Interconceptional Counseling: A Community Based Approach

1
Interconceptional Counseling A Community
Based Approach

• Presented By
• Broward Healthy Start Coalition
• Robin Davenport, RN, BSN
• Barbara Lesh, MPA

2
Who Receives?

• Mothers and Infants in Healthy Start
• Prenatal woman who experiences a fetal loss,
  infant death or poor birth outcome
• Prenatal woman who had a loss due to adoption or
  foster care

3
Length of Time

• A mother or infant until infants case is closed
• A woman who experiences a fetal loss, poor birth
  outcome or infant death up to 2 years

4
The Goal for Interconceptional Care

• Identifies reducible or reversible risks prior to
  pregnancy
• Maximizes maternal health
• Intervenes to achieve optimal birth outcome

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Is Broward County, FL Achieving These Goals?

• Goal Reduce Infant Mortality

The Infant Mortality Rate is Slowly Starting To
Increase
Source www.floridacharts.com
6
Goal Reduce the number ofLow Birth Weight Babies
The Low Birth Weight Babies Rate is Slowly
Starting To Increase
Source www.floridacharts.com
7
In Florida

• 502 babies a week are born preterm
  (32-37 wks)
• 84 babies a week are born very preterm (32 wks)

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In Florida

• 323 babies a week are born low birth weight
  (1500gm-2500gm)
• 63 babies a week are born very low birth weight
  (

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In Florida

• Infant mortality rate 2000 was 7.0, 2003
  was 7.5
• Low birth weight 2000 was 8.0, 2003 was 8.5
• per 1000 live births

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Care Coordination focus on

• Primary Health Care
• Maternal infection
• Family Planning
• Baby spacing
• Dental Care
• Substance Abuse Treatment

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Care Coordination focus on

• Counseling to reduce stress
• Nutrition Counseling
• Physical activity
• Environmental Risk factors
• Smoking Cessation
• Folic Acid
• Florida s Vita Grant

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Assessment and Reassessment

• Primary Health
• Dental Health
• Social Conditions
• Risk Taking Health Behaviors
• Psychological Conditions
• Environmental Conditions
• Barriers to Family Planning

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Interconceptional Counseling CurriculumHow to
use it

• Identify the clients needs from the Womens
  Health Questionnaire
• Individualize the topics to the needs of the
  participant
• Use the curriculum as a guide to ensure critical
  topics are covered

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Interconceptional Counseling CurriculumHow to
use it

• Omit topics that do not apply to the participant
• Use handouts / and demonstration activities to
  reinforce the visit
• Follow up and obtain feedback to see if
  participant understood the information
• Evaluate

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Delivery of Interconceptional Counseling

• All Healthy Start Case managers receive an eight
  hour training
• An Interconceptional Counseling Curriculum is used

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Training Objectives

• How to engage the participant
• How to discuss fetal or infant loss with the
  participant so that she understands the
  importance of participating in Interconceptional
  Counseling
• How to effectively communicate with the
  participant regarding her health behaviors and
  risk factors
• Talking points
• Effects of risk factors on pregnancy and fetal
  development

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Training Objectives

• Cultural beliefs on pregnancy and miscarriage
• Assessment of health behaviors and risk factors
• Implementation of curriculum
• Documentation
• Available resources
• Broward County diversity reflects four primary
  languages

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Where do our clients receive services?

• Individualized home visits
• Group education
• