --> 03:13:13,009
POLICY WITH THE IDEA THAT WE

5355
03:13:13,009 --> 03:13:14,744
HAVE SO MANY GREAT PRESENTATIONS

5356
03:13:14,744 --> 03:13:19,983
YESTERDAY ABOUT  WHEREE WE'RE

5357
03:13:19,983 --> 03:13:22,952
GOING AND WHAT DO WE DO NEXT.

5358
03:13:22,952 --> 03:13:26,790
WHEN WE FIND OUT INFORMATION

5359
03:13:26,790 --> 03:13:28,958
ABOUT VULNERABLE COMMUNITIES AND

5360
03:13:28,958 --> 03:13:29,626
INDIVIDUALS AND HEALTH

5361
03:13:29,626 --> 03:13:33,129
INEQUITIES, HOW DO WE USE THAT

5362
03:13:33,129 --> 03:13:35,031
TO HELP MATERNAL POPULATIONS TO

5363
03:13:35,031 --> 03:13:37,033
HAVE BETTER OUTCOMES AND SO

5364
03:13:37,033 --> 03:13:38,268
UNFORTUNATELY THE BEST ANSWERS

5365
03:13:38,268 --> 03:13:40,236
FOR THAT ARE DATA AND POLICY

5366
03:13:40,236 --> 03:13:42,205
WHICH NOBODY REALLY LIKES TO

5367
03:13:42,205 --> 03:13:43,940
HEAR, BUT HOPEFULLY IF WE CAN

5368
03:13:43,940 --> 03:13:46,276
TALK ABOUT THEM WE CAN HAVE A

5369
03:13:46,276 --> 03:13:47,110
BETTER OPPORTUNITY TO IMPLEMENT

5370
03:13:47,110 --> 03:13:50,547
ALL OF THE GREAT WORK THAT YOU

5371
03:13:50,547 --> 03:13:51,981
ALL ARE DOING.

5372
03:13:51,981 --> 03:13:55,118
SO, YOU KNOW THIS WAY BETTER

5373
03:13:55,118 --> 03:13:56,886
THAN I DO, BUT MATERNAL

5374
03:13:56,886 --> 03:13:58,621
MORTALITY IS A REALLY BIG DEAL

5375
03:13:58,621 --> 03:14:00,824
AND A REALLY BIG ISSUE.

5376
03:14:00,824 --> 03:14:04,894
IT'S GETTING BETTER IN MOST OF

5377
03:14:04,894 --> 03:14:07,530
THE WORLD.

5378
03:14:07,530 --> 03:14:09,732
BETWEEN 2000 AND 2020 DECREASED

5379
03:14:09,732 --> 03:14:11,000
34% ACROSS THE WORLD.

5380
03:14:11,000 --> 03:14:14,504
YOU CAN SEE THAT IN PLACES LIKE

5381
03:14:14,504 --> 03:14:16,706
THE U.K., AND SWEDEN, THAT HAVE

5382
03:14:16,706 --> 03:14:19,542
BOTH GONE DOWN DURING THAT TIME

5383
03:14:19,542 --> 03:14:20,610
PERIOD.

5384
03:14:20,610 --> 03:14:21,611
IN CONTRAST TO THAT, THE UNITED

5385
03:14:21,611 --> 03:14:25,448
STATES STARTED OUT WORSE AND HAS

5386
03:14:25,448 --> 03:14:26,216
GOTTEN DRAMATICALLY WORSE.

5387
03:14:26,216 --> 03:14:28,618
WHAT IS IT THAT WE'RE DOING

5388
03:14:28,618 --> 03:14:30,153
WRONG?

5389
03:14:30,153 --> 03:14:32,021
WHY ARE WE GETTING WORSE THAN

5390
03:14:32,021 --> 03:14:34,224
OTHER PLACES ARE GETTING BETTER.

5391
03:14:34,224 --> 03:14:35,425
THE NETHERLANDS STARTED OUT

5392
03:14:35,425 --> 03:14:37,260
WORSE THAN UNITED STATES AND GOT

5393
03:14:37,260 --> 03:14:38,661
MUCH, MUCH BETTER, WHAT ARE THEY

5394
03:14:38,661 --> 03:14:40,530
DOING RIGHT THAT WE'RE NOT

5395
03:14:40,530 --> 03:14:40,730
DOING?

5396
03:14:40,730 --> 03:14:45,368
THE ANSWERS ARE DATA AND POLICY.

5397
03:14:45,368 --> 03:14:48,104
SO, THEY CREATED -- THEY WERE

5398
03:14:48,104 --> 03:14:51,040
TROUBLED BY THEIR POOR MATERNAL

5399
03:14:51,040 --> 03:14:51,708
MORTALITY IN THIS 2000

5400
03:14:51,708 --> 03:14:52,675
MEASUREMENT AND DECIDED THEY

5401
03:14:52,675 --> 03:14:55,411
WERE GOING TO DO SOMETHING ABOUT

5402
03:14:55,411 --> 03:14:55,979
IT.

5403
03:14:55,979 --> 03:14:58,114
THEY CREATED THIS NATIONAL

5404
03:14:58,114 --> 03:14:59,048
PERINATAL REGISTRY, COLLECT

5405
03:14:59,048 --> 03:15:00,884
UNIFORM DATA EACH YEAR ON

5406
03:15:00,884 --> 03:15:02,085
LOCATIONS AND OUTCOMES, THEY

5407
03:15:02,085 --> 03:15:05,288
USED THAT DATA TO CONDUCT

5408
03:15:05,288 --> 03:15:07,457
RESEARCH, ESTABLISHED NATIONAL

5409
03:15:07,457 --> 03:15:09,325
STEERING COMMITTEE, STAKEHOLDER

5410
03:15:09,325 --> 03:15:11,194
ADVISORY GROUPS DOING LISTENING

5411
03:15:11,194 --> 03:15:13,263
SESSIONS, TALKING TO DOCTORS,

5412
03:15:13,263 --> 03:15:14,697
INVESTIGATING CASES, AND THEN

5413
03:15:14,697 --> 03:15:17,100
THEY USED THAT RESEARCH TO

5414
03:15:17,100 --> 03:15:17,967
DEVELOP EVIDENCE-BASED

5415
03:15:17,967 --> 03:15:19,736
INTERVENTIONS AND POLICY

5416
03:15:19,736 --> 03:15:20,003
SOLUTIONS.

5417
03:15:20,003 --> 03:15:21,371
THEY WERE IDENTIFYING GEOGRAPHIC

5418
03:15:21,371 --> 03:15:24,240
BARRIERS TO CARE AND ELIMINATING

5419
03:15:24,240 --> 03:15:26,509
THEM.

5420
03:15:26,509 --> 03:15:28,811
THEY WERE AUDITING PRE-TERM

5421
03:15:28,811 --> 03:15:29,512
DEATH, INSTITUTED PRENATAL

5422
03:15:29,512 --> 03:15:31,214
SCREENING, ESTABLISHED A

5423
03:15:31,214 --> 03:15:32,482
COMMISSION ON PRENATAL CARE.

5424
03:15:32,482 --> 03:15:35,385
THIS IS BASED OFF THE 2000

5425
03:15:35,385 --> 03:15:38,121
REPORT, 2001 WAS THE FIRST YEAR

5426
03:15:38,121 --> 03:15:39,289
THEY STARTED COLLECTING UNIFORM

5427
03:15:39,289 --> 03:15:40,823
DATA EVERY YEAR.

5428
03:15:40,823 --> 03:15:42,825
FIRST REPORTS AND RESULTS CAME

5429
03:15:42,825 --> 03:15:45,261
OUT IN 2007 WITH THE FOLLOW-UP

5430
03:15:45,261 --> 03:15:46,529
IN 2013.

5431
03:15:46,529 --> 03:15:49,098
SO WITH THOSE NUMBERS SPOUTED AT

5432
03:15:49,098 --> 03:15:51,267
YOU, LOOK AT WHAT HAPPENED.

5433
03:15:51,267 --> 03:15:54,504
THEY WENT FROM ONE OF THE WORST

5434
03:15:54,504 --> 03:15:55,572
AMONG DEVELOPING NATIONS IN

5435
03:15:55,572 --> 03:15:57,440
2000, STARTED COLLECTING THIS

5436
03:15:57,440 --> 03:16:02,779
DATA, USED IT FOR POLICY

5437
03:16:02,779 --> 03:16:04,414
SOLUTIONS IN 2007 AND 2013,

5438
03:16:04,414 --> 03:16:05,949
EVERY YEAR THEY KEEP GETTING

5439
03:16:05,949 --> 03:16:06,182
BETTER.

5440
03:16:06,182 --> 03:16:12,388
HOW CAN WE USE WHAT  WE'VE

5441
03:16:12,388 --> 03:16:13,056
LEARNED AND VOLUME POLICY

5442
03:16:13,056 --> 03:16:14,157
SOLUTIONS THAT WORK IN THE

5443
03:16:14,157 --> 03:16:15,158
UNITED STATES?

5444
03:16:15,158 --> 03:16:16,559
WHY DOESN'T IT ALREADY EXIST

5445
03:16:16,559 --> 03:16:16,759
HERE?

5446
03:16:16,759 --> 03:16:17,860
WHY DON'T WE HAVE A CLEAR

5447
03:16:17,860 --> 03:16:19,395
DATASET WE CAN USE FOR THE EXACT

5448
03:16:19,395 --> 03:16:21,831
SAME THINGS THEY ARE DOING?

5449
03:16:21,831 --> 03:16:22,899
IT'S COMPLICATED.

5450
03:16:22,899 --> 03:16:24,467
PART IS THE MULTI-PAYER SYSTEM

5451
03:16:24,467 --> 03:16:28,071
IN THE UNITED STATES, RESULTS IN

5452
03:16:28,071 --> 03:16:29,172
VERY FRAGMENTED DATA.

5453
03:16:29,172 --> 03:16:31,474
I WAS PART OF CONVERTING OUR

5454
03:16:31,474 --> 03:16:33,109
HOSPITAL AND HEALTHCARE SYSTEM

5455
03:16:33,109 --> 03:16:35,845
FROM AN OLD ELECTRONIC HEALTH

5456
03:16:35,845 --> 03:16:38,648
RECORD TO EPIC, EVEN WITHIN OUR

5457
03:16:38,648 --> 03:16:40,483
HOSPITAL WE HAD 13 DIFFERENT

5458
03:16:40,483 --> 03:16:41,651
ELECTRONIC HEALTH RECORDS, ALL

5459
03:16:41,651 --> 03:16:42,619
ON DIFFERENT THINGS.

5460
03:16:42,619 --> 03:16:44,721
IF YOU WENT FROM AMBULATORY TO

5461
03:16:44,721 --> 03:16:48,524
INPATIENT OR AMBULATORY TO

5462
03:16:48,524 --> 03:16:49,425
AMBULATORY COULDN'T TRANSFER

5463
03:16:49,425 --> 03:16:51,160
YOUR RECORDS, JUST WITH OUR

5464
03:16:51,160 --> 03:16:52,895
DOCTORS IN OUR HOSPITAL.

5465
03:16:52,895 --> 03:16:54,764
TALK ABOUT TRANSFERRING TO A

5466
03:16:54,764 --> 03:16:56,733
NATIONWIDE DATASET, TRYING TO

5467
03:16:56,733 --> 03:17:04,907
GET UNIFORM INFORMATION IT JUST

5468
03:17:04,907 --> 03:17:06,909
DOESN'T HAPPEN.

5469
03:17:06,909 --> 03:17:08,011
THERE'S LACK OF

5470
03:17:08,011 --> 03:17:09,545
INTEROPERABILITY, WE CAN'T GET

5471
03:17:09,545 --> 03:17:11,614
THEM OVER, FHIR AND HL7 HELPED

5472
03:17:11,614 --> 03:17:14,217
BUT WE JUST AREN'T THERE YET.

5473
03:17:14,217 --> 03:17:17,520
EVEN IF WE WERE, THERE IS A LACK

5474
03:17:17,520 --> 03:17:19,822
OF DATA ON U3 POPULATIONS, THE

5475
03:17:19,822 --> 03:17:21,791
GROUPS YOU CARE ABOUT HAVE LESS

5476
03:17:21,791 --> 03:17:23,660
DATA THAN EVERYBODY ELSE.

5477
03:17:23,660 --> 03:17:31,968
AND SO HOW DO WE HAVE EQUITABLE

5478
03:17:31,968 --> 03:17:38,541
DATA TO GET TO EQUITY

5479
03:17:38,541 --> 03:17:38,708
 AND

5480
03:17:38,708 --> 03:17:39,275
SOLUTIONS.

5481
03:17:39,275 --> 03:17:44,247
IT'S ESTIMATED TO BE WORTH $300

5482
03:17:44,247 --> 03:17:46,516
TO $450 BILLION A YEAR SO WHY

5483
03:17:46,516 --> 03:17:47,717
WOULD ANYBODY SHARE DATA WHEN

5484
03:17:47,717 --> 03:17:49,385
THEY CAN MAKE SO MUCH MONEY OFF

5485
03:17:49,385 --> 03:17:50,253
IT OTHERWISE?

5486
03:17:50,253 --> 03:17:52,021
THERE'S VERY LITTLE MONEY FOR

5487
03:17:52,021 --> 03:17:54,190
DATASET CURATION AND CREATION OF

5488
03:17:54,190 --> 03:17:54,724
NEW DATASETS.

5489
03:17:54,724 --> 03:17:56,059
IT'S STARTING TO CHANGE.

5490
03:17:56,059 --> 03:17:58,361
THAT'S WHY I WAS EXCITED WHEN

5491
03:17:58,361 --> 03:17:59,395
THEY HAD ADMINISTRATIVE

5492
03:17:59,395 --> 03:18:01,998
SUPPLEMENT DATA OPTION.

5493
03:18:01,998 --> 03:18:04,534
NORMALLY WE AS RESEARCHERS ARE

5494
03:18:04,534 --> 03:18:10,907
JUDGED, WE GET PROMOTION,

5495
03:18:10,907 --> 03:18:11,974
TENURE, BUILDING A DATASET HELPS

5496
03:18:11,974 --> 03:18:13,309
EVERYBODY BUT YOU UNLESS YOU

5497
03:18:13,309 --> 03:18:14,510
KEEP IT FOR YOURSELF.

5498
03:18:14,510 --> 03:18:18,381
THIEVES ARE NOT WAYS WE CAN

5499
03:18:18,381 --> 03:18:20,083
ADVANCE WHAT'S HAPPENING IN THE

5500
03:18:20,083 --> 03:18:22,151
COUNTRY, ONLY WHEN WE HAVE AND

5501
03:18:22,151 --> 03:18:23,386
SHARE UNIFORM DATASETS SO

5502
03:18:23,386 --> 03:18:26,289
EVERYONE CAN DO RESEARCH THAT

5503
03:18:26,289 --> 03:18:28,057
WE'RE MAKING ADVANCES.

5504
03:18:28,057 --> 03:18:30,259
SO THESE ARE THE DISINCENTIVES

5505
03:18:30,259 --> 03:18:32,462
FOR RESEARCHERS AND DATA OWNERS

5506
03:18:32,462 --> 03:18:37,233
TO SHARE WHAT THEY ALREADY HAVE.

5507
03:18:37,233 --> 03:18:39,435
SO, THE PURPOSE OF THIS SESSION

5508
03:18:39,435 --> 03:18:42,171
TO USE DATA AND POLICY TO BEND

5509
03:18:42,171 --> 03:18:44,474
THIS CURVE, WE'LL TALK ABOUT THE

5510
03:18:44,474 --> 03:18:45,875
DATASET THAT WE'RE CREATING BUT

5511
03:18:45,875 --> 03:18:48,845
ALSO WHAT DOES THAT MEAN WITH

5512
03:18:48,845 --> 03:18:49,078
POLICY?

5513
03:18:49,078 --> 03:18:50,947
HOPEFULLY I'VE CONVINCE YOU HAD

5514
03:18:50,947 --> 03:18:52,014
BUILDING A DATASET IS A GOOD

5515
03:18:52,014 --> 03:18:52,348
IDEA.

5516
03:18:52,348 --> 03:18:57,253
WHERE DOES IT GET USED AND DO WE

5517
03:18:57,253 --> 03:19:00,223
HAVE  INFRASTRUCTURE AND FORMAT

5518
03:19:00,223 --> 03:19:00,890
TO USE IT.

5519
03:19:00,890 --> 03:19:03,092
THERE ARE GREAT THINGS ONGOING

5520
03:19:03,092 --> 03:19:04,393
ALSO HAVING STRUGGLES IN THE

5521
03:19:04,393 --> 03:19:06,462
POLICY WORLD.

5522
03:19:06,462 --> 03:19:09,065
THE BIGGEST OPPORTUNITY FOR THIS

5523
03:19:09,065 --> 03:19:11,834
AND BIGGEST CHANGE RECENTLY IS

5524
03:19:11,834 --> 03:19:12,902
FEDERAL LAW, EVIDENCE ACT OF

5525
03:19:12,902 --> 03:19:16,472
2018, ALSO KNOWN AS THE

5526
03:19:16,472 --> 03:19:18,174
FOUNDATIONS FOR EVIDENCE-BASED

5527
03:19:18,174 --> 03:19:20,276
POLICY MAKING ACT OF 2018,

5528
03:19:20,276 --> 03:19:21,778
PASSED IN 2019 BUT THAT'S WHEN

5529
03:19:21,778 --> 03:19:23,746
IT WAS PROPOSED AND ORIGINATED.

5530
03:19:23,746 --> 03:19:28,584
IT'S THIS COOL LAW THAT IS

5531
03:19:28,584 --> 03:19:30,119
INTENDED TO INCREASE DATA

5532
03:19:30,119 --> 03:19:31,220
AVAILABILITY AND DATA USE SO

5533
03:19:31,220 --> 03:19:35,591
THAT WE WILL USE IT TO IMPROVE

5534
03:19:35,591 --> 03:19:37,026
OUR POLICIES AND LEGISLATIONS.

5535
03:19:37,026 --> 03:19:40,897
IT WILL -- IT'S INTENDED TO

5536
03:19:40,897 --> 03:19:43,366
BUILD THE DATA, REQUIRE EVIDENCE

5537
03:19:43,366 --> 03:19:45,468
BUILDING PLANS AND STRATEGIC

5538
03:19:45,468 --> 03:19:46,536
PLANS, IDENTIFY POLICY RELEVANT

5539
03:19:46,536 --> 03:19:47,637
SOLUTION, WHAT DATA ARE NEEDED

5540
03:19:47,637 --> 03:19:49,405
TO DO THAT, WHAT THE RESEARCH

5541
03:19:49,405 --> 03:19:52,909
QUESTIONS ARE, WHO CAN DO THAT

5542
03:19:52,909 --> 03:19:54,310
RESEARCH, AND HOW THAT RESEARCH

5543
03:19:54,310 --> 03:19:57,046
WILL THEN LEAD INTO POLICY.

5544
03:19:57,046 --> 03:19:58,681
THERE'S REGULAR REPORTING.

5545
03:19:58,681 --> 03:19:59,682
THERE'S EVALUATIONS.

5546
03:19:59,682 --> 03:20:00,683
THERE'S PROGRESS.

5547
03:20:00,683 --> 03:20:02,285
THERE'S METADATA, BUT ONE OF THE

5548
03:20:02,285 --> 03:20:04,053
COOL PARTS OF IT IN ADDITION TO,

5549
03:20:04,053 --> 03:20:06,322
HEY, LET'S USE THIS EVIDENCE TO

5550
03:20:06,322 --> 03:20:07,990
IMPROVE OUR POLICIES AND IMPROVE

5551
03:20:07,990 --> 03:20:10,493
OUR LEGISLATION, IT ALSO HAS THE

5552
03:20:10,493 --> 03:20:14,730
OPEN GOVERNMENT DATA ACT  AS PAT

5553
03:20:14,730 --> 03:20:17,233
OF THE IT, FEDERAL DEPARTMENTS

5554
03:20:17,233 --> 03:20:18,501
AND AGENCIES WITH STATISTICAL

5555
03:20:18,501 --> 03:20:21,637
DATA HAVE TO MAKE THAT DATA

5556
03:20:21,637 --> 03:20:24,473
PUBLICLY AVAILABLE IN MACHINE

5557
03:20:24,473 --> 03:20:25,474
READABLE FORMAT, COMMON DATA

5558
03:20:25,474 --> 03:20:27,076
ELEMENT, ALL THE THINGS WE WANT

5559
03:20:27,076 --> 03:20:33,115
TO DO THE RESEARCH WE HAVE.

5560
03:20:33,115 --> 03:20:34,450
IT'S AMAZING, BUT THERE'S NO

5561
03:20:34,450 --> 03:20:37,486
MONEY TO DO IT.

5562
03:20:37,486 --> 03:20:38,955
THE DIFFERENCE BETWEEN

5563
03:20:38,955 --> 03:20:39,622
CONGRESSIONAL AUTHORIZATION,

5564
03:20:39,622 --> 03:20:41,424
CREATING A LAW TO DO IT, AND

5565
03:20:41,424 --> 03:20:43,259
SAYING THOU SHALT DO THIS AND

5566
03:20:43,259 --> 03:20:45,728
THEN ASSIGNING MONEY TO IT ARE

5567
03:20:45,728 --> 03:20:47,563
TWO VERY DIFFERENT THINGS.

5568
03:20:47,563 --> 03:20:51,534
SO, ALL OF THIS IS AN INCREDIBLE

5569
03:20:51,534 --> 03:20:52,635
AMOUNT OF WORK.

5570
03:20:52,635 --> 03:20:54,136
IF YOU CURATED DATASETS YOU KNOW

5571
03:20:54,136 --> 03:20:55,671
HOW HARD IT IS TO CONTINUALLY

5572
03:20:55,671 --> 03:20:57,874
UPDATE TO COLLECT DATA, MAKE IT

5573
03:20:57,874 --> 03:20:59,609
MACHINE READABLE TO VALIDATE, TO

5574
03:20:59,609 --> 03:21:00,543
VERIFY, TO FACT CHECK, TO

5575
03:21:00,543 --> 03:21:02,245
RESPOND TO ALL OF THE QUESTIONS,

5576
03:21:02,245 --> 03:21:05,748
TO PUT IT IN FORMATS THAT OTHER

5577
03:21:05,748 --> 03:21:07,617
PEOPLE CAN USE.

5578
03:21:07,617 --> 03:21:13,389
TO FIX GLITCHES THAT GO WRONG.

5579
03:21:13,389 --> 03:21:16,359
THERE IS NO MONEY GIVEN TO ANY

5580
03:21:16,359 --> 03:21:18,294
PART OF THE FEDERAL GOVERNMENT

5581
03:21:18,294 --> 03:21:20,830
TO ACCOMPLISH THIS.

5582
03:21:20,830 --> 03:21:23,032
SO, NIH AND ALL OF THEIR DATA

5583
03:21:23,032 --> 03:21:26,969
HAVE TO EITHER TAKE AWAY MONEY

5584
03:21:26,969 --> 03:21:28,037
FROM GRANTS OR ADMINISTRATION,

5585
03:21:28,037 --> 03:21:30,506
AND/OR TAKE AWAY STAFF TO BE

5586
03:21:30,506 --> 03:21:31,941
DOING THIS INSTEAD OF WHAT THE

5587
03:21:31,941 --> 03:21:33,075
OTHER THINGS THEY ARE MANDATED

5588
03:21:33,075 --> 03:21:34,176
TO DO.

5589
03:21:34,176 --> 03:21:35,912
THAT'S TRUE ACROSS GOVERNMENT.

5590
03:21:35,912 --> 03:21:37,246
SO IT BECOMES VERY, VERY

5591
03:21:37,246 --> 03:21:40,983
CHALLENGING TO MAKE IT HAPPEN.

5592
03:21:40,983 --> 03:21:42,952
SO, WHERE DOES THIS GO?

5593
03:21:42,952 --> 03:21:44,720
THE ANSWER IS IT'S COMPLICATED

5594
03:21:44,720 --> 03:21:46,455
BUT THERE'S REALLY GOOD THINGS

5595
03:21:46,455 --> 03:21:48,524
HAPPENING AND OPPORTUNITIES FOR

5596
03:21:48,524 --> 03:21:49,959
US AS THE RESEARCH COMMUNITY.

5597
03:21:49,959 --> 03:21:52,295
WHEN I WAS GOING ABOUT CREATING

5598
03:21:52,295 --> 03:21:53,696
OUR DATASET TO HELP ALL OF YOU,

5599
03:21:53,696 --> 03:21:55,865
THERE ARE A LOT OF DATASETS AND

5600
03:21:55,865 --> 03:21:58,167
DIFFERENT WAYS TO CREATE THINGS.

5601
03:21:58,167 --> 03:21:58,768
ONE IS SURVEYS.

5602
03:21:58,768 --> 03:22:00,369
A LOT OF YOU TALKED ABOUT

5603
03:22:00,369 --> 03:22:03,439
SURVEYS AND VALUE OF GOING INTO

5604
03:22:03,439 --> 03:22:04,740
THE COMMUNITY AND UNDERSTANDING

5605
03:22:04,740 --> 03:22:08,577
NEEDS OF INDIVIDUALS, NEEDS OF

5606
03:22:08,577 --> 03:22:09,011
GROUPS.

5607
03:22:09,011 --> 03:22:10,546
IT'S PARTICIPATION BASED.

5608
03:22:10,546 --> 03:22:13,582
YOU GET PEOPLE TO BE PART OF IT,

5609
03:22:13,582 --> 03:22:14,250
INDIVIDUAL STORIES, THAT

5610
03:22:14,250 --> 03:22:16,018
IMPACTFUL WHY DOES THIS MATTER,

5611
03:22:16,018 --> 03:22:17,086
IMPACTS THIS PERSON, THIS GROUP.

5612
03:22:17,086 --> 03:22:19,288
THOSE ARE GREAT BUT ARE REALLY

5613
03:22:19,288 --> 03:22:20,923
HARD TO DESIGN.

5614
03:22:20,923 --> 03:22:22,992
THEY ARE LOW SAMPLE SIZES,

5615
03:22:22,992 --> 03:22:25,728
POTENTIAL BIAS WITH THE LOW

5616
03:22:25,728 --> 03:22:27,163
SAMPLE SIZE, MIGHT BE MISSING

5617
03:22:27,163 --> 03:22:28,364
PEOPLE, YOU DON'T KNOW IF THEY

5618
03:22:28,364 --> 03:22:33,302
AP MY TO  EVERY -- APPLY TO EVEY

5619
03:22:33,302 --> 03:22:33,836
GROUP.

5620
03:22:33,836 --> 03:22:35,604
THERE ARE REGISTRATION, COHORT

5621
03:22:35,604 --> 03:22:37,473
TEMPORAL DATA EXTENDS OVER TIME

5622
03:22:37,473 --> 03:22:38,774
LIKE THE NETHERLANDS THAT YOU

5623
03:22:38,774 --> 03:22:40,509
CAN FOLLOW AND MAKE CHANGES AND

5624
03:22:40,509 --> 03:22:42,645
EVALUATE WHETHER OR NOT CHANGES

5625
03:22:42,645 --> 03:22:43,579
WERE IMPACTFUL.

5626
03:22:43,579 --> 03:22:45,681
BUT IT'S HARD TO RECRUIT PEOPLE

5627
03:22:45,681 --> 03:22:46,015
TO REGISTRIES.

5628
03:22:46,015 --> 03:22:49,652
AGAIN, THERE ARE LOW SAMPLE

5629
03:22:49,652 --> 03:22:50,953
SIZE, POTENTIAL BIAS.

5630
03:22:50,953 --> 03:22:52,722
LOOKING AT OLD CHARTS IS GREAT.

5631
03:22:52,722 --> 03:22:54,457
THERE'S LOTS OF HEALTH RECORDS

5632
03:22:54,457 --> 03:22:56,125
BUT IT CAN BE HARD TO

5633
03:22:56,125 --> 03:22:56,625
EXPERIMENTALLY CONTROL.

5634
03:22:56,625 --> 03:22:58,294
HOW DO YOU KNOW WHAT HAPPENED

5635
03:22:58,294 --> 03:22:59,495
AND WHAT CHANGED IN THAT TIME?

5636
03:22:59,495 --> 03:23:02,031
AND SO THE ONE WE DECIDED TO GO

5637
03:23:02,031 --> 03:23:03,566
WITH WAS POPULATION LEVEL.

5638
03:23:03,566 --> 03:23:04,967
THERE'S NO INDIVIDUAL

5639
03:23:04,967 --> 03:23:05,267
INFORMATION.

5640
03:23:05,267 --> 03:23:06,936
IT DOESN'T HAVE A LOT OF WHAT

5641
03:23:06,936 --> 03:23:08,904
ALL ARE MOST INTERESTED IN.

5642
03:23:08,904 --> 03:23:11,440
BUT IT HAS REALLY LARGE SAMPLE

5643
03:23:11,440 --> 03:23:14,710
SIZES AND REPRESENTS THE ENTIRE

5644
03:23:14,710 --> 03:23:15,311
COMMUNITY.

5645
03:23:15,311 --> 03:23:16,779
AND SO IT'S NOT OPPOSITE WHAT

5646
03:23:16,779 --> 03:23:17,880
YOU'RE DOING IN RESEARCH BUT

5647
03:23:17,880 --> 03:23:19,415
WHAT IT DOES IS ALLOW YOU TO

5648
03:23:19,415 --> 03:23:21,617
TAKE WHAT YOU'RE DOING AND

5649
03:23:21,617 --> 03:23:22,785
CONTEXTUALIZE IT.

5650
03:23:22,785 --> 03:23:25,621
DOES WHAT I'M FINDING HERE

5651
03:23:25,621 --> 03:23:27,056
REPRESENT MY UNIQUE POPULATION,

5652
03:23:27,056 --> 03:23:28,824
BUT NEEDS A DIFFERENT DATA AND

5653
03:23:28,824 --> 03:23:30,226
POLICY SOLUTION OR DOES IT

5654
03:23:30,226 --> 03:23:32,928
EXTEND TO A BROADER GROUP OR IS

5655
03:23:32,928 --> 03:23:34,830
IT REPRESENTATIVE OF THE U.S. AS

5656
03:23:34,830 --> 03:23:36,465
A WHOLE, HOW CAN YOU FIND

5657
03:23:36,465 --> 03:23:37,700
SOLUTIONS OTHER PLACES AND SEE

5658
03:23:37,700 --> 03:23:39,869
IF THEY ARE GOING TO APPLY TO

5659
03:23:39,869 --> 03:23:40,636
WHAT YOU'RE DOING HERE?

5660
03:23:40,636 --> 03:23:43,172
THIS IS THE ONLY WAY WE COULD

5661
03:23:43,172 --> 03:23:46,509
GET A NATIONWIDE DATASET FOR

5662
03:23:46,509 --> 03:23:49,812
COMPARISON AND TO LOOK AT

5663
03:23:49,812 --> 03:23:51,380
SPECIFIC POPULATIONS OF

5664
03:23:51,380 --> 03:23:53,549
INTEREST. 

5665
03:23:53,549 --> 03:23:54,450
SO, OUR ADMINISTRATIVE

5666
03:23:54,450 --> 03:23:56,285
SUPPLEMENT IS ONE YEAR OF GREAT

5667
03:23:56,285 --> 03:23:59,355
AMOUNT OF MONEY BUT NOT ENOUGH

5668
03:23:59,355 --> 03:24:01,223
TO REALLY DO BIG MASSIVE THINGS

5669
03:24:01,223 --> 03:24:02,425
OVER A LARGE TIME SCALE.

5670
03:24:02,425 --> 03:24:04,927
AND SO WHAT WE'RE DOING IS

5671
03:24:04,927 --> 03:24:06,796
CREATING TAKING PUBLICLY

5672
03:24:06,796 --> 03:24:08,731
AVAILABLE DATA SOURCES,

5673
03:24:08,731 --> 03:24:12,501
AGGREGATING THEM ON A NATIONWIDE

5674
03:24:12,501 --> 03:24:14,703
LEVEL, WITH GEOGRAPHY, WITH

5675
03:24:14,703 --> 03:24:15,871
SOCIOECONOMICS, WITH

5676
03:24:15,871 --> 03:24:18,407
DEMOGRAPHICS, AND WITH HOSPITAL

5677
03:24:18,407 --> 03:24:19,408
UTILIZATION SPECIFICALLY TIED TO

5678
03:24:19,408 --> 03:24:21,677
PREGNANCY AT THE ZIP CODE LEVEL.

5679
03:24:21,677 --> 03:24:23,779
THAT WAY WE CAN LOOK AT ALL

5680
03:24:23,779 --> 03:24:25,981
SORTS OF FACTORS AND SEE WHICH

5681
03:24:25,981 --> 03:24:30,519
ONES ARE WEIGHING MOST.

5682
03:24:30,519 --> 03:24:32,688
WE KNOW THERE'S RACIAL-RELATED

5683
03:24:32,688 --> 03:24:33,823
DIFFERENTIAL OUTCOMES IN

5684
03:24:33,823 --> 03:24:34,657
PREGNANCY.

5685
03:24:34,657 --> 03:24:37,660
WE KNOW THERE'S DIFFERENCES

5686
03:24:37,660 --> 03:24:38,327
BETWEEN RURAL AND URBAN.

5687
03:24:38,327 --> 03:24:40,096
WHICH ONE IS THE DRIVING FACTOR

5688
03:24:40,096 --> 03:24:41,063
AND WHICH IS SECONDARY?

5689
03:24:41,063 --> 03:24:45,668
HOW CAN YOU LOOK AT THESE LARGE

5690
03:24:45,668 --> 03:24:46,435
POPULATIONS?

5691
03:24:46,435 --> 03:24:49,472
IS WHAT WE'RE EXPERIENCING IN

5692
03:24:49,472 --> 03:24:50,473
OKLAHOMA DIFFERENT THAN

5693
03:24:50,473 --> 03:24:51,373
MISSISSIPPI OR IN PITTSBURGH OR

5694
03:24:51,373 --> 03:24:53,109
ALL OF THE OTHER AREAS WHERE

5695
03:24:53,109 --> 03:24:54,310
THESE CENTERS ARE FOCUSED?

5696
03:24:54,310 --> 03:24:55,511
AND WHAT WE'RE GOING TO DO IN

5697
03:24:55,511 --> 03:24:58,881
THE SECOND PART OF THIS IS

5698
03:24:58,881 --> 03:25:00,416
DEVELOP EXAMPLE METHODS AND

5699
03:25:00,416 --> 03:25:01,750
CONVERT THESE DATASETS INTO

5700
03:25:01,750 --> 03:25:03,185
USEFUL FORMATS SO WHATEVER

5701
03:25:03,185 --> 03:25:04,487
FORMAT YOU'RE TRYING AND WANTING

5702
03:25:04,487 --> 03:25:06,021
TO USE IT IN, WHATEVER YOU'RE

5703
03:25:06,021 --> 03:25:08,657
MOST FAMILIAR WITH YOU CAN USE.

5704
03:25:08,657 --> 03:25:10,626
IN AN IDEAL WORLD WE WOULD USE

5705
03:25:10,626 --> 03:25:11,927
SEQUEL BUT EVERYBODY TRYING TO

5706
03:25:11,927 --> 03:25:14,130
LEARN SEQUEL TO APPLY IN NEW

5707
03:25:14,130 --> 03:25:16,632
WAYS IS NOT THE BEST WAY OF

5708
03:25:16,632 --> 03:25:19,702
MAKING DATA ACCESSIBLE TO

5709
03:25:19,702 --> 03:25:19,969
EVERYBODY.

5710
03:25:19,969 --> 03:25:22,872
AND SO THESE ARE SOME OF THE

5711
03:25:22,872 --> 03:25:25,141
DATASETS THAT WE'RE

5712
03:25:25,141 --> 03:25:32,481
INCORPORATING, WE'RE USING STATE

5713
03:25:32,481 --> 03:25:34,383
DATABASES, TO LOOK AT PREGNANCY

5714
03:25:34,383 --> 03:25:36,218
RELATED CCSR GROUPINGS AND PULL

5715
03:25:36,218 --> 03:25:37,987
THOSE OUT INDIVIDUALLY AND IN

5716
03:25:37,987 --> 03:25:40,823
AGGREGATE TO LOOK AT LOW AND

5717
03:25:40,823 --> 03:25:41,924
HIGH RISK HOSPITALIZATIONS

5718
03:25:41,924 --> 03:25:43,692
RELATED TO PREGNANCY AND CHILD

5719
03:25:43,692 --> 03:25:44,560
BIRTH.

5720
03:25:44,560 --> 03:25:47,563
WE'RE LOOKING AT FACTORS IN THE

5721
03:25:47,563 --> 03:25:48,330
SOCIAL VULNERABILITY INDEX TO

5722
03:25:48,330 --> 03:25:50,799
LOOK AT SOCIAL DETERMINANTS OF

5723
03:25:50,799 --> 03:25:51,567
HEALTH AND UNDERSTAND

5724
03:25:51,567 --> 03:25:52,668
INFORMATION ABOUT COMMUNITIES.

5725
03:25:52,668 --> 03:25:54,203
AND THEN WE'RE PULLING CENSUS

5726
03:25:54,203 --> 03:25:57,239
DATA TO LOOK AT AGE, SEX, RACE,

5727
03:25:57,239 --> 03:25:59,108
AND OTHER IDENTIFYING FACTORS SO

5728
03:25:59,108 --> 03:26:00,976
WE CAN LINK AND GROUP THESE TO

5729
03:26:00,976 --> 03:26:03,612
LOOK AT THEM INDIVIDUALLY AND

5730
03:26:03,612 --> 03:26:06,448
COLLECTIVELY, TO FIND OUT HOW

5731
03:26:06,448 --> 03:26:08,317
MUCH ALL OF THIS IS

5732
03:26:08,317 --> 03:26:08,918
REPRESENTATIVE.

5733
03:26:08,918 --> 03:26:10,186
WE'RE VERY PRELIMINARY IN ANY

5734
03:26:10,186 --> 03:26:12,154
SORT OF RESULTS AND ANALYSIS SO

5735
03:26:12,154 --> 03:26:14,523
I'LL GIVE QUICK THINGS JUST TO

5736
03:26:14,523 --> 03:26:17,726
SHOW HOW WE DO REPRESENTATIVE

5737
03:26:17,726 --> 03:26:18,027
COMPARISON.

5738
03:26:18,027 --> 03:26:21,130
BIRTH RATE ACROSS THE U.S. IS 11

5739
03:26:21,130 --> 03:26:22,498
DOWN AT THE BOTTOM.

5740
03:26:22,498 --> 03:26:23,699
WHEN YOU COMPARE WHAT'S

5741
03:26:23,699 --> 03:26:25,834
HAPPENING IN OKLAHOMA WE HAVE A

5742
03:26:25,834 --> 03:26:30,005
HIGHER BIRTH RATE, BIRTH RATE IS

5743
03:26:30,005 --> 03:26:30,573
HIGHER AMONG NON-WHITE

5744
03:26:30,573 --> 03:26:30,873
POPULATIONS.

5745
03:26:30,873 --> 03:26:33,309
WHEN WE LOOK AT RURAL AND URBAN,

5746
03:26:33,309 --> 03:26:35,144
BIRTH RATE IN URBAN AREAS IS

5747
03:26:35,144 --> 03:26:36,378
HIGHER THAN RURAL AREAS.

5748
03:26:36,378 --> 03:26:37,813
THIS MIGHT SEEM A LITTLE BIT ODD

5749
03:26:37,813 --> 03:26:40,516
UNTIL YOU LOOK AT THE POPULATION

5750
03:26:40,516 --> 03:26:42,585
MAP OF OKLAHOMA, 37% OF OUR

5751
03:26:42,585 --> 03:26:45,087
POPULATION LIVES IN TWO

5752
03:26:45,087 --> 03:26:46,622
COUNTIES, TWO MOST POPULOUS

5753
03:26:46,622 --> 03:26:48,457
COUNTIES, TWO OF THE MOST

5754
03:26:48,457 --> 03:26:49,725
RACIALLY DIVERSE IN THE STATE.

5755
03:26:49,725 --> 03:26:52,328
YOU CAN SEE HOW THIS IS A LINK

5756
03:26:52,328 --> 03:26:54,530
BETWEEN THE TWO, IT'S NOT --

5757
03:26:54,530 --> 03:26:55,731
ONLY WHEN YOU LOOK AT LARGE DATA

5758
03:26:55,731 --> 03:26:57,833
CAN YOU SEE THAT WASN'T

5759
03:26:57,833 --> 03:27:01,103
NECESSARILY LOGICAL LOOKING AT

5760
03:27:01,103 --> 03:27:03,305
SOME OTHER PLACES.

5761
03:27:03,305 --> 03:27:04,940
SO, WE'RE SEEING THAT TAKEN

5762
03:27:04,940 --> 03:27:06,141
TOGETHER THIS DATES BIRTHS ARE

5763
03:27:06,141 --> 03:27:11,380
MORE LIKELY IN URBAN AREAS, AND

5764
03:27:11,380 --> 03:27:12,481
AMONG NON-WHITES.

5765
03:27:12,481 --> 03:27:13,249
THAT DOESN'T REALLY MAP WITH

5766
03:27:13,249 --> 03:27:16,018
WHERE PEOPLE ARE GOING INTO THE

5767
03:27:16,018 --> 03:27:17,186
HOSPITALS FOR PREGNANCY-RELATED

5768
03:27:17,186 --> 03:27:17,553
CONDITIONS.

5769
03:27:17,553 --> 03:27:19,188
WE'RE SEEING THAT WHITE

5770
03:27:19,188 --> 03:27:20,723
EXPECTANT MOTHERS ARE SLIGHTLY

5771
03:27:20,723 --> 03:27:22,591
MORE LIKELY TO BE HOSPITALIZE

5772
03:27:22,591 --> 03:27:24,526
AND SLIGHTLY MORE LIKELY TO DIE

5773
03:27:24,526 --> 03:27:25,194
IN OKLAHOMA.

5774
03:27:25,194 --> 03:27:26,962
THAT IS NOT WHAT OTHER

5775
03:27:26,962 --> 03:27:27,596
RESEARCHERS HAVE SERIOUS

5776
03:27:27,596 --> 03:27:29,031
CONDITION, SO THIS IS AN AREA

5777
03:27:29,031 --> 03:27:31,000
WHERE THERE'S SOMETHING UNIQUE

5778
03:27:31,000 --> 03:27:32,134
HAPPENING IN OKLAHOMA.

5779
03:27:32,134 --> 03:27:33,936
URBAN EXPECTANT MOTHERS ARE MORE

5780
03:27:33,936 --> 03:27:37,306
LIKELY TO BE HOSPITALIZED BUT

5781
03:27:37,306 --> 03:27:41,110
RURAL MORE LIKELY TO DIE.

5782
03:27:41,110 --> 03:27:43,379
STATISTICS ON RURAL VERSUS

5783
03:27:43,379 --> 03:27:45,247
URBAN, STRONGER EFFECTS THERE.

5784
03:27:45,247 --> 03:27:46,015
GIVEN DEMOGRAPHICS AND BREAKDOWN

5785
03:27:46,015 --> 03:27:47,683
WE CAN LOOK AT MORE SPECIFIC

5786
03:27:47,683 --> 03:27:48,751
FACTORS BUT THESE ARE THE TYPES

5787
03:27:48,751 --> 03:27:53,989
OF THINGS THAT WE CAN LOOK AT.

5788
03:27:53,989 --> 03:27:59,995
THESE ARE  PRELIMINARY RESULTS,

5789
03:27:59,995 --> 03:28:03,832
IT'S A NATIONWIDE DATASET WE CAN

5790
03:28:03,832 --> 03:28:05,701
LOOK AT IT EVERYWHERE.

5791
03:28:05,701 --> 03:28:07,770
SO, IN SUMMARY WHAT WE'RE TRYING

5792
03:28:07,770 --> 03:28:10,539
TO DO IS BUILD AND SHARE THESE

5793
03:28:10,539 --> 03:28:11,740
MATERNAL DATASETS.

5794
03:28:11,740 --> 03:28:14,243
THANKS TO THE ADMINISTRATIVE

5795
03:28:14,243 --> 03:28:15,277
SUPPLEMENT, I ACTUALLY AM

5796
03:28:15,277 --> 03:28:16,512
INCENTIVIZED TO SHARE MORE THAN

5797
03:28:16,512 --> 03:28:17,946
KEEP TO MYSELF AND MINE FOR

5798
03:28:17,946 --> 03:28:18,914
PUBLICATIONS FOR THE NEXT TEN

5799
03:28:18,914 --> 03:28:19,281
YEARS.

5800
03:28:19,281 --> 03:28:21,250
I WANT YOU TO DO IT BECAUSE I

5801
03:28:21,250 --> 03:28:22,451
WANT TO IMPROVE WHAT THIS IS

5802
03:28:22,451 --> 03:28:25,287
DOING IN THE FIELD, NO

5803
03:28:25,287 --> 03:28:26,488
TRADITIONAL A MATERNAL HEALTH

5804
03:28:26,488 --> 03:28:27,589
RESEARCH BUT IF I CAN HELP

5805
03:28:27,589 --> 03:28:30,125
SUPPORT YOU TO ADVANCE A CAUSE

5806
03:28:30,125 --> 03:28:32,094
WE ALL CARE ABOUT IT'S WHERE I'M

5807
03:28:32,094 --> 03:28:34,363
IN THIS FOR, TO SUPPORT

5808
03:28:34,363 --> 03:28:36,231
RESEARCH, MORE IMPORTANTLY TO

5809
03:28:36,231 --> 03:28:39,501
INFORM POLICY AND IMPROVE

5810
03:28:39,501 --> 03:28:39,768
OUTCOMES.

5811
03:28:39,768 --> 03:28:44,006
WE'RE BUILDING AND LINKING THE

5812
03:28:44,006 --> 03:28:45,207
DATASET ACROSS GEOGRAPHIES,

5813
03:28:45,207 --> 03:28:45,841
FACTORS TO UNDERSTAND

5814
03:28:45,841 --> 03:28:49,678
UTILIZATION AND FIND OUT WHERE

5815
03:28:49,678 --> 03:28:50,512
WE CAN HAVE IMPROVEMENTS,

5816
03:28:50,512 --> 03:28:51,447
IMPLEMENTATIONS, BE ABLE TO

5817
03:28:51,447 --> 03:28:52,848
EVALUATE OUTCOMES AS THE DATA

5818
03:28:52,848 --> 03:28:55,617
CHANGE OVER TIME.

5819
03:28:55,617 --> 03:28:56,819
I TALKED ABOUT PRELIMINARY

5820
03:28:56,819 --> 03:28:58,320
RESULTS, WHAT WE'RE SEEING.

5821
03:28:58,320 --> 03:29:00,289
BUT THE LEADING THING SO FAR IS

5822
03:29:00,289 --> 03:29:02,825
THAT THE MOST LIKELY COMMON

5823
03:29:02,825 --> 03:29:04,226
FACTOR AND RISK IS GEOGRAPHIC

5824
03:29:04,226 --> 03:29:07,062
BARRIERS TO CARE SO HOW CAN WE

5825
03:29:07,062 --> 03:29:08,731
OVERCOME THOSE, WITH THE NUMBER

5826
03:29:08,731 --> 03:29:10,933
OF RURAL HOSPITALS THAT ARE

5827
03:29:10,933 --> 03:29:14,403
CLOSING AND THE NUMBER OF RURAL

5828
03:29:14,403 --> 03:29:16,171
HOSPITALS THAT ARE ELIMINATING

5829
03:29:16,171 --> 03:29:17,339
THEIR MATERNAL SERVICES CARE

5830
03:29:17,339 --> 03:29:19,108
LINES, THIS IS ONLY GOING TO GET

5831
03:29:19,108 --> 03:29:19,541
WORSE.

5832
03:29:19,541 --> 03:29:22,277
SO IF WE HAVE BETTER DATA AND

5833
03:29:22,277 --> 03:29:25,581
EVIDENCE LIKE THEY DO IN FRANCE,

5834
03:29:25,581 --> 03:29:27,216
FOR EXAMPLE, AND IN NETHERLANDS

5835
03:29:27,216 --> 03:29:29,618
TO SAY THESE ARE HUGE ISSUES,

5836
03:29:29,618 --> 03:29:31,487
HOW CAN WE ADVOCATE FOR POLICY

5837
03:29:31,487 --> 03:29:32,988
AND LEGISLATURE CHANGES AND HOW

5838
03:29:32,988 --> 03:29:34,656
CAN WE GET HOSPITALS AND

5839
03:29:34,656 --> 03:29:36,058
HEALTHCARE SYSTEMS TO BETTER

5840
03:29:36,058 --> 03:29:38,360
ADDRESS THESE NEEDS, THEN WE'RE

5841
03:29:38,360 --> 03:29:41,530
ALL MOVING FORWARD.

5842
03:29:41,530 --> 03:29:43,866
SO A COUPLE POLICY

5843
03:29:43,866 --> 03:29:46,802
RECOMMENDATION, SMALL P NOT THE

5844
03:29:46,802 --> 03:29:48,103
BIG GOVERNMENT CHANGING IS THERE

5845
03:29:48,103 --> 03:29:51,173
ARE 36 STATES THAT REPORT

5846
03:29:51,173 --> 03:29:55,711
PREGNANCY-RELATED DATA TO -- ALL

5847
03:29:55,711 --> 03:29:58,747
STATES REPORT TO HCUP, 36 MAKE

5848
03:29:58,747 --> 03:30:00,649
IT PUBLICLY AVAILABLE, WE CAN

5849
03:30:00,649 --> 03:30:02,718
STAND ACROSS THE NATION.

5850
03:30:02,718 --> 03:30:03,585
HOSTING WORKSHOPS, STATE

5851
03:30:03,585 --> 03:30:05,020
DEPARTMENTS OF HEALTH CAN

5852
03:30:05,020 --> 03:30:07,189
DEVELOP COMMON DATA ELEMENTS SO

5853
03:30:07,189 --> 03:30:10,359
IT'S ALL PUBLICLY AVAILABLE IN

5854
03:30:10,359 --> 03:30:11,794
THE SAME FORMAT.

5855
03:30:11,794 --> 03:30:13,095
OKLAHOMA MAKES AN INCREDIBLE

5856
03:30:13,095 --> 03:30:14,296
AMOUNT OF DETAILED DATA

5857
03:30:14,296 --> 03:30:15,197
AVAILABLE ONLINE.

5858
03:30:15,197 --> 03:30:19,101
BUT IT'S DIFFERENT DATA THAN

5859
03:30:19,101 --> 03:30:19,768
EVERYWHERE ELSE.

5860
03:30:19,768 --> 03:30:22,504
WE COULD WORK ON DOING THAT

5861
03:30:22,504 --> 03:30:22,738
BETTER.

5862
03:30:22,738 --> 03:30:24,807
WE CAN INCENTIVIZE DATA SHARING

5863
03:30:24,807 --> 03:30:26,508
AND DATASETS IN AND OF

5864
03:30:26,508 --> 03:30:26,809
THEMSELVES.

5865
03:30:26,809 --> 03:30:28,510
SO THOSE ARE THE POLICY

5866
03:30:28,510 --> 03:30:29,945
RECOMMENDATIONS OF HOW WE CAN

5867
03:30:29,945 --> 03:30:31,814
HELP ENABLE DATA AND HELP THE

5868
03:30:31,814 --> 03:30:32,080
OUTCOMES.

5869
03:30:32,080 --> 03:30:34,082
I HOPE I DIDN'T BORE YOU TOO

5870
03:30:34,082 --> 03:30:35,951
MUCH BUT THERE'S MY DATA AND

5871
03:30:35,951 --> 03:30:46,428
POLICY LECTURE FOR THE WEEK.

5872
03:30:47,129 --> 03:30:47,663
>> FASCINATING.

5873
03:30:47,663 --> 03:30:54,336
ARE THERE ANY QUESTIONS IN THE

5874
03:30:54,336 --> 03:30:56,438
AUDIENCE?

5875
03:30:56,438 --> 03:30:56,972
>> HI.

5876
03:30:56,972 --> 03:31:00,909
I THINK IT'S BRINGING UP GREAT

5877
03:31:00,909 --> 03:31:02,010
INFORMATION.

5878
03:31:02,010 --> 03:31:04,446
IT'S A HUGE DIFFERENCE, WE CAN'T

5879
03:31:04,446 --> 03:31:08,016
GET WITH THE TYPE OF SYSTEM WE

5880
03:31:08,016 --> 03:31:08,250
HAVE.

5881
03:31:08,250 --> 03:31:11,653
MY QUESTION, WHERE DO YOU DRAW

5882
03:31:11,653 --> 03:31:14,490
THE DATA, ICD-10, WHERE ARE YOU

5883
03:31:14,490 --> 03:31:17,559
BUILDING UP, BECAUSE DATA SITES

5884
03:31:17,559 --> 03:31:20,062
WILL BE THE MAIN THING.

5885
03:31:20,062 --> 03:31:22,197
IF WE HAVE TO RELY ON DATA SAT

5886
03:31:22,197 --> 03:31:24,666
WE NEED TO BE SURE THE

5887
03:31:24,666 --> 03:31:25,534
INFORMATION COMING IN CORRECT,

5888
03:31:25,534 --> 03:31:27,736
OTHERWISE THEY ARE GOING TO

5889
03:31:27,736 --> 03:31:29,705
START TO MAKE INFERENCE, THEN

5890
03:31:29,705 --> 03:31:31,240
MIGHT NOT BE PROPER BUT I THINK

5891
03:31:31,240 --> 03:31:32,875
THE DIRECTION IS GREAT AND

5892
03:31:32,875 --> 03:31:35,277
HOPEFULLY WE CAN GET MORE OUT

5893
03:31:35,277 --> 03:31:36,378
THERE AND BUILDING DATASET I

5894
03:31:36,378 --> 03:31:39,448
THINK IS IMPORTANT, VERY

5895
03:31:39,448 --> 03:31:40,482
IMPORTANT.

5896
03:31:40,482 --> 03:31:40,782
>> THANKS.

5897
03:31:40,782 --> 03:31:42,184
THESE SPECIFICALLY BASICALLY I

5898
03:31:42,184 --> 03:31:43,719
FIND WHATEVER DATA ARE PUBLICLY

5899
03:31:43,719 --> 03:31:45,153
AVAILABLE AND USE THOSE, THEY

5900
03:31:45,153 --> 03:31:48,757
ARE NOT PERFECT AND I APOLOGIZE

5901
03:31:48,757 --> 03:31:51,793
TO ANYBODY FROM AHRQ IF I MESS

5902
03:31:51,793 --> 03:31:53,896
UP BY EXPLANATION BUT THE AGENCY

5903
03:31:53,896 --> 03:31:56,298
FOR HEALTH CARE RESEARCH AND

5904
03:31:56,298 --> 03:31:57,833
QUALITY, PART OF HHS, GOT A

5905
03:31:57,833 --> 03:31:59,701
MANDATE FROM CONGRESS TO LOOK

5906
03:31:59,701 --> 03:32:02,204
INTO WHY THE SAME HEALTH CARE

5907
03:32:02,204 --> 03:32:04,940
PROCEDURES COSTS DIFFERENT

5908
03:32:04,940 --> 03:32:06,275
AMOUNTS IN DIFFERENT PLACES,

5909
03:32:06,275 --> 03:32:07,576
MANDATORY REPORTING FOR ALL CMS

5910
03:32:07,576 --> 03:32:08,677
HOSPITALS TO REPORT THESE DATA

5911
03:32:08,677 --> 03:32:10,746
AND THEY DO ALL SORTS OF AMAZING

5912
03:32:10,746 --> 03:32:12,614
THINGS WITH THEM AND MAKE THE

5913
03:32:12,614 --> 03:32:15,484
DATA PUBLICLY AVAILABLE SO IT'S

5914
03:32:15,484 --> 03:32:20,289
BASED ON THEIR GROUPINGS OF

5915
03:32:20,289 --> 03:32:21,957
ICD-10 CATEGORIES, CCSR-PLUS

5916
03:32:21,957 --> 03:32:26,895
AVAILABLE SINCE 2016, SO ICD-10

5917
03:32:26,895 --> 03:32:30,032
DIFFERENT THAN ICD-9 PREVIOUSLY,

5918
03:32:30,032 --> 03:32:34,503
BASED ON DISCHARGE DATA AND

5919
03:32:34,503 --> 03:32:36,004
ICD-10 PRIMARY AND SECONDARY

5920
03:32:36,004 --> 03:32:36,204
CODES.

5921
03:32:36,204 --> 03:32:38,240
>> MY QUESTION BUILDING ON
THAT.

5922
03:32:38,240 --> 03:32:41,109
THANK YOU FOR YOUR TALK.

5923
03:32:41,109 --> 03:32:43,011
IT'S GOING TO BE POWERFUL TO

5924
03:32:43,011 --> 03:32:43,845
CONNECT DATASETS, THERE'S A LOT

5925
03:32:43,845 --> 03:32:45,380
OF INFORMATION WE CAN GET OUT OF

5926
03:32:45,380 --> 03:32:45,781
THEM.

5927
03:32:45,781 --> 03:32:51,620
RELATED TO THE QUESTION JUST

5928
03:32:51,620 --> 03:32:52,921
ASKED, DO YOU ANTICIPATE IN

5929
03:32:52,921 --> 03:32:55,123
PLACES WITH HOME BIRTHS OR

5930
03:32:55,123 --> 03:32:56,191
THINGS LIKE THAT?

5931
03:32:56,191 --> 03:32:58,193
>> YEAH, THERE'S A DECENT
AMOUNT

5932
03:32:58,193 --> 03:32:59,494
OF MISSING DATA, WE'RE TRYING TO

5933
03:32:59,494 --> 03:33:01,897
FIND WAYS TO ADD THOSE IN.

5934
03:33:01,897 --> 03:33:02,998
THERE'S ALSO SUPPRESSION.

5935
03:33:02,998 --> 03:33:05,500
SO IF THERE ARE 10 OR FEWER OF A

5936
03:33:05,500 --> 03:33:08,036
SPECIFIC DIAGNOSIS GROUP IN A

5937
03:33:08,036 --> 03:33:09,538
COUNTY IT GETS SUPPRESSED.

5938
03:33:09,538 --> 03:33:11,373
BUT IT DIDN'T INCLUDE IT IN THE

5939
03:33:11,373 --> 03:33:13,275
PROPOSAL BUT IT'S MUCH HARDER TO

5940
03:33:13,275 --> 03:33:14,476
DO BUT LOOKING AT OVERALL BIRTH

5941
03:33:14,476 --> 03:33:16,478
NUMBERS AND THEN ACCOUNTING FOR

5942
03:33:16,478 --> 03:33:18,313
WHAT IS MISSING THEN YOU'RE

5943
03:33:18,313 --> 03:33:19,448
INCLUDING BIRTHS HAPPENING

5944
03:33:19,448 --> 03:33:22,250
OUTSIDE OF HOSPITALS OUTSIDE THE

5945
03:33:22,250 --> 03:33:24,019
HEALTHCARE SYSTEM, STILL MISSING

5946
03:33:24,019 --> 03:33:25,420
BIRTHS THAT AREN'T REPORTED FOR

5947
03:33:25,420 --> 03:33:27,956
A BIRTH CERTIFICATE, BUT THOSE

5948
03:33:27,956 --> 03:33:30,258
ARE MUCH SMALLER NUMBERS.

5949
03:33:30,258 --> 03:33:34,396
LOOKING AT STATISTICAL METHODS

5950
03:33:34,396 --> 03:33:35,163
HOW WE CANNOT REIDENTIFY

5951
03:33:35,163 --> 03:33:36,832
DE-IDENTIFIED DATA BUT ACCOUNT

5952
03:33:36,832 --> 03:33:39,868
FOR IT IN OTHER WAYS.

5953
03:33:39,868 --> 03:33:41,303
BEYOND OF SCOPE BUT WHERE I'M

5954
03:33:41,303 --> 03:33:49,044
TRYING TO GO NEXT AND LOOKING AT

5955
03:33:49,044 --> 03:33:50,512
MORE SPECIFIC OUTCOMES.

5956
03:33:50,512 --> 03:33:52,681
>> WE'RE CLOSE TO TIME.

5957
03:33:52,681 --> 03:33:54,650
MAYBE WE CAN CATCH UP AT BREAK.

5958
03:33:54,650 --> 03:33:55,183
>> SURE.

5959
03:33:55,183 --> 03:33:57,719
>> WE'RE PLEASED TO
INTRODUCE

5960
03:33:57,719 --> 03:34:00,322
OUR NEXT SPEAKER.

5961
03:34:00,322 --> 03:34:01,990
 

5962
03:34:01,990 --> 03:34:04,926
DR. GAMBLE FROM THE TULANE

5963
03:34:04,926 --> 03:34:07,462
UNIVERSITY SOUTHERN CENTER FOR

5964
03:34:07,462 --> 03:34:14,970
MATERNAL HEALTH EQUITY CENTER OF

5965
03:34:14,970 --> 03:34:16,204
EXCELLENCE.

5966
03:34:16,204 --> 03:34:19,808
>> IT'S AN HONOR TO
PRESENT ON

5967
03:34:19,808 --> 03:34:24,713
THE CENTER FOR MATERNAL HEALTH

5968
03:34:24,713 --> 03:34:25,947
EQUITY, FUNDED TO TULANE

5969
03:34:25,947 --> 03:34:27,549
UNIVERSITY SCHOOL OF PUBLIC

5970
03:34:27,549 --> 03:34:29,217
HEALTH AND TROPICAL MEDICINE.

5971
03:34:29,217 --> 03:34:32,154
I'M ABBY GAMBLE, NOT AT TULANE

5972
03:34:32,154 --> 03:34:32,454
UNIVERSITY.

5973
03:34:32,454 --> 03:34:34,022
I AM FACULTY AT THE UNIVERSITY

5974
03:34:34,022 --> 03:34:35,991
OF MISSISSIPPI MEDICAL CENTER.

5975
03:34:35,991 --> 03:34:39,494
AND I'M A PART OF ONE OF THREE

5976
03:34:39,494 --> 03:34:40,862
RESEARCH PROJECTS UNDERSTOOD THE

5977
03:34:40,862 --> 03:34:42,130
SOUTHERN CENTER.

5978
03:34:42,130 --> 03:34:44,433
ONE OF WHICH THAT'S THE PROJECT

5979
03:34:44,433 --> 03:34:45,534
WHICH I'LL PRESENT TO YOU TODAY

5980
03:34:45,534 --> 03:34:50,505
WHICH IS THE IMPACT OF MEDICAID

5981
03:34:50,505 --> 03:34:52,307
POSTPARTUM EXTENSION AND

5982
03:34:52,307 --> 03:34:54,076
MANDATED POSTPARTUM DEPRESSION

5983
03:34:54,076 --> 03:34:55,711
SCREENING, CARE FOR GESTATIONAL

5984
03:34:55,711 --> 03:34:56,712
DIABETES AND HYPERTENSIVE

5985
03:34:56,712 --> 03:34:57,779
DISORDERS IN PREGNANCY.

5986
03:34:57,779 --> 03:35:01,416
I WILL REFER TO THIS AS RP 3, AS

5987
03:35:01,416 --> 03:35:04,052
YOU CAN TELL IT'S A LONG TITLE

5988
03:35:04,052 --> 03:35:06,221
AND WE'RE FUNDED BY THE

5989
03:35:06,221 --> 03:35:07,189
"IMPROVE" INITIATIVE.

5990
03:35:07,189 --> 03:35:09,257
THE OVERALL GOAL OF THE SOUTHERN

5991
03:35:09,257 --> 03:35:11,159
CENTER IS TO ESTABLISH A

5992
03:35:11,159 --> 03:35:13,962
MATERNAL HEALTH RESEARCH CENTER

5993
03:35:13,962 --> 03:35:14,963
THAT'S EMBEDDED WITHIN

5994
03:35:14,963 --> 03:35:16,498
HISTORICAL COMMUNITY

5995
03:35:16,498 --> 03:35:17,365
PARTNERSHIPS AND EXISTING

5996
03:35:17,365 --> 03:35:20,202
INFRASTRUCTURE TO BUILD AND

5997
03:35:20,202 --> 03:35:21,470
STRENGTHEN A NETWORK FOR

5998
03:35:21,470 --> 03:35:24,239
IMPROVED MATERNAL HEALTH IN THE

5999
03:35:24,239 --> 03:35:25,574
GULF SOUTH.

6000
03:35:25,574 --> 03:35:28,210
IN ADDITION TO OUR

6001
03:35:28,210 --> 03:35:30,145
ADMINISTRATIVE CORES, OUR

6002
03:35:30,145 --> 03:35:33,648
TRAINING CORE AND OUR COMMUNITY

6003
03:35:33,648 --> 03:35:35,617
ACCOUNTABILITY CORE, WE HAVE

6004
03:35:35,617 --> 03:35:36,618
THREE R01-LEVEL RESEARCH

6005
03:35:36,618 --> 03:35:39,254
PROJECTS THAT ARE FUNDED UNDER

6006
03:35:39,254 --> 03:35:42,090
THE SOUTHERN CENTER.

6007
03:35:42,090 --> 03:35:45,026
THESE PROJECTS SPAN THE SOCIAL

6008
03:35:45,026 --> 03:35:46,361
ECOLOGICAL MODEL SEEKING TO

6009
03:35:46,361 --> 03:35:49,097
ADDRESS SOCIAL AND STRUCTURAL

6010
03:35:49,097 --> 03:35:51,266
BARRIERS TO EQUITABLE MATERNITY

6011
03:35:51,266 --> 03:35:54,002
HEALTHCARE AND HEALTH OUTCOMES.

6012
03:35:54,002 --> 03:35:59,708
SO, RP 3 FOCUSES ON POLICY

6013
03:35:59,708 --> 03:36:00,675
LEVEL, SPECIFICALLY MEDICAID

6014
03:36:00,675 --> 03:36:02,110
POSTPARTUM COVERAGE EXTENSION

6015
03:36:02,110 --> 03:36:10,552
AND OTHER HEALTH POLICIES LIKE

6016
03:36:10,552 --> 03:36:14,356
POSTPARTUM DEPRESSION SCREENING

6017
03:36:14,356 --> 03:36:14,623
MANDATES.

6018
03:36:14,623 --> 03:36:17,559
IN THE FIRST YEAR TRAINEESES LED

6019
03:36:17,559 --> 03:36:19,427
A HISTORICAL POLICY SCAN LOOKING

6020
03:36:19,427 --> 03:36:21,596
AT MATERNAL HEALTH LEGISLATION

6021
03:36:21,596 --> 03:36:22,731
ENACTED ACROSS THREE STATES,

6022
03:36:22,731 --> 03:36:27,302
LOUISIANA AND MISSISSIPPI AND

6023
03:36:27,302 --> 03:36:30,138
ARKANSAS BETWEEN 2018 AND 2023.

6024
03:36:30,138 --> 03:36:32,440
THEY FOUND 40 POLICIES IN ALL

6025
03:36:32,440 --> 03:36:34,509
ENACTED ACROSS ALL THREE STATES,

6026
03:36:34,509 --> 03:36:36,611
25 OF WHICH WERE ENACTED IN

6027
03:36:36,611 --> 03:36:40,782
LOUISIANA, 11 IN ARKANSAS, 4 IN

6028
03:36:40,782 --> 03:36:43,852
MISSISSIPPI. 

6029
03:36:43,852 --> 03:36:45,020
WE ALREADY KNOW THAT THERE THERE

6030
03:36:45,020 --> 03:36:47,889
DIFFERENCES IN TERMS OF WHAT THE

6031
03:36:47,889 --> 03:36:49,658
POLICY LANDSCAPE LOOKS LIKE.

6032
03:36:49,658 --> 03:36:54,930
IMPORTANTLY IN TERMS OF MEDICAID

6033
03:36:54,930 --> 03:36:55,530
POSTPARTUM COVERAGE EXTENSION,

6034
03:36:55,530 --> 03:36:56,932
EXTENSION HAS BEEN IMPROVED IN

6035
03:36:56,932 --> 03:36:58,233
BOTH LOUISIANA AND MISSISSIPPI

6036
03:36:58,233 --> 03:36:59,534
BUT NOT IN ARKANSAS.

6037
03:36:59,534 --> 03:37:02,604
AND THEN IN TERMS OF POSTPARTUM

6038
03:37:02,604 --> 03:37:03,271
DEPRESSION SCREENING MANDATES

6039
03:37:03,271 --> 03:37:05,674
THERE ARE MANDATES IN LOUISIANA

6040
03:37:05,674 --> 03:37:06,775
AND ARKANSAS BUT NOT

6041
03:37:06,775 --> 03:37:07,409
MISSISSIPPI.

6042
03:37:07,409 --> 03:37:10,712
AND THEN IN TERMS OF OVERALL

6043
03:37:10,712 --> 03:37:12,047
MEDICAID EXPANSION, LOUISIANA

6044
03:37:12,047 --> 03:37:14,516
AND ARKANSAS ARE EXPANSION

6045
03:37:14,516 --> 03:37:17,252
STATES AND MISSISSIPPI IS NOT.

6046
03:37:17,252 --> 03:37:18,820
AGAIN, DIVERSE LANDSCAPES IN

6047
03:37:18,820 --> 03:37:24,159
TERMS OF POLICY, SIMILAR HEALTH

6048
03:37:24,159 --> 03:37:24,526
OUTCOMES.

6049
03:37:24,526 --> 03:37:26,361
MEDICAID POSTPARTUM EXTENSION

6050
03:37:26,361 --> 03:37:29,297
AND OTHER MATERNAL HEALTH

6051
03:37:29,297 --> 03:37:30,732
POLICIES HAVE PARTICULAR

6052
03:37:30,732 --> 03:37:33,134
IMPLICATIONS FOR PREGNANCIES

6053
03:37:33,134 --> 03:37:34,102
COMPLICATED BY GESTATIONAL

6054
03:37:34,102 --> 03:37:36,438
DIABETES, SPECIFICALLY IN THE

6055
03:37:36,438 --> 03:37:38,273
POSTPARTUM PERIOD WE KNOW THAT

6056
03:37:38,273 --> 03:37:41,676
BIRTHING PERSONS WHO EXPERIENCE

6057
03:37:41,676 --> 03:37:42,978
GESTATIONAL DIABETES, 70% WILL

6058
03:37:42,978 --> 03:37:44,746
DEVELOP TYPE 2 DIABETES WITHIN

6059
03:37:44,746 --> 03:37:47,148
THREE YEARS AFTER THEIR

6060
03:37:47,148 --> 03:37:48,216
PREGNANCY.

6061
03:37:48,216 --> 03:37:49,017
SIMILAR WITH HYPERTENSIVE

6062
03:37:49,017 --> 03:37:52,621
DISORDERS IN PREGNANCY,

6063
03:37:52,621 --> 03:37:53,121
SPECIFICALLY GESTATIONAL

6064
03:37:53,121 --> 03:37:54,055
HYPERTENSION OR PREECLAMPSIA, 1

6065
03:37:54,055 --> 03:37:57,125
IN 5 THOSE BIRTHING PERSONS

6066
03:37:57,125 --> 03:38:01,830
REMAIN HYPERTENSIVE AT 3 MONTHS

6067
03:38:01,830 --> 03:38:02,264
POST-DELIVERY.

6068
03:38:02,264 --> 03:38:03,565
COMBINED, PREGNANCIES

6069
03:38:03,565 --> 03:38:05,100
COMPLICATED BY GDM OR

6070
03:38:05,100 --> 03:38:06,735
HYPERTENSIVE DISORDERS IN

6071
03:38:06,735 --> 03:38:12,007
PREGNANCY HAVE INCREASED RISK

6072
03:38:12,007 --> 03:38:13,675
FOR POSTPARTUM DEPRESSION.

6073
03:38:13,675 --> 03:38:16,845
WHAT DOES THAT HAVE TO DO WITH

6074
03:38:16,845 --> 03:38:19,781
MEDICAID AND OTHER POLICIES?

6075
03:38:19,781 --> 03:38:20,682
HISTORICALLY MEDICAID COVERAGE

6076
03:38:20,682 --> 03:38:23,351
WAS MANDATED TO LAST UP TO 60

6077
03:38:23,351 --> 03:38:24,019
DAYS POST-DELIVERY.

6078
03:38:24,019 --> 03:38:26,388
WHEN YOU COMPARE THAT WITH THE

6079
03:38:26,388 --> 03:38:27,489
ACOG GUIDELINES FOR PREVENTIVE

6080
03:38:27,489 --> 03:38:29,658
CARE IN THE POSTPARTUM PERIOD,

6081
03:38:29,658 --> 03:38:32,727
MOST OF THOSE BIRTHING PERSONS

6082
03:38:32,727 --> 03:38:36,464
WOULD LOSE ELIGIBILITY AND

6083
03:38:36,464 --> 03:38:38,099
ESSENTIALLY THEIR ACCESS TO CARE

6084
03:38:38,099 --> 03:38:39,868
AND THEY WOULD LOSE THAT ACCESS

6085
03:38:39,868 --> 03:38:42,137
TO THE PREVENTIVE CARE SERVICES

6086
03:38:42,137 --> 03:38:44,205
THAT IS RECOMMENDED BY ACOG.

6087
03:38:44,205 --> 03:38:47,142
UNDER THE EXTENSION UP TO 12

6088
03:38:47,142 --> 03:38:49,811
MONTHS POSTPARTUM THESE WOMEN

6089
03:38:49,811 --> 03:38:54,082
NOW HAVE ACCESS TO CARE,

6090
03:38:54,082 --> 03:38:54,849
IMPORTANT PREVENTIVE CARE,

6091
03:38:54,849 --> 03:38:58,019
SPECIFICALLY BLOOD GLUCOSE AND

6092
03:38:58,019 --> 03:38:59,220
BLOOD PRESSURE MONITORING AND

6093
03:38:59,220 --> 03:39:05,593
FOR THOSE THAT DEVELOP TYPE 2

6094
03:39:05,593 --> 03:39:06,561
DIABETES OR HYPERTENSION GETTING

6095
03:39:06,561 --> 03:39:09,197
THEIR CONDITIONS UNDER CONTROL

6096
03:39:09,197 --> 03:39:10,498
AND MANAGING CARE AND HAVING

6097
03:39:10,498 --> 03:39:12,400
ACCESS TO SCREENING AND

6098
03:39:12,400 --> 03:39:14,469
HEALTHCARE SERVICES FOR

6099
03:39:14,469 --> 03:39:15,904
POSTPARTUM DEPRESSION.

6100
03:39:15,904 --> 03:39:19,808
BUT WE KNOW THAT POLICY ALONE IS

6101
03:39:19,808 --> 03:39:20,909
NOT ENOUGH TO TRANSLATE INTO

6102
03:39:20,909 --> 03:39:22,344
HEALTH CARE PRACTICES AND

6103
03:39:22,344 --> 03:39:23,912
IMPROVED HEALTH OUTCOMES.

6104
03:39:23,912 --> 03:39:27,482
WE ALSO KNOW THERE ARE GAPS IN

6105
03:39:27,482 --> 03:39:28,583
POLICY RESEARCH.

6106
03:39:28,583 --> 03:39:31,886
SO, WE HAVE A VERY SMALL

6107
03:39:31,886 --> 03:39:34,255
EMPIRICAL EVIDENCE BASE THAT

6108
03:39:34,255 --> 03:39:34,923
SUPPORTS POLICY STRATEGIES TO

6109
03:39:34,923 --> 03:39:36,691
IMPROVE POSTPARTUM CARE.

6110
03:39:36,691 --> 03:39:40,395
WE ALSO KNOW THAT IN TERMS OF

6111
03:39:40,395 --> 03:39:41,930
POLICY EVALUATIONS THERE'S A

6112
03:39:41,930 --> 03:39:45,300
LACK OF INDIVIDUAL LEVEL COST

6113
03:39:45,300 --> 03:39:46,534
EFFECTIVENESS EVALUATIONS AND

6114
03:39:46,534 --> 03:39:48,269
THAT NONE OF ECONOMIC

6115
03:39:48,269 --> 03:39:50,038
EVALUATIONS AT THE INDIVIDUAL

6116
03:39:50,038 --> 03:39:52,540
LEVEL HAVE REALLY USED

6117
03:39:52,540 --> 03:39:53,141
DISTRIBUTIONAL COST EFFECTIVE

6118
03:39:53,141 --> 03:39:56,578
MODELS TO LOOK AT DIFFERENCES IN

6119
03:39:56,578 --> 03:39:57,379
SUBPOPULATIONS, REALLY IMPORTANT

6120
03:39:57,379 --> 03:39:59,414
FOR EXPLORING HEALTH EQUITY AND

6121
03:39:59,414 --> 03:40:01,850
HEALTH DISPARITY CONCERNS.

6122
03:40:01,850 --> 03:40:05,020
AND THEN LAST, THERE'S COMPLEX

6123
03:40:05,020 --> 03:40:06,488
CONTEXTUAL FACTORS AT THE MICRO

6124
03:40:06,488 --> 03:40:09,724
LEVEL THAT IMPACT HOW THESE

6125
03:40:09,724 --> 03:40:11,359
POLICIES TRANSLATE FROM, SAY,

6126
03:40:11,359 --> 03:40:13,328
FEDERAL TO STATE, DOWN TO THE

6127
03:40:13,328 --> 03:40:14,629
HEALTH SYSTEMS, PROVIDER AND

6128
03:40:14,629 --> 03:40:17,165
THEN THE ACTUAL PATIENT LEVEL.

6129
03:40:17,165 --> 03:40:18,266
IT'S IMPORTANT TO UNDERSTAND

6130
03:40:18,266 --> 03:40:21,436
THOSE THINGS IN ORDER TO CREATE

6131
03:40:21,436 --> 03:40:22,504
BETTER INTERVENTIONS FOR

6132
03:40:22,504 --> 03:40:23,138
IMPLEMENTATION AND

6133
03:40:23,138 --> 03:40:23,972
DISSEMINATION.

6134
03:40:23,972 --> 03:40:27,909
SO THE PURPOSE OF RP3, WE'RE

6135
03:40:27,909 --> 03:40:29,010
WANTING TO IDENTIFY

6136
03:40:29,010 --> 03:40:29,978
IMPLEMENTATION STRATEGIES THAT

6137
03:40:29,978 --> 03:40:34,682
AIM TO IMPROVE MATERNAL

6138
03:40:34,682 --> 03:40:37,519
POSTPARTUM HEALTH PARTICULARLY

6139
03:40:37,519 --> 03:40:46,961
IN PREGNANCIES  COMPLICATED BY

6140
03:40:46,961 --> 03:40:48,730
GDM OR HYPERTENSION.

6141
03:40:48,730 --> 03:40:50,165
IN SHORT, OVERALL PROVIDES

6142
03:40:50,165 --> 03:40:53,968
FRAMEWORK FOR US TO DISENTANGLE

6143
03:40:53,968 --> 03:40:55,270
AND HOPEFULLY UNDERSTAND THOSE

6144
03:40:55,270 --> 03:40:56,805
COMPLEX DYNAMICS WITHIN AND

6145
03:40:56,805 --> 03:40:58,506
ACROSS SETTINGS AND LEVELS, AS

6146
03:40:58,506 --> 03:41:01,976
THEY CONVERGE ON THE HEALTHCARE

6147
03:41:01,976 --> 03:41:04,045
UTILIZATION, HEALTHCARE ACCESS,

6148
03:41:04,045 --> 03:41:06,781
OUTCOMES, SOCIETAL IMPACTS,

6149
03:41:06,781 --> 03:41:07,882
PARTICULARLY HEALTHCARE COSTS.

6150
03:41:07,882 --> 03:41:11,152
SO IN AIM 1, WE'RE LOOKING TO

6151
03:41:11,152 --> 03:41:12,787
EVALUATE OVERALL EFFECTIVENESS

6152
03:41:12,787 --> 03:41:20,261
OF MEDICAID POSTPARTUM EXTENSION

6153
03:41:20,261 --> 03:41:21,262
AND POSTPARTUM DEPRESSION

6154
03:41:21,262 --> 03:41:22,063
SCREENING, POSTPARTUM DEPRESSION

6155
03:41:22,063 --> 03:41:26,534
SCREENING, RATES OF DIAGNOSIS

6156
03:41:26,534 --> 03:41:31,739
FOR DIABETES, HYPERTENSION,

6157
03:41:31,739 --> 03:41:32,440
POSTPARTUM DEPRESSION,

6158
03:41:32,440 --> 03:41:33,541
HYPERTENSION AND DIABETES

6159
03:41:33,541 --> 03:41:34,843
CONTROL, EXPLORING DISPARITIES

6160
03:41:34,843 --> 03:41:37,011
AND LOOKING AT UTILIZATION

6161
03:41:37,011 --> 03:41:39,013
PRACTICES, THERE WILL BE A

6162
03:41:39,013 --> 03:41:39,747
COMPARISON NOT NECESSARILY ALL

6163
03:41:39,747 --> 03:41:44,419
OF THIS COMPARED TO ARKANSAS BUT

6164
03:41:44,419 --> 03:41:46,988
IN THE CONTEXT OF THE

6165
03:41:46,988 --> 03:41:47,655
DIFFERENTIAL POLICIES ACROSS

6166
03:41:47,655 --> 03:41:50,291
STATES WE'LL LOOK AT THOSE

6167
03:41:50,291 --> 03:41:51,059
DIFFERENCES.

6168
03:41:51,059 --> 03:42:01,469
AIM 2, WE WILL EXAMINE 

6169
03:42:05,106 --> 03:42:06,508
CROSS-EFFECTIVENESS.

6170
03:42:06,508 --> 03:42:09,677
AND THEN WITH AIM 3, THIS WILL

6171
03:42:09,677 --> 03:42:10,445
BE ENGAGING MULTIPLE

6172
03:42:10,445 --> 03:42:13,281
STAKEHOLDERS ACROSS THREE STATES

6173
03:42:13,281 --> 03:42:14,716
TO UNDERSTAND THE DIFFERENT

6174
03:42:14,716 --> 03:42:16,050
CONTEXTUAL FACTORS THAT LEAD TO

6175
03:42:16,050 --> 03:42:22,724
APPROXIMATELY SHY -- POLICY SAY

6176
03:42:22,724 --> 03:42:23,024
DOPINGS.

6177
03:42:23,024 --> 03:42:25,126
WE HAVE INTERVIEWS TO UNDERSTAND

6178
03:42:25,126 --> 03:42:29,697
HOW CHANGES IN POLICY ARE BEING

6179
03:42:29,697 --> 03:42:31,032
IMPLEMENTED AT THE HEALTHCARE

6180
03:42:31,032 --> 03:42:32,634
SYSTEMS LEVEL AND PROVIDERS.

6181
03:42:32,634 --> 03:42:36,704
WE'LL USE GROUP CONCEPT MAPPING

6182
03:42:36,704 --> 03:42:37,172
WITH STAKEHOLDERS AND

6183
03:42:37,172 --> 03:42:38,773
POLICYMAKERS TO UNDERSTAND WHAT

6184
03:42:38,773 --> 03:42:41,309
ARE THE MOST IMPORTANT FACTORS

6185
03:42:41,309 --> 03:42:42,710
LEADING TO MATERNAL HEALTH

6186
03:42:42,710 --> 03:42:44,279
POLICY IN THE RESPECTIVE STATES,

6187
03:42:44,279 --> 03:42:46,681
AND WE'LL DO A COMBINATION OF

6188
03:42:46,681 --> 03:42:47,982
LONGITUDINAL INTERVIEWS AND

6189
03:42:47,982 --> 03:42:50,418
GROUP CONCEPT MAPPING WITH

6190
03:42:50,418 --> 03:42:51,853
PATIENTS DIAGNOSED WITH

6191
03:42:51,853 --> 03:42:54,155
GESTATIONAL DIABETES OR

6192
03:42:54,155 --> 03:42:55,023
HYPERTENSIVE DISORDERS IN

6193
03:42:55,023 --> 03:42:56,357
PREGNANCY, STARTING IN THE

6194
03:42:56,357 --> 03:42:57,892
PREGNANCY PERIOD AND FALLING

6195
03:42:57,892 --> 03:43:00,061
INTO THE POSTPARTUM PERIOD SO WE

6196
03:43:00,061 --> 03:43:02,797
CAN UNDERSTAND NOT JUST

6197
03:43:02,797 --> 03:43:04,432
EXPERIENCES OF HEALTHCARE DURING

6198
03:43:04,432 --> 03:43:05,733
PREGNANCY BUT THERE'S ALSO THE

6199
03:43:05,733 --> 03:43:08,069
CONTINUITY OF CARE FROM

6200
03:43:08,069 --> 03:43:09,837
PREGNANCY TO POSTPARTUM PERIOD

6201
03:43:09,837 --> 03:43:12,106
AND HOW MEDICAID POSTPARTUM

6202
03:43:12,106 --> 03:43:14,943
EXTENSION IS IMPACTING THEIR

6203
03:43:14,943 --> 03:43:17,178
UTILIZATION AND EXPERIENCES OF

6204
03:43:17,178 --> 03:43:19,647
CARE FOLLOWING THOSE DIAGNOSES

6205
03:43:19,647 --> 03:43:21,716
IN PREGNANCY.

6206
03:43:21,716 --> 03:43:23,151
WE HAVE SEVERAL POPULATION

6207
03:43:23,151 --> 03:43:24,485
HEALTH IMPLICATIONS.

6208
03:43:24,485 --> 03:43:27,422
SO THE OUTCOMES OF RP3 WE HOPE

6209
03:43:27,422 --> 03:43:30,592
TO USE TO BETTER INFORM

6210
03:43:30,592 --> 03:43:31,793
PATIENT-CENTERED STRATEGIES FOR

6211
03:43:31,793 --> 03:43:33,895
INTERVENTIONS THAT WILL COME IN

6212
03:43:33,895 --> 03:43:37,465
THE FUTURE, USING

6213
03:43:37,465 --> 03:43:38,366
COMMUNITY-BASED PRINCIPLES.

6214
03:43:38,366 --> 03:43:39,467
WE'RE LOOKING AT EXPLORING

6215
03:43:39,467 --> 03:43:44,405
BARRIERS TO CARE ACROSS MULTIPLE

6216
03:43:44,405 --> 03:43:46,140
LEVELS AND PERSPECTIVES TO

6217
03:43:46,140 --> 03:43:47,909
INFORM FUTURE POLICY STRATEGY

6218
03:43:47,909 --> 03:43:50,178
AND TO GENERATE IMPORTANT DATA

6219
03:43:50,178 --> 03:43:51,946
THAT'S NEEDED TO BETTER

6220
03:43:51,946 --> 03:43:52,914
DISSEMINATE AND IMPLEMENT

6221
03:43:52,914 --> 03:43:54,582
PRACTICES ACROSS THESE DIFFERENT

6222
03:43:54,582 --> 03:43:56,985
SETTINGS AND THROUGHOUT THE

6223
03:43:56,985 --> 03:43:58,186
UNITED STATES.

6224
03:43:58,186 --> 03:44:00,255
OUR PROGRESS TO DATE, AS I

6225
03:44:00,255 --> 03:44:03,758
MENTIONED WE HAVE PUBLISHED A

6226
03:44:03,758 --> 03:44:05,960
HISTORICAL POLICY SURVEILLANCE

6227
03:44:05,960 --> 03:44:12,634
FROM 2018 TO 2023, OUR TRAINEES

6228
03:44:12,634 --> 03:44:18,840
ARE CURRENTLY WORKING WITH OUR

6229
03:44:18,840 --> 03:44:21,709
IMPLEMENTATION HUB TO CONTINUE

6230
03:44:21,709 --> 03:44:23,778
TO MONITOR POLICY THAT IS BEING

6231
03:44:23,778 --> 03:44:27,048
NOT JUST  ENACTED BUT INTRODUCE

6232
03:44:27,048 --> 03:44:28,683
AND WHAT'S HAPPENING TO POLICIES

6233
03:44:28,683 --> 03:44:29,851
AND BILLS ONCE INTRODUCED, HOW

6234
03:44:29,851 --> 03:44:34,155
THEY ARE PROGRESSING THROUGH THE

6235
03:44:34,155 --> 03:44:40,328
LEGISLATIVE PROS IS. -- PROCESS.

6236
03:44:40,328 --> 03:44:42,830
WE ARE EXPLORING THE

6237
03:44:42,830 --> 03:44:43,598
COST-BENEFIT OF POSTPARTUM

6238
03:44:43,598 --> 03:44:45,233
DEPRESSION SCREENING TREATMENT

6239
03:44:45,233 --> 03:44:46,000
AND PREVENTION STRATEGIES, WE

6240
03:44:46,000 --> 03:44:47,201
SHOULD BE SENDING THAT OUT FOR

6241
03:44:47,201 --> 03:44:48,836
PEER REVIEW BEFORE THE END OF

6242
03:44:48,836 --> 03:44:50,171
THE CALENDAR YEAR, AND WE ALSO

6243
03:44:50,171 --> 03:44:52,807
HAVE A SEPARATE GROUP OF

6244
03:44:52,807 --> 03:44:55,176
TRAINEES THAT ARE CONDUCTING THE

6245
03:44:55,176 --> 03:44:55,843
SAME SYSTEMATIC REVIEW USING

6246
03:44:55,843 --> 03:44:58,046
A.I. AND SO THAT WE HOPE TO HAVE

6247
03:44:58,046 --> 03:45:00,648
PUBLISHED IN THE FIRST QUARTER

6248
03:45:00,648 --> 03:45:01,416
OF 2025.

6249
03:45:01,416 --> 03:45:04,819
WE HAVE DATA USE AGREEMENTS

6250
03:45:04,819 --> 03:45:11,259
UNDERWAY, SUBMITTED DATA REQUEST

6251
03:45:11,259 --> 03:45:14,462
TO RESDAC, UMC AND TULANE HAVE A

6252
03:45:14,462 --> 03:45:15,430
PRELIMINARY ELECTRONIC HEALTH

6253
03:45:15,430 --> 03:45:19,267
RECORD DATASET THAT WE'RE

6254
03:45:19,267 --> 03:45:20,468
WORKING WITH RIGHT NOW TO BETTER

6255
03:45:20,468 --> 03:45:22,904
PREPARE THE DATASET SO WE CAN

6256
03:45:22,904 --> 03:45:26,507
LINK A SUBSET OF DATA TO OUR

6257
03:45:26,507 --> 03:45:27,809
MEDICAID CLAIMS ONCE WE RECEIVE

6258
03:45:27,809 --> 03:45:30,645
THOSE AND FOR OUR AIM 3 WORK WE

6259
03:45:30,645 --> 03:45:33,948
HAVE OUR IRB UNDER WAY, WORKING

6260
03:45:33,948 --> 03:45:34,816
ON RELIANCE AGREEMENTS ACROSS

6261
03:45:34,816 --> 03:45:37,218
OUR SITES AND HOPE TO BEGIN OUR

6262
03:45:37,218 --> 03:45:38,119
DATA COLLECTION, RECRUITMENT AND

6263
03:45:38,119 --> 03:45:41,189
DATA COLLECTION IN JANUARY OF

6264
03:45:41,189 --> 03:45:44,225
2025.

6265
03:45:44,225 --> 03:45:50,898
AND THAT IS RP3 FOR THE SOUTHERN

6266
03:45:50,898 --> 03:45:54,736
CENTER, A SMALL PORTION, LISTED

6267
03:45:54,736 --> 03:45:56,270
HERE, DOES NOT INCLUDE

6268
03:45:56,270 --> 03:45:57,672
INVESTIGATORS AND COMMUNITY

6269
03:45:57,672 --> 03:45:59,440
PARTNERS FOR OUR OTHER RESEARCH

6270
03:45:59,440 --> 03:45:59,974
PROJECTS.

6271
03:45:59,974 --> 03:46:08,416
WITH THAT I WILL OPEN UP FOR

6272
03:46:08,416 --> 03:46:09,650
QUESTIONS.

6273
03:46:09,650 --> 03:46:10,818
>> WE HAVE SIX MINUTES FOR

6274
03:46:10,818 --> 03:46:12,720
QUESTIONS BEFORE WE TAKE A

6275
03:46:12,720 --> 03:46:12,920
BREAK.

6276
03:46:12,920 --> 03:46:14,389
I'D LIKE TO INVITE ANYBODY IN

6277
03:46:14,389 --> 03:46:15,757
THE AUDIENCE IN PERSON TO COME

6278
03:46:15,757 --> 03:46:17,058
TO THE MIC.

6279
03:46:17,058 --> 03:46:19,694
AGAIN VIRTUALLY IF YOU HAVE

6280
03:46:19,694 --> 03:46:20,495
ATTENDEES ONLINE CAN SUBMIT

6281
03:46:20,495 --> 03:46:23,631
QUESTIONS TO THE Q&A BOX.

6282
03:46:23,631 --> 03:46:26,467
ANY QUESTIONS?

6283
03:46:26,467 --> 03:46:32,473
 

6284
03:46:32,473 --> 03:46:37,645
 

6285
03:46:37,645 --> 03:46:38,846
>> YOU MENTIONED
DIFFERENTIAL

6286
03:46:38,846 --> 03:46:40,915
IMPLEMENTATION OF MEDICAID.

6287
03:46:40,915 --> 03:46:42,784
CAN YOU EXPAND MORE ABOUT THAT?

6288
03:46:42,784 --> 03:46:44,752
WHEN WE VISITED YOUR SITE THAT

6289
03:46:44,752 --> 03:46:46,287
WAS SOMETHING THAT WE WERE NOT

6290
03:46:46,287 --> 03:46:47,922
SO AWARE OF, SO CAN YOU EXPAND A

6291
03:46:47,922 --> 03:46:49,924
LITTLE BIT MORE.

6292
03:46:49,924 --> 03:46:51,058
>> ABOUT MEDICAID
POSTPARTUM

6293
03:46:51,058 --> 03:46:54,495
EXTENSION IN PARTICULAR?

6294
03:46:54,495 --> 03:46:57,331
YEAH, SO, ACROSS DIFFERENT

6295
03:46:57,331 --> 03:47:00,868
SITES, LOOKING AT THE IMPACTS OF

6296
03:47:00,868 --> 03:47:02,503
EXTENSION ON HEALTHCARE

6297
03:47:02,503 --> 03:47:03,371
UTILIZATION AND HEALTHCARE COST

6298
03:47:03,371 --> 03:47:05,339
ACROSS THE THREE STATES WHERE

6299
03:47:05,339 --> 03:47:09,277
MISSISSIPPI AND LOUISIANA BOTH

6300
03:47:09,277 --> 03:47:11,446
HAVE EXTENSION, ARKANSAS DOES

6301
03:47:11,446 --> 03:47:13,214
NOT, BUT UNDERSTANDING JUST

6302
03:47:13,214 --> 03:47:15,550
HAVING THAT STATE-LEVEL POLICY

6303
03:47:15,550 --> 03:47:16,417
DOESN'T NECESSARILY TRANSLATE TO

6304
03:47:16,417 --> 03:47:20,021
BEST PRACTICES AT THE HEALTHCARE

6305
03:47:20,021 --> 03:47:20,388
LEVEL.

6306
03:47:20,388 --> 03:47:22,323
AND HOW PATIENTS ARE

6307
03:47:22,323 --> 03:47:23,758
EXPERIENCING THAT HEALTH CARE.

6308
03:47:23,758 --> 03:47:27,261
AND SO WE HOPE WITH AIM 3 WHEN

6309
03:47:27,261 --> 03:47:30,097
WE TALK WITH PATIENTS AND

6310
03:47:30,097 --> 03:47:31,532
PROVIDERS AND HEALTH CARE SYSTEM

6311
03:47:31,532 --> 03:47:32,099
ADMINISTRATORS TO UNDERSTAND

6312
03:47:32,099 --> 03:47:35,136
WHAT THEY ARE DOING IN RESPONSE

6313
03:47:35,136 --> 03:47:36,637
TO THAT LEGISLATION THAT WILL

6314
03:47:36,637 --> 03:47:37,438
HELP US BETTER UNDERSTAND LIKE

6315
03:47:37,438 --> 03:47:40,608
WHAT ARE THE BARRIERS AND

6316
03:47:40,608 --> 03:47:42,510
FACILITATORS AT THOSE LEVELS,

6317
03:47:42,510 --> 03:47:45,880
WHAT INTERVENTIONS ARE NEEDED TO

6318
03:47:45,880 --> 03:47:48,483
SUPPORT CREATING LIKE BEST

6319
03:47:48,483 --> 03:47:51,652
PRACTICES FOR CARE, IN RESPONSE

6320
03:47:51,652 --> 03:47:53,955
TO THAT POLICY THAT PATIENTS NOW

6321
03:47:53,955 --> 03:47:56,691
HAVE ACCESS TO CARE FOR UP TO 12

6322
03:47:56,691 --> 03:47:57,358
MONTHS POSTPARTUM.

6323
03:47:57,358 --> 03:48:00,161
ONE OF THE BEST EXAMPLES AT THE

6324
03:48:00,161 --> 03:48:01,262
UNIVERSITY OF MISSISSIPPI

6325
03:48:01,262 --> 03:48:02,830
MEDICAL CENTER THE MAJORITY OF

6326
03:48:02,830 --> 03:48:05,199
BIRTHING PEOPLE THAT DELIVER AT

6327
03:48:05,199 --> 03:48:06,501
OUR HOSPITAL DON'T RECEIVE

6328
03:48:06,501 --> 03:48:09,270
POSTPARTUM CARE IN OUR HOSPITAL

6329
03:48:09,270 --> 03:48:09,737
SYSTEM.

6330
03:48:09,737 --> 03:48:11,372
MAJORITY OF THEM GO BACK TO

6331
03:48:11,372 --> 03:48:12,673
THEIR COMMUNITY HEALTH CENTER TO

6332
03:48:12,673 --> 03:48:13,574
RECEIVE CARE.

6333
03:48:13,574 --> 03:48:14,642
SO THERE'S REALLY NO

6334
03:48:14,642 --> 03:48:16,377
UNDERSTANDING OF WHAT'S

6335
03:48:16,377 --> 03:48:17,912
HAPPENING IN THAT TRANSLATION.

6336
03:48:17,912 --> 03:48:19,447
THERE REALLY ARE NO BEST

6337
03:48:19,447 --> 03:48:22,984
PRACTICES FOR MAKING THOSE WARM

6338
03:48:22,984 --> 03:48:24,485
HANDOFFS, THAT WILL HELP US

6339
03:48:24,485 --> 03:48:29,524
BETTER UNDERSTAND WHAT

6340
03:48:29,524 --> 03:48:31,259
INTERVENTIONS OR APPROACHES WE

6341
03:48:31,259 --> 03:48:32,827
COULD POTENTIALLY EXPLORE IN THE

6342
03:48:32,827 --> 03:48:34,495
FUTURE.

6343
03:48:34,495 --> 03:48:35,496
>> THANK YOU FOR THAT.

6344
03:48:35,496 --> 03:48:38,900
I HAVE A MEASUREMENT QUESTION.

6345
03:48:38,900 --> 03:48:41,068
IN GEORGIA, WE EXTEND THE

6346
03:48:41,068 --> 03:48:44,138
MEDICAID UNDER THE PUBLIC HEALTH

6347
03:48:44,138 --> 03:48:46,307
EMERGENCY AND THEN IN 2021 THAT

6348
03:48:46,307 --> 03:48:47,642
BECAME MORE FORMALIZED, WE'VE

6349
03:48:47,642 --> 03:48:49,810
BEEN TRYING TO STUDY A NUMBER OF

6350
03:48:49,810 --> 03:48:51,245
OUTCOMES RELATED TO THAT

6351
03:48:51,245 --> 03:48:53,080
EXTENSION, AMONG THEM LOOKING AT

6352
03:48:53,080 --> 03:48:53,748
SCREENING FOR POSTPARTUM

6353
03:48:53,748 --> 03:48:55,316
DEPRESSION BUT WE'VE HAD ISSUES

6354
03:48:55,316 --> 03:48:58,686
WITH EVEN HOW IT'S CODED,

6355
03:48:58,686 --> 03:49:00,454
WHETHER IT'S CAPTURED, PERHAPS

6356
03:49:00,454 --> 03:49:02,423
IT HAS TO DO WITH BILLING, A

6357
03:49:02,423 --> 03:49:03,958
NUMBER OF THINGS, OFTENTIMES

6358
03:49:03,958 --> 03:49:05,693
SCREENINGS ARE NOT MEASURED,

6359
03:49:05,693 --> 03:49:07,895
SOCIAL DETERMINANTS ARE NOT

6360
03:49:07,895 --> 03:49:08,763
MEASURED UNIFORMLY.

6361
03:49:08,763 --> 03:49:10,298
I WAS WONDERING HOW YOU'RE

6362
03:49:10,298 --> 03:49:12,800
MEASURING AND IF YOU'VE HAD

6363
03:49:12,800 --> 03:49:15,202
SUCCESS IN HELPING PROVIDERS IN

6364
03:49:15,202 --> 03:49:17,438
PRACTICES REALIZE CODING FOR

6365
03:49:17,438 --> 03:49:18,406
THAT SCREENING IS IMPORTANT IN

6366
03:49:18,406 --> 03:49:20,041
THE STATE IN WHICH YOU'RE

6367
03:49:20,041 --> 03:49:20,274
WORKING.

6368
03:49:20,274 --> 03:49:21,042
>> GREAT QUESTION,
SOMETHING

6369
03:49:21,042 --> 03:49:24,645
THAT OUR DATA WORKING GROUP IS

6370
03:49:24,645 --> 03:49:26,581
CURRENTLY WORKING THROUGH.

6371
03:49:26,581 --> 03:49:28,583
AS I SAID, WE DON'T HAVE OUR

6372
03:49:28,583 --> 03:49:30,885
MEDICAID CLAIMS DATA YET BUT

6373
03:49:30,885 --> 03:49:32,420
WE'RE WORKING WITH PRELIMINARY

6374
03:49:32,420 --> 03:49:35,623
DATASET FROM OUR EHR.

6375
03:49:35,623 --> 03:49:39,660
WE'RE MAPPING OUR EHR DATA TO

6376
03:49:39,660 --> 03:49:41,729
THE PCORnet MODEL, AND HOPING

6377
03:49:41,729 --> 03:49:42,830
THAT AT LEAST IN MISSISSIPPI AND

6378
03:49:42,830 --> 03:49:45,900
I THINK WE CAN DO THIS WITH A

6379
03:49:45,900 --> 03:49:48,936
SUBSET OF DATA IN LOUISIANA WE

6380
03:49:48,936 --> 03:49:51,439
CAN ALSO USE OMOP AS WELL.

6381
03:49:51,439 --> 03:49:53,874
SO WE KNOW THERE ARE GOING TO BE

6382
03:49:53,874 --> 03:49:54,942
CHALLENGES, WHAT THE CHALLENGES

6383
03:49:54,942 --> 03:49:56,477
ARE YET WE DON'T KNOW.

6384
03:49:56,477 --> 03:49:58,012
WE'RE JUST STARTING THAT WORK

6385
03:49:58,012 --> 03:50:02,483
RIGHT NOW.

6386
03:50:02,483 --> 03:50:07,855
WE DO KNOW THAT WE ANTICIPATE

6387
03:50:07,855 --> 03:50:09,390
THAT SCREENING FOR POSTPARTUM

6388
03:50:09,390 --> 03:50:11,792
DEPRESSION IS NOT GOING TO BE

6389
03:50:11,792 --> 03:50:14,195
COMMON AT LEAST IN MISSISSIPPI,

6390
03:50:14,195 --> 03:50:16,530
NO MANDATE FOR IT, AND WE HAVE A

6391
03:50:16,530 --> 03:50:18,466
SHORTAGE OF MENTAL HEALTH CARE

6392
03:50:18,466 --> 03:50:18,733
PROVIDERS.

6393
03:50:18,733 --> 03:50:19,800
SO PEOPLE DON'T SCREEN BECAUSE

6394
03:50:19,800 --> 03:50:21,335
THEY DON'T HAVE ANYWHERE TO

6395
03:50:21,335 --> 03:50:23,738
REFER THEM TO.

6396
03:50:23,738 --> 03:50:25,473
SO, WE HYPOTHESIZE IT'S WHAT

6397
03:50:25,473 --> 03:50:28,309
WE'RE GOING TO FIND, AND SO THAT

6398
03:50:28,309 --> 03:50:29,276
WILL HELP US BETTER RESPOND, YOU

6399
03:50:29,276 --> 03:50:30,411
KNOW, GOING FORWARD.

6400
03:50:30,411 --> 03:50:32,380
WE HAVE TO ADDRESS THE

6401
03:50:32,380 --> 03:50:32,813
HEALTHCARE SHORTAGE.

6402
03:50:32,813 --> 03:50:34,115
IF WE'RE GOING TO START

6403
03:50:34,115 --> 03:50:35,650
SCREENING WE HAVE TO HAVE A WAY

6404
03:50:35,650 --> 03:50:37,718
TO RESPOND TO WHAT THE NEEDS

6405
03:50:37,718 --> 03:50:37,885
ARE.

6406
03:50:37,885 --> 03:50:42,123
I'M NOT SURE IN LOUISIANA

6407
03:50:42,123 --> 03:50:43,190
WHAT -- WHEN THE POSTPARTUM

6408
03:50:43,190 --> 03:50:44,425
MANDATE WENT INTO EFFECT, I

6409
03:50:44,425 --> 03:50:47,695
BELIEVE TEST LAST -- IT WAS LAST

6410
03:50:47,695 --> 03:50:49,997
YEAR SO I THINK THEY ARE

6411
03:50:49,997 --> 03:50:50,865
ANTICIPATING ONCE WE FIGURE OUT

6412
03:50:50,865 --> 03:50:53,034
HOW TO SEARCH AND CODE FOR

6413
03:50:53,034 --> 03:50:54,468
EVERYTHING ANTICIPATING INCREASE

6414
03:50:54,468 --> 03:50:55,503
IN SCREENING PRACTICES, AND

6415
03:50:55,503 --> 03:50:56,737
WE'RE CURIOUS TO SEE WHAT WE'RE

6416
03:50:56,737 --> 03:50:59,006
GOING TO FIND IN TERMS OF

6417
03:50:59,006 --> 03:51:00,107
TREATMENT AND HOW THAT GOES FROM

6418
03:51:00,107 --> 03:51:03,944
THERE WITH THE DATA THAT WE

6419
03:51:03,944 --> 03:51:09,617
HAVE. 

6420
03:51:09,617 --> 03:51:11,686
>> ANY OTHER QUESTIONS
FROM

6421
03:51:11,686 --> 03:51:13,854
IN-PERSON AUDIENCE OR -- NOTHING

6422
03:51:13,854 --> 03:51:15,489
ONLINE RIGHT NOW.

6423
03:51:15,489 --> 03:51:16,924
IF THERE'S QUESTIONS PLEASE FEEL

6424
03:51:16,924 --> 03:51:19,427
FREE TO COME.

6425
03:51:19,427 --> 03:51:23,831
 

6426
03:51:23,831 --> 03:51:26,333
HEARING THAT, WE'LL TAKE A BRIEF

6427
03:51:26,333 --> 03:51:31,214
BREAK FROM 2:50 TO THREE  3:00.

6428
03:51:31,214 --> 03:51:32,949
>> WE'RE GOING TO GET
STARTED

6429
03:51:32,949 --> 03:51:34,818
WITH PART 2 OF SESSION 6, USING

6430
03:51:34,818 --> 03:51:37,287
DATA AND POLICY TO BEND THE

6431
03:51:37,287 --> 03:51:39,623
CURVE OF MATERNAL MORBIDITY AND

6432
03:51:39,623 --> 03:51:39,956
MORTALITY.

6433
03:51:39,956 --> 03:51:42,692
OUR FIRST PRESENTER IS READY TO

6434
03:51:42,692 --> 03:51:43,026
START.

6435
03:51:43,026 --> 03:51:44,227
PLEASE INTRODUCE YOURSELF AND WE

6436
03:51:44,227 --> 03:51:45,996
WILL GO AHEAD AND START.

6437
03:51:45,996 --> 03:51:47,931
THANK YOU.

6438
03:51:47,931 --> 03:51:51,234
>> HI. 

6439
03:51:51,234 --> 03:51:53,003
I'M DR. CHERYL McFARLAND,

6440
03:51:53,003 --> 03:51:54,537
CENTRAL JERSEY FAMILY HEALTH

6441
03:51:54,537 --> 03:51:55,438
CONSORTIUM.

6442
03:51:55,438 --> 03:52:00,443
AND TODAY I'M GOING TO TALK

6443
03:52:00,443 --> 03:52:02,312
ABOUT A PREGNANCY, PRE-PREGNANCY

6444
03:52:02,312 --> 03:52:03,546
MATERNAL MORBIDITY ALGORITHM

6445
03:52:03,546 --> 03:52:11,521
WE'VE DEVELOPED.

6446
03:52:11,521 --> 03:52:17,294
I'LL JUST DO THIS.

6447
03:52:17,294 --> 03:52:17,861
OKAY.

6448
03:52:17,861 --> 03:52:19,396
SO THIS WORK WOULD NOT HAVE BEEN

6449
03:52:19,396 --> 03:52:22,866
POSSIBLE WOULD YOU THE

6450
03:52:22,866 --> 03:52:23,767
CONNECTING THE COMMUNITY,

6451
03:52:23,767 --> 03:52:27,504
MATERNITY HEALTH CHALLENGE

6452
03:52:27,504 --> 03:52:29,606
THROUGH NIH.

6453
03:52:29,606 --> 03:52:32,542
WE HAVE BEEN ABLE TO COMPLETE

6454
03:52:32,542 --> 03:52:34,744
THIS PROJECT AND CONTINUE TO

6455
03:52:34,744 --> 03:52:37,347
WORK ON IMPROVING OUR OUTCOMES,

6456
03:52:37,347 --> 03:52:40,216
AND MOVING FORWARD, IT WOULD NOT

6457
03:52:40,216 --> 03:52:41,084
BE POSSIBLE WITHOUT NIH.

6458
03:52:41,084 --> 03:52:46,122
SO JUST A LITTLE BIT ABOUT OUR

6459
03:52:46,122 --> 03:52:46,456
ORGANIZATION.

6460
03:52:46,456 --> 03:52:52,062
WE ARE A 501(c)3 LICENSE AND

6461
03:52:52,062 --> 03:52:53,730
REGULATED BY NEW JERSEY

6462
03:52:53,730 --> 03:52:59,069
DEPARTMENT OF HEALTH, A

6463
03:52:59,069 --> 03:53:02,339
MATERNAL-CHILD HEALTH

6464
03:53:02,339 --> 03:53:04,207
CONSORTIUM, WE DO QUALITY

6465
03:53:04,207 --> 03:53:05,875
IMPROVEMENT DATA FOR THE

6466
03:53:05,875 --> 03:53:08,345
BIRTHING FACILITIES IN THE

6467
03:53:08,345 --> 03:53:10,547
CENTRAL REGION OF NEW JERSEY.

6468
03:53:10,547 --> 03:53:14,718
THANKS TO IMPROVE WE'VE ADDED TO

6469
03:53:14,718 --> 03:53:16,920
OUR REPERTOIRE RESEARCH.

6470
03:53:16,920 --> 03:53:20,390
SO, YOU'VE SEEN THESE NUMBERS.

6471
03:53:20,390 --> 03:53:23,460
80% OF MATERNAL DEATHS OR MORE

6472
03:53:23,460 --> 03:53:24,594
ARE PREVENTIBLE.

6473
03:53:24,594 --> 03:53:25,996
IT'S ESTIMATED THAT THERE'S

6474
03:53:25,996 --> 03:53:30,467
ABOUT 700 WOMEN WHO DIE EACH

6475
03:53:30,467 --> 03:53:31,468
YEAR DURING BIRTH.

6476
03:53:31,468 --> 03:53:36,339
THAT'S ONLY THE TIP OF THE

6477
03:53:36,339 --> 03:53:38,041
PROVERBIAL ICEBERG.

6478
03:53:38,041 --> 03:53:39,609
MATERNITY -- SEVERE MATERNAL

6479
03:53:39,609 --> 03:53:41,311
MORBIDITY IMPACTS NEARLY 50,000

6480
03:53:41,311 --> 03:53:45,048
WOMEN PER YEAR, POSSIBLY MORE.

6481
03:53:45,048 --> 03:53:48,218
THIS PROJECT HAD THREE MAIN

6482
03:53:48,218 --> 03:53:50,854
AIMS, THE FIRST AIM WAS TO LOOK

6483
03:53:50,854 --> 03:53:51,788
AT SEVERE MATERNAL MORBIDITY

6484
03:53:51,788 --> 03:53:53,056
OVER TIME.

6485
03:53:53,056 --> 03:53:55,358
WE KNOW THAT SEVERE MATERNAL

6486
03:53:55,358 --> 03:53:59,195
MORBIDITY IS INCREASE  INCREASIT

6487
03:53:59,195 --> 03:54:01,798
DON'T HAVE A GOOD UNDERSTANDING

6488
03:54:01,798 --> 03:54:02,565
HOW.

6489
03:54:02,565 --> 03:54:04,200
POSTER UPSTAIRS IS OUR FIRST

6490
03:54:04,200 --> 03:54:07,937
RESEARCH AIM WHERE WE TALK ABOUT

6491
03:54:07,937 --> 03:54:09,339
THE CHANGE IN MATERNAL MORBIDITY

6492
03:54:09,339 --> 03:54:10,473
OVER TIME.

6493
03:54:10,473 --> 03:54:14,677
SECOND AIM IS TO LOOK AT

6494
03:54:14,677 --> 03:54:15,578
PREDICTORS OF MATERNAL

6495
03:54:15,578 --> 03:54:16,713
MORBIDITY, AND THEN FINALLY THE

6496
03:54:16,713 --> 03:54:19,616
THIRD AIM WHICH I'LL BE

6497
03:54:19,616 --> 03:54:24,654
PRESENTING ON NOW IS TO CREATE

6498
03:54:24,654 --> 03:54:26,322
AND ALGORITHM TO PREDICT WHETHER

6499
03:54:26,322 --> 03:54:31,127
A WOMAN -- WHETHER A BIRTHING

6500
03:54:31,127 --> 03:54:34,664
PERSON WILL EXPERIENCE MATERNAL

6501
03:54:34,664 --> 03:54:39,469
MORBIDITY PRIOR TO BIRTH.

6502
03:54:39,469 --> 03:54:41,771
SO, LOOKING AT YOUR FIRST

6503
03:54:41,771 --> 03:54:45,508
PRENATAL VISIT ARE YOU AT RISK

6504
03:54:45,508 --> 03:54:47,877
FOR SEVERE MATERNAL MORBIDITY?

6505
03:54:47,877 --> 03:54:51,081
SO, OUR -- WE DID A

6506
03:54:51,081 --> 03:54:53,817
RETROSPECTIVE COHORT STUDY USING

6507
03:54:53,817 --> 03:54:55,585
MARKET SCAN MULTI-STATE MEDICAID

6508
03:54:55,585 --> 03:54:57,887
AND COMMERCIAL CLAIMS DATA.

6509
03:54:57,887 --> 03:55:03,059
WE HAVE A SAMPLE OF OVER A

6510
03:55:03,059 --> 03:55:06,296
MILLION BIRTHS BETWEEN 2019 AND

6511
03:55:06,296 --> 03:55:07,297
2022.

6512
03:55:07,297 --> 03:55:08,832
OVERALL, THE ANALYTIC COHORT

6513
03:55:08,832 --> 03:55:14,270
COMPRISED OF, LIKE I SAID, JUST

6514
03:55:14,270 --> 03:55:17,340
OVER A MILLION BIRTHS, 864,000

6515
03:55:17,340 --> 03:55:20,076
MOTHERS, AND WE DID MACHINE

6516
03:55:20,076 --> 03:55:21,845
LEARNING MODELS, AND WE TRAINED

6517
03:55:21,845 --> 03:55:26,216
ON 80% OF THE SAMPLE, AND DID

6518
03:55:26,216 --> 03:55:31,488
VALIDATION ON 20% OF THE SAMPLE.

6519
03:55:31,488 --> 03:55:41,331
THIS STUDY WAS APPROVED THROUGH

6520
03:55:41,331 --> 03:55:42,999
RUTGERS IRB AND VIRUS IRB.

6521
03:55:42,999 --> 03:55:45,635
WE HAD EXPERIENCE IN MATERNAL

6522
03:55:45,635 --> 03:55:46,603
MORTALITY REVIEW, AND I ALSO

6523
03:55:46,603 --> 03:55:49,539
WORK ON A PROJECT LOOKING AT

6524
03:55:49,539 --> 03:55:51,074
PEDIATRIC MEDICAL COMPLEXITY.

6525
03:55:51,074 --> 03:55:53,510
WITH THE PROBLEMS WE WERE SEEING

6526
03:55:53,510 --> 03:55:56,346
IN MATERNAL MORTALITY, I WAS

6527
03:55:56,346 --> 03:55:57,413
VERY INTERESTED IN USING THE

6528
03:55:57,413 --> 03:56:00,383
WORK THAT WAS DONE ON OTHER

6529
03:56:00,383 --> 03:56:01,818
CHRONIC DISEASE ALGORITHMS TO

6530
03:56:01,818 --> 03:56:05,221
DETERMINE IF WE COULD USE THAT

6531
03:56:05,221 --> 03:56:08,258
TO PREDICT SEVERE MATERNAL

6532
03:56:08,258 --> 03:56:10,260
MORBIDITY AND POTENTIALLY

6533
03:56:10,260 --> 03:56:11,161
PREVENT MATERNAL DEATHS.

6534
03:56:11,161 --> 03:56:13,429
SO WE LOOKED AT THE LITERATURE,

6535
03:56:13,429 --> 03:56:17,267
WE HAD A CLINICAL OVERSIGHT

6536
03:56:17,267 --> 03:56:19,002
COMMITTEE THAT LOOKED AT OUR

6537
03:56:19,002 --> 03:56:20,170
BODY SYSTEMS.

6538
03:56:20,170 --> 03:56:23,940
WE LITERALLY WENT THROUGH ALL OF

6539
03:56:23,940 --> 03:56:26,109
THE ICD-10 CODES, CLUMPED INTO

6540
03:56:26,109 --> 03:56:28,211
BODY SYSTEMS, AND WORKED WITH

6541
03:56:28,211 --> 03:56:29,279
OUR CLINICAL OVERSIGHT COMMITTEE

6542
03:56:29,279 --> 03:56:31,915
TO HELP DEVELOP THIS ALGORITHM.

6543
03:56:31,915 --> 03:56:37,487
WE DID SOME EXPLORATORY DATA

6544
03:56:37,487 --> 03:56:37,754
ANALYSIS.

6545
03:56:37,754 --> 03:56:39,556
THEN WE DETERMINED WHICH MACHINE

6546
03:56:39,556 --> 03:56:42,959
LEARNING PROCESS WE SHOULD USE,

6547
03:56:42,959 --> 03:56:46,129
SO WE LOOKED AT RANDOM FORESTS

6548
03:56:46,129 --> 03:56:51,401
AND  EXTREME GRADIENT BOOSTING.

6549
03:56:51,401 --> 03:56:54,337
WE LOOKED AT IMBALANCE IN THE

6550
03:56:54,337 --> 03:56:56,639
MODELS AND PUNISHING THE MODELS

6551
03:56:56,639 --> 03:57:01,110
FOR FALSE POSITIVES AND FALSE

6552
03:57:01,110 --> 03:57:01,377
NEGATIVES.

6553
03:57:01,377 --> 03:57:02,512
AND ULTIMATELY DETERMINED WHICH

6554
03:57:02,512 --> 03:57:05,481
FEATURES WERE THE MOST IMPORTANT

6555
03:57:05,481 --> 03:57:06,049
IN THE MODEL.

6556
03:57:06,049 --> 03:57:09,319
SO JUST A LITTLE BIT OF

6557
03:57:09,319 --> 03:57:14,791
INFORMATION ABOUT OUR SAMPLE,

6558
03:57:14,791 --> 03:57:16,693
USING THE TRUVIAN MARKET SCAN

6559
03:57:16,693 --> 03:57:19,395
DATA THERE ARE LIMITATIONS.

6560
03:57:19,395 --> 03:57:19,996
COMMERCIAL INSURANCE, THEY DID

6561
03:57:19,996 --> 03:57:21,731
NOT HAVE RACE/ETHNICITY.

6562
03:57:21,731 --> 03:57:24,901
FOR THE MEDICAID INSURANCE, THEY

6563
03:57:24,901 --> 03:57:26,536
DIDN'T HAVE STATES.

6564
03:57:26,536 --> 03:57:30,173
SO ORIGINALLY WE WANTED TO LOOK

6565
03:57:30,173 --> 03:57:31,808
AT COMMUNITY LEVEL BUT WITH THE

6566
03:57:31,808 --> 03:57:38,047
USE OF THE MARKET SCAN DATA WE

6567
03:57:38,047 --> 03:57:39,682
MOVED TO STATE LEVEL.

6568
03:57:39,682 --> 03:57:43,753
SO THERE'S SOME DIFFERENCES IN

6569
03:57:43,753 --> 03:57:44,721
MEDICAID VERSUS COMMERCIAL DATA.

6570
03:57:44,721 --> 03:57:47,357
WHAT I WANT TO DRAW OUR

6571
03:57:47,357 --> 03:57:52,829
ATTENTION TO IS THE

6572
03:57:52,829 --> 03:57:54,998
CHARACTERISTICS, THESE BODY

6573
03:57:54,998 --> 03:57:57,300
SYSTEM CHARACTERISTICS BY SEVERE

6574
03:57:57,300 --> 03:57:59,168
MATERNAL MORBIDITY AND NO SEVERE

6575
03:57:59,168 --> 03:58:00,236
MATERNAL MORBIDITY.

6576
03:58:00,236 --> 03:58:06,042
YOU CAN SEE MENTAL HEALTH IS THE

6577
03:58:06,042 --> 03:58:08,244
HIGHEST MORBIDITY IN THE

6578
03:58:08,244 --> 03:58:08,544
POPULATION.

6579
03:58:08,544 --> 03:58:13,750
SO, 30% WITH NO SEVERE MATERNAL

6580
03:58:13,750 --> 03:58:17,553
MORBIDITY HAVE MENTAL HEALTH

6581
03:58:17,553 --> 03:58:20,657
CONDITIONS, 53% SEVERE MATERNAL

6582
03:58:20,657 --> 03:58:21,424
MORBIDITY.

6583
03:58:21,424 --> 03:58:22,392
FREQUENCY DISTRIBUTION IS

6584
03:58:22,392 --> 03:58:24,060
RELATIVELY SIMILAR IN BOTH

6585
03:58:24,060 --> 03:58:26,562
GROUPS EXCEPT EVERY SINGLE

6586
03:58:26,562 --> 03:58:30,266
FACTOR IS HIGHER AMONG THE

6587
03:58:30,266 --> 03:58:31,467
SEVERE MATERNAL MORBIDITY GROUP.

6588
03:58:31,467 --> 03:58:33,002
LET'S TALK ABOUT RESULTS.

6589
03:58:33,002 --> 03:58:36,272
OVERALL WE RAN THREE MODELS.

6590
03:58:36,272 --> 03:58:37,707
LOGISTIC REGRESSION WHICH IS

6591
03:58:37,707 --> 03:58:41,444
USED A LOT IN RESEARCH.

6592
03:58:41,444 --> 03:58:44,380
AND IN EPIDEMIC SETTINGS.

6593
03:58:44,380 --> 03:58:55,091
IT WAS NOT GOOD WITH PREDICTING

6594
03:58:55,091 --> 03:58:58,294
MATERNAL MORBIDITY, SENSITIVITY.

6595
03:58:58,294 --> 03:59:00,163
SPECIFICITY WAS HIGH, WE

6596
03:59:00,163 --> 03:59:02,799
ULTIMATELY CAME TO THE EXTREME

6597
03:59:02,799 --> 03:59:06,169
GRADIENT BOOSTING METHOD, WHICH

6598
03:59:06,169 --> 03:59:11,240
GAVE US 82.5, ALMOST 82.6%

6599
03:59:11,240 --> 03:59:14,310
SENSITIVITY MEANING BEING ABLE

6600
03:59:14,310 --> 03:59:19,816
TO PREDICT MATERNAL MORBIDITY

6601
03:59:19,816 --> 03:59:21,551
BASED ON PRE-PREGNANCY

6602
03:59:21,551 --> 03:59:22,518
DIAGNOSIS.

6603
03:59:22,518 --> 03:59:25,488
WITH SPECIFICITY OF ALMOST 96%,

6604
03:59:25,488 --> 03:59:28,091
OVERALL ACCURACY OF ALMOST 94%.

6605
03:59:28,091 --> 03:59:30,960
SO THIS IS A REALLY GOOD

6606
03:59:30,960 --> 03:59:36,332
INDICATOR THAT WE CAN USE

6607
03:59:36,332 --> 03:59:44,374
DIAGNOSTIC CRITERIA TO PREDICT

6608
03:59:44,374 --> 03:59:46,809
MATERNAL MORBIDITY.

6609
03:59:46,809 --> 03:59:50,646
THIS IS A SHAPELY ADDITIVE

6610
03:59:50,646 --> 03:59:52,615
EXPLANATION, IT GIVES

6611
03:59:52,615 --> 03:59:54,150
TRANSPARENCY AND EXPLANATION OF

6612
03:59:54,150 --> 03:59:55,451
MACHINE LEARNING MODELS.

6613
03:59:55,451 --> 03:59:58,221
SO, WHAT WE'RE SEEING IN THIS

6614
03:59:58,221 --> 04:00:00,289
WATER FALL CASCADE IS THE LEVEL

6615
04:00:00,289 --> 04:00:02,825
OF IMPORTANCE OF EACH OF THIEVES

6616
04:00:02,825 --> 04:00:05,661
BODY SYSTEMS, AS WELL AS STATE

6617
04:00:05,661 --> 04:00:07,864
FACTORS. 

6618
04:00:07,864 --> 04:00:12,568
SO YOU CAN SEE FOR HEMATOLOGICAL

6619
04:00:12,568 --> 04:00:15,304
ISSUES, THAT'S A VERY -- HAS A

6620
04:00:15,304 --> 04:00:17,039
VERY HIGH POSITIVE PREDICTOR FOR

6621
04:00:17,039 --> 04:00:19,375
SEVERE MATERNAL MORBIDITY.

6622
04:00:19,375 --> 04:00:23,413
AGAIN, THESE ARE PREDICTORS

6623
04:00:23,413 --> 04:00:25,681
PRIOR TO PREGNANCY.

6624
04:00:25,681 --> 04:00:26,482
FOR INSTITUTIONAL HEALTH, THIS

6625
04:00:26,482 --> 04:00:27,683
IS A STATE LEVEL MEASURE.

6626
04:00:27,683 --> 04:00:30,186
IF YOU'RE IN THE HIGHEST

6627
04:00:30,186 --> 04:00:32,054
QUARTILE OF INSTITUTIONAL

6628
04:00:32,054 --> 04:00:34,891
HEALTH, IT'S A NEGATIVE

6629
04:00:34,891 --> 04:00:35,992
PREDICTOR OF SEVERE MATERNAL

6630
04:00:35,992 --> 04:00:36,259
MORBIDITY.

6631
04:00:36,259 --> 04:00:38,494
MAKES SENSE, FOR THOSE WHO STUDY

6632
04:00:38,494 --> 04:00:41,364
SOCIAL DETERMINANTS, THE STATES

6633
04:00:41,364 --> 04:00:44,300
THAT HAVE THE BEST HEALTH CARE

6634
04:00:44,300 --> 04:00:45,201
SYSTEM, BEST INSTITUTIONAL

6635
04:00:45,201 --> 04:00:47,136
HEALTH, BEST FOCUS ON HEALTH, DO

6636
04:00:47,136 --> 04:00:54,510
BETTER AS FAR AS THESE

6637
04:00:54,510 --> 04:00:55,178
MORBIDITIES.

6638
04:00:55,178 --> 04:00:57,580
OVERALL OUR FINDINGS, IT'S NOT

6639
04:00:57,580 --> 04:01:00,016
SHOWN IN THE CASCADE, BUT WE DID

6640
04:01:00,016 --> 04:01:04,353
FIND THE USE OF WHAT WE CALLED Z

6641
04:01:04,353 --> 04:01:07,990
CODES, FOR THOSE FAMILY WITH

6642
04:01:07,990 --> 04:01:09,392
ICD-10 CODES, THEY ARE YOUR

6643
04:01:09,392 --> 04:01:12,361
SOCIAL DETERMINANTS OF HEALTH

6644
04:01:12,361 --> 04:01:12,562
CODES.

6645
04:01:12,562 --> 04:01:16,866
WE FOUND THAT IT INCREASED

6646
04:01:16,866 --> 04:01:18,835
SENSITIVITY DRAMATICALLY WHEN WE

6647
04:01:18,835 --> 04:01:21,237
INCLUDED THESE CODES.

6648
04:01:21,237 --> 04:01:22,772
HOWEVER, THE OVERALL ACCURACY

6649
04:01:22,772 --> 04:01:23,039
WENT DOWN.

6650
04:01:23,039 --> 04:01:25,641
IN THE CASCADE MODEL THAT YOU

6651
04:01:25,641 --> 04:01:31,781
SAW WE DIDN'T SHOW THE Z CODES.

6652
04:01:31,781 --> 04:01:33,649
WHAT WE'RE FINDINGS IS THESE CAN

6653
04:01:33,649 --> 04:01:41,424
BE VERY INFLUENTIAL IN

6654
04:01:41,424 --> 04:01:43,092
DETERMINING AND PREDICTING RISK.

6655
04:01:43,092 --> 04:01:44,260
IT'S LIKELY WE'RE NOT SEEING

6656
04:01:44,260 --> 04:01:45,895
THEM IN FINAL MODELS BECAUSE

6657
04:01:45,895 --> 04:01:47,997
THEY ARE NOT WIDELY USED BY

6658
04:01:47,997 --> 04:01:48,297
PHYSICIANS.

6659
04:01:48,297 --> 04:01:50,433
SO FOR ANY OF YOU WHO ARE

6660
04:01:50,433 --> 04:01:51,934
FAMILIAR WITH USING DIAGNOSTIC

6661
04:01:51,934 --> 04:01:54,036
CODES, WE KNOW THOSE DIAGNOSTIC

6662
04:01:54,036 --> 04:02:00,376
CODES CAN BE PROBLEMATIC IN THE

6663
04:02:00,376 --> 04:02:00,576
DATA.

6664
04:02:00,576 --> 04:02:06,282
Z CODES ARE NOT USED WIDELY.

6665
04:02:06,282 --> 04:02:07,483
HOWEVER, THINGS LIKE EXPERIENCE

6666
04:02:07,483 --> 04:02:10,319
OF HEMATOLOGICAL ISSUES PRIOR TO

6667
04:02:10,319 --> 04:02:15,892
PREGNANCY IS ALSO SIGNIFICANT,

6668
04:02:15,892 --> 04:02:17,994
AND YOU'RE SEEING THAT LIKE WE

6669
04:02:17,994 --> 04:02:20,396
TALKED EARLIER ABOUT ANEMIA, CAN

6670
04:02:20,396 --> 04:02:30,339
BE MONITORED AND PREVENTED.

6671
04:02:30,339 --> 04:02:30,773
OR ADDRESSED.

6672
04:02:30,773 --> 04:02:32,408
SEVERE MATERNAL MORBIDITY RISK

6673
04:02:32,408 --> 04:02:37,780
IS PREDICT AL R. R.  --

6674
04:02:37,780 --> 04:02:38,347
PREDICTABLE.

6675
04:02:38,347 --> 04:02:45,454
WE CAN PREDICT AT 95% ACCURACY.

6676
04:02:45,454 --> 04:02:46,656
SOME RISK FACTORS ARE

6677
04:02:46,656 --> 04:02:47,523
MODIFIABLE.

6678
04:02:47,523 --> 04:02:49,725
YOU CAN'T CHANGE A PERSON'S

6679
04:02:49,725 --> 04:02:50,493
DEMOGRAPHIC CHARACTERISTICS OR

6680
04:02:50,493 --> 04:02:52,562
THEIR MEDICAL HISTORY.

6681
04:02:52,562 --> 04:02:57,700
BUT YOU CAN INTERVENE TO ADDRESS

6682
04:02:57,700 --> 04:03:00,102
ISSUES ASSOCIATED WITH THEIR

6683
04:03:00,102 --> 04:03:02,071
PRIOR MEDICAL HISTORY, AND YOU

6684
04:03:02,071 --> 04:03:09,111
CAN BUILD ON RESILIENCE FACTORS

6685
04:03:09,111 --> 04:03:10,613
SUCH AS FAMILY UNIT, COMMUNITY

6686
04:03:10,613 --> 04:03:15,551
UNITY THAT CAN STRENGTH BE THE

6687
04:03:15,551 --> 04:03:20,122
DECREASE IN SEVERE MATERNAL

6688
04:03:20,122 --> 04:03:22,091
MORBIDITY RISK.

6689
04:03:22,091 --> 04:03:23,826
TARGETING INTERACTIONS IS KEY TO

6690
04:03:23,826 --> 04:03:25,728
SEVERE MATERNAL MORBIDITY

6691
04:03:25,728 --> 04:03:26,028
PREVENTION.

6692
04:03:26,028 --> 04:03:27,263
CERTAIN COMBINATIONS OF RISK

6693
04:03:27,263 --> 04:03:29,332
FACTORS PUT YOU IN HIGH LEVELS

6694
04:03:29,332 --> 04:03:29,665
OF RISK.

6695
04:03:29,665 --> 04:03:32,969
IF YOU CAN ADDRESS THINGS LIKE

6696
04:03:32,969 --> 04:03:35,471
SOCIOECONOMIC STATUS, ACCESS TO

6697
04:03:35,471 --> 04:03:37,106
HEALTH CARE, THAT COMPOUND

6698
04:03:37,106 --> 04:03:41,277
EFFECT OF SEVERE  MATERNAL

6699
04:03:41,277 --> 04:03:42,345
MORBIDITY YOU CAN POTENTIALLY

6700
04:03:42,345 --> 04:03:43,479
PINPOINT INTERVENTIONS TO HELP

6701
04:03:43,479 --> 04:03:51,087
BIRTHING PEOPLE WHO ARE AT RISK 

6702
04:03:51,087 --> 04:03:52,922
A FEW LESSONS LEARNED, ONE THE

6703
04:03:52,922 --> 04:03:59,261
LIMITATIONS IN THE DATA. 

6704
04:03:59,261 --> 04:04:02,131
WE KNOW CLAIMS DATA IS --

6705
04:04:02,131 --> 04:04:09,238
THERE'S SOME INACCURACIES IN

6706
04:04:09,238 --> 04:04:10,339
DIAGNOSTIC CODING.

6707
04:04:10,339 --> 04:04:11,607
CONTINUITY OF INSURANCE CHANGES.

6708
04:04:11,607 --> 04:04:14,477
WE CAN FOLLOW PEOPLE OVER TIME.

6709
04:04:14,477 --> 04:04:16,012
HOWEVER, IF THEY CHANGE INSURES,

6710
04:04:16,012 --> 04:04:19,515
WE CAN NO LONGER FOLLOW THEM.

6711
04:04:19,515 --> 04:04:22,451
SO THAT'S ONE LIMITATION.

6712
04:04:22,451 --> 04:04:24,453
ANOTHER LIMITATION IS THE

6713
04:04:24,453 --> 04:04:26,422
INABILITY TO PREDICT MORBIDITY

6714
04:04:26,422 --> 04:04:31,227
FOR THOSE WITH NO MEDICAL CLAIMS

6715
04:04:31,227 --> 04:04:31,460
HISTORY.

6716
04:04:31,460 --> 04:04:33,763
SO, IF YOU'RE COMING IN AND YOU

6717
04:04:33,763 --> 04:04:36,499
HAVE NO MEDICAL CLAIMS IN THE

6718
04:04:36,499 --> 04:04:38,467
THREE YEARS PRIOR TO PREGNANCY,

6719
04:04:38,467 --> 04:04:40,202
WE CAN'T PREDICT YOUR RISK.

6720
04:04:40,202 --> 04:04:44,073
BUT WE DO KNOW BASED ON OUTCOMES

6721
04:04:44,073 --> 04:04:46,208
THAT GROUP IS AT HIGHEST RISK.

6722
04:04:46,208 --> 04:04:50,813
17% OF OUR GROUP THAT HAD NO --

6723
04:04:50,813 --> 04:04:55,518
SORRY, OF THOSE WHO HAVE NO

6724
04:04:55,518 --> 04:04:57,186
PRE-PREGNANCY CLAIMS DATA, 17%

6725
04:04:57,186 --> 04:04:59,789
ENDED UP WITH A SEVERE MATERNAL

6726
04:04:59,789 --> 04:05:01,323
MORBIDITY, SO THAT'S PRETTY HIGH

6727
04:05:01,323 --> 04:05:02,658
NUMBER TO LOOK AT BUT WE

6728
04:05:02,658 --> 04:05:05,861
COULDN'T INCLUDE IT IN THE MODEL

6729
04:05:05,861 --> 04:05:11,967
BECAUSE WE DIDN'T HAVE THE PRIOR

6730
04:05:11,967 --> 04:05:12,168
DATA.

6731
04:05:12,168 --> 04:05:13,703
SOME LESSONS LEARNED, SO I'M

6732
04:05:13,703 --> 04:05:15,671
PART OF A NON-PROFIT.

6733
04:05:15,671 --> 04:05:18,040
WE DON'T TYPICALLY DO RESEARCH.

6734
04:05:18,040 --> 04:05:20,843
AND WE LEARNED A LOT FROM THE

6735
04:05:20,843 --> 04:05:21,744
"IMPROVE" INITIATIVE.

6736
04:05:21,744 --> 04:05:23,546
CONTINGENCY PLANNING WAS ONE.

6737
04:05:23,546 --> 04:05:25,648
OUR ORIGINAL PROPOSAL WE WERE

6738
04:05:25,648 --> 04:05:28,951
USING MEDICAID DATA, AND WE WERE

6739
04:05:28,951 --> 04:05:30,886
INTEGRATING COUNTY LEVEL FACTORS

6740
04:05:30,886 --> 04:05:34,690
WITHIN NEW JERSEY TO HELP

6741
04:05:34,690 --> 04:05:38,260
PREDICT MATERNAL MORBIDITY.

6742
04:05:38,260 --> 04:05:42,064
WE HAD AGREEMENT AND 18 MONTHS

6743
04:05:42,064 --> 04:05:44,400
LATER WE RECEIVED THE APPROVAL

6744
04:05:44,400 --> 04:05:45,901
TO RECEIVE THE DATA ON THE DAY

6745
04:05:45,901 --> 04:05:49,105
THIS REPORT WAS DUE SO WE HAD

6746
04:05:49,105 --> 04:05:50,706
CONTINGENCY PLANNING IN PLACE,

6747
04:05:50,706 --> 04:05:52,908
SO THAT WE WERE ABLE TO USE

6748
04:05:52,908 --> 04:05:56,645
DIFFERENT DATASET AND CHANGE OUR

6749
04:05:56,645 --> 04:05:58,948
AIMS A LITTLE AND WERE STILL

6750
04:05:58,948 --> 04:06:03,152
ABLE TO SUCCESSFULLY ACCOMPLISH

6751
04:06:03,152 --> 04:06:04,587
THE PROJECT.

6752
04:06:04,587 --> 04:06:06,222
CAPACITY BUILDING, WE SPENT A

6753
04:06:06,222 --> 04:06:07,757
LOTS OF TIME DURING PREPARATION

6754
04:06:07,757 --> 04:06:11,594
AND WAITING FOR DATA IN TRAINING

6755
04:06:11,594 --> 04:06:16,832
MY TEAM SO WE HAD TRAINING

6756
04:06:16,832 --> 04:06:21,237
SESSION HOW TO DO RESEARCH,

6757
04:06:21,237 --> 04:06:22,638
INTEGRATE RESEARCH INTO

6758
04:06:22,638 --> 04:06:24,406
PROGRAMMING.

6759
04:06:24,406 --> 04:06:25,708
OVERALL THE BIGGEST LESSON

6760
04:06:25,708 --> 04:06:27,109
LEARNED IS THAT OF MOTHERHOOD.

6761
04:06:27,109 --> 04:06:28,043
IT TAKES A VILLAGE.

6762
04:06:28,043 --> 04:06:32,014
THIS PROJECT WOULD NOT HAVE BEEN

6763
04:06:32,014 --> 04:06:33,149
POSSIBLE WITHOUT NIH, WITHOUT

6764
04:06:33,149 --> 04:06:35,217
OUR OVERSIGHT COMMITTEE THAT

6765
04:06:35,217 --> 04:06:37,787
HELPED US WITH THE CLINICAL AND

6766
04:06:37,787 --> 04:06:41,891
SOCIAL ASPECTS INCLUDED IN THE

6767
04:06:41,891 --> 04:06:42,224
MODEL.

6768
04:06:42,224 --> 04:06:45,728
MY ORGANIZATIONAL BUY-IN, I WENT

6769
04:06:45,728 --> 04:06:50,332
TO A SERVICE-BASED NON-PROFIT

6770
04:06:50,332 --> 04:06:52,835
AND SAID, HEY, I WANT TO DO

6771
04:06:52,835 --> 04:06:53,035
THIS.

6772
04:06:53,035 --> 04:06:54,603
MY ORGANIZATION SUPPORTED ME AND

6773
04:06:54,603 --> 04:06:56,906
WE WERE ABLE TO SUCCESSFULLY

6774
04:06:56,906 --> 04:06:58,207
COMPLETE THIS RESEARCH.

6775
04:06:58,207 --> 04:06:59,742
I COULD NOT DO IT WITHOUT MY

6776
04:06:59,742 --> 04:06:59,942
TEAM.

6777
04:06:59,942 --> 04:07:04,547
AND I WOULD BE REMISS NOT TO

6778
04:07:04,547 --> 04:07:05,881
MENTION MY CO-INVESTIGATOR,

6779
04:07:05,881 --> 04:07:07,516
LAUREN, WHO REALLY HIT THE

6780
04:07:07,516 --> 04:07:10,586
GROUND RUNNING WHEN WE RECEIVED

6781
04:07:10,586 --> 04:07:13,322
THE DATA AND REALLY ALLOWED US

6782
04:07:13,322 --> 04:07:14,990
TO BE SUCCESSFUL.

6783
04:07:14,990 --> 04:07:16,725
SO NEXT STEPS.

6784
04:07:16,725 --> 04:07:20,429
WE'RE NOT DONE.

6785
04:07:20,429 --> 04:07:22,431
WE ARE WORKING WITH OUR

6786
04:07:22,431 --> 04:07:24,533
OVERSIGHT COMMITTEE TO DEVELOP

6787
04:07:24,533 --> 04:07:27,469
THRESHOLDS OF RISK SO THAT WE

6788
04:07:27,469 --> 04:07:32,141
CAN STRATIFY BASED ON LEVEL OF

6789
04:07:32,141 --> 04:07:34,243
RISK AND OFFER SERVICES TO

6790
04:07:34,243 --> 04:07:35,444
REMEDIATE THAT RISK.

6791
04:07:35,444 --> 04:07:38,614
WE ALSO ARE WORKING ON IMPROVING

6792
04:07:38,614 --> 04:07:41,350
SPECIFICITY, SO REDUCING OUR

6793
04:07:41,350 --> 04:07:43,319
FALSE NEGATIVES, BUILDING

6794
04:07:43,319 --> 04:07:45,421
SUBSEQUENTS MODELS TO PREDICT

6795
04:07:45,421 --> 04:07:46,722
SPECIFIC TYPES OF SEVERE

6796
04:07:46,722 --> 04:07:51,861
MATERNAL MORE BUILDTY  AND --

6797
04:07:51,861 --> 04:07:53,262
MORBIDITY AND KEY PERIODS OF

6798
04:07:53,262 --> 04:07:55,030
VULNERABILITY OF THOSE RISK.

6799
04:07:55,030 --> 04:07:56,899
WE'RE WORKING ON DEVELOPING A

6800
04:07:56,899 --> 04:07:58,734
PROGRAM AND APPLYING FOR

6801
04:07:58,734 --> 04:07:59,835
FUNDING.

6802
04:07:59,835 --> 04:08:00,569
I'M CURRENTLY IN CONVERSATIONS

6803
04:08:00,569 --> 04:08:03,572
WITH ONE OF THE LARGEST INSURERS

6804
04:08:03,572 --> 04:08:05,107
IN NEW JERSEY, AND HOPEFULLY WE

6805
04:08:05,107 --> 04:08:07,643
WILL BE ABLE TO SET UP A MEETING

6806
04:08:07,643 --> 04:08:10,279
AND DISCUSS THE POSSIBILITY OF

6807
04:08:10,279 --> 04:08:12,448
TESTING THIS ALGORITHM IN THEIR

6808
04:08:12,448 --> 04:08:13,549
PATIENT POPULATION AND OFFER

6809
04:08:13,549 --> 04:08:16,485
SERVICES TO THOSE AT HIGHEST

6810
04:08:16,485 --> 04:08:16,986
RISK.

6811
04:08:16,986 --> 04:08:19,355
SO, WE'RE NOT DONE.

6812
04:08:19,355 --> 04:08:22,057
AND WE LOOK FORWARD TO WHAT

6813
04:08:22,057 --> 04:08:30,165
COMES NEXT.

6814
04:08:30,165 --> 04:08:30,599
THANK YOU.

6815
04:08:30,599 --> 04:08:31,800
>> THANK YOU SO MUCH.

6816
04:08:31,800 --> 04:08:34,003
I WOULD LIKE TO SEE IF THERE ARE

6817
04:08:34,003 --> 04:08:36,171
QUESTIONS IN THE AUDIENCE.

6818
04:08:36,171 --> 04:08:46,282
WE MIGHT HAVE ONE. 

6819
04:08:46,282 --> 04:08:48,150
>> HI, CHRIS AGAIN.

6820
04:08:48,150 --> 04:08:51,320
I CONFESS I HAVE TO LOOK AT WHAT

6821
04:08:51,320 --> 04:08:52,621
EXTREME GRADIENT BOOSTING IS.

6822
04:08:52,621 --> 04:08:54,490
I LOOKED IT UP.

6823
04:08:54,490 --> 04:08:56,992
I LEARNED SOMETHING IN TWO

6824
04:08:56,992 --> 04:08:57,226
MINUTES.

6825
04:08:57,226 --> 04:08:58,861
CAN YOU EXPLAIN WHAT IT IS, IT'S

6826
04:08:58,861 --> 04:09:03,132
A DECISION TREE AS I UNDERSTAND,

6827
04:09:03,132 --> 04:09:03,866
APPROACH, MORE IMPORTANTLY WHY

6828
04:09:03,866 --> 04:09:11,006
DO YOU THINK IT PERFORMS SO MUCH

6829
04:09:11,006 --> 04:09:12,341
RATHER THAN LOGISTIC MODEL?

6830
04:09:12,341 --> 04:09:17,346
I HAVE TO PUNT ON THAT ONE.

6831
04:09:17,346 --> 04:09:19,648
LAUREN, MY CO-INVESTIGATOR, IS

6832
04:09:19,648 --> 04:09:22,818
MY BIOSTATISTICIAN, SO SHE IS

6833
04:09:22,818 --> 04:09:25,020
THE ONE THAT WORKED WITH SOME

6834
04:09:25,020 --> 04:09:26,989
MODELS THAT FRANKLY I HAD NEVER

6835
04:09:26,989 --> 04:09:28,324
HEARD OF.

6836
04:09:28,324 --> 04:09:32,594
MY BACKGROUND I'M A SOCIOLOGIST,

6837
04:09:32,594 --> 04:09:33,996
LOGISTIC REGRESSION, OLS IS THE

6838
04:09:33,996 --> 04:09:35,097
WAY TO GO.

6839
04:09:35,097 --> 04:09:36,632
WE LOOKED AT SOME MACHINE

6840
04:09:36,632 --> 04:09:39,702
LEARNING MODELS THAT OTHERS HAVE

6841
04:09:39,702 --> 04:09:42,538
USED, AND SHE RAN WITH IT.

6842
04:09:42,538 --> 04:09:45,808
SO, IF YOU PROVIDE ME YOUR

6843
04:09:45,808 --> 04:09:46,608
INFORMATION, I CAN DEFINITELY

6844
04:09:46,608 --> 04:09:49,211
PROVIDE AN ANSWER TO THAT

6845
04:09:49,211 --> 04:09:58,854
QUESTION ONCE I TALK TO LAUREN. 

6846
04:09:58,854 --> 04:10:00,789
 

6847
04:10:00,789 --> 04:10:01,890
>> DOESN'T LOOK LIKE THERE
ARE

6848
04:10:01,890 --> 04:10:03,158
ANY OTHER QUESTIONS.

6849
04:10:03,158 --> 04:10:05,394
WE'LL SEE IF THERE'S ANYTHING IN

6850
04:10:05,394 --> 04:10:07,262
THE -- NOTHING ONLINE, OKAY.

6851
04:10:07,262 --> 04:10:17,740
I'M PLEASED TO INTRODUCE OUR

6852
04:10:20,175 --> 04:10:23,045
NEXT SPEAKER, ANDREEA CREANGA.

6853
04:10:23,045 --> 04:10:29,952
 

6854
04:10:29,952 --> 04:10:32,354
>> GOOD AFTERNOON,
EVERYONE.

6855
04:10:32,354 --> 04:10:33,555
I'M REPRESENTING THE DATA

6856
04:10:33,555 --> 04:10:35,758
INNOVATION AND COORDINATION HUB.

6857
04:10:35,758 --> 04:10:38,394
I'M GOING TO CHANGE GEARS FROM

6858
04:10:38,394 --> 04:10:39,695
THE WONDERFUL PRESENTATION WE

6859
04:10:39,695 --> 04:10:42,398
HEARD BEFORE MOVING AWAY FROM

6860
04:10:42,398 --> 04:10:43,732
MACHINE LEARNING MODELING TO

6861
04:10:43,732 --> 04:10:48,003
LEARNING A LITTLE BIT ABOUT THE

6862
04:10:48,003 --> 04:10:48,570
DATA HUB.

6863
04:10:48,570 --> 04:10:51,840
SO LET ME MAKE SURE THIS IS

6864
04:10:51,840 --> 04:10:52,074
WORKING.

6865
04:10:52,074 --> 04:10:53,942
WHAT I'M GOING TO DO, I'M GOING

6866
04:10:53,942 --> 04:10:56,011
TO TALK ABOUT HOW WE WORK WITH

6867
04:10:56,011 --> 04:10:57,546
OUR CENTERS OF EXCELLENCE.

6868
04:10:57,546 --> 04:10:59,982
I'M GOING TO TURN YOU A LITTLE

6869
04:10:59,982 --> 04:11:01,717
BIT ABOUT WHAT WE LEARNED FROM

6870
04:11:01,717 --> 04:11:04,553
THEM OVER THE COURSE OF THE

6871
04:11:04,553 --> 04:11:05,888
PREVIOUS YEAR.

6872
04:11:05,888 --> 04:11:08,424
SO OUR SPECIFIC AIMS ARE TO

6873
04:11:08,424 --> 04:11:09,191
ESTABLISH COORDINATION

6874
04:11:09,191 --> 04:11:10,492
INFRASTRUCTURE TO FOSTER

6875
04:11:10,492 --> 04:11:13,228
COMMUNICATION AND COLLABORATION

6876
04:11:13,228 --> 04:11:19,468
ACROSS  IMPROVE CENTERS OF

6877
04:11:19,468 --> 04:11:21,336
EXCELLENCE, DEVELOP DATA

6878
04:11:21,336 --> 04:11:23,739
COLLECTION ANALYSIS AND SHARING

6879
04:11:23,739 --> 04:11:26,375
TOOLS AND STRENGTHEN DATA SIGNS

6880
04:11:26,375 --> 04:11:27,910
AND INNOVATION CAPABILITYES

6881
04:11:27,910 --> 04:11:28,877
THROUGH TECHNICAL ASSISTANCE,

6882
04:11:28,877 --> 04:11:30,979
SKILLS COACHING, TRAINING AND

6883
04:11:30,979 --> 04:11:31,280
MENTORSHIP.

6884
04:11:31,280 --> 04:11:34,249
SO IN TERMS OF COORDINATION THIS

6885
04:11:34,249 --> 04:11:36,318
IS A SLIDE SHOWING THE

6886
04:11:36,318 --> 04:11:38,220
COMPOSITION OF OUR CORE TEAM.

6887
04:11:38,220 --> 04:11:40,923
SOME TEAM MEMBERS OFFER GENERAL

6888
04:11:40,923 --> 04:11:41,590
COORDINATION AND SUPPORT,

6889
04:11:41,590 --> 04:11:43,926
LEADERSHIP TO THE PROGRAM.

6890
04:11:43,926 --> 04:11:47,729
AND SOME OF OUR COLLEAGUES SERVE

6891
04:11:47,729 --> 04:11:48,330
AS SCIENTIFIC LIAISONS WORKING

6892
04:11:48,330 --> 04:11:50,332
WITH TWO OR THREE CENTERS OF

6893
04:11:50,332 --> 04:11:51,233
EXCELLENCE, TRYING TO SUPPORT

6894
04:11:51,233 --> 04:11:53,335
AND FIRST OF ALL LEARN ABOUT

6895
04:11:53,335 --> 04:11:55,804
NEEDS AND THEN SUPPORT AND MEET

6896
04:11:55,804 --> 04:11:59,341
THEIR NEEDS.

6897
04:11:59,341 --> 04:12:02,511
ALSO HAVE TRAINEES, A NUMBER OF

6898
04:12:02,511 --> 04:12:04,346
STUDENTS NOT ONLY SUPPORTING OUR

6899
04:12:04,346 --> 04:12:07,382
WORK AND HELPING BUT LEARNING BY

6900
04:12:07,382 --> 04:12:10,452
DOING IN THE PROCESS.

6901
04:12:10,452 --> 04:12:12,354
SO YOU ALREADY KNOW WE'RE

6902
04:12:12,354 --> 04:12:14,156
WORKING WITH 12 CENTERS OF

6903
04:12:14,156 --> 04:12:16,792
EXCELLENCE OF WHICH TWO WERE

6904
04:12:16,792 --> 04:12:17,893
ADDED RECENTLY IN 2024.

6905
04:12:17,893 --> 04:12:20,462
WE'RE VERY HAPPY TO HAVE MORE

6906
04:12:20,462 --> 04:12:23,398
CENTERS TO WORK WITH.  WE HAVE

6907
04:12:23,398 --> 04:12:24,166
DEVELOPED A PUBLIC-FACING

6908
04:12:24,166 --> 04:12:27,136
WEBSITE FOR THE ENTIRE

6909
04:12:27,136 --> 04:12:27,469
INITIATIVE.

6910
04:12:27,469 --> 04:12:29,538
SO WE'RE TRYING TO HIGHLIGHT THE

6911
04:12:29,538 --> 04:12:31,140
WORK THE CENTERS ARE DOING AND

6912
04:12:31,140 --> 04:12:32,941
SHARE SOME OF THE RESEARCH

6913
04:12:32,941 --> 04:12:36,011
PROJECT THAT ARE GOING TO BE

6914
04:12:36,011 --> 04:12:37,746
COMING AVAILABLE VERY SOON.

6915
04:12:37,746 --> 04:12:39,615
AND WE DEVELOPED A COLLABORATION

6916
04:12:39,615 --> 04:12:40,682
PORTAL FOR OUR INTERNAL USE

6917
04:12:40,682 --> 04:12:44,553
WITHIN THE NETWORK.

6918
04:12:44,553 --> 04:12:45,854
THIS COLLABORATION PORTAL OFFERS

6919
04:12:45,854 --> 04:12:47,823
INDIVIDUAL WORKING SPACE FOR

6920
04:12:47,823 --> 04:12:49,224
EACH OF THE CENTERS, ALSO WE

6921
04:12:49,224 --> 04:12:52,528
HAVE A COMMON SPACE FOR THE

6922
04:12:52,528 --> 04:12:54,730
ENTIRE NETWORK WITH RESEARCH

6923
04:12:54,730 --> 04:12:57,566
LIBRARY, DISCUSSION FORUM, AND

6924
04:12:57,566 --> 04:13:00,035
IMPORTANTLY WE HAVE A TECHNICAL

6925
04:13:00,035 --> 04:13:01,403
ASSISTANCE REQUEST FORM TO WHICH

6926
04:13:01,403 --> 04:13:05,040
OUR CENTERS ARE ABLE TO REQUEST

6927
04:13:05,040 --> 04:13:06,542
TECHNICAL ASSISTANCE, SUPPORT,

6928
04:13:06,542 --> 04:13:07,676
CONSULTATION FROM BOTH HUBS,

6929
04:13:07,676 --> 04:13:11,580
DATA HUSBAND AND IMPLEMENTATION

6930
04:13:11,580 --> 04:13:12,147
SCIENCE.

6931
04:13:12,147 --> 04:13:13,215
SO YOU HAVE ALREADY LEARNED A

6932
04:13:13,215 --> 04:13:15,884
LOT ABOUT OUR CENTERS OF

6933
04:13:15,884 --> 04:13:16,518
EXCELLENCE.

6934
04:13:16,518 --> 04:13:20,255
AND I'M GOING TO RECAP  SOME

6935
04:13:20,255 --> 04:13:21,023
INFORMATION, MAYBE ADD SOME NEW

6936
04:13:21,023 --> 04:13:21,890
INFORMATION TO YOU.

6937
04:13:21,890 --> 04:13:25,060
ALL OF THE CENTERS HAVE A FOCUS

6938
04:13:25,060 --> 04:13:27,129
ON HEALTH EQUITY.

6939
04:13:27,129 --> 04:13:29,331
THREE OF OUR CENTERS WORK WITH

6940
04:13:29,331 --> 04:13:30,098
INDIGENOUS POPULATIONS, AND THEY

6941
04:13:30,098 --> 04:13:33,035
ARE LISTED HERE.

6942
04:13:33,035 --> 04:13:36,171
WE HAVE ELEVATE, CIRCLE, AND

6943
04:13:36,171 --> 04:13:40,475
MARCH. 

6944
04:13:40,475 --> 04:13:46,715
THERE IS A FOCUS ON THE

6945
04:13:46,715 --> 04:13:51,620
ANTENATAL AND PERINATAL CARE,

6946
04:13:51,620 --> 04:13:52,588
FIVE CENTERS.

6947
04:13:52,588 --> 04:13:58,660
THREE CENTERS FOCUSING ON BOTH.

6948
04:13:58,660 --> 04:14:01,163
THERE'S A VARIETY OF RESEARCH

6949
04:14:01,163 --> 04:14:03,065
TOPICS THAT THE CENTERS ARE

6950
04:14:03,065 --> 04:14:04,366
STUDYING.

6951
04:14:04,366 --> 04:14:08,870
AND THIS IS JUST A VERY BRIEF

6952
04:14:08,870 --> 04:14:10,505
GRAPHICAL DEPICTION OF THE KEY

6953
04:14:10,505 --> 04:14:13,141
TOPICS THEY ARE WORKING ON.

6954
04:14:13,141 --> 04:14:15,410
SO IF YOU'RE FOLLOWING THE

6955
04:14:15,410 --> 04:14:18,146
CENTERS THAT HAVE A YELLOW

6956
04:14:18,146 --> 04:14:19,381
MARKER, THOSE ARE CENTERS, FIVE

6957
04:14:19,381 --> 04:14:21,883
OF THEM WORKING ON MENTAL HEALTH

6958
04:14:21,883 --> 04:14:22,884
ASPECTS.

6959
04:14:22,884 --> 04:14:25,387
WE HAVE TWO CENTERS WORKING ON

6960
04:14:25,387 --> 04:14:25,954
SUBSTANCE USE DISORDER.

6961
04:14:25,954 --> 04:14:28,790
THOSE ARE SHOWN WITH A GREEN

6962
04:14:28,790 --> 04:14:29,024
CIRCLE.

6963
04:14:29,024 --> 04:14:33,161
WE HAVE THREE CENTERS WORKING ON

6964
04:14:33,161 --> 04:14:34,596
MATERNAL ANEMIA, CARDIOVASCULAR

6965
04:14:34,596 --> 04:14:35,230
DISEASE, HYPERTENSIVE DISORDERS

6966
04:14:35,230 --> 04:14:36,765
OF PREGNANCY.

6967
04:14:36,765 --> 04:14:44,339
WE HAVE SEVEN CENTERS ACTUALLY

6968
04:14:44,339 --> 04:14:45,073
LOOKING AT MATERNAL MORTALITY,

6969
04:14:45,073 --> 04:14:51,980
TWO ON FOOD OR HOUSING

6970
04:14:51,980 --> 04:14:58,387
INSECURITY AND INFLUENCE ON

6971
04:14:58,387 --> 04:14:59,788
MATERNAL HEALTH OUTCOMES.

6972
04:14:59,788 --> 04:15:03,191
EACH FOCUS AROUND QUALITY OF

6973
04:15:03,191 --> 04:15:03,392
CARE.

6974
04:15:03,392 --> 04:15:05,160
EITHER BY IMPLEMENTING QUALITY

6975
04:15:05,160 --> 04:15:06,828
IMPROVEMENT INITIATIVE OR USING

6976
04:15:06,828 --> 04:15:09,231
QUALITY CARE FRAMEWORK OR

6977
04:15:09,231 --> 04:15:10,332
QUALITY CARE MEASURES TO

6978
04:15:10,332 --> 04:15:11,533
IMPLEMENT THEIR PROGRAM AND

6979
04:15:11,533 --> 04:15:14,936
EVALUATE THEIR PROGRAMS AND

6980
04:15:14,936 --> 04:15:15,904
RESEARCH.

6981
04:15:15,904 --> 04:15:18,340
GIVEN THAT WE'RE WORKING WITH 12

6982
04:15:18,340 --> 04:15:22,277
CENTERS AND EACH OF THEM HAVE A

6983
04:15:22,277 --> 04:15:24,780
WIDE VARIETY OF INTEREST, HOW DO

6984
04:15:24,780 --> 04:15:25,781
WE COORDINATE?

6985
04:15:25,781 --> 04:15:28,083
FIRST, WE TRY TO LISTEN.

6986
04:15:28,083 --> 04:15:30,786
AND OFT LISTENING WE TRY TO

6987
04:15:30,786 --> 04:15:31,687
ADAPT OUR OFFERINGS TO THE

6988
04:15:31,687 --> 04:15:33,121
SPECIFIC NEEDS OF THE CENTER.

6989
04:15:33,121 --> 04:15:35,957
AND WE DO THIS BY WORKING WITH

6990
04:15:35,957 --> 04:15:39,161
SCIENTIFIC LIAISONS.

6991
04:15:39,161 --> 04:15:41,630
WE HAVE SCIENTIFIC LIAISONS

6992
04:15:41,630 --> 04:15:43,498
DEDICATED TO WORKING WITH

6993
04:15:43,498 --> 04:15:45,167
SPECIFIC CENTERS, MATCHED BASED

6994
04:15:45,167 --> 04:15:48,537
ON RESEARCH INTEREST AND SKILLS

6995
04:15:48,537 --> 04:15:50,639
AND EXPERTISE.

6996
04:15:50,639 --> 04:15:52,374
REGULAR CHECK-IN MEETINGS,

6997
04:15:52,374 --> 04:15:54,309
OFFERING TECHNICAL ASSISTANCE,

6998
04:15:54,309 --> 04:15:55,510
RESPOND TO REQUESTS THAT ARE

6999
04:15:55,510 --> 04:15:57,512
SENT TO US THROUGH THE

7000
04:15:57,512 --> 04:15:58,513
COLLABORATION PORTAL, SOMETIMES

7001
04:15:58,513 --> 04:16:01,917
VIA E-MAILS WE REACH OUT TO

7002
04:16:01,917 --> 04:16:03,118
P.I.s AND COLLABORATORS VIA

7003
04:16:03,118 --> 04:16:05,187
E-MAIL AS WELL TO SHARE

7004
04:16:05,187 --> 04:16:06,188
INFORMATION, TO REQUEST

7005
04:16:06,188 --> 04:16:07,823
INFORMATION, SO THERE'S A BACK

7006
04:16:07,823 --> 04:16:10,292
AND FORTH BETWEEN US AND THE

7007
04:16:10,292 --> 04:16:10,625
CENTERS.

7008
04:16:10,625 --> 04:16:15,597
WE ALSO HAVE A MONTHLY

7009
04:16:15,597 --> 04:16:16,598
NEWSLETTER PROVIDING REMINDERS,

7010
04:16:16,598 --> 04:16:17,766
INFORMATION THAT'S NEW,

7011
04:16:17,766 --> 04:16:20,402
REQUESTING FEEDBACK ON OUR

7012
04:16:20,402 --> 04:16:21,503
OFFERINGS.

7013
04:16:21,503 --> 04:16:24,673
AND IN JUNE OF 2024 CON

7014
04:16:24,673 --> 04:16:25,774
CONVENIENT INDIGENOUS MATERNAL

7015
04:16:25,774 --> 04:16:26,641
RESEARCH COMMUNITY OF LEARNING,

7016
04:16:26,641 --> 04:16:29,478
THE PURPOSE OF THIS WAS TO

7017
04:16:29,478 --> 04:16:32,314
CONNECT THE THREE CENTERS

7018
04:16:32,314 --> 04:16:33,215
WORKING WITH INDIGENOUS

7019
04:16:33,215 --> 04:16:33,615
POPULATIONS.

7020
04:16:33,615 --> 04:16:35,717
MAKING SURE WE OFFER A PLATFORM

7021
04:16:35,717 --> 04:16:38,120
TO LEARN FROM EACH OTHER AND

7022
04:16:38,120 --> 04:16:40,422
COLLABORATE WITH ONE ANOTHER.

7023
04:16:40,422 --> 04:16:41,823
DURING THE FIRST MEETING

7024
04:16:41,823 --> 04:16:42,824
CO-DESIGNED OBJECTIVES OF THE

7025
04:16:42,824 --> 04:16:43,925
COMMUNITY THAT YOU'RE SEEING

7026
04:16:43,925 --> 04:16:46,895
HERE ON THE BOTTOM OF THE SLIDE.

7027
04:16:46,895 --> 04:16:49,931
MOVING FORWARD WE'RE GOING USE A

7028
04:16:49,931 --> 04:16:51,800
SIMILAR APPROACH TO ACTUALLY

7029
04:16:51,800 --> 04:16:53,335
GROUP CENTERS BASED ON RESEARCH

7030
04:16:53,335 --> 04:16:55,203
INTERESTS, BASED ON THEIR DATA

7031
04:16:55,203 --> 04:16:57,572
SCIENCE NEEDS AND INTERESTS AND

7032
04:16:57,572 --> 04:16:58,373
WORK.

7033
04:16:58,373 --> 04:17:00,542
SO THAT WE ONCE AGAIN IMPROVE

7034
04:17:00,542 --> 04:17:06,248
COORDINATION AND COLLABORATION

7035
04:17:06,248 --> 04:17:07,449
ACROSS CENTERS.

7036
04:17:07,449 --> 04:17:09,151
PART OF THAT WORK, TECHNICAL

7037
04:17:09,151 --> 04:17:10,652
ASSISTANCE OVER THE NEXT YEAR,

7038
04:17:10,652 --> 04:17:12,954
IS GOING TO HAVE TO DO WITH

7039
04:17:12,954 --> 04:17:14,923
COMMON DATA ELEMENTS.

7040
04:17:14,923 --> 04:17:17,426
YOU'RE FAMILIAR ALREADY WITH OUR

7041
04:17:17,426 --> 04:17:18,760
WORK TRYING TO DEVELOP

7042
04:17:18,760 --> 04:17:20,162
RECOMMENDATIONS FOR COMMON DATA

7043
04:17:20,162 --> 04:17:30,672
ELEMENTS IN MATERNAL HEALTH. 

7044
04:17:31,173 --> 04:17:34,309
DEFINITIONS USED CONSTRUCT, WE

7045
04:17:34,309 --> 04:17:42,050
USED NIH CDE DEFINITION AND TALK

7046
04:17:42,050 --> 04:17:50,258
ABOUT CDE BUNDLES, GROUPING OF

7047
04:17:50,258 --> 04:17:54,529
CDEs THAT ARE INDIVISIBLE.

7048
04:17:54,529 --> 04:17:56,832
THE PROCESS FOR DEVELOPING

7049
04:17:56,832 --> 04:17:57,432
RECOMMENDATIONS, WE DEVELOPED

7050
04:17:57,432 --> 04:17:59,367
FIVE-STEP PROCESS FOR DEVELOPING

7051
04:17:59,367 --> 04:18:00,869
THIS CDE RECOMMENDATION STARTING

7052
04:18:00,869 --> 04:18:03,605
WITH LANDSCAPE ANALYSIS OF

7053
04:18:03,605 --> 04:18:05,874
PUBLICLY AVAILABLE CDEs, CDE

7054
04:18:05,874 --> 04:18:08,844
REPOSITORIES, AS WELL AS REVIEW

7055
04:18:08,844 --> 04:18:10,045
OF PROPOSALS SUBMITTED BY

7056
04:18:10,045 --> 04:18:13,081
CENTERS OF EXCELLENCE MAKING

7057
04:18:13,081 --> 04:18:16,051
SURE WE IDENTIFY ALL THOSE

7058
04:18:16,051 --> 04:18:17,819
CDEs NEEDED AND OF INTEREST ON

7059
04:18:17,819 --> 04:18:19,354
OUR CENTERS OF EXCELLENCE.

7060
04:18:19,354 --> 04:18:21,957
WE FORMED TWO WORKING GROUPS

7061
04:18:21,957 --> 04:18:22,724
PREPARING FOR WHO DELPHI

7062
04:18:22,724 --> 04:18:23,058
PROCESSES.

7063
04:18:23,058 --> 04:18:26,027
WE HAD A WORKING GROUP FOR

7064
04:18:26,027 --> 04:18:27,762
BIOMEDICAL CDEs, ONE MORE

7065
04:18:27,762 --> 04:18:28,663
PSYCHOSOCIAL CDEs.

7066
04:18:28,663 --> 04:18:32,567
WE HAD A FIRST DELPHI EXERCISE

7067
04:18:32,567 --> 04:18:33,602
WE THOUGHT WE'VE DONE, WE

7068
04:18:33,602 --> 04:18:36,938
COMPLETED IN THE SPRING OF THIS

7069
04:18:36,938 --> 04:18:39,574
YEAR, TRYING TO PRIORITIZE

7070
04:18:39,574 --> 04:18:41,643
CONSTRUCTS THAT SHOULD BE

7071
04:18:41,643 --> 04:18:45,280
MEASURED BY ALL MATERNAL HEALTH

7072
04:18:45,280 --> 04:18:46,915
RESEARCHERS, TRYING CATEGORIZE

7073
04:18:46,915 --> 04:18:49,751
PRIORITIES IN THREE GROUPS, TIER

7074
04:18:49,751 --> 04:18:52,587
1, THESE WERE CDEs THAT SHOULD

7075
04:18:52,587 --> 04:18:55,090
BE COLLECTED BY ALL MATERNAL

7076
04:18:55,090 --> 04:18:55,757
HEALTH RESEARCHERS.

7077
04:18:55,757 --> 04:18:58,827
TIER 2 TO BE COLLECTED BY THOSE

7078
04:18:58,827 --> 04:19:01,563
WHO HAVE SPECIFIC INTEREST, AND

7079
04:19:01,563 --> 04:19:02,764
THIRD GROUP CONSTRUCTED WERE NOT

7080
04:19:02,764 --> 04:19:06,368
THE PRIORITY FOR THE FIELD.

7081
04:19:06,368 --> 04:19:07,903
AFTER THE COMPLETION OF THE

7082
04:19:07,903 --> 04:19:11,206
FIRST DELPHI EXERCISE WE MOVED

7083
04:19:11,206 --> 04:19:13,475
INTO LITERATURE REVIEW PHASE TO

7084
04:19:13,475 --> 04:19:16,344
IDENTIFY CDE CANDIDATES AND ALSO

7085
04:19:16,344 --> 04:19:18,747
TO IDENTIFY SOME OF THE

7086
04:19:18,747 --> 04:19:20,515
INFORMATION FROM PUBLISHED

7087
04:19:20,515 --> 04:19:22,150
STUDIES AROUND FEASIBILITY AND

7088
04:19:22,150 --> 04:19:24,019
VALIDITY OF THESE MEASURES.

7089
04:19:24,019 --> 04:19:25,887
WITH OUR SECOND DELPHI EXERCISE

7090
04:19:25,887 --> 04:19:28,957
WE'RE ABLE TO SELECT CDE

7091
04:19:28,957 --> 04:19:31,459
CANDIDATES. 

7092
04:19:31,459 --> 04:19:33,862
WE HAD OUR PANELISTS RAISE THE

7093
04:19:33,862 --> 04:19:37,933
VISIBILITY AND VALIDITY OF THESE

7094
04:19:37,933 --> 04:19:39,000
MEASURES AND ENDORSE

7095
04:19:39,000 --> 04:19:43,071
RECOMMENDATIONS FOR OUR FINAL

7096
04:19:43,071 --> 04:19:44,606
CDEs.

7097
04:19:44,606 --> 04:19:51,379
HERE I'M SHOWING OUR PROCESS FOR

7098
04:19:51,379 --> 04:19:55,216
DEVELOPING -- MORE THE

7099
04:19:55,216 --> 04:19:57,419
BIOMEDICAL CONSTRUCT

7100
04:19:57,419 --> 04:20:00,355
PRIORITIZATION, STARTED WITH

7101
04:20:00,355 --> 04:20:02,624
267, TIER 1 BIOMEDICAL

7102
04:20:02,624 --> 04:20:04,859
CONSTRUCTS, THERE WERE 36 AND

7103
04:20:04,859 --> 04:20:09,130
COVERING ASPECTS AROUND

7104
04:20:09,130 --> 04:20:10,298
PREGNANCY EPISODE, DELIVERY

7105
04:20:10,298 --> 04:20:11,499
EPISODE, HEALTH PREGNANCY

7106
04:20:11,499 --> 04:20:12,701
HISTORY, MENTAL HEALTH

7107
04:20:12,701 --> 04:20:15,270
CONDITIONS, NEONATAL

7108
04:20:15,270 --> 04:20:18,206
CHARACTERISTICS AND OUTCOMES.

7109
04:20:18,206 --> 04:20:19,741
WE STARTED WITH 194 CONSTRUCTS

7110
04:20:19,741 --> 04:20:23,778
BEFORE THE FIRST DELPHI

7111
04:20:23,778 --> 04:20:25,580
EXERCISE, AND DELPHI 1

7112
04:20:25,580 --> 04:20:27,916
PRIORITIZED 23 TIER 1

7113
04:20:27,916 --> 04:20:28,516
PSYCHOSOCIAL CONSTRUCTING, I'M

7114
04:20:28,516 --> 04:20:30,552
SHOWING HERE.

7115
04:20:30,552 --> 04:20:32,420
THEY COVER ELEMENTS AROUND

7116
04:20:32,420 --> 04:20:35,357
MATERNAL MENTAL HEALTH,

7117
04:20:35,357 --> 04:20:37,125
SUBSTANCE USE, SOME ASPECTS

7118
04:20:37,125 --> 04:20:39,527
REGARDING ACCESS TO MEDICAL

7119
04:20:39,527 --> 04:20:43,064
CARE, BIAS AND DISCRIMINATION,

7120
04:20:43,064 --> 04:20:43,465
SOCIODEMOGRAPHICS.

7121
04:20:43,465 --> 04:20:47,202
MANY THANKS TO THE PANELISTS,

7122
04:20:47,202 --> 04:20:50,372
WHO SERVED IN ONE OF THESE TWO

7123
04:20:50,372 --> 04:20:52,340
WORKING GROUPS, SPECIAL THANKS

7124
04:20:52,340 --> 04:20:55,310
TO TO THE COORDINATOR ON OUR

7125
04:20:55,310 --> 04:20:55,777
SITE.

7126
04:20:55,777 --> 04:20:58,146
AND ALSO WE WORKED CLOSELY AND

7127
04:20:58,146 --> 04:21:00,382
COORDINATED WITH NICHD ON THIS

7128
04:21:00,382 --> 04:21:02,784
PROJECT, AND WE HAD TWO

7129
04:21:02,784 --> 04:21:07,922
COLLEAGUES PART OF THE

7130
04:21:07,922 --> 04:21:09,658
BIOMEDICAL WORKING GROUP, AND

7131
04:21:09,658 --> 04:21:12,827
ALSO HAD TWO COLLEAGUES FROM

7132
04:21:12,827 --> 04:21:15,797
NICHD, DR. JESSICA GLEASON AND

7133
04:21:15,797 --> 04:21:16,998
CAROLINE SIGNORE WHO OFFERED

7134
04:21:16,998 --> 04:21:18,733
COORDINATION AND SUPPORT TO THE

7135
04:21:18,733 --> 04:21:20,035
ENTIRE TEAM.

7136
04:21:20,035 --> 04:21:21,703
MOVING FORWARD IN NOVEMBER WE'RE

7137
04:21:21,703 --> 04:21:26,074
GOING TO SHARE WITH YOU OUR

7138
04:21:26,074 --> 04:21:27,275
REPORT OF CDE RECOMMENDATIONS,

7139
04:21:27,275 --> 04:21:30,645
WORKING HARD AT THAT.

7140
04:21:30,645 --> 04:21:37,018
WE'RE GOING TO TREAT THE FIRST

7141
04:21:37,018 --> 04:21:39,320
YEAR AS IMPLEMENTATION AND

7142
04:21:39,320 --> 04:21:41,723
REFINEMENT STAGE, TO TEST,

7143
04:21:41,723 --> 04:21:44,459
SOLICIT FEEDBACK AND PROVIDE

7144
04:21:44,459 --> 04:21:45,994
SOME TOOLS TO SUPPORT

7145
04:21:45,994 --> 04:21:47,529
IMPLEMENTATION OF THE CDEs.

7146
04:21:47,529 --> 04:21:49,064
AFTER THAT, THE LAST FIVE YEARS

7147
04:21:49,064 --> 04:21:54,736
OF OUR GRAND WE'RE GOING TO DATA

7148
04:21:54,736 --> 04:21:57,706
COLLECTION MODE, ON THE DATA HUB

7149
04:21:57,706 --> 04:21:58,873
SITE OFFER TECHNICAL ASSISTANCE

7150
04:21:58,873 --> 04:22:00,775
TO MAKE SURE AT THE END OF THE

7151
04:22:00,775 --> 04:22:04,612
GRANT PERIOD WE'RE ABLE TO

7152
04:22:04,612 --> 04:22:08,349
SUPPORT THE CENTERS, SUBMIT

7153
04:22:08,349 --> 04:22:09,884
DE-IDENTIFIED DATA TO THE

7154
04:22:09,884 --> 04:22:10,285
REPOSITORY.

7155
04:22:10,285 --> 04:22:12,487
I'M GOING TO SPEND THE LAST

7156
04:22:12,487 --> 04:22:14,689
COUPLE MINUTES TALKING ABOUT OUR

7157
04:22:14,689 --> 04:22:15,557
APPROACH TO RESEARCH CAPACITY

7158
04:22:15,557 --> 04:22:20,395
DEVELOPMENT WHICH IS KEY TO OUR

7159
04:22:20,395 --> 04:22:21,830
PROJECT.

7160
04:22:21,830 --> 04:22:26,067
WE HAVE ADAPTED THE GROUP

7161
04:22:26,067 --> 04:22:30,905
FRAMEWORK THAT HAS SIX DOMAINS

7162
04:22:30,905 --> 04:22:32,774
STARTING WITH SKILLS AND

7163
04:22:32,774 --> 04:22:36,177
CONFIDENCE BUILDING, CLOSE TO

7164
04:22:36,177 --> 04:22:38,480
PRACTICE, LINKAGE AND

7165
04:22:38,480 --> 04:22:39,914
COLLABORATION, APPROPRIATE

7166
04:22:39,914 --> 04:22:40,982
DISSEMINATION, AND

7167
04:22:40,982 --> 04:22:41,349
INFRASTRUCTURE.

7168
04:22:41,349 --> 04:22:43,051
THIS IS ACROSS INDIVIDUAL

7169
04:22:43,051 --> 04:22:44,586
RESEARCHERS, OUR CENTER OF

7170
04:22:44,586 --> 04:22:46,354
EXCELLENCE TEAM, THE

7171
04:22:46,354 --> 04:22:48,423
ORGANIZATION, ALSO OUR NETWORK,

7172
04:22:48,423 --> 04:22:50,158
THE IMPROVE NETWORK.

7173
04:22:50,158 --> 04:22:52,827
WE'RE LOOKING AT ALL THE CENTERS

7174
04:22:52,827 --> 04:22:55,230
OF EXCELLENCE INDIVIDUALLY TO

7175
04:22:55,230 --> 04:22:57,198
ASSESS THEIR NEEDS, TO MEET

7176
04:22:57,198 --> 04:22:58,199
NEEDS, THE ENTIRE PROGRAM AND

7177
04:22:58,199 --> 04:22:59,834
NETWORK WE'RE ALL PART OF.

7178
04:22:59,834 --> 04:23:02,103
WE'RE TRYING TO DO EVERYTHING IN

7179
04:23:02,103 --> 04:23:07,809
OUR POWER TO MAKE US TOGETHER

7180
04:23:07,809 --> 04:23:08,109
SUCCESSFUL.

7181
04:23:08,109 --> 04:23:12,180
TO HAVE A BASELINE TO MAKE SURE

7182
04:23:12,180 --> 04:23:17,786
WE KNOW THE STARTING POINT WE

7183
04:23:17,786 --> 04:23:19,320
CONDUCTED A RESEARCH CAPACITY

7184
04:23:19,320 --> 04:23:22,824
SURVEY USING SOME MEASURES FROM

7185
04:23:22,824 --> 04:23:23,458
THAT HOLDEN DEVELOPED.

7186
04:23:23,458 --> 04:23:24,893
SO BETWEEN JULY AND SEPTEMBER OF

7187
04:23:24,893 --> 04:23:27,562
THIS YEAR WE CONDUCTED A SURVEY

7188
04:23:27,562 --> 04:23:28,863
ONLINE WITH RESEARCH AFFILIATES.

7189
04:23:28,863 --> 04:23:30,832
ACROSS THE TEN CENTERS OF

7190
04:23:30,832 --> 04:23:34,469
EXCELLENCE WE'RE WORKING WITH AT

7191
04:23:34,469 --> 04:23:43,878
THE TIME, WE HAD 290.

7192
04:23:43,878 --> 04:23:47,682
OUT OF THIS,  82 RESPONDED.

7193
04:23:47,682 --> 04:23:50,318
WE'RE GOING TO REPEAT THIS ON AN

7194
04:23:50,318 --> 04:23:52,954
ANNUAL BASIS, PROBABLY BEFORE

7195
04:23:52,954 --> 04:23:58,259
THE BEGINNING OF THE SUMMER  SO

7196
04:23:58,259 --> 04:24:00,028
WE HAVE BETTER RESPONSE RATE.

7197
04:24:00,028 --> 04:24:04,199
THE GOAL TO ASSESS INDIVIDUAL

7198
04:24:04,199 --> 04:24:07,902
AND ORGANIZATIONAL CAPACITY.

7199
04:24:07,902 --> 04:24:09,437
YOU SEE RESPONDENT

7200
04:24:09,437 --> 04:24:10,638
CHARACTERISTICS, ONLY 82

7201
04:24:10,638 --> 04:24:11,406
RESPONSES, RESPONSE RATE IF

7202
04:24:11,406 --> 04:24:13,842
WE'RE TO CONSIDER THE ROSTER OF

7203
04:24:13,842 --> 04:24:15,476
RESEARCH AFFILIATES WE HAVE THE

7204
04:24:15,476 --> 04:24:20,048
RESPONSE RATE IS ONLY 28%.

7205
04:24:20,048 --> 04:24:22,584
SO WE HAVE TO INTERPRET WITH

7206
04:24:22,584 --> 04:24:26,521
CAUTION THE RESULTS HERE. 

7207
04:24:26,521 --> 04:24:27,822
WE HAD 19 RESPONDENTS WERE

7208
04:24:27,822 --> 04:24:36,598
P.I.s OR CO-P.I.s, 25% EARLY

7209
04:24:36,598 --> 04:24:37,332
INVESTIGATOR -- EARLY-STAGE

7210
04:24:37,332 --> 04:24:43,671
INVESTIGATORS, 50%

7211
04:24:43,671 --> 04:24:45,440
UNDERREPRESENTED MINORITIES IN

7212
04:24:45,440 --> 04:24:46,040
RESEARCH.

7213
04:24:46,040 --> 04:24:48,176
THIS IS THE HOLDEN VALIDATED

7214
04:24:48,176 --> 04:24:49,944
SCALE FOR SKILL AND CONFIDENCE.

7215
04:24:49,944 --> 04:24:54,849
WHAT I WANT TO MENTION, TWO

7216
04:24:54,849 --> 04:24:55,283
THINGS.

7217
04:24:55,283 --> 04:24:57,352
SO, WE ASKED RESPONDENTS TO RATE

7218
04:24:57,352 --> 04:25:00,188
SKILL LEVEL ON A SCALE FROM 1 TO

7219
04:25:00,188 --> 04:25:00,455
10.

7220
04:25:00,455 --> 04:25:01,856
10 BEING HIGHEST LEVEL.

7221
04:25:01,856 --> 04:25:04,359
ON ALL OF THE 17 ITEMS HERE FROM

7222
04:25:04,359 --> 04:25:05,393
THE HOLDEN MEASURE.

7223
04:25:05,393 --> 04:25:10,031
AND THE NUMBER ONE THING I WANT

7224
04:25:10,031 --> 04:25:11,599
TO MENTION, THE OVERALL MEAN WAS

7225
04:25:11,599 --> 04:25:13,701
7.2 OUT OF 10.

7226
04:25:13,701 --> 04:25:16,004
OUR CENTERS ALREADY HAVE A VERY

7227
04:25:16,004 --> 04:25:17,105
HIGH CAPACITY FOR CONDUCTING

7228
04:25:17,105 --> 04:25:17,739
RESEARCH.

7229
04:25:17,739 --> 04:25:20,909
THE GOOD NEWS FOR THE DATA HUB

7230
04:25:20,909 --> 04:25:21,576
THERE'S STILL ROOM FOR

7231
04:25:21,576 --> 04:25:28,349
IMPROVEMENT, STILL A WAY FOR US

7232
04:25:28,349 --> 04:25:34,522
TO BE USEFUL SECOND METHOD ON

7233
04:25:34,522 --> 04:25:37,358
THE BOTTOM, AREAS WHERE WE CAN

7234
04:25:37,358 --> 04:25:38,760
IMPROVE, MAYBE STRENGTHP OUR

7235
04:25:38,760 --> 04:25:41,596
SUPPORT, SUPPORT WE OFFER TO THE

7236
04:25:41,596 --> 04:25:41,829
CENTERS.

7237
04:25:41,829 --> 04:25:50,004
SO THOSE ITEMS WERE REGARDING

7238
04:25:50,004 --> 04:25:51,773
ANALYSIS OF QUANTITATIVE DATA,

7239
04:25:51,773 --> 04:25:53,641
PUBLICATIONS IN PEER-REVIEWED

7240
04:25:53,641 --> 04:25:55,410
JOURNALS AND PREPARING

7241
04:25:55,410 --> 04:25:55,743
APPLICATIONS.

7242
04:25:55,743 --> 04:25:59,881
OUR SURVEY WAS ABLE TO CONFIRM

7243
04:25:59,881 --> 04:26:01,983
ALL OF OUR CENTERS AND SOME

7244
04:26:01,983 --> 04:26:04,185
CENTER AFFILIATES WITH WORKING

7245
04:26:04,185 --> 04:26:05,286
CLOSELY WITHIN THEIR CENTERS AND

7246
04:26:05,286 --> 04:26:06,254
WORKING WITH COMMUNITY PARTNERS,

7247
04:26:06,254 --> 04:26:08,890
WHAT WE WANTED TO SEE A THE THIS

7248
04:26:08,890 --> 04:26:10,525
POINT IN TIME.

7249
04:26:10,525 --> 04:26:12,327
IN TERMS OF INFRASTRUCTURE,

7250
04:26:12,327 --> 04:26:13,895
THERE'S CENTERS OF EXCELLENCE

7251
04:26:13,895 --> 04:26:16,564
ARE ALREADY OFFERING A LOT OF

7252
04:26:16,564 --> 04:26:18,967
SUPPORT TO THEIR RESEARCHERS.

7253
04:26:18,967 --> 04:26:22,570
SO, WHAT I'M POINTING ON THE

7254
04:26:22,570 --> 04:26:27,809
BOTTOM HALF OF THE GRAPH ON THE

7255
04:26:27,809 --> 04:26:32,113
LEFT ARE SOME AREAS WHERE WE CAN

7256
04:26:32,113 --> 04:26:33,614
ACTUALLY MAKE IMPROVEMENT FAST.

7257
04:26:33,614 --> 04:26:35,483
ON THE RIGHT-HAND SIDE I'M

7258
04:26:35,483 --> 04:26:38,219
SHOWING THE BARRIERS IDENTIFIED

7259
04:26:38,219 --> 04:26:38,886
BY RESPONDENTS.

7260
04:26:38,886 --> 04:26:40,388
ONE OF THE MOST INTERESTING

7261
04:26:40,388 --> 04:26:43,458
FINDINGS IN MY OPINION WAS THAT

7262
04:26:43,458 --> 04:26:45,126
33% OF OUR RESPONDENTS REPORTED

7263
04:26:45,126 --> 04:26:46,661
NO BARRIER TO CONDUCTING

7264
04:26:46,661 --> 04:26:47,929
RESEARCH.

7265
04:26:47,929 --> 04:26:51,132
HOWEVER, 50% OF THE SAMPLE

7266
04:26:51,132 --> 04:26:52,333
ACTUALLY REPORTED COMPETING

7267
04:26:52,333 --> 04:26:54,402
PRIORITIES AS A KEY BARRIER TO

7268
04:26:54,402 --> 04:26:56,437
THEIR CONDUCTING RESEARCH.

7269
04:26:56,437 --> 04:26:58,573
WE ASKED ABOUT WHAT SUPPORTS ARE

7270
04:26:58,573 --> 04:27:03,811
NEEDED FROM THE DATA HUB, WANTED

7271
04:27:03,811 --> 04:27:05,146
TO ADDRESS THE NEEDS OF THE

7272
04:27:05,146 --> 04:27:07,215
CENTERS IN THE PROPER FASHION.

7273
04:27:07,215 --> 04:27:10,718
WEBINARS AND FACILITATION OF

7274
04:27:10,718 --> 04:27:11,252
DISCUSSIONS ACROSS CENTERS

7275
04:27:11,252 --> 04:27:13,021
EMERGED AS KEY NEEDS FROM THE

7276
04:27:13,021 --> 04:27:16,858
CENTERS, AND WAYS WE CAN

7277
04:27:16,858 --> 04:27:18,459
CONTRIBUTE TO THEIR WORK.

7278
04:27:18,459 --> 04:27:21,095
SO, I HAVE ONE MORE MINUTE TO GO

7279
04:27:21,095 --> 04:27:22,864
OVER TRAINING ACTIVITIES.

7280
04:27:22,864 --> 04:27:25,600
I'M GOING START WITH OUR MONTHLY

7281
04:27:25,600 --> 04:27:26,434
WEBINARS, CUSTOMIZED TO THE FEED

7282
04:27:26,434 --> 04:27:29,404
BACK AND NEEDS OF THE CENTERS,

7283
04:27:29,404 --> 04:27:30,738
SOME FUTURE TOPICS LISTED HERE

7284
04:27:30,738 --> 04:27:34,008
BUT ON A REGULAR BASIS WE TRIED

7285
04:27:34,008 --> 04:27:39,614
TO TAILOR CONTENT TO THE NEEDS

7286
04:27:39,614 --> 04:27:41,049
THAT OUR CENTERS HAVE.

7287
04:27:41,049 --> 04:27:44,652
SLIDES AND RECORDINGS ARE

7288
04:27:44,652 --> 04:27:47,388
AVAILABLE ON COLLABORATION

7289
04:27:47,388 --> 04:27:50,124
PORTAL, TRYING TO INCREASE

7290
04:27:50,124 --> 04:27:51,426
AROUND THE UPCOMING PROFESSIONAL

7291
04:27:51,426 --> 04:27:52,860
MEETINGS WITHIN HOPKINS, OUTSIDE

7292
04:27:52,860 --> 04:27:53,761
HOPKINS, THROUGH MONTHLY

7293
04:27:53,761 --> 04:27:55,930
WEBINARS.

7294
04:27:55,930 --> 04:27:57,231
A SCHOLARSHIP FUND IS OFFERING

7295
04:27:57,231 --> 04:27:58,800
$4,000 SCHOLARSHIP FOR EACH

7296
04:27:58,800 --> 04:28:00,768
STORY BUILD DATA SCIENCE SKILLS

7297
04:28:00,768 --> 04:28:03,037
AMONG RESEARCH AFFILIATES AND

7298
04:28:03,037 --> 04:28:04,238
TRAINEES, ABLE TO OFFER 11 SUCH

7299
04:28:04,238 --> 04:28:05,907
SCHOLARSHIPS LAST YEAR, HOPE TO

7300
04:28:05,907 --> 04:28:09,710
DOUBLE THIS NUMBER FOR THE

7301
04:28:09,710 --> 04:28:11,379
CURRENT YEAR.

7302
04:28:11,379 --> 04:28:14,315
ONE PIECE WE'RE PROUD OF IS

7303
04:28:14,315 --> 04:28:17,318
MATERNAL HEALTH DATA SCIENCE

7304
04:28:17,318 --> 04:28:18,086
PARTNERSHIP WHICH INTRODUCES

7305
04:28:18,086 --> 04:28:20,021
PHYSICIAN-SCIENTIST AND

7306
04:28:20,021 --> 04:28:22,990
Ph.D.-LEVEL SCIENTISTS AS WELL

7307
04:28:22,990 --> 04:28:28,329
AS MASTER LEVEL SCIENTISTS, OMOP

7308
04:28:28,329 --> 04:28:32,633
COMMON DATA ELEMENT, MONTHLY

7309
04:28:32,633 --> 04:28:34,469
TRAINING MEETINGS, WORK GROUP

7310
04:28:34,469 --> 04:28:38,439
MEETINGS LED BY COLLEAGUES FROM

7311
04:28:38,439 --> 04:28:43,711
THE PRISM CENTER, MANY THANKS TO

7312
04:28:43,711 --> 04:28:47,415
STEPHANIE, AND PRACTICE SESSIONS

7313
04:28:47,415 --> 04:28:49,684
USING DATASETS AND MEETINGS WITH

7314
04:28:49,684 --> 04:28:51,552
A CAREER MEANTOR.

7315
04:28:51,552 --> 04:28:54,288
FIRST COHORT STARTED IN

7316
04:28:54,288 --> 04:28:56,357
SEPTEMBER, WE HAVE SELECTED 22

7317
04:28:56,357 --> 04:28:57,792
FELLOWS FROM MORE THAN 40

7318
04:28:57,792 --> 04:29:01,829
APPLICANTS, IMPORTANT TO NOTE

7319
04:29:01,829 --> 04:29:03,231
FOR THE AUDIENCE 15 FELLOWS ARE

7320
04:29:03,231 --> 04:29:08,402
FROM NINE OF THE CENTERS OF

7321
04:29:08,402 --> 04:29:09,203
EXCELLENCE.

7322
04:29:09,203 --> 04:29:10,271
CENTERS ARE ALREADY

7323
04:29:10,271 --> 04:29:11,672
DISSEMINATING THEIR FINDINGS,

7324
04:29:11,672 --> 04:29:12,907
I'M JUST GIVING EXAMPLES OF THE

7325
04:29:12,907 --> 04:29:14,842
WORK THAT'S BEEN PUBLISHED IN

7326
04:29:14,842 --> 04:29:17,712
THE PAST THREE MONTHS.

7327
04:29:17,712 --> 04:29:21,782
AND ALSO WE LOOKED TO SEE WHICH

7328
04:29:21,782 --> 04:29:22,884
CONFERENCE ACTUALLY BENEFITED

7329
04:29:22,884 --> 04:29:26,354
FROM STRONG PARTICIPATION FROM

7330
04:29:26,354 --> 04:29:28,656
OUR CENTERS, AND THE PREGNANCY

7331
04:29:28,656 --> 04:29:31,159
MEETING IN 2024 EMERGES AT TOP

7332
04:29:31,159 --> 04:29:33,261
CONFERENCE MANY OF US ACTUALLY

7333
04:29:33,261 --> 04:29:36,330
WENT TO AND PARTICIPATED, HAD

7334
04:29:36,330 --> 04:29:39,767
ABSTRACTS OR ORAL PRESENTATIONS,

7335
04:29:39,767 --> 04:29:42,970
POSTER PRESENTATIONS, SO 7 OF

7336
04:29:42,970 --> 04:29:44,872
THE 10 HAD PRESENTATIONS, ALSO

7337
04:29:44,872 --> 04:29:47,141
WITNESSED COLLABORATIONS BETWEEN

7338
04:29:47,141 --> 04:29:48,910
THE CENTERS OF EXCELLENCE.

7339
04:29:48,910 --> 04:29:51,312
AND LAST BUT NOT LEAST AND MAYBE

7340
04:29:51,312 --> 04:29:53,915
I SHOULD MENTION THIS, IT IS MY

7341
04:29:53,915 --> 04:29:56,350
FAVORITE PIECE FROM YEAR 1 OF

7342
04:29:56,350 --> 04:29:57,485
THE PROGRAM, MATERNAL HEALTH

7343
04:29:57,485 --> 04:29:58,920
DATA MOSAIC TO SUPPORT DATA

7344
04:29:58,920 --> 04:30:00,354
SHARING AND LEARNING ACROSS

7345
04:30:00,354 --> 04:30:02,290
CENTERS OF EXCELLENCE BY

7346
04:30:02,290 --> 04:30:03,824
ADDRESSING COMMON RESEARCH

7347
04:30:03,824 --> 04:30:06,761
THEME, THE THEME THIS YEAR WAS

7348
04:30:06,761 --> 04:30:12,333
COVID-19 AND INFLUENCE ON

7349
04:30:12,333 --> 04:30:12,967
MATERNAL/FETAL/NEWBORN OUTCOMES.

7350
04:30:12,967 --> 04:30:15,536
YOU MAY HAVE SEEN POSTERS

7351
04:30:15,536 --> 04:30:16,337
SUBMITTED BY CENTERS, PRINTED

7352
04:30:16,337 --> 04:30:19,607
AND DAYS PLAYED AT THE MEETING,

7353
04:30:19,607 --> 04:30:20,474
EIGHT CENTERS RECEIVING AWARDS.

7354
04:30:20,474 --> 04:30:23,311
WE'RE GOING TO DO IT NEXT YEAR,

7355
04:30:23,311 --> 04:30:24,645
HOPEFULLY WITH MORE CENTERS

7356
04:30:24,645 --> 04:30:26,113
PARTICIPATE, MORE AWARDS TO BE

7357
04:30:26,113 --> 04:30:26,814
GIVEN.

7358
04:30:26,814 --> 04:30:34,388
THANK YOU SO MUCH. 

7359
04:30:34,388 --> 04:30:35,289
>> THANK YOU.

7360
04:30:35,289 --> 04:30:36,857
WE'RE GOING TO MOVE ON FOR

7361
04:30:36,857 --> 04:30:38,259
TIME'S SAKE TO THE LAST

7362
04:30:38,259 --> 04:30:40,428
PRESENTATION BUT WE WILL HAVE

7363
04:30:40,428 --> 04:30:44,265
TIME FOR OPEN DISCUSSION AT

7364
04:30:44,265 --> 04:30:44,465
4:00.

7365
04:30:44,465 --> 04:30:50,238
SO LAST BUT NOT LEAST WE ARE

7366
04:30:50,238 --> 04:30:54,242
WELCOMING REBECCA HAMM,

7367
04:30:54,242 --> 04:30:55,977
UNIVERSITY OF PENNSYLVANIA

7368
04:30:55,977 --> 04:30:57,745
IMPLEMENTATION SCIENCE HUB.

7369
04:30:57,745 --> 04:31:01,215
>> I'M REPRESENTING OUR
TEAM

7370
04:31:01,215 --> 04:31:02,550
FROM AMETHIST.

7371
04:31:02,550 --> 04:31:05,486
WE'RE THE OTHER RESOURCE HUB FOR

7372
04:31:05,486 --> 04:31:06,387
THE "IMPROVE" INITIATIVE.

7373
04:31:06,387 --> 04:31:17,031
I'M PRESENTING ON BEHALF OF MY

7374
04:31:17,031 --> 04:31:17,865
CO-DIRECTOR MEGHAN LANE-FALL.

7375
04:31:17,865 --> 04:31:19,500
I'M SURE EVERYBODY IS READY TO

7376
04:31:19,500 --> 04:31:20,935
GO HOME.

7377
04:31:20,935 --> 04:31:23,104
IMPLEMENTATION SCIENCE IS AN

7378
04:31:23,104 --> 04:31:25,072
AMAZING TOOL TO HELP ACTUALLY

7379
04:31:25,072 --> 04:31:28,142
BEND THE CURVE IN MATERNITY

7380
04:31:28,142 --> 04:31:29,477
MORBIDITY AND MORTALITY AND

7381
04:31:29,477 --> 04:31:31,746
SECOND HOW WE CAN HELP YOU MOVE

7382
04:31:31,746 --> 04:31:32,513
YOUR PROJECTS AHEAD.

7383
04:31:32,513 --> 04:31:35,149
SO AS MANY OF YOU PROBABLY KNOW,

7384
04:31:35,149 --> 04:31:36,017
QUALITY IMPROVEMENT IS A GREAT

7385
04:31:36,017 --> 04:31:38,185
TOOL IN AND OF ITSELF BUT HAS

7386
04:31:38,185 --> 04:31:40,321
ITS LIMITS.

7387
04:31:40,321 --> 04:31:43,124
WE CAN GO AROUND AND AROUND

7388
04:31:43,124 --> 04:31:44,859
DOING PDSA CYCLES AND MAY NOT

7389
04:31:44,859 --> 04:31:47,161
MAKE A DIFFERENCE IN OUTCOME.

7390
04:31:47,161 --> 04:31:48,329
THE REASON TRADITIONAL QI

7391
04:31:48,329 --> 04:31:50,564
DOESN'T ALWAYS WORK HEALTHCARE

7392
04:31:50,564 --> 04:31:52,500
IMPLENTIATION IS SO COMPLEX, YOU

7393
04:31:52,500 --> 04:31:53,501
TALKED ABOUT IT TODAY.

7394
04:31:53,501 --> 04:31:56,037
YOU KNOW, THERE ARE THE ISSUES

7395
04:31:56,037 --> 04:31:57,905
WHERE CLINICIANS DON'T KNOW THE

7396
04:31:57,905 --> 04:31:59,206
CURRENT RESEARCH, WE ALL LEARNED

7397
04:31:59,206 --> 04:32:01,609
SOMETHING NEW IN THE

7398
04:32:01,609 --> 04:32:02,043
PRESENTATIONS TODAY.

7399
04:32:02,043 --> 04:32:03,911
ORGANIZATIONS AND PROVIDERS LACK

7400
04:32:03,911 --> 04:32:05,313
THE NECESSARY TOOLS THEY NEED TO

7401
04:32:05,313 --> 04:32:07,715
MAKE DIFFERENCES IN THEIR

7402
04:32:07,715 --> 04:32:08,349
PRACTICE.

7403
04:32:08,349 --> 04:32:10,017
AND SOME INTERVENTIONS WHICH

7404
04:32:10,017 --> 04:32:11,686
SEEM EFFICACIOUS IN RESEARCH

7405
04:32:11,686 --> 04:32:12,987
STUDIES MAY NOT ACTUALLY MEET

7406
04:32:12,987 --> 04:32:14,955
THE NEEDS OF THE POPULATIONS

7407
04:32:14,955 --> 04:32:16,324
THAT THEY ARE INTENDED FOR OR

7408
04:32:16,324 --> 04:32:18,592
WHO REALLY HAVE THE BIGGEST

7409
04:32:18,592 --> 04:32:19,994
DISPARITIES IN THOSE OUTCOMES.

7410
04:32:19,994 --> 04:32:23,597
AND SO WE THINK ABOUT THESE

7411
04:32:23,597 --> 04:32:24,865
FACTORS THAT IMPACT OUR ATTEMPTS

7412
04:32:24,865 --> 04:32:26,767
TO IMPLEMENT CHANGES IN

7413
04:32:26,767 --> 04:32:27,468
EVIDENCE-BASED PRACTICES, AND

7414
04:32:27,468 --> 04:32:29,337
YOU COULD GO ON AND ON ABOUT A

7415
04:32:29,337 --> 04:32:31,706
LIST BUT SOME OF THEM ARE THE

7416
04:32:31,706 --> 04:32:34,642
PHYSICAL ENVIRONMENT WE'RE

7417
04:32:34,642 --> 04:32:36,177
PRACTICING IN, THE MANY

7418
04:32:36,177 --> 04:32:36,711
SOCIOECONOMIC AND SOCIAL

7419
04:32:36,711 --> 04:32:37,912
CONTEXTS YOU BROUGHT UP TODAY

7420
04:32:37,912 --> 04:32:39,914
AND THE HEALTH SYSTEM AND END

7421
04:32:39,914 --> 04:32:40,448
USER CHARACTERISTICS WE'RE

7422
04:32:40,448 --> 04:32:43,084
TAKING CARE OF.

7423
04:32:43,084 --> 04:32:44,185
IT'S REALLY NOT SURPRISING

7424
04:32:44,185 --> 04:32:45,820
EVIDENCE-BASED PRACTICES WE

7425
04:32:45,820 --> 04:32:47,288
BELIEVE COULD IMPROVE OBSTETRIC

7426
04:32:47,288 --> 04:32:49,990
OUTCOMES HAVEN'T MADE THEIR WAY

7427
04:32:49,990 --> 04:32:50,991
INTO WIDESPREAD USE.

7428
04:32:50,991 --> 04:32:52,960
AND SO THE GOAL OF

7429
04:32:52,960 --> 04:32:54,495
IMPLEMENTATION SCIENCE IS TO

7430
04:32:54,495 --> 04:32:56,230
HAVE A CONCRETE METHODOLOGY TO

7431
04:32:56,230 --> 04:32:59,066
REALLY BRIDGE THAT EVIDENCE TO

7432
04:32:59,066 --> 04:32:59,400
PRACTICE GAP.

7433
04:32:59,400 --> 04:33:00,401
ONE DEFINITION IMPLEMENTATION

7434
04:33:00,401 --> 04:33:02,737
SCIENCE IS THAT STUDY OF PLANNED

7435
04:33:02,737 --> 04:33:05,139
HUMAN BEHAVIORAL CHANGE UNDER

7436
04:33:05,139 --> 04:33:05,806
ORGANIZATIONAL CONSTRAINTS THAT

7437
04:33:05,806 --> 04:33:07,675
WE ARE ALL PRACTICING IN.

7438
04:33:07,675 --> 04:33:09,744
THE FIELD OF IMPLEMENTATION

7439
04:33:09,744 --> 04:33:12,513
SCIENCE BRINGS TOGETHER TONS OF

7440
04:33:12,513 --> 04:33:14,248
FIELDS, FROM PUBLIC HEALTH AND

7441
04:33:14,248 --> 04:33:16,117
PSYCHOLOGY, BEHAVIORAL SCIENCE

7442
04:33:16,117 --> 04:33:18,519
TO COMMUNITY PARTNERED RESEARCH,

7443
04:33:18,519 --> 04:33:20,388
TO HUMAN FACTORS, ENGINEERING,

7444
04:33:20,388 --> 04:33:22,890
ORGANIZATIONAL THEORY TO ANSWER

7445
04:33:22,890 --> 04:33:26,260
SOME QUESTIONS.

7446
04:33:26,260 --> 04:33:27,495
SOME FIELDS HAVE BEEN AROUND

7447
04:33:27,495 --> 04:33:28,896
FOREVER BUT WE HAVEN'T USED THEM

7448
04:33:28,896 --> 04:33:30,664
WELL IN HEALTH CARE.

7449
04:33:30,664 --> 04:33:32,733
YOU'VE ALL BROUGHT UP MANY

7450
04:33:32,733 --> 04:33:33,968
EVIDENCE-BASED PRACTICES TODAY

7451
04:33:33,968 --> 04:33:44,011
THAT EXIST IN MATERNAL

7452
04:33:44,011 --> 04:33:44,245
 HEALTH

7453
04:33:44,245 --> 04:33:44,645
WITH GAPS.

7454
04:33:44,645 --> 04:33:46,514
SOME OF YOU MAY HAVE SEEN THIS

7455
04:33:46,514 --> 04:33:46,981
BEFORE.

7456
04:33:46,981 --> 04:33:50,351
IT IS THE SUBWAY MAP THAT MY

7457
04:33:50,351 --> 04:33:52,319
CO-DIRECTOR HELPED TO DEVELOP OF

7458
04:33:52,319 --> 04:33:54,188
RESEARCH IN GENERAL WHICH STARTS

7459
04:33:54,188 --> 04:33:56,323
UP HERE AT EFFICACY, DO WE HAVE

7460
04:33:56,323 --> 04:33:57,358
AN EVIDENCE-BASED PRACTICE THAT

7461
04:33:57,358 --> 04:33:59,093
WORKS IN CONTROLLED RESEARCH

7462
04:33:59,093 --> 04:33:59,360
SETTINGS?

7463
04:33:59,360 --> 04:34:04,031
AND THEN CAN WE PROVE

7464
04:34:04,031 --> 04:34:05,132
EFFECTIVENESS, DOES THAT WORK IN

7465
04:34:05,132 --> 04:34:06,634
THE REAL WORLD AND THE MOST

7466
04:34:06,634 --> 04:34:07,635
IMPORTANT QUESTION HOW DO WE GET

7467
04:34:07,635 --> 04:34:09,403
PEOPLE TO USE IT.

7468
04:34:09,403 --> 04:34:10,905
SO SOME STUDIES BROUGHT UP TODAY

7469
04:34:10,905 --> 04:34:14,341
LIVE IN THIS CENTRAL PART OF

7470
04:34:14,341 --> 04:34:15,176
HYBRID EFFECTIVENESS

7471
04:34:15,176 --> 04:34:15,776
IMPLEMENTATION TRIAL WORLD, WE

7472
04:34:15,776 --> 04:34:18,179
NEED TO LOOK AT EFFECTIVENESS

7473
04:34:18,179 --> 04:34:20,114
BUT ALSO ALWAYS, ALWAYS NEED TO

7474
04:34:20,114 --> 04:34:21,048
STUDY IMPLEMENTATION.

7475
04:34:21,048 --> 04:34:23,517
I WOULD ARGUE EVEN IN THAT

7476
04:34:23,517 --> 04:34:25,252
EFFICACY STAGE YOU'RE DOING THE

7477
04:34:25,252 --> 04:34:26,520
FIRST GOLD STANDARD RCT OF

7478
04:34:26,520 --> 04:34:29,223
SOMETHING, YOU STILL NEED TO BE

7479
04:34:29,223 --> 04:34:34,728
STARTING WITH ASSESSMENT OF

7480
04:34:34,728 --> 04:34:35,162
IMPLEMENTATION.

7481
04:34:35,162 --> 04:34:35,729
THERE'S SOME EVIDENCE-BASED

7482
04:34:35,729 --> 04:34:36,964
THING THAT NEEDS TO BE

7483
04:34:36,964 --> 04:34:38,933
IMPLEMENTED WITH PARTNERSHIP

7484
04:34:38,933 --> 04:34:39,500
WITH PATIENTS, CLIENTS,

7485
04:34:39,500 --> 04:34:41,135
COMMUNITIES LIKE YOU'RE DOING

7486
04:34:41,135 --> 04:34:42,536
YOUR WORK ALREADY,

7487
04:34:42,536 --> 04:34:43,637
IMPLEMENTATION SCIENCE OUTCOMES

7488
04:34:43,637 --> 04:34:48,776
ARE DIFFERENT THAN TRADITIONAL

7489
04:34:48,776 --> 04:34:49,443
EFFECTIVENESS OUTCOMES, IT'S

7490
04:34:49,443 --> 04:34:51,078
SOMETHING VALUABLE, A PIECE OF

7491
04:34:51,078 --> 04:34:51,445
DATA.

7492
04:34:51,445 --> 04:34:53,481
A LOT OF TIMES WHEN THINKING

7493
04:34:53,481 --> 04:34:54,682
ABOUT A STANDARD RANDOMIZED

7494
04:34:54,682 --> 04:34:56,217
TRIAL YOU'RE WORKING HOW

7495
04:34:56,217 --> 04:34:56,984
DIFFERENCES ARE IMPACTING THE

7496
04:34:56,984 --> 04:35:00,688
QUALITY OF YOUR WORK WHEN IN

7497
04:35:00,688 --> 04:35:01,789
REALITY CONTEXTUAL NUANCE MAKES

7498
04:35:01,789 --> 04:35:03,424
THIS IMPORTANT, WHAT MAKES US

7499
04:35:03,424 --> 04:35:06,927
ANSWER THESE QUESTIONS.

7500
04:35:06,927 --> 04:35:09,129
AND WE HAVE SPECIFIC LANGUAGE,

7501
04:35:09,129 --> 04:35:10,564
METHODS, FRAMEWORKS AND

7502
04:35:10,564 --> 04:35:11,065
STRATEGIES.

7503
04:35:11,065 --> 04:35:15,903
SO TO BRIEFLY COVER WHAT THIS

7504
04:35:15,903 --> 04:35:17,972
FIELD LOOKS LIKE, THERE ARE A

7505
04:35:17,972 --> 04:35:20,174
BREAKDOWN OF THINGS THAT FIT

7506
04:35:20,174 --> 04:35:24,578
INTO THE IMPLEMENTATION SCIENCE

7507
04:35:24,578 --> 04:35:27,314
WORLD, FRAMEWORKS, THEORIES,

7508
04:35:27,314 --> 04:35:28,082
MODELS, STRATEGIES, SPECIFIC

7509
04:35:28,082 --> 04:35:31,051
STUDY DESIGNS AND KEY TOOLS.

7510
04:35:31,051 --> 04:35:33,220
THERE ARE A REPOSITORY OF OVER

7511
04:35:33,220 --> 04:35:34,722
60 THEORY OF MODELS FRAMEWORK

7512
04:35:34,722 --> 04:35:35,389
SPECIFIC TO IMPLEMENTATION, MANY

7513
04:35:35,389 --> 04:35:36,991
OF YOU ARE USING THEM IN THE

7514
04:35:36,991 --> 04:35:39,226
WORK THAT YOU ARE DOING TODAY,

7515
04:35:39,226 --> 04:35:42,630
BUT WHAT WE KNOW IS THESE

7516
04:35:42,630 --> 04:35:44,932
CONCEPTUAL APPROACHES ARE SO

7517
04:35:44,932 --> 04:35:45,599
VALUABLE IN DRIVING

7518
04:35:45,599 --> 04:35:46,100
IMPLEMENTATION, DOESN'T

7519
04:35:46,100 --> 04:35:47,668
NECESSARILY MATTER WHICH ONE YOU

7520
04:35:47,668 --> 04:35:48,736
USE BUT YOU PICK ONE OR MORE

7521
04:35:48,736 --> 04:35:50,638
THAT FIT WITH THE WORK THAT

7522
04:35:50,638 --> 04:35:52,840
YOU'RE DOING TO REALLY FIGURE

7523
04:35:52,840 --> 04:35:56,110
OUT SOMETHING ABOUT YOUR WORK

7524
04:35:56,110 --> 04:35:57,344
AND CONTEXTUALIZE.

7525
04:35:57,344 --> 04:36:01,015
USE THESE BEFORE A PROJECT

7526
04:36:01,015 --> 04:36:02,449
STARTS, DURING IMPLEMENTATION OR

7527
04:36:02,449 --> 04:36:06,053
AFTER TO UNDERSTAND WHY YOU

7528
04:36:06,053 --> 04:36:07,354
SUCCEEDED OR FAILED.

7529
04:36:07,354 --> 04:36:11,492
THERE ARE STRATEGIES THAT ARE

7530
04:36:11,492 --> 04:36:12,726
HOW WE GET IMPLEMENTATION BASED

7531
04:36:12,726 --> 04:36:14,295
INTO PRACTICE, THERE ARE

7532
04:36:14,295 --> 04:36:15,462
COMPENDIUMS OF MORE THAN 50

7533
04:36:15,462 --> 04:36:17,431
STRATEGIES, THINGS YOU MAY BE

7534
04:36:17,431 --> 04:36:19,934
USING BUT MAY NOT HAVE NAMED

7535
04:36:19,934 --> 04:36:21,902
BIKE COMMUNITY AND STAKEHOLDER

7536
04:36:21,902 --> 04:36:26,073
BUY-IN AND INCENTIVES.

7537
04:36:26,073 --> 04:36:30,544
THE BARRIERS WE'VE ALREADY

7538
04:36:30,544 --> 04:36:31,312
IDENTIFIED IN YOUR WORK.

7539
04:36:31,312 --> 04:36:34,281
THERE ARE A SLEW OF OUTCOMES WE

7540
04:36:34,281 --> 04:36:37,117
CAN HELP PEOPLE STUDY CRITICAL

7541
04:36:37,117 --> 04:36:39,086
TO IMPLEMENTATION SUCCESS.

7542
04:36:39,086 --> 04:36:40,721
ACCEPTABILITY FROM THE PATIENT,

7543
04:36:40,721 --> 04:36:44,258
COMMUNITY, OR THE PHYSICIAN

7544
04:36:44,258 --> 04:36:45,159
ANGLE, ADOPTION, APPROPRIATENESS

7545
04:36:45,159 --> 04:36:48,529
FOR THE PLACE YOU'RE TRYING TO

7546
04:36:48,529 --> 04:36:50,831
IMPLEMENT, HOW FEASIBLE, ARE WE

7547
04:36:50,831 --> 04:36:52,333
DOING IT ACCURATELY, FIDELITY,

7548
04:36:52,333 --> 04:36:55,202
COST IS A CRITICAL

7549
04:36:55,202 --> 04:36:55,970
IMPLEMENTATION OUTCOME,

7550
04:36:55,970 --> 04:36:57,404
PRESENTATION, ARE PEOPLE USING

7551
04:36:57,404 --> 04:37:00,808
IT AND BY, YOU KNOW, DIFFERENT

7552
04:37:00,808 --> 04:37:01,875
CLINICIANS, AND SUSTAINABILITY

7553
04:37:01,875 --> 04:37:04,078
WHICH IS SO IGNORED IN OUR WORK,

7554
04:37:04,078 --> 04:37:07,247
CAN WE CONTINUE TO USE THESE

7555
04:37:07,247 --> 04:37:09,650
INTERVENTIONS OVER TIME.

7556
04:37:09,650 --> 04:37:12,052
THE IMPLEMENTATION SCIENCE BEGAN

7557
04:37:12,052 --> 04:37:13,821
IN THE BASICS OF QUALITY

7558
04:37:13,821 --> 04:37:15,122
IMPROVEMENT PEOPLE DOING STUDIES

7559
04:37:15,122 --> 04:37:18,392
SIMPLE PRE AND POST STUDIES,

7560
04:37:18,392 --> 04:37:19,493
DIFFERENCE IN ANALYSIS.

7561
04:37:19,493 --> 04:37:22,463
HOW CAN WE HELP YOU MOVE TO THE

7562
04:37:22,463 --> 04:37:23,764
MORE ADVANCED IMPLEMENTATION

7563
04:37:23,764 --> 04:37:24,398
SCIENCE STUDY DESIGNS THINKING

7564
04:37:24,398 --> 04:37:27,835
ABOUT SMART TRIALS OR ADAPTIVE

7565
04:37:27,835 --> 04:37:29,670
TRIALS THAT WILL ACTUALLY HELP

7566
04:37:29,670 --> 04:37:32,206
GET TRIAL TO END IN SUCCESSFUL

7567
04:37:32,206 --> 04:37:32,940
IMPLEMENTATION RATHER THAN

7568
04:37:32,940 --> 04:37:34,475
WAITING FIVE YEARS TO SEE

7569
04:37:34,475 --> 04:37:37,244
WHETHER YOUR THING WORKED OR

7570
04:37:37,244 --> 04:37:37,678
NOT.

7571
04:37:37,678 --> 04:37:39,079
IMPLEMENTATION SCIENCE ALSO

7572
04:37:39,079 --> 04:37:40,848
TAKES INTO ACCOUNT HEALTH

7573
04:37:40,848 --> 04:37:41,115
EQUITY.

7574
04:37:41,115 --> 04:37:44,318
WE KNOW WE CAN FRAME

7575
04:37:44,318 --> 04:37:46,420
IMPLEMENTATION SCIENCE TO FOCUS

7576
04:37:46,420 --> 04:37:48,155
ON HEALTH DISPARITIES, FOCUS ON

7577
04:37:48,155 --> 04:37:49,490
REACH FROM THE BEGINNING, DESIGN

7578
04:37:49,490 --> 04:37:50,724
AND SELECT INTERVENTIONS WITH

7579
04:37:50,724 --> 04:37:51,925
POPULATIONS IN MIND JUST LIKE

7580
04:37:51,925 --> 04:37:53,794
AGAIN SO MANY OF YOU ARE ALREADY

7581
04:37:53,794 --> 04:37:54,662
DOING.

7582
04:37:54,662 --> 04:37:56,530
WE CAN DEVELOP IMPLEMENTATION

7583
04:37:56,530 --> 04:37:57,831
STRATEGIES THAT SPECIFICALLY

7584
04:37:57,831 --> 04:38:03,270
REDUCE INEQUITIES IN CARE, AND

7585
04:38:03,270 --> 04:38:04,738
ADAPT INTERVENTIONS OTHER TIME.

7586
04:38:04,738 --> 04:38:06,340
AMETHIST@PENN GOAL TO HELP YOU

7587
04:38:06,340 --> 04:38:08,642
INCORPORATE THOSE CONCEPTS I

7588
04:38:08,642 --> 04:38:09,543
DISCUSSED, INTO YOUR WORK AS

7589
04:38:09,543 --> 04:38:11,278
MUCH AS WE CAN.

7590
04:38:11,278 --> 04:38:12,279
AGAIN, UNDERSTANDING THAT MANY

7591
04:38:12,279 --> 04:38:14,348
OF YOU ARE ALREADY DOING THAT TO

7592
04:38:14,348 --> 04:38:15,716
SOME AGREE.

7593
04:38:15,716 --> 04:38:18,085
SO WE'RE SUPPORTING

7594
04:38:18,085 --> 04:38:20,688
IMPLEMENTATION SCIENCE AND

7595
04:38:20,688 --> 04:38:21,889
MATERNAL HEALTH ACROSS IMPROVE

7596
04:38:21,889 --> 04:38:27,227
NETWORK, NOT JUST TO SUPPORT

7597
04:38:27,227 --> 04:38:30,864
CENTERS OF EXCELLENCE BUT TO

7598
04:38:30,864 --> 04:38:32,866
EXPAND TO THE IMPROVE PROGRAMS.

7599
04:38:32,866 --> 04:38:35,803
FOR THOSE WHAT DON'T KNOW ABOUT

7600
04:38:35,803 --> 04:38:37,805
AMETHIST WE'RE BROKEN INTO FIVE

7601
04:38:37,805 --> 04:38:39,740
COURSE, ADMIN AND EQUITY,

7602
04:38:39,740 --> 04:38:41,075
DESIGN, POLICY, AND TRAINING

7603
04:38:41,075 --> 04:38:41,275
CORE.

7604
04:38:41,275 --> 04:38:43,143
I'M GOING COVER WHAT WE'VE DONE

7605
04:38:43,143 --> 04:38:45,112
SO FAR IN THE SPACES AND FOCUS

7606
04:38:45,112 --> 04:38:46,547
ON THE FUTURE AND HOW WE CAN

7607
04:38:46,547 --> 04:38:49,383
HELP YOU THROUGH THE NEXT FEW

7608
04:38:49,383 --> 04:38:49,650
YEARS.

7609
04:38:49,650 --> 04:39:00,060
THIS IS JUST TO SHOW THE

7610
04:39:01,829 --> 04:39:02,296
LEADERSHIP.

7611
04:39:02,296 --> 04:39:04,498
IN TALKING ABOUT ADMIN CORE ONE

7612
04:39:04,498 --> 04:39:07,468
THINK THING WE ACCOMPLISHED IN

7613
04:39:07,468 --> 04:39:10,404
YEAR ONE IS COMPLETED A BASELINE

7614
04:39:10,404 --> 04:39:10,738
SURVEY.

7615
04:39:10,738 --> 04:39:13,240
WE GAINED INFORMATION ABOUT

7616
04:39:13,240 --> 04:39:15,409
WHERE THE CENTERS OF EXCELLENCE

7617
04:39:15,409 --> 04:39:17,711
ARE WHERE THEY WERE COMING FROM

7618
04:39:17,711 --> 04:39:19,246
IN TERMS OF IMPLEMENTATION

7619
04:39:19,246 --> 04:39:20,481
SCIENCE EXPERTISE.

7620
04:39:20,481 --> 04:39:22,015
THERE'S A HUGE VARIETY, WHAT WE

7621
04:39:22,015 --> 04:39:22,649
LEARNED.

7622
04:39:22,649 --> 04:39:24,418
PEOPLE ARE COMING FROM A BIG

7623
04:39:24,418 --> 04:39:25,919
RANGE OF IDEAS.

7624
04:39:25,919 --> 04:39:28,322
PEOPLE WERE PLANNING TO USE

7625
04:39:28,322 --> 04:39:29,223
QUALITATIVE AND MIXED METHODS,

7626
04:39:29,223 --> 04:39:33,160
LESS IN SOME MORE RIGOROUS

7627
04:39:33,160 --> 04:39:34,228
IMPLEMENTATION STUDY DESIGNS,

7628
04:39:34,228 --> 04:39:35,996
HALF WERE THINKING ABOUT USING

7629
04:39:35,996 --> 04:39:38,499
AT LEAST ONE IMPLEMENTATION

7630
04:39:38,499 --> 04:39:40,901
OUTCOME, MORE COMMONLY WERE

7631
04:39:40,901 --> 04:39:42,903
ACCEPTABILITY AND AFFORDABILITY,

7632
04:39:42,903 --> 04:39:43,137
EQUITY.

7633
04:39:43,137 --> 04:39:45,205
PEOPLE REPORTED STRENGTH IN

7634
04:39:45,205 --> 04:39:46,273
INCORPORATING IMPLEMENTATION

7635
04:39:46,273 --> 04:39:47,908
FRAMEWORKS INTO THEIR WORK BUT

7636
04:39:47,908 --> 04:39:51,111
LESS STRENGTH IN MEASURING

7637
04:39:51,111 --> 04:39:51,845
IMPLEMENTATION OUTCOMES, THESE

7638
04:39:51,845 --> 04:39:53,614
ARE SOME THINGS WE'VE BEEN

7639
04:39:53,614 --> 04:39:55,048
FOCUSED ON OVER THE NEXT YEAR.

7640
04:39:55,048 --> 04:39:58,852
FROM AN EQUITY COMMUNITY AND

7641
04:39:58,852 --> 04:39:59,319
STAKEHOLDER ENGAGEMENT

7642
04:39:59,319 --> 04:40:01,155
PERSPECTIVE, ANOTHER CORE I'LL

7643
04:40:01,155 --> 04:40:01,955
GET INTO DETAIL ABOUT, WE FOUND

7644
04:40:01,955 --> 04:40:04,324
ALL OF THE CENTERS OF EXCELLENCE

7645
04:40:04,324 --> 04:40:07,528
WERE COMING FROM A LOT OF

7646
04:40:07,528 --> 04:40:09,029
STRENGTHS IN THOSE PLACES, MAYBE

7647
04:40:09,029 --> 04:40:11,899
WE NEEDED TO CHANGE OUR ANGLE

7648
04:40:11,899 --> 04:40:16,069
WHERE THE CORE WAS COMING FROM.

7649
04:40:16,069 --> 04:40:16,837
POLICY, DISSEMINATION AND

7650
04:40:16,837 --> 04:40:18,672
COMMUNICATION, THERE WAS

7651
04:40:18,672 --> 04:40:19,573
GREATEST NEED, WE FOCUSED

7652
04:40:19,573 --> 04:40:22,643
DEVELOPMENT OF RESOURCES IN THIS

7653
04:40:22,643 --> 04:40:23,277
SPACE.

7654
04:40:23,277 --> 04:40:24,711
THERE WAS LESS EXPERIENCE WITH

7655
04:40:24,711 --> 04:40:27,548
STORY TELLING OR COMMUNICATING

7656
04:40:27,548 --> 04:40:30,117
WITH POLICY OR ENCOURAGING AND

7657
04:40:30,117 --> 04:40:30,851
COMMUNICATION-BACKED

7658
04:40:30,851 --> 04:40:32,052
STAKEHOLDERS IN TERMS OF

7659
04:40:32,052 --> 04:40:33,420
RESEARCH FINDINGS.

7660
04:40:33,420 --> 04:40:35,322
TRAINING AND CAPACITY IN REGARD

7661
04:40:35,322 --> 04:40:37,191
TO IMPLEMENTATION SCIENCE

7662
04:40:37,191 --> 04:40:37,791
TRAINING SPECIFICALLY REALLY

7663
04:40:37,791 --> 04:40:39,827
VARIED, AS YOU CAN SEE IT'S

7664
04:40:39,827 --> 04:40:42,462
EVENLY BROKEN DOWN BETWEEN

7665
04:40:42,462 --> 04:40:43,530
BEGINNER, INTERMEDIATE, ADVANCED

7666
04:40:43,530 --> 04:40:44,731
EXPERIENCE FROM THE

7667
04:40:44,731 --> 04:40:46,834
IMPLEMENTATION SCIENCE FACULTY

7668
04:40:46,834 --> 04:40:47,801
AND WHAT TRAINING PROGRAMS

7669
04:40:47,801 --> 04:40:48,669
LOOKED LIKE.

7670
04:40:48,669 --> 04:40:50,170
THIS FULL REPORT IS AVAILABLE TO

7671
04:40:50,170 --> 04:40:54,374
ALL OF YOU ON THE WEBSITE.

7672
04:40:54,374 --> 04:40:56,343
THE OTHER THINGS THE ADMIN CORE

7673
04:40:56,343 --> 04:40:57,311
WORK ON OTHER THAN COLLABORATING

7674
04:40:57,311 --> 04:40:59,813
WITH ALL OF YOU AND THE NICHD

7675
04:40:59,813 --> 04:41:03,584
AND OUR HUB IS OUR VIRTUAL SITE

7676
04:41:03,584 --> 04:41:05,919
VISIT COMPLETED WITH 12 COEs

7677
04:41:05,919 --> 04:41:10,023
AND FIRST OF THE IMPROVE CYPs.

7678
04:41:10,023 --> 04:41:12,659
WE'VE COLLECTED GRANTS FROM THE

7679
04:41:12,659 --> 04:41:14,928
MAJORITY OF CENTERS, GRANT

7680
04:41:14,928 --> 04:41:18,932
ABSTRACTED TO HELP YOU BEST MOVE

7681
04:41:18,932 --> 04:41:19,233
FORWARD.

7682
04:41:19,233 --> 04:41:21,768
NEXT THE YEAR 2 SURVEY WILL BE

7683
04:41:21,768 --> 04:41:24,338
GOING OUT, AND THE GOAL IS TO

7684
04:41:24,338 --> 04:41:27,241
MOVE AHEAD, REALLY NOT TO REPEAT

7685
04:41:27,241 --> 04:41:28,375
WHAT WE KNOW ABOUT THE WORK YOU

7686
04:41:28,375 --> 04:41:30,844
HAVE PLANNED BUT WHAT ARE THE

7687
04:41:30,844 --> 04:41:32,379
ISSUES, THE BARRIERS, HOW CAN WE

7688
04:41:32,379 --> 04:41:34,882
HELP YOU OVERCOME THEM.

7689
04:41:34,882 --> 04:41:37,517
WE PLAN TO ENGAGE OUTSIDE

7690
04:41:37,517 --> 04:41:39,553
COEs, AND THE AIM TO BEGIN

7691
04:41:39,553 --> 04:41:42,022
MIXED METHOD WORK OF THE

7692
04:41:42,022 --> 04:41:47,828
BARRIERS AND  FACILITATORS,

7693
04:41:47,828 --> 04:41:49,496
YOU'LL HEAR FROM US HOW TO

7694
04:41:49,496 --> 04:41:53,967
ENGAGE IN THAT AND HOPE BOTH YOU

7695
04:41:53,967 --> 04:41:55,836
AND RESEARCHERS, TRAINEES,

7696
04:41:55,836 --> 04:41:56,803
COMMUNITY PARTNERS, WILL HELP

7697
04:41:56,803 --> 04:41:58,505
ENGAGE IN SOME OF THAT RESEARCH

7698
04:41:58,505 --> 04:42:00,741
FOR US TO HELP ANSWER

7699
04:42:00,741 --> 04:42:04,344
GENERALIZABLE QUESTIONS IN THE

7700
04:42:04,344 --> 04:42:04,544
SPACE.

7701
04:42:04,544 --> 04:42:08,415
THE EQUITY CORE'S PURCHASE TO

7702
04:42:08,415 --> 04:42:09,850
CONVENE EQUITY ENHANCEMENT

7703
04:42:09,850 --> 04:42:12,819
COLLABORATIVE, AN AMAZING

7704
04:42:12,819 --> 04:42:14,788
PROGRAM WITH THREE MEETINGS WITH

7705
04:42:14,788 --> 04:42:18,058
MULTIPLE SITES GROUPED AGAIN IN

7706
04:42:18,058 --> 04:42:19,393
THESE POPULATION CONTEXTS.

7707
04:42:19,393 --> 04:42:21,795
SIMILAR TO WHAT THE DATA HUB HAD

7708
04:42:21,795 --> 04:42:22,896
SPOKEN ABOUT.

7709
04:42:22,896 --> 04:42:24,431
THESE ARE WAYS FOR THESE GROUPS

7710
04:42:24,431 --> 04:42:26,300
TO COME TOGETHER AND TALK ABOUT

7711
04:42:26,300 --> 04:42:29,469
THE ISSUES THEY ARE HAVING IN

7712
04:42:29,469 --> 04:42:31,238
BOTH ENGAGING COMMUNITY PARTNERS

7713
04:42:31,238 --> 04:42:32,973
IN THE WORK THEY ARE DOING,

7714
04:42:32,973 --> 04:42:34,374
COMMUNITY PARTNERS TO TALK ABOUT

7715
04:42:34,374 --> 04:42:35,876
ISSUES WITH ENGAGING WITH

7716
04:42:35,876 --> 04:42:38,779
RESEARCHERS, AND ALSO TO TALK

7717
04:42:38,779 --> 04:42:40,514
ABOUT ISSUES WITH ENROLLING AND

7718
04:42:40,514 --> 04:42:41,381
SUSTAINING RELATIONSHIPS WITH

7719
04:42:41,381 --> 04:42:43,116
THE POPULATIONS THEY ARE TRYING

7720
04:42:43,116 --> 04:42:45,085
TO WORK WITH IN THEIR TRIALS.

7721
04:42:45,085 --> 04:42:48,155
SO THERE'S A COUPLE ANGLES HERE.

7722
04:42:48,155 --> 04:42:53,527
OUR GOAL AT THE END IS TO

7723
04:42:53,527 --> 04:42:54,261
GENERATE EQUITY CONSIDERATION

7724
04:42:54,261 --> 04:42:56,263
REPORT, THE FIRST IS WORKED ON

7725
04:42:56,263 --> 04:42:58,565
NOW, TAKING DATA WE'VE ATTAINED

7726
04:42:58,565 --> 04:43:01,301
FROM THE REPORTS LOOKING FOR

7727
04:43:01,301 --> 04:43:07,574
GENERALIZABLE MESSAGES , HELPING

7728
04:43:07,574 --> 04:43:11,478
US IN THIS ROOM AND NATIONALLY

7729
04:43:11,478 --> 04:43:11,912
MOVING EQUITY AHEAD.

7730
04:43:11,912 --> 04:43:20,253
THIS IS WHAT OUR LAB A --

7731
04:43:20,253 --> 04:43:21,722
COLLABORATIVE LOOKS LIKE, A

7732
04:43:21,722 --> 04:43:23,523
VARIETY OF SPECIALISTS TAKING

7733
04:43:23,523 --> 04:43:26,259
CARE OF RURAL AND INDIGENOUS

7734
04:43:26,259 --> 04:43:28,462
POPULATIONS, FOCUSING ON EQUITY

7735
04:43:28,462 --> 04:43:32,065
AND LGBTQ OR BIPOC OR

7736
04:43:32,065 --> 04:43:33,367
REPRODUCTIVE JUSTICE.

7737
04:43:33,367 --> 04:43:35,869
OUR DESIGN CORE, A GREAT WAY TO

7738
04:43:35,869 --> 04:43:36,737
BEGIN INITIATE YOUR RELATIONSHIP

7739
04:43:36,737 --> 04:43:39,172
WITH US IF YOU HAVEN'T MUCH

7740
04:43:39,172 --> 04:43:40,574
ALREADY IS REALLY THE PURPOSE TO

7741
04:43:40,574 --> 04:43:43,844
BRING TOGETHER A GROUP OF

7742
04:43:43,844 --> 04:43:44,945
INDIVIDUALS HERE TO SUPPORT YOU

7743
04:43:44,945 --> 04:43:47,247
IN THE WORK YOU'RE DOING.

7744
04:43:47,247 --> 04:43:51,218
WE HAVE A CONSULTANT PANEL OF

7745
04:43:51,218 --> 04:43:55,789
SPECIALISTS IN DIFFERENT AREAS

7746
04:43:55,789 --> 04:43:57,391
OF IMPLEMENTATION SCIENCE AND

7747
04:43:57,391 --> 04:43:58,425
CLINICAL TOPICS, BRINGING A TEAM

7748
04:43:58,425 --> 04:43:59,960
OF PEOPLE TOGETHER TO MEET WITH

7749
04:43:59,960 --> 04:44:02,162
YOU AND YOUR STUDY TEAM TO

7750
04:44:02,162 --> 04:44:06,767
ANSWER A TARGETED AND SPECIFIC

7751
04:44:06,767 --> 04:44:07,601
QUESTION.

7752
04:44:07,601 --> 04:44:10,704
SO WE HOLD INDIVIDUAL CONSULTS,

7753
04:44:10,704 --> 04:44:13,340
SUCCESSFUL FOR SOME GROUPS BUT

7754
04:44:13,340 --> 04:44:14,674
THAT GROUP CONSULTATION MAY BE A

7755
04:44:14,674 --> 04:44:18,812
NEW METHOD SO OVER THE NEXT YEAR

7756
04:44:18,812 --> 04:44:19,679
WE'LL WORK ON GROUP

7757
04:44:19,679 --> 04:44:21,114
CONSULTATIONS, PEOPLE FEEL LIKE

7758
04:44:21,114 --> 04:44:23,283
SPENDING AN HOUR OF TIME ON ONE

7759
04:44:23,283 --> 04:44:24,184
QUESTION THEY MIGHT NOT FEEL

7760
04:44:24,184 --> 04:44:25,719
LIKE THE QUESTION IS BIG ENOUGH.

7761
04:44:25,719 --> 04:44:27,421
AND SO OUR FIRST GROUP

7762
04:44:27,421 --> 04:44:30,190
CONSULTATION IS AT THE END OF

7763
04:44:30,190 --> 04:44:31,625
THIS MONTH, ON RAPID QUALITATIVE

7764
04:44:31,625 --> 04:44:34,327
ANALYSIS, PEOPLE CONSIDERING

7765
04:44:34,327 --> 04:44:36,530
USING THAT TYPE OF METHODOLOGY.

7766
04:44:36,530 --> 04:44:40,033
WE'RE HIGHLIGHTING CONSULTANTS

7767
04:44:40,033 --> 04:44:41,134
IN NEWSLETTERS, HOPEFULLY YOU'RE

7768
04:44:41,134 --> 04:44:42,669
GETTING THAT, IF NOT LET US

7769
04:44:42,669 --> 04:44:44,304
KNOW, SO YOU CAN SEE SOME AREAS

7770
04:44:44,304 --> 04:44:46,139
YOU NEVER EVEN THOUGHT TO

7771
04:44:46,139 --> 04:44:48,475
UTILIZE IN YOUR WORK SUCH AS

7772
04:44:48,475 --> 04:44:49,476
BEHAVIORAL ECONOMICS OR

7773
04:44:49,476 --> 04:44:54,281
ORGANIZATIONAL THEORY THAT MIGHT

7774
04:44:54,281 --> 04:44:58,485
BE HELPFUL AS WE MOVE AHEAD.

7775
04:44:58,485 --> 04:45:05,692
WE HELD FOUR OR FIVE TOPIC

7776
04:45:05,692 --> 04:45:09,396
FORUMS, MEASURING ACCEPTABILITY,

7777
04:45:09,396 --> 04:45:10,497
MEASURING REACH IN RESEARCH,

7778
04:45:10,497 --> 04:45:12,599
TURNED EACH INTO A RESOURCE

7779
04:45:12,599 --> 04:45:13,900
DOCUMENT, WORKING ON GETTING

7780
04:45:13,900 --> 04:45:18,472
THAT OUT VIA THE WEBSITE THAT

7781
04:45:18,472 --> 04:45:21,641
WILL HOPEFULLY GUIDE YOU THREE

7782
04:45:21,641 --> 04:45:22,576
UTILIZATION AT ANY POINT YOU

7783
04:45:22,576 --> 04:45:24,611
WANT TO REFER IT TO.

7784
04:45:24,611 --> 04:45:27,647
WE HAVE A MEASURE REPOSITORY

7785
04:45:27,647 --> 04:45:29,950
THAT HASN'T BEEN USED, IF YOU'RE

7786
04:45:29,950 --> 04:45:32,252
INTERESTED IN POSTING A SURVEY

7787
04:45:32,252 --> 04:45:33,787
OR AN INTERVIEW GUIDE FOR

7788
04:45:33,787 --> 04:45:35,856
SOMETHING THAT YOU'RE TRYING

7789
04:45:35,856 --> 04:45:37,424
ASSESS, THEN THAT IS A GREAT

7790
04:45:37,424 --> 04:45:39,593
PLACE TO PUT IT AND HOPEFULLY

7791
04:45:39,593 --> 04:45:42,562
WE'LL HAVE SOME COLLABORATION IN

7792
04:45:42,562 --> 04:45:43,296
THAT SPACE.

7793
04:45:43,296 --> 04:45:45,532
POLICY CORE FOCUSES ON MEDIA

7794
04:45:45,532 --> 04:45:49,102
TRAINING, OP ED AND LAY PRESS

7795
04:45:49,102 --> 04:45:50,871
WRITING, TEACHING OR HELPING

7796
04:45:50,871 --> 04:45:55,275
PATIENT PARTNERS TELL THEIR

7797
04:45:55,275 --> 04:45:55,742
STORIES.

7798
04:45:55,742 --> 04:45:59,980
WE'VE HAD A COUPLE OF THESE

7799
04:45:59,980 --> 04:46:00,714
POLICY-RELATED WORKSHOPS, AND

7800
04:46:00,714 --> 04:46:08,522
OUR PATIENT PARTNER IS AN 

7801
04:46:08,522 --> 04:46:10,824
AMAZING SPEAKER AND HUMAN HAS A

7802
04:46:10,824 --> 04:46:12,459
VIDEO TO BEGIN THAT PROCESS FOR

7803
04:46:12,459 --> 04:46:14,194
YOU IF THAT'S SOMETHING YOU'RE

7804
04:46:14,194 --> 04:46:16,429
INTERESTED IN.

7805
04:46:16,429 --> 04:46:18,465
SHE ALSO WILL HELP YOU RECRUIT

7806
04:46:18,465 --> 04:46:19,666
PATIENTS TO BE PART OF TELLING

7807
04:46:19,666 --> 04:46:21,701
THEIR STORY AS PART OF YOUR WORK

7808
04:46:21,701 --> 04:46:25,071
SO THERE'S A LOT OF PIECES HERE.

7809
04:46:25,071 --> 04:46:26,373
POLICY DAY, FIRST ONE, PLANNED

7810
04:46:26,373 --> 04:46:27,374
FOR NEXT SPRING.

7811
04:46:27,374 --> 04:46:29,209
YOU'LL HEAR MORE ABOUT THAT.

7812
04:46:29,209 --> 04:46:31,077
WE KNOW POLICY CAN FEEL

7813
04:46:31,077 --> 04:46:35,015
OVERWHELMING WHEN YOU HAVEN'T

7814
04:46:35,015 --> 04:46:36,349
ACTUALLY COMPLETED YOUR RESEARCH

7815
04:46:36,349 --> 04:46:37,150
PROJECT, AND HAD SPECIFIC DATA

7816
04:46:37,150 --> 04:46:38,785
TO PRESENT AS OF YET BUT ALL OF

7817
04:46:38,785 --> 04:46:40,420
YOU ARE COMING FROM A PLACE

7818
04:46:40,420 --> 04:46:43,390
FOCUSING ON AN ISSUE THAT'S OF

7819
04:46:43,390 --> 04:46:45,392
CRITICAL IMPORTANCE TO LAWMAKERS

7820
04:46:45,392 --> 04:46:46,560
AND POLICYMAKERS AND THERE ARE

7821
04:46:46,560 --> 04:46:49,596
THINGS TO SAY EVEN WHERE YOU'RE

7822
04:46:49,596 --> 04:46:50,864
AT IN YOUR RESEARCH PROJECTS AND

7823
04:46:50,864 --> 04:46:51,798
YOUR CENTER.

7824
04:46:51,798 --> 04:46:57,938
IN TERMS OF TRAINING CORE WE

7825
04:46:57,938 --> 04:47:00,674
HAVE MONTHLY SEMINARS ACROSS A

7826
04:47:00,674 --> 04:47:04,044
TOPICS ACROSS AN ARRAY OF

7827
04:47:04,044 --> 04:47:05,145
ISSUES.

7828
04:47:05,145 --> 04:47:08,515
WE HAVE THE PENN IMPLEMENTATION

7829
04:47:08,515 --> 04:47:09,616
SCIENCE INSTITUTE, WE SPONSORED

7830
04:47:09,616 --> 04:47:10,717
11 PARTICIPANTS FROM CENTERS OF

7831
04:47:10,717 --> 04:47:13,553
EXCELLENCE TO COME AND DO A

7832
04:47:13,553 --> 04:47:14,788
MATERNAL HEALTH TRACK, AMAZING

7833
04:47:14,788 --> 04:47:15,422
AND INTERACTIVE.

7834
04:47:15,422 --> 04:47:17,290
NEXT WILL BE IN JUNE OF NEXT

7835
04:47:17,290 --> 04:47:17,724
YEAR.

7836
04:47:17,724 --> 04:47:21,895
LOOK OUT FOR A  ALL FOR THAT.

7837
04:47:21,895 --> 04:47:24,664
WE HOLD AN ANNUAL IN-PERSON

7838
04:47:24,664 --> 04:47:29,436
GATHERING, THE NEXT ONE WILL BE

7839
04:47:29,436 --> 04:47:31,204
IN DECEMBER AT ACADEMY HEALTH,

7840
04:47:31,204 --> 04:47:34,774
SIGN-UPS ARE AVAILABLE IN THE

7841
04:47:34,774 --> 04:47:36,142
NEWSLETTER.

7842
04:47:36,142 --> 04:47:37,877
TRAINEE OFFICE HOURS TO TALK

7843
04:47:37,877 --> 04:47:39,212
ABOUT THE RESEARCH THEY ARE

7844
04:47:39,212 --> 04:47:41,047
DOING, GET IDEAS AND FEEDBACK.

7845
04:47:41,047 --> 04:47:42,916
BEGINNING THIS YEAR OUR REACH

7846
04:47:42,916 --> 04:47:44,551
PROGRAM WHICH TRAINS

7847
04:47:44,551 --> 04:47:45,118
INVESTIGATORS AND COMMUNITY

7848
04:47:45,118 --> 04:47:46,519
PARTNERS TO WORK TOGETHER.

7849
04:47:46,519 --> 04:47:49,155
WE KNOW THE COMPLEXITY OF THAT

7850
04:47:49,155 --> 04:47:52,559
RELATIONSHIP IS HIGH.

7851
04:47:52,559 --> 04:47:54,427
FINALLY, MY LAST SLIDE, PILOT

7852
04:47:54,427 --> 04:47:55,528
GRANT PROGRAM.

7853
04:47:55,528 --> 04:48:00,000
WE FUNDED THE FIRST THREE THIS

7854
04:48:00,000 --> 04:48:01,434
YEAR FOR EXCITING TOPICS, FOR

7855
04:48:01,434 --> 04:48:05,138
TWO PEOPLE FROM DIFFERENT

7856
04:48:05,138 --> 04:48:06,906
CENTERS OF EXCELLENCE, AND ONE

7857
04:48:06,906 --> 04:48:10,176
INTERNAL PERSON TO DO EXCITING

7858
04:48:10,176 --> 04:48:12,579
WORK ON IMPLEMENTATION SCIENCE,

7859
04:48:12,579 --> 04:48:14,547
SUBPROJECTS OF THEIR OVERARCHING

7860
04:48:14,547 --> 04:48:17,083
COE WORK AND FURTHER

7861
04:48:17,083 --> 04:48:20,120
IMPLEMENTATION SCIENCE, THE NEXT

7862
04:48:20,120 --> 04:48:22,322
CALL IN JUNE, WE'LL FOCUS ON ONE

7863
04:48:22,322 --> 04:48:24,324
FOR A COMMUNITY PARTNER,

7864
04:48:24,324 --> 04:48:27,127
MATERNAL HEALTH AND

7865
04:48:27,127 --> 04:48:27,627
IMPLEMENTATION RESEARCH

7866
04:48:27,627 --> 04:48:28,328
SCIENTIST RESEARCH SCHOLAR WHO

7867
04:48:28,328 --> 04:48:30,196
YOU HEARD EARLIER TODAY.

7868
04:48:30,196 --> 04:48:32,165
SHE HAS BEEN A FANTASTIC START

7869
04:48:32,165 --> 04:48:34,234
TO THE PROGRAM, DOING THAT EACH

7870
04:48:34,234 --> 04:48:35,101
YEAR.

7871
04:48:35,101 --> 04:48:36,970
NEXT APPLICATIONS OPEN IN

7872
04:48:36,970 --> 04:48:38,638
JANUARY, WE'RE OPENING A NURSE

7873
04:48:38,638 --> 04:48:39,639
SCHOLAR PROGRAM PARALLEL FOR

7874
04:48:39,639 --> 04:48:40,807
NEXT YEAR AS THAT.

7875
04:48:40,807 --> 04:48:42,676
WE HAVE INTERNAL POSTDOCS AND

7876
04:48:42,676 --> 04:48:43,043
SUMMER STUDENTS.

7877
04:48:43,043 --> 04:48:45,078
I THANK ALL OF YOU WHO

7878
04:48:45,078 --> 04:48:46,313
PARTICIPATED IN OUR SUMMER

7879
04:48:46,313 --> 04:48:48,081
STUDENTS RESEARCH PROGRAM TRYING

7880
04:48:48,081 --> 04:48:50,483
TO GENERATE A MEASURE TO ASSESS

7881
04:48:50,483 --> 04:48:51,918
QUALITY OF EQUITABLE

7882
04:48:51,918 --> 04:48:52,919
RELATIONSHIPS BETWEEN COMMUNITY

7883
04:48:52,919 --> 04:48:53,987
PARTNERS AND RESEARCHERS AND

7884
04:48:53,987 --> 04:48:55,722
THAT I THINK IS GOING TO BE A

7885
04:48:55,722 --> 04:48:57,924
REALLY EXCITING PROJECT THAT

7886
04:48:57,924 --> 04:48:58,925
CONTINUES TO MOVE AHEAD.

7887
04:48:58,925 --> 04:49:00,427
THANK YOU TO THE NIH AND THANK

7888
04:49:00,427 --> 04:49:02,529
YOU TO ALL OF YOU FOR LISTENING

7889
04:49:02,529 --> 04:49:06,032
AND CONTRIBUTING AND BEING PART

7890
04:49:06,032 --> 04:49:06,666
OF OUR HUB.

7891
04:49:06,666 --> 04:49:10,170
IF THERE'S YOU INNING  -- IF

7892
04:49:10,170 --> 04:49:12,038
THERE'S ANYTHING YOU NEED OR

7893
04:49:12,038 --> 04:49:13,373
WANT FROM US WE'RE HELP TO

7894
04:49:13,373 --> 04:49:15,875
ADJUST SO PLEASE LET US KNOW.

7895
04:49:15,875 --> 04:49:20,146
>> WE HAVE ABOUT A MINUTE
FOR

7896
04:49:20,146 --> 04:49:20,814
QUESTIONS.

7897
04:49:20,814 --> 04:49:24,651
IF YOU HAVE QUESTIONS COME TO

7898
04:49:24,651 --> 04:49:27,787
THE MIC. 

7899
04:49:27,787 --> 04:49:30,957
>> THANK YOU FOR THAT.

7900
04:49:30,957 --> 04:49:32,192
EMILY LITTLE, NURTURE LEE.

7901
04:49:32,192 --> 04:49:34,461
I HEARD YOU HIGHLIGHT CENTERS OF

7902
04:49:34,461 --> 04:49:35,662
EXCELLENCE A LOT.

7903
04:49:35,662 --> 04:49:41,267
AND WE'RE NOT REPRESENTING A

7904
04:49:41,267 --> 04:49:43,536
CENTER OF EXCELLENCE, WE WERE A

7905
04:49:43,536 --> 04:49:44,971
CONNECTING THE COMMUNITY FOR

7906
04:49:44,971 --> 04:49:46,406
MATERNAL HEALTH CHALLENGE

7907
04:49:46,406 --> 04:49:47,607
WINNER, AND OUR RESEARCH AND

7908
04:49:47,607 --> 04:49:50,009
LOVE TO HEAR ABOUT ALL THESE

7909
04:49:50,009 --> 04:49:57,684
RESOURCES AND  CURIOUS IF WE'RE

7910
04:49:57,684 --> 04:49:59,085
ELIGIBLE FOR COLLABORATION.

7911
04:49:59,085 --> 04:50:00,520
>> I APPRECIATE THAT.

7912
04:50:00,520 --> 04:50:03,022
OVER OUR FIRST YEAR WITH THE

7913
04:50:03,022 --> 04:50:04,124
INITIAL FUNDING WE WERE FOCUSED

7914
04:50:04,124 --> 04:50:07,727
ON FIRST CENTERS OF EXCELLENCE,

7915
04:50:07,727 --> 04:50:08,828
NOW THAT WE'RE EXPERIENCING THE

7916
04:50:08,828 --> 04:50:10,163
SPAN OF THE FULL IMPROVE

7917
04:50:10,163 --> 04:50:11,331
INITIATIVE OUR GOAL OVER THE

7918
04:50:11,331 --> 04:50:14,000
NEXT YEAR IS TO EXPAND ALL OF

7919
04:50:14,000 --> 04:50:17,137
THIS TO ENCOMPASS EVERYONE UNDER

7920
04:50:17,137 --> 04:50:18,671
THE IMPROVE UMBRELLA.

7921
04:50:18,671 --> 04:50:21,608
WE'LL GET CONTACTS FOR EVERYONE

7922
04:50:21,608 --> 04:50:22,675
AND MAKE SURE RESOURCES ARE

7923
04:50:22,675 --> 04:50:23,076
AVAILABLE.

7924
04:50:23,076 --> 04:50:27,113
>> THANK YOU.

7925
04:50:27,113 --> 04:50:29,249
>> THANK YOU, THANKS TO
ALL THE

7926
04:50:29,249 --> 04:50:39,759
PRESENTERS FROM SESSION  6.

7927
04:50:39,759 --> 04:50:43,062
WE'LL NOW TRANSITION TO THE NEXT

7928
04:50:43,062 --> 04:50:46,666
SESSION AND INVITE DR. GINA WEI

7929
04:50:46,666 --> 04:50:48,234
TO THE STAGE.

7930
04:50:48,234 --> 04:50:50,103
>> HOME STRETCH.

7931
04:50:50,103 --> 04:50:52,705
WE HAVE ABOUT 40 PEOPLE STILL IN

7932
04:50:52,705 --> 04:50:53,139
ZOOM.

7933
04:50:53,139 --> 04:50:55,575
THAT'S A GOOD NUMBER.

7934
04:50:55,575 --> 04:50:58,845
I CAN'T REALLY SEE THE LIGHT

7935
04:50:58,845 --> 04:51:00,613
HERE, I'M GUESSING PROBABLY

7936
04:51:00,613 --> 04:51:02,682
40ISH AS WELL.

7937
04:51:02,682 --> 04:51:07,086
YEAH, WE'VE STILL GOT 80 PEOPLE

7938
04:51:07,086 --> 04:51:08,154
STRONG HERE, EXCELLENT.

7939
04:51:08,154 --> 04:51:12,325
THE FIRST THING I'M GOING TO DO

7940
04:51:12,325 --> 04:51:13,726
IS REVIEW.

7941
04:51:13,726 --> 04:51:18,465
I THANK MY COLLEAGUES AT NICHD

7942
04:51:18,465 --> 04:51:19,132
FOR DOING THIS.

7943
04:51:19,132 --> 04:51:20,767
THIS IS NOT IT.

7944
04:51:20,767 --> 04:51:22,035
THIS IS OUR QUESTIONS.

7945
04:51:22,035 --> 04:51:27,440
MAYBE IF WE CAN HAVE THE SUPPORT

7946
04:51:27,440 --> 04:51:31,911
BACK THERE TO PUT UP THE SLIDE.

7947
04:51:31,911 --> 04:51:37,951
 

7948
04:51:37,951 --> 04:51:40,687
 

7949
04:51:40,687 --> 04:51:41,921
 

7950
04:51:41,921 --> 04:51:42,922
THERE WE GO.

7951
04:51:42,922 --> 04:51:43,122
THERE.

7952
04:51:43,122 --> 04:51:48,328
EXCELLENT.

7953
04:51:48,328 --> 04:51:48,928
NOT THERE.

7954
04:51:48,928 --> 04:51:50,897
ALMOST.

7955
04:51:50,897 --> 04:51:51,531
95% THERE.

7956
04:51:51,531 --> 04:51:54,601
ALL RIGHT.

7957
04:51:54,601 --> 04:51:54,801
OKAY. 

7958
04:51:54,801 --> 04:51:55,101
GREAT.

7959
04:51:55,101 --> 04:51:57,437
ALL RIGHT.

7960
04:51:57,437 --> 04:52:03,476
 

7961
04:52:03,476 --> 04:52:05,011
 

7962
04:52:05,011 --> 04:52:06,946
I MAY HAVE MESSED IT UP.

7963
04:52:06,946 --> 04:52:08,348
I'M GOING TO NOT TOUCH ANYTHING

7964
04:52:08,348 --> 04:52:15,755
AND LET YOU ALL DO IT AGAIN. 

7965
04:52:15,755 --> 04:52:17,357
 

7966
04:52:17,357 --> 04:52:19,325
ALL RIGHT.

7967
04:52:19,325 --> 04:52:20,527
SO TODAY WAS ANOTHER WONDERFUL

7968
04:52:20,527 --> 04:52:20,860
DAY.

7969
04:52:20,860 --> 04:52:22,095
YESTERDAY WAS A WONDERFUL DAY,

7970
04:52:22,095 --> 04:52:24,030
TODAY IS A WONDERFUL DAY, I

7971
04:52:24,030 --> 04:52:25,031
LEARNED QUITE A LOT.

7972
04:52:25,031 --> 04:52:30,169
WE WANT TO THANK THE TWO NEW

7973
04:52:30,169 --> 04:52:30,436
AWARDEES.

7974
04:52:30,436 --> 04:52:30,737
[APPLAUSE]

7975
04:52:30,737 --> 04:52:32,705
YEAH, I DON'T KNOW IF YOU'RE

7976
04:52:32,705 --> 04:52:34,107
STILL HERE.

7977
04:52:34,107 --> 04:52:35,742
UNIVERSITY OF ILLINOIS, CHICAGO.

7978
04:52:35,742 --> 04:52:36,442
AND UNIVERSITY OF PITTSBURGH.

7979
04:52:36,442 --> 04:52:38,945
I DON'T KNOW IF YOU'RE HERE.

7980
04:52:38,945 --> 04:52:42,649
I DON'T WANT TO CALL YOU OUT.

7981
04:52:42,649 --> 04:52:44,517
YEAH, OKAY, EXCELLENT.

7982
04:52:44,517 --> 04:52:44,884
WELCOME.

7983
04:52:44,884 --> 04:52:48,821
GREAT PRESENTATIONS, GREAT TO

7984
04:52:48,821 --> 04:52:50,189
HAVE YOU.

7985
04:52:50,189 --> 04:52:53,159
IN THE MORNING WE HEARD SPECIAL

7986
04:52:53,159 --> 04:52:57,764
PANELS ON THEMES FROM THE SOCIAL

7987
04:52:57,764 --> 04:52:58,731
DETERMINANTS OF HEALTH.

7988
04:52:58,731 --> 04:53:02,035
REALLY TO ME IT WAS EYE OPENING,

7989
04:53:02,035 --> 04:53:03,102
TRANSPORTATION WITH COMMON ISSUE

7990
04:53:03,102 --> 04:53:05,505
FOR A FEW OF THE RURAL AREAS,

7991
04:53:05,505 --> 04:53:12,078
TWO HOURS TO GET TO OB.

7992
04:53:12,078 --> 04:53:13,413
I COUNT MYSELF FORTUNATE NOT TO

7993
04:53:13,413 --> 04:53:15,148
HAVE TO WORRY ABOUT THAT BUT

7994
04:53:15,148 --> 04:53:16,449
IT'S SOMETHING WE'RE DEALING

7995
04:53:16,449 --> 04:53:18,952
WITH REALITY AND TRYING TO

7996
04:53:18,952 --> 04:53:19,185
ADDRESS.

7997
04:53:19,185 --> 04:53:21,287
SO TRANSPORTATION, DISTANCE TO

7998
04:53:21,287 --> 04:53:29,262
CARE, LIMITED OPTIONS, MA TERCHT

7999
04:53:29,262 --> 04:53:32,332
-- MATERNITY DESERTS.

8000
04:53:32,332 --> 04:53:35,935
LONGSTANDING SYSTEMS THAT

8001
04:53:35,935 --> 04:53:39,305
IMPACT, HOUSING AND STABILITY,

8002
04:53:39,305 --> 04:53:40,640
AND FOOD INSECURITY.

8003
04:53:40,640 --> 04:53:47,213
WE HEARD ABOUT MEASURING

8004
04:53:47,213 --> 04:53:49,582
ALLOSTATIC LOAD, BIOLOGICAL

8005
04:53:49,582 --> 04:53:51,451
WEATHERING, INTERGENERATIONAL

8006
04:53:51,451 --> 04:53:57,457
TRAUMA AS WELL AS JUST

8007
04:53:57,457 --> 04:54:00,627
INTERVENING AT THE MULTI-LEVEL

8008
04:54:00,627 --> 04:54:01,194
INTERVENTIONS.

8009
04:54:01,194 --> 04:54:04,998
WE HEARD ABOUT THE OTHER PANELS,

8010
04:54:04,998 --> 04:54:06,666
WE HEARD EXCITING PANELS ON

8011
04:54:06,666 --> 04:54:09,736
CARDIOVASCULAR AND BLOOD HEALTH,

8012
04:54:09,736 --> 04:54:11,638
HOW TO OPTIMIZE INTERVENTIONS.

8013
04:54:11,638 --> 04:54:12,772
THERE'S TREATMENT SUPPORTS,

8014
04:54:12,772 --> 04:54:14,641
WE'VE GOT TWO TECHNOLOGIES THAT

8015
04:54:14,641 --> 04:54:16,976
WE HEARD TODAY.

8016
04:54:16,976 --> 04:54:18,711
AND JUST DIFFERENT ADVANCEMENTS.

8017
04:54:18,711 --> 04:54:24,417
WE HEARD IMPORTANCE OF ANEMIA,

8018
04:54:24,417 --> 04:54:26,753
HOW THAT'S PREVALENT AND

8019
04:54:26,753 --> 04:54:29,756
UNDERDIAGNOSED, HEMORRHAGE, ALSO

8020
04:54:29,756 --> 04:54:34,560
BLOOD PRESSURE AND PREECLAMPSIA 

8021
04:54:34,560 --> 04:54:35,028
THEN WE HEARD ABOUT

8022
04:54:35,028 --> 04:54:36,996
OPPORTUNITIES TO TRY TO BEND THE

8023
04:54:36,996 --> 04:54:39,065
CURVE, THAT THE NATION IS

8024
04:54:39,065 --> 04:54:42,035
HEADING IN THE WRONG DIRECTION,

8025
04:54:42,035 --> 04:54:44,203
TO BEND IT DOWN AND IMPROVE

8026
04:54:44,203 --> 04:54:45,972
MATERNAL HEALTH.

8027
04:54:45,972 --> 04:54:47,507
SEVERAL DATA INSIGHTS,

8028
04:54:47,507 --> 04:54:50,243
MULTI-LEVEL AND SYSTEMS

8029
04:54:50,243 --> 04:54:53,846
APPROACHES WE HEARD, AND POLICY

8030
04:54:53,846 --> 04:54:55,715
TO IMPROVE THE OUTCOMES, MEASURE

8031
04:54:55,715 --> 04:54:59,218
DATA TO INFLUENCE POLICY AND

8032
04:54:59,218 --> 04:55:01,821
ACTUALLY MEASURED AFTERWARDS TO

8033
04:55:01,821 --> 04:55:02,188
CONTINUE ON.

8034
04:55:02,188 --> 04:55:04,691
THE AFTERNOON PANELS WE HEARD

8035
04:55:04,691 --> 04:55:08,628
ABOUT THE PREDICTION OF JUST

8036
04:55:08,628 --> 04:55:11,798
TRYING TO PREDICT TOOLS AS WELL

8037
04:55:11,798 --> 04:55:13,900
AS WONDERFUL RESOURCES FROM OUR

8038
04:55:13,900 --> 04:55:15,635
IMPLEMENTATION SCIENCE HUB AND

8039
04:55:15,635 --> 04:55:19,338
ALSO OUR DATA INNOVATION HUB AS

8040
04:55:19,338 --> 04:55:19,806
WELL.

8041
04:55:19,806 --> 04:55:22,408
SO I THINK THAT'S JUST BRIEF

8042
04:55:22,408 --> 04:55:24,577
SUMMARY, REALLY WONDERFUL TO

8043
04:55:24,577 --> 04:55:26,345
HEAR THE PRESENTATION AND THEN

8044
04:55:26,345 --> 04:55:26,913
THE ENGAGEMENT.

8045
04:55:26,913 --> 04:55:33,252
RIGHT NOW WE'RE GOING TO MOVE

8046
04:55:33,252 --> 04:55:43,763
FORWARD TO THE SESSION HERE. 

8047
04:55:47,133 --> 04:55:47,266
OKAY.

8048
04:55:47,266 --> 04:55:51,037
SO, WE WANT TO HEAR FROM YOU.

8049
04:55:51,037 --> 04:55:56,309
WE KNOW YOU SAT HERE FOR THE

8050
04:55:56,309 --> 04:55:58,678
LAST TWO DAYS, YOU HEARD A LOT

8051
04:55:58,678 --> 04:55:59,912
OF TALKS.

8052
04:55:59,912 --> 04:56:00,613
YOU ENGAGED.

8053
04:56:00,613 --> 04:56:02,982
NOW WE REALLY WANT YOU TO COME

8054
04:56:02,982 --> 04:56:06,719
HELP US THINK ABOUT HOW IMPROVE

8055
04:56:06,719 --> 04:56:09,021
CAN MOVE FORWARD TO THE FUTURE.

8056
04:56:09,021 --> 04:56:10,423
THERE ARE NO GUARANTEES BUT WE

8057
04:56:10,423 --> 04:56:11,991
LOVE TO HEAR YOUR IDEAS.

8058
04:56:11,991 --> 04:56:14,060
SO YOU CAN SEE WE HAVE THREE

8059
04:56:14,060 --> 04:56:17,330
QUESTIONS THAT YOU CAN PICK AND

8060
04:56:17,330 --> 04:56:17,563
CHOOSE.

8061
04:56:17,563 --> 04:56:25,671
FIRST TO SHARE YOUR THOUGHTS,

8062
04:56:25,671 --> 04:56:27,540
COULD BE WILD, POTENTIAL FUTURE

8063
04:56:27,540 --> 04:56:28,407
OPPORTUNITIES, AREAS OF SCIENCE

8064
04:56:28,407 --> 04:56:30,042
THE IMPROVE PROGRAM COULD

8065
04:56:30,042 --> 04:56:31,778
ADDRESS TO ADVANCE MATERNAL

8066
04:56:31,778 --> 04:56:32,678
HEALTH RESEARCH, THAT'S THE

8067
04:56:32,678 --> 04:56:34,947
BROAD TEAM.

8068
04:56:34,947 --> 04:56:37,283
WHAT CAN IMPROVE DO AND THINK

8069
04:56:37,283 --> 04:56:38,251
WILDLY.

8070
04:56:38,251 --> 04:56:43,990
THE OTHER TWO ARE REFLECTION.

8071
04:56:43,990 --> 04:56:46,392
THE SECOND QUESTION IS WHAT

8072
04:56:46,392 --> 04:56:47,393
POTENTIAL NEW COLLABORATIONS

8073
04:56:47,393 --> 04:56:49,595
FROM PROJECTS OR FROM OTHER

8074
04:56:49,595 --> 04:56:53,266
IMPROVE WORK STREAMS HAVE RISEN

8075
04:56:53,266 --> 04:56:54,700
FROM NETWORKING OPPORTUNITIES OR

8076
04:56:54,700 --> 04:56:56,469
JUST FROM YOU LISTENING AND

8077
04:56:56,469 --> 04:56:58,905
CONNECTING WITH PEOPLE

8078
04:56:58,905 --> 04:56:59,305
AFTERWARDS.

8079
04:56:59,305 --> 04:57:02,408
SO, WE LOVE TO HEAR ABOUT THAT.

8080
04:57:02,408 --> 04:57:04,210
THIRD IS AGAIN EVEN MORE PERSON

8081
04:57:04,210 --> 04:57:09,348
DID YOU IDENTIFY ONE OR MORE NEW

8082
04:57:09,348 --> 04:57:11,083
IDENTITIES OR AREAS YOU PLAN TO

8083
04:57:11,083 --> 04:57:14,153
EXPLORE OR PURSUE FURTHER AFTER

8084
04:57:14,153 --> 04:57:15,788
THIS MEETING.

8085
04:57:15,788 --> 04:57:17,223
SO, THESE ARE THE OPEN

8086
04:57:17,223 --> 04:57:17,657
QUESTIONS.

8087
04:57:17,657 --> 04:57:20,293
THEY ARE OPEN TO BOTH THOSE ON

8088
04:57:20,293 --> 04:57:23,796
THE ZOOM ROOM WHICH I CAN SEE

8089
04:57:23,796 --> 04:57:28,434
AND ALSO FOR YOU TO SHARE.

8090
04:57:28,434 --> 04:57:33,306
ANY TAKERS?

8091
04:57:33,306 --> 04:57:35,408
 

8092
04:57:35,408 --> 04:57:37,810
GREAT, ALL RIGHT.

8093
04:57:37,810 --> 04:57:46,485
I CAN'T SEE SO I NEED HELP.

8094
04:57:46,485 --> 04:57:47,019
>> THANK YOU.

8095
04:57:47,019 --> 04:57:49,088
AGAIN, THANK YOU TO ALL OF YOU

8096
04:57:49,088 --> 04:57:51,190
FOR HOSTING THIS IN-PERSON

8097
04:57:51,190 --> 04:57:53,359
MEETING, EXTREMELY VALUABLE,

8098
04:57:53,359 --> 04:57:58,865
WE'RE ALL GRATEFUL FOR THIS

8099
04:57:58,865 --> 04:58:02,335
OPPORTUNITY.

8100
04:58:02,335 --> 04:58:04,770
I'M BIASED, BUT THE "IMPROVE"

8101
04:58:04,770 --> 04:58:06,505
INITIATIVE TO FOCUS ON SPEAK

8102
04:58:06,505 --> 04:58:11,777
BEING RESEARCHING OF  TRADITIONL

8103
04:58:11,777 --> 04:58:12,945
AND CULTURAL PRACTICES,

8104
04:58:12,945 --> 04:58:13,913
INNOVATION AND NEW TECHNOLOGIES,

8105
04:58:13,913 --> 04:58:16,115
I LOVED HEARING ABOUT THE

8106
04:58:16,115 --> 04:58:19,385
WONDERFUL NEW TECHNOLOGIES THAT

8107
04:58:19,385 --> 04:58:20,286
WERE PROPOSED AND DEVELOPED, ALL

8108
04:58:20,286 --> 04:58:23,556
OF THAT IS EXTREMELY NEEDED AND

8109
04:58:23,556 --> 04:58:24,357
VALUABLE.

8110
04:58:24,357 --> 04:58:28,694
AND ALSO WE KNOW THERE ARE SOME

8111
04:58:28,694 --> 04:58:29,428
ANCIENT TECHNOLOGIES AND

8112
04:58:29,428 --> 04:58:36,602
CULTURAL TOOLS THAT HAVE NOT

8113
04:58:36,602 --> 04:58:37,003
GOTTEN APPROPRIATE

8114
04:58:37,003 --> 04:58:41,274
ACKNOWLEDGMENT AND ATTENTION

8115
04:58:41,274 --> 04:58:42,708
FROM THE SCIENTIFIC COMMUNITY,

8116
04:58:42,708 --> 04:58:44,043
CARING BEING ONE BUT POSTPARTUM

8117
04:58:44,043 --> 04:58:50,149
CARE PRACTICES AROUND THE WORLD,

8118
04:58:50,149 --> 04:58:52,351
PELVIC STEAMING, INFANT MASSAGE,

8119
04:58:52,351 --> 04:58:53,552
POSTPARTUM NUTRITION PRACTICES,

8120
04:58:53,552 --> 04:58:55,488
ALL OF THESE THINGS THAT WERE

8121
04:58:55,488 --> 04:59:00,326
CALLED OUT IN THE WOMEN'S HEALTH

8122
04:59:00,326 --> 04:59:01,460
INNOVATION OPPORTUNITY MAP BY

8123
04:59:01,460 --> 04:59:04,931
NIH AND GATES FOUNDATION FROM A

8124
04:59:04,931 --> 04:59:05,798
GLOBAL HEALTH PERSPECTIVE, I

8125
04:59:05,798 --> 04:59:07,433
WANTED TO PUT THAT TO THE TABLE

8126
04:59:07,433 --> 04:59:08,968
AS FAR AS A RESEARCH AREA THAT

8127
04:59:08,968 --> 04:59:10,870
COULD BE REALLY EXPLORED AND

8128
04:59:10,870 --> 04:59:13,639
UTILIZED TO TACKLE SOME OF THESE

8129
04:59:13,639 --> 04:59:15,808
POSTPARTUM HEALTH CHALLENGES IN

8130
04:59:15,808 --> 04:59:16,108
PARTICULAR.

8131
04:59:16,108 --> 04:59:16,609
THANK YOU.

8132
04:59:16,609 --> 04:59:20,012
>> THANK YOU.

8133
04:59:20,012 --> 04:59:20,880
THANK YOU.

8134
04:59:20,880 --> 04:59:23,749
YOU'RE THE FIRST ONE TO SPEAK

8135
04:59:23,749 --> 04:59:25,151
UP.

8136
04:59:25,151 --> 04:59:25,351
GREAT.

8137
04:59:25,351 --> 04:59:26,619
>> I THINK MY THOUGHT
MAYBE

8138
04:59:26,619 --> 04:59:29,021
SPANS ALL THREE OF THOSE A BIT

8139
04:59:29,021 --> 04:59:33,159
BUT I THINK ONE PARTICULARLY

8140
04:59:33,159 --> 04:59:34,927
FRUITFUL AREA THAT IMPROVE COULD

8141
04:59:34,927 --> 04:59:45,404
SUPPORT IS REALLY THE NEXUS

8142
04:59:48,474 --> 04:59:51,777
AMONG WORKFORCE EXPANSION,

8143
04:59:51,777 --> 04:59:53,212
TOGETHER WITH INNOVATIONS,

8144
04:59:53,212 --> 04:59:54,547
TECHNOLOGIC INNOVATIONS THAT

8145
04:59:54,547 --> 04:59:56,515
WOULD ENABLE MORE COMMUNITY-BASE

8146
04:59:56,515 --> 04:59:58,384
AND HOME MONITORING TO

8147
04:59:58,384 --> 04:59:59,485
ACCOMPLISHING MONITORING AND

8148
04:59:59,485 --> 05:00:00,786
SURVEILLANCE AND THE PREGNANCY

8149
05:00:00,786 --> 05:00:03,422
AND POSTPARTUM PERIOD IN A WAY

8150
05:00:03,422 --> 05:00:05,057
THAT'S VERY CULTURALLY ENGAGE

8151
05:00:05,057 --> 05:00:07,460
AND ACCESSIBLE, LOOKING AT

8152
05:00:07,460 --> 05:00:10,629
MODELS TO REALLY ENGAGE THE

8153
05:00:10,629 --> 05:00:12,164
HUMAN FACTOR AND TECHNOLOGIC

8154
05:00:12,164 --> 05:00:14,500
FACTOR IN A WAY THAT'S MEETING

8155
05:00:14,500 --> 05:00:15,668
THE NEEDS OF THE COMMUNITIES

8156
05:00:15,668 --> 05:00:26,012
MOST AT RISK FOR THESE OUTCOMES 

8157
05:00:26,012 --> 05:00:30,750
>> A COMMON THEME ABOUT

8158
05:00:30,750 --> 05:00:32,952
CULTURAL, YOU ADDED USING

8159
05:00:32,952 --> 05:00:38,758
TECHNOLOGY IN A RESPONSIBLE WAY.

8160
05:00:38,758 --> 05:00:40,292
>> SO THIS MIGHT BE TOO
BIG OF A

8161
05:00:40,292 --> 05:00:44,030
QUESTION FOR THIS GROUP.

8162
05:00:44,030 --> 05:00:46,665
I MIGHT BE BIASED, WANTING TO

8163
05:00:46,665 --> 05:00:48,534
TALK ABOUT ONE SPECIFIC

8164
05:00:48,534 --> 05:00:54,573
COMPONENT OF INTERVENTION WE

8165
05:00:54,573 --> 05:00:56,342
USE, COMMUNITY HEALTH WORKERS,

8166
05:00:56,342 --> 05:00:58,878
HOME VISITING.

8167
05:00:58,878 --> 05:01:00,913
I'VE NOTICED THAT THIRD IF NOT

8168
05:01:00,913 --> 05:01:03,549
MORE OF THE CENTERS ARE IN ONE

8169
05:01:03,549 --> 05:01:06,585
SHAPE OR ANOTHER USE SIMILAR

8170
05:01:06,585 --> 05:01:07,686
TIMES OF INTERVENTIONS,

8171
05:01:07,686 --> 05:01:09,455
COMMUNITY HEALTH WORKERS, YET

8172
05:01:09,455 --> 05:01:12,191
THE BIGGEST ISSUE WE FEEL WE

8173
05:01:12,191 --> 05:01:13,526
DON'T HAVE SUSTAINABILITY SO

8174
05:01:13,526 --> 05:01:15,494
THERE'S NO SUSTAINABLE FUNDING

8175
05:01:15,494 --> 05:01:17,763
THAT ALLOWS LIVING WAGE, LIVABLE

8176
05:01:17,763 --> 05:01:19,331
WAGE FOR COMMUNITY HEALTH

8177
05:01:19,331 --> 05:01:21,767
WORKERS AND I WONDER, I KNOW

8178
05:01:21,767 --> 05:01:26,138
IMPROVE'S  MISSION IS TO FUND

8179
05:01:26,138 --> 05:01:30,743
RESEARCH BUT IF THERE'S A WAY,

8180
05:01:30,743 --> 05:01:33,145
TO REALLY INFLUENCE AND COULD BE

8181
05:01:33,145 --> 05:01:39,351
INFLUENCE THE FEDERAL

8182
05:01:39,351 --> 05:01:39,952
GOVERNMENT, STATE GOVERNMENT,

8183
05:01:39,952 --> 05:01:43,222
WHOM EVER, A COALITION OF VERY

8184
05:01:43,222 --> 05:01:47,026
SMART PEOPLE WITH POWERS TO GET

8185
05:01:47,026 --> 05:01:48,994
TO A FUNDABLE MODEL, SUSTAINABLE

8186
05:01:48,994 --> 05:01:50,663
FUND AND MODEL, ONE EXAMPLE, ONE

8187
05:01:50,663 --> 05:01:53,199
TOOL WE HAVE EVIDENCE THAT IT

8188
05:01:53,199 --> 05:01:55,267
WORKS SO IT'S ONE OF THE, YOU

8189
05:01:55,267 --> 05:01:57,436
KNOW, THINGS, RIGHT, THAT WE'RE

8190
05:01:57,436 --> 05:01:58,971
TRYING TO SUSTAIN AND IMPLEMENT,

8191
05:01:58,971 --> 05:02:04,043
YET IT'S LIKE THE BIGGEST HURDLE

8192
05:02:04,043 --> 05:02:06,545
WE FACE IS SUSTAINING IT, AND

8193
05:02:06,545 --> 05:02:07,613
WE'RE TALKING ABOUT INDIVIDUALS,

8194
05:02:07,613 --> 05:02:09,582
LIVING WAGE, WE'RE TALKING ABOUT

8195
05:02:09,582 --> 05:02:14,720
EQUITY IN THE WORKFORCE, ALL OF

8196
05:02:14,720 --> 05:02:15,054
THOSE THINGS.

8197
05:02:15,054 --> 05:02:16,489
>> THANK YOU.

8198
05:02:16,489 --> 05:02:17,523
SO YOU'RE TALKING --

8199
05:02:17,523 --> 05:02:18,524
>> CAN I RESPOND?

8200
05:02:18,524 --> 05:02:19,959
>> YEAH, THANK YOU.

8201
05:02:19,959 --> 05:02:21,393
>> I THINK DATA, YOUR DATA
IS

8202
05:02:21,393 --> 05:02:25,764
GOING TO BE SO IMPORTANT BECAUSE

8203
05:02:25,764 --> 05:02:27,099
ONCE WE HAVE DATA SHOWING AT

8204
05:02:27,099 --> 05:02:28,367
LEAST WITHIN THE CENTERS, THIS

8205
05:02:28,367 --> 05:02:30,402
IS WHAT WE HAVE BECAUSE WE'RE

8206
05:02:30,402 --> 05:02:34,473
NOT NECESSARILY A SERVICE

8207
05:02:34,473 --> 05:02:36,742
ORGANIZATION, RIGHT, BUT WE CAN

8208
05:02:36,742 --> 05:02:38,611
ADVOCATE WITH YOUR RESEARCH,

8209
05:02:38,611 --> 05:02:42,681
THAT'S THE STRENGTH OF ALL YOUR

8210
05:02:42,681 --> 05:02:43,449
WORK.

8211
05:02:43,449 --> 05:02:45,784
>> YEAH, I DON'T KNOW,
KEISHA

8212
05:02:45,784 --> 05:02:48,587
AND I WERE TALKING ABOUT THIS

8213
05:02:48,587 --> 05:02:49,355
DURING BREAK.

8214
05:02:49,355 --> 05:02:52,758
WHAT IS IT THAT NIH COULD DO AND

8215
05:02:52,758 --> 05:02:55,361
WHAT IS IT THAT OTHER AGENCIES

8216
05:02:55,361 --> 05:02:57,997
LIKE HRSA AND CDC, SO WHAT IS

8217
05:02:57,997 --> 05:03:00,199
OUR SWIM LANE, WHERE CAN WE

8218
05:03:00,199 --> 05:03:02,701
MERGE TOGETHER TO HELP EACH

8219
05:03:02,701 --> 05:03:03,135
OTHER?

8220
05:03:03,135 --> 05:03:04,036
HRSA, THEY ARE OFFERING

8221
05:03:04,036 --> 05:03:05,771
SERVICES, RIGHT?

8222
05:03:05,771 --> 05:03:09,141
THEY DO THE HOME HEALTH CARE,

8223
05:03:09,141 --> 05:03:10,876
HOME VISITING NURSES PROGRAM SO

8224
05:03:10,876 --> 05:03:12,745
THEY HAVE THAT.

8225
05:03:12,745 --> 05:03:15,047
THEY ALSO HAVE PROGRAMS TO

8226
05:03:15,047 --> 05:03:19,318
ENABLE USE OF AIM BUNDLE.

8227
05:03:19,318 --> 05:03:20,553
KEISHA, ARE YOU STILL HERE?

8228
05:03:20,553 --> 05:03:22,588
SHE MAY HAVE LEFT.

8229
05:03:22,588 --> 05:03:27,660
SHE USED TO WORK AT HRSA AND SHE

8230
05:03:27,660 --> 05:03:29,728
SAYS OFTENTIMES WHEN HRSA

8231
05:03:29,728 --> 05:03:33,199
BUDGETS GET CUT THE FIRST THING

8232
05:03:33,199 --> 05:03:35,634
THAT GOES IS THE DATA AND

8233
05:03:35,634 --> 05:03:36,402
EVALUATION PIECE.

8234
05:03:36,402 --> 05:03:39,004
ALSO WHAT'S REALLY NEEDED IS FOR

8235
05:03:39,004 --> 05:03:40,706
RESEARCH DATA TO BE GENERATED TO

8236
05:03:40,706 --> 05:03:44,176
BE ABLE TO HELP TO IMPLEMENT

8237
05:03:44,176 --> 05:03:47,346
PROGRAMS OR TO SAY, OKAY, IF

8238
05:03:47,346 --> 05:03:49,748
THIS CAN BE IMPLEMENTABLE IN ONE

8239
05:03:49,748 --> 05:03:52,785
SETTING, WHAT RESEARCH IS NEEDED

8240
05:03:52,785 --> 05:03:55,321
IN THE WIDER SETTING, ALSO

8241
05:03:55,321 --> 05:03:56,355
POLICY IMPACT, ET CETERA.

8242
05:03:56,355 --> 05:03:57,056
GREAT QUESTION.

8243
05:03:57,056 --> 05:03:58,290
THIS IS SOMETHING WE WANT TO

8244
05:03:58,290 --> 05:04:00,893
CONTINUE TO THINK ABOUT WHERE WE

8245
05:04:00,893 --> 05:04:02,595
CAN SORT OF FIT THE NEED AND

8246
05:04:02,595 --> 05:04:06,699
ALSO CONTINUE TO WORK TOGETHER

8247
05:04:06,699 --> 05:04:08,367
WITH OTHER AGENCIES.

8248
05:04:08,367 --> 05:04:10,436
>> I WANTED TO ADD WITH
THE

8249
05:04:10,436 --> 05:04:11,503
POTENTIAL NEW COLLABORATIONS ONE

8250
05:04:11,503 --> 05:04:13,706
OF THE MOST BEAUTIFUL THINGS

8251
05:04:13,706 --> 05:04:15,774
ABOUT THE IMPROVE MODEL WITH THE

8252
05:04:15,774 --> 05:04:18,644
CENTERS OF EXCELLENCE HAS BEEN

8253
05:04:18,644 --> 05:04:20,512
THAT COMMUNITY PARTNERSHIP

8254
05:04:20,512 --> 05:04:20,913
COMPONENT.

8255
05:04:20,913 --> 05:04:24,650
OUR CONTACT P.I. IS AN

8256
05:04:24,650 --> 05:04:25,651
INCREDIBLE CLINICIAN WHO REACHED

8257
05:04:25,651 --> 05:04:27,720
OUT TO MYSELF AND COMMUNITY

8258
05:04:27,720 --> 05:04:30,789
PARTNER TO SEE IF WE WANTED TO

8259
05:04:30,789 --> 05:04:33,058
ASSIST HER IN THIS.

8260
05:04:33,058 --> 05:04:35,394
WE PARTNERED TOGETHER FOR TEN

8261
05:04:35,394 --> 05:04:37,463
YEARS, NEVER HAD SEVEN YEARS OF

8262
05:04:37,463 --> 05:04:38,530
SUSTAINABLE FUNDING SO IT'S BEEN

8263
05:04:38,530 --> 05:04:41,300
BEAUTIFUL TO HAVE THAT KIND OF

8264
05:04:41,300 --> 05:04:42,835
SECURITY IN A COMMUNITY-BASED

8265
05:04:42,835 --> 05:04:44,470
ORGANIZATION, IT'S BEEN AWESOME.

8266
05:04:44,470 --> 05:04:47,306
IT'S ALSO ALLOWED US TO MAKE

8267
05:04:47,306 --> 05:04:48,073
CONNECTIONS, WHEN YOU'RE GETTING

8268
05:04:48,073 --> 05:04:50,609
YEAR TO YEAR FUNDING WITH YOUR

8269
05:04:50,609 --> 05:04:52,344
PARTNER YOU'RE WRITING THE NEXT

8270
05:04:52,344 --> 05:04:53,979
GRANT LIKE BEFORE THE ONE FIRST

8271
05:04:53,979 --> 05:04:55,180
IS HALFWAY DONE.

8272
05:04:55,180 --> 05:05:04,156
WE'VE GOT TEN TO MEET INCREDIBLE

8273
05:05:04,156 --> 05:05:04,490
CENTERS.

8274
05:05:04,490 --> 05:05:08,327
YOU THINK I'M THE ONLY ONE

8275
05:05:08,327 --> 05:05:10,062
HAVING PROBLEMS WITH XYZ, YOU

8276
05:05:10,062 --> 05:05:11,397
CONNECT ACROSS CENTERS, OH, YOU

8277
05:05:11,397 --> 05:05:13,899
HAD PROBLEMS WITH THAT ERA

8278
05:05:13,899 --> 05:05:15,100
COMMONS REGISTRATION TOO, HAD

8279
05:05:15,100 --> 05:05:16,535
YOU TO WRITE COMMUNITY

8280
05:05:16,535 --> 05:05:18,070
BIOSKETCHES IN THE MIDDLE OF THE

8281
05:05:18,070 --> 05:05:18,904
NIGHT TOO.

8282
05:05:18,904 --> 05:05:20,372
WE'RE EXCITED ABOUT THE

8283
05:05:20,372 --> 05:05:22,741
POTENTIAL TO SHARE OUR

8284
05:05:22,741 --> 05:05:24,276
EXPERIENCES IN HOPE OF

8285
05:05:24,276 --> 05:05:25,210
CONTRIBUTING TO POSITIVE

8286
05:05:25,210 --> 05:05:26,312
IMPROVEMENTS, NOT TO CRITICIZE

8287
05:05:26,312 --> 05:05:28,113
BUT TO SAY HOW CAN WE WELCOME

8288
05:05:28,113 --> 05:05:30,516
MORE PEOPLE TO THE TABLE, SO

8289
05:05:30,516 --> 05:05:32,017
IT'S BEEN SUCH A COOL SPACE TO

8290
05:05:32,017 --> 05:05:32,818
DO THAT.

8291
05:05:32,818 --> 05:05:34,019
THANK YOU FOR THAT.

8292
05:05:34,019 --> 05:05:35,888
>> THANK YOU FOR THE
FEEDBACK

8293
05:05:35,888 --> 05:05:42,227
AND COMMENT.

8294
05:05:42,227 --> 05:05:43,662
YES, THANKS.

8295
05:05:43,662 --> 05:05:48,334
>> I'M FROM THE CIRCLE
CENTER.

8296
05:05:48,334 --> 05:05:50,202
I THINK THIS IS A WONDERFUL

8297
05:05:50,202 --> 05:05:52,938
OPPORTUNITY, EXCITED TO BE HERE

8298
05:05:52,938 --> 05:05:55,574
AND HEAR THESE TALKS.

8299
05:05:55,574 --> 05:05:57,443
I LOVE THE PRESENTATIONS ON THE

8300
05:05:57,443 --> 05:05:57,776
TECHNOLOGIES.

8301
05:05:57,776 --> 05:06:02,147
I KNOW THAT OUR FLOURISH TEAM

8302
05:06:02,147 --> 05:06:04,116
WHICH IS FOCUSED ON FOOD

8303
05:06:04,116 --> 05:06:10,989
SECURITY INTERVENTION HAS BEEN

8304
05:06:10,989 --> 05:06:12,725
INTERESTED IN IMPLEMENTING

8305
05:06:12,725 --> 05:06:15,794
WEARABLES, FOR COLLABORATION.

8306
05:06:15,794 --> 05:06:19,298
MY BACKGROUND IS SOCIAL

8307
05:06:19,298 --> 05:06:20,632
DEMOGRAPHER, WORKING SOME WITH

8308
05:06:20,632 --> 05:06:21,967
BIOMEDICAL DATA BUT WEARABLE

8309
05:06:21,967 --> 05:06:23,335
DATA IS OVERWHELMING TO ME.

8310
05:06:23,335 --> 05:06:25,437
I THINK FOR THOSE OF US THAT DID

8311
05:06:25,437 --> 05:06:29,274
NOT BUILD THAT INTO OUR PROJECT

8312
05:06:29,274 --> 05:06:32,778
TO BEGIN WITH, IN ORDER TO DO A

8313
05:06:32,778 --> 05:06:35,848
GOOD JOB WITH IMPLEMENTING NEW

8314
05:06:35,848 --> 05:06:37,316
TECHNOLOGY, WE REALLY NEED SOME

8315
05:06:37,316 --> 05:06:38,517
COLLABORATION FROM THOSE OF YOU

8316
05:06:38,517 --> 05:06:41,620
WHO DO THIS ON A REGULAR BASIS

8317
05:06:41,620 --> 05:06:42,087
AND HAVE THOSE SKILLS.

8318
05:06:42,087 --> 05:06:47,659
SO I DON'T KNOW IF THERE'S A WAY

8319
05:06:47,659 --> 05:06:48,961
MAYBE THROUGH THE DATA

8320
05:06:48,961 --> 05:06:51,397
INNOVATION HUB OR SOME WAY TO

8321
05:06:51,397 --> 05:06:54,566
CONNECT THE PROJECTS, WHEN TO

8322
05:06:54,566 --> 05:06:56,402
ADD IN ADDITIONAL COMPONENT WITH

8323
05:06:56,402 --> 05:06:59,037
WEARABLES, HOW WE FIND

8324
05:06:59,037 --> 05:07:01,006
APPROPRIATE PARTNERS, WHAT WE DO

8325
05:07:01,006 --> 05:07:02,541
WITH THE VAST AMOUNT OF DATA, IF

8326
05:07:02,541 --> 05:07:04,076
WE ADD THAT IN.

8327
05:07:04,076 --> 05:07:05,611
THOSE ARE SOME THINGS I THINK

8328
05:07:05,611 --> 05:07:09,882
ABOUT WHEN I SEE EXCITING

8329
05:07:09,882 --> 05:07:10,883
OPPORTUNITIES, BUT I KNOW THE

8330
05:07:10,883 --> 05:07:16,555
REALITY OF HAVING A TON OF DATA.

8331
05:07:16,555 --> 05:07:18,524
>> THANK YOU.

8332
05:07:18,524 --> 05:07:19,625
>> GREAT POINTS.

8333
05:07:19,625 --> 05:07:22,027
WE'LL TURN ON OUR TEAM LATER BUT

8334
05:07:22,027 --> 05:07:25,097
I THINK AT LEAST INITIALLY

8335
05:07:25,097 --> 05:07:26,498
CONNECTING EVERYONE TOGETHER WAS

8336
05:07:26,498 --> 05:07:29,768
OUR GOAL FOR THIS SO I'M GLAD

8337
05:07:29,768 --> 05:07:32,304
EVERYBODY IS HERE TO HEAR THE

8338
05:07:32,304 --> 05:07:33,605
TECHNOLOGY TALKS AND THEN THE

8339
05:07:33,605 --> 05:07:35,140
NEXT PHASE IS TRYING TO FIGURE

8340
05:07:35,140 --> 05:07:38,343
OUT HOW TO CONNECT YOU ALL AS

8341
05:07:38,343 --> 05:07:44,149
YOU NEED TO WITH THE VARIOUS

8342
05:07:44,149 --> 05:07:44,416
ENTITIES.

8343
05:07:44,416 --> 05:07:48,086
>> ONE OF MY PROMPT
QUESTIONS IS

8344
05:07:48,086 --> 05:07:49,655
ABOUT TECHNOLOGY, FOR YOU ALL TO

8345
05:07:49,655 --> 05:07:52,591
SHARE WHAT YOU THINK ARE THE

8346
05:07:52,591 --> 05:07:57,095
BENEFITS AND BARRIERS THAT YOU

8347
05:07:57,095 --> 05:07:59,498
SEE IN PROMOTING OR IMPLEMENTING

8348
05:07:59,498 --> 05:08:03,001
USE OF REMOTE MONITORING AND

8349
05:08:03,001 --> 05:08:04,736
POINT OF CARE DEVICES.

8350
05:08:04,736 --> 05:08:06,071
>> REBECCA HAD A
FOLLOW-UP.

8351
05:08:06,071 --> 05:08:09,208
>> IT COULD RELATE TO THAT
TOO.

8352
05:08:09,208 --> 05:08:10,542
I THINK COMBINING WHAT JESSICA

8353
05:08:10,542 --> 05:08:12,344
SAID IS IMPORTANT IN TERMS OF

8354
05:08:12,344 --> 05:08:13,812
THINKING ABOUT THE FACT THAT

8355
05:08:13,812 --> 05:08:15,481
SUSTAINABILITY IS A FEAR OF ALL

8356
05:08:15,481 --> 05:08:18,183
OF OURS, WE GO INTO THIS WORK

8357
05:08:18,183 --> 05:08:20,619
KNOWING WE'RE TRYING TO EITHER

8358
05:08:20,619 --> 05:08:21,487
GENERATE EVIDENCE OR IMPLEMENT

8359
05:08:21,487 --> 05:08:23,422
SOMETHING IN A WAY THAT THEN

8360
05:08:23,422 --> 05:08:28,260
WOULD BE GENERALIZABLE AND WE

8361
05:08:28,260 --> 05:08:29,795
FEAR THAT WOULD DISAPPEAR.

8362
05:08:29,795 --> 05:08:31,430
WHAT YOU BROUGHT UP, COMMUNITY

8363
05:08:31,430 --> 05:08:35,501
PARTNERS AT THE TABLE, ELEVATES

8364
05:08:35,501 --> 05:08:36,335
THAT.

8365
05:08:36,335 --> 05:08:42,841
WHAT  YOU SAID ABOUT SAFETY

8366
05:08:42,841 --> 05:08:44,343
SCARES ME, POLICY AND

8367
05:08:44,343 --> 05:08:45,444
DISSEMINATION PIECE NOW, IT'S

8368
05:08:45,444 --> 05:08:47,079
EASY TO SAY WE'RE GOING WAIT

8369
05:08:47,079 --> 05:08:50,349
UNTIL WE'RE DONE WITH SEVEN-YEAR

8370
05:08:50,349 --> 05:08:52,451
GRANTS, WE'LL FIVE OR SIX WE'LL

8371
05:08:52,451 --> 05:08:54,419
THINK ABOUT IT, WE NEED TO WORK

8372
05:08:54,419 --> 05:08:54,853
ON IT NOW.

8373
05:08:54,853 --> 05:08:58,690
WAYS PEOPLE WANT TO CONTINUE TO

8374
05:08:58,690 --> 05:08:59,691
COLLABORATE THROUGH OUR HUB

8375
05:08:59,691 --> 05:09:05,831
WE'RE HAPPY TO DO THAT.

8376
05:09:05,831 --> 05:09:08,667
>> I THINK -- SO I'M FROM
ALSO

8377
05:09:08,667 --> 05:09:10,302
NOT ONE OF THE MATERNAL CENTERS

8378
05:09:10,302 --> 05:09:12,271
OF EXCELLENCE BUT FROM THE

8379
05:09:12,271 --> 05:09:14,139
CONNECTING THE COMMUNITY

8380
05:09:14,139 --> 05:09:14,406
CHALLENGE.

8381
05:09:14,406 --> 05:09:17,776
AND I WORK AS A CERTIFIED NURSE

8382
05:09:17,776 --> 05:09:19,611
MIDWIFE IN ATLANTA.

8383
05:09:19,611 --> 05:09:21,580
AND LISTENING TO THESE, THINKING

8384
05:09:21,580 --> 05:09:24,449
ABOUT OUR PROJECT, I DO THINK

8385
05:09:24,449 --> 05:09:28,287
THERE'S AN OPPORTUNITY TO ENGAGE

8386
05:09:28,287 --> 05:09:30,789
MIDWIFERY, AND I HEARD THAT IN

8387
05:09:30,789 --> 05:09:32,524
OTHER PRESENTATIONS, BUT FOR

8388
05:09:32,524 --> 05:09:35,594
MOST OF THE PEOPLE IN THE U.S.

8389
05:09:35,594 --> 05:09:37,563
THE WAY MIDWIFERY OPERATES IS

8390
05:09:37,563 --> 05:09:39,431
OUTSIDE OF LIKE ACADEMIC MEDICAL

8391
05:09:39,431 --> 05:09:41,233
INSTITUTIONS SO I THINK

8392
05:09:41,233 --> 05:09:43,569
STRUCTURALLY IT'S HARD TO GET

8393
05:09:43,569 --> 05:09:46,204
THAT INTO STUFF LIKE THIS BUT

8394
05:09:46,204 --> 05:09:49,708
WHEN YOU'RE THINKING HOW YOU CAN

8395
05:09:49,708 --> 05:09:53,845
ENGAGE COMMUNITIES THERE ARE

8396
05:09:53,845 --> 05:09:55,314
MANY PEOPLE WHO PRACTICE

8397
05:09:55,314 --> 05:09:57,816
MIDWIFELY OUTSIDE OF WHAT THE

8398
05:09:57,816 --> 05:09:59,151
MEDICAL BOARDS ARE RECOGNIZING

8399
05:09:59,151 --> 05:10:02,821
BUT HAVE A LOT OF KNOWLEDGE AND

8400
05:10:02,821 --> 05:10:06,892
PROBABLY LIKE ARE ALREADY DOING

8401
05:10:06,892 --> 05:10:07,859
A LOT OF IMPROVEMENT THINGS

8402
05:10:07,859 --> 05:10:10,495
WE'RE LEARNING CAN BE HELPFUL,

8403
05:10:10,495 --> 05:10:12,197
SO I THINK FIGURING CERTAINLY

8404
05:10:12,197 --> 05:10:17,235
LIKE OUR STATE HAS CHALLENGES

8405
05:10:17,235 --> 05:10:19,204
WITH DIFFERENT TIMES OF

8406
05:10:19,204 --> 05:10:20,472
MIDWIVES, HAVEN'T BEEN ABLE TO

8407
05:10:20,472 --> 05:10:22,007
PROVIDE LICENSURE AND WORK

8408
05:10:22,007 --> 05:10:24,509
TOGETHER BUT I THINK, YOU KNOW,

8409
05:10:24,509 --> 05:10:26,478
THERE'S NO SENSE REINVENTING THE

8410
05:10:26,478 --> 05:10:32,284
WHEEL, IT MAKES SENSE TO ME TO

8411
05:10:32,284 --> 05:10:33,485
ENGAGE THAT COMMUNITY

8412
05:10:33,485 --> 05:10:33,785
PARTNERSHIP.

8413
05:10:33,785 --> 05:10:42,027
>> THANK YOU. 

8414
05:10:42,027 --> 05:10:44,363
>> I'M NOT SURE IF WE HAVE

8415
05:10:44,363 --> 05:10:45,297
ONLINE QUESTIONS.

8416
05:10:45,297 --> 05:10:45,864
>> I'M CHECKING.

8417
05:10:45,864 --> 05:10:53,105
NOTHING ONLINE. 

8418
05:10:53,105 --> 05:10:55,607
>> FOR US, IT'S A NEW
COMPONENT

8419
05:10:55,607 --> 05:10:57,342
OF MAKING SURE THAT THERE'S

8420
05:10:57,342 --> 05:10:59,845
EQUITY AND THE COMMUNITY

8421
05:10:59,845 --> 05:11:01,380
PERSPECTIVE BECAUSE WE REALIZE

8422
05:11:01,380 --> 05:11:04,349
THAT MATERNITY MORBIDITY AND

8423
05:11:04,349 --> 05:11:05,350
MORTALITY IS MULTI-FACTORIAL,

8424
05:11:05,350 --> 05:11:06,618
POLICY LEVEL AND THAT THERE ARE

8425
05:11:06,618 --> 05:11:09,821
A LOT OF CHALLENGES IN

8426
05:11:09,821 --> 05:11:10,489
ADDRESSING IT.

8427
05:11:10,489 --> 05:11:13,125
SO WE INTENTIONALLY WROTE THE

8428
05:11:13,125 --> 05:11:14,993
FUNDING ANNOUNCEMENT WITH HAVING

8429
05:11:14,993 --> 05:11:15,961
EQUALITY IN THE COMMUNITY

8430
05:11:15,961 --> 05:11:17,696
PARTNERSHIP FROM THE BEGINNING.

8431
05:11:17,696 --> 05:11:21,099
THANK YOU ALL FOR RECOGNIZING

8432
05:11:21,099 --> 05:11:21,299
THAT.

8433
05:11:21,299 --> 05:11:22,734
AND ACTUALLY HAVING IT ACTUALLY

8434
05:11:22,734 --> 05:11:23,935
COME TO LIFE BECAUSE IT'S ONE

8435
05:11:23,935 --> 05:11:26,038
THING TO WRITE IT, IT'S ANOTHER

8436
05:11:26,038 --> 05:11:28,974
THING FOR IT TO MATERIALIZE SO

8437
05:11:28,974 --> 05:11:31,276
WE THANK YOU, HOW YOU PUT THE

8438
05:11:31,276 --> 05:11:32,277
CENTERS TOGETHER.

8439
05:11:32,277 --> 05:11:33,278
YOUR ACTIVITIES TOGETHER.

8440
05:11:33,278 --> 05:11:36,214
SO THAT YOU CAN REFLECT THE

8441
05:11:36,214 --> 05:11:38,283
COMMUNITY PERSPECTIVE IN ALL

8442
05:11:38,283 --> 05:11:38,950
THAT WE DO.

8443
05:11:38,950 --> 05:11:40,585
>> YEAH.

8444
05:11:40,585 --> 05:11:42,120
ALL RIGHT.

8445
05:11:42,120 --> 05:11:43,889
I'M JUST GOING TO SEE IF ANYBODY

8446
05:11:43,889 --> 05:11:49,461
WOULD LIKE TO SAY ANYTHING ELSE

8447
05:11:49,461 --> 05:11:50,862
BEFORE I THANK PEOPLE AND CLOSE

8448
05:11:50,862 --> 05:11:54,800
THE MEETING. 

8449
05:11:54,800 --> 05:11:57,302
NO?

8450
05:11:57,302 --> 05:11:59,171
 

8451
05:11:59,171 --> 05:12:01,707
>> IF I MAY SUGGEST THE
NEXT ONE

8452
05:12:01,707 --> 05:12:04,276
TO BE EXCLUSIVELY IN PERSON

8453
05:12:04,276 --> 05:12:05,243
PERHAPS, THE NEXT MEETING.

8454
05:12:05,243 --> 05:12:08,680
WE GET MORE OF US -- I MEAN, IT

8455
05:12:08,680 --> 05:12:12,050
WAS GREAT TO MEET AND ACTUALLY

8456
05:12:12,050 --> 05:12:14,252
TALK TO MANY OF YOU AS OPPOSED

8457
05:12:14,252 --> 05:12:15,987
TO ZOOM.

8458
05:12:15,987 --> 05:12:18,190
WE KNOW IT'S CHEAP BUT -- JUST A

8459
05:12:18,190 --> 05:12:18,423
THOUGHT.

8460
05:12:18,423 --> 05:12:19,524
>> ABSOLUTELY, YES.

8461
05:12:19,524 --> 05:12:20,258
THANK YOU.

8462
05:12:20,258 --> 05:12:22,594
WE'RE HOPING TO DO THIS

8463
05:12:22,594 --> 05:12:22,928
ANNUALLY.

8464
05:12:22,928 --> 05:12:27,065
>> YEAH. 

8465
05:12:27,065 --> 05:12:30,469
I KNOW I LEARNED SO MUCH.

8466
05:12:30,469 --> 05:12:31,570
AND IT'S REALLY -- I DON'T KNOW

8467
05:12:31,570 --> 05:12:36,341
HOW TO DESCRIBE IT. 

8468
05:12:36,341 --> 05:12:40,312
TO HAVE A COALITION OF

8469
05:12:40,312 --> 05:12:41,513
LIKEMINDED PASSIONATE

8470
05:12:41,513 --> 05:12:43,815
RESEARCHERS, COMMUNITY ENGAGED

8471
05:12:43,815 --> 05:12:47,753
FOLKS, AND PARTNERS, JUST ALL

8472
05:12:47,753 --> 05:12:48,720
TOGETHER TRYING TO TACKLE THIS

8473
05:12:48,720 --> 05:12:52,891
ATROCITY IN THE U.S., AND JUST

8474
05:12:52,891 --> 05:12:55,327
DOING IT TOGETHER AND IT'S VERY

8475
05:12:55,327 --> 05:13:01,233
INSPIRING AND I HOPE THAT YOU

8476
05:13:01,233 --> 05:13:04,202
REALLY ENJOYED THE LAST FEW DAYS

8477
05:13:04,202 --> 05:13:06,037
LIKE I HAD.

8478
05:13:06,037 --> 05:13:10,208
I WANT TO THANK NAHIDA, BUT YOU

8479
05:13:10,208 --> 05:13:12,277
REPRESENT ALL THE COLLEAGUES AND

8480
05:13:12,277 --> 05:13:14,813
THE PEOPLE THAT WORK BEHIND THE

8481
05:13:14,813 --> 05:13:16,681
SCENES, TO MAKE THIS HAPPEN.

8482
05:13:16,681 --> 05:13:19,284
IT'S REALLY -- ALL OF YOU FOR

8483
05:13:19,284 --> 05:13:21,453
ATTENDING, ALL OF YOU, BOTH ON

8484
05:13:21,453 --> 05:13:23,989
THE ZOOM AND ALSO IN PERSON, AND

8485
05:13:23,989 --> 05:13:25,624
YOUR PRESENTATIONS, BUT NOT JUST

8486
05:13:25,624 --> 05:13:26,958
YOUR PRESENTATIONS BUT WHAT YOU

8487
05:13:26,958 --> 05:13:28,727
ALL DID BEFORE YOU CAME HERE,

8488
05:13:28,727 --> 05:13:31,663
ALL OF THE WORK YOU'VE DONE THE

8489
05:13:31,663 --> 05:13:33,632
PAST YEAR OR EVEN BEFORE THAT,

8490
05:13:33,632 --> 05:13:37,035
AS PART OF THE IMPROVE FAMILY,

8491
05:13:37,035 --> 05:13:40,405
PART OF IMPROVE AWARDEES, IT'S

8492
05:13:40,405 --> 05:13:40,939
TREMENDOUS.

8493
05:13:40,939 --> 05:13:42,707
>> ONE MORE COMMENT.

8494
05:13:42,707 --> 05:13:44,142
>> SORRY, A QUICK
REFLECTION.

8495
05:13:44,142 --> 05:13:46,578
I'M WITH THE DATA INNOVATION AND

8496
05:13:46,578 --> 05:13:47,312
COORDINATION HUB.

8497
05:13:47,312 --> 05:13:48,980
I THINK THIS IS A GREAT

8498
05:13:48,980 --> 05:13:51,183
OPPORTUNITY FOR US TO MAKE THOSE

8499
05:13:51,183 --> 05:13:53,118
CONNECTIONS, WE'VE ALL BEEN

8500
05:13:53,118 --> 05:13:56,188
MEETING ONLINE, AND I ECHO WHAT

8501
05:13:56,188 --> 05:13:57,823
CHRIS IS SAYING, THE VALUE OF

8502
05:13:57,823 --> 05:13:59,591
BEING IN PERSON AND FURTHER

8503
05:13:59,591 --> 05:14:03,094
THOSE CONNECTIONS, I WANT TO

8504
05:14:03,094 --> 05:14:13,305
REFLECT ON A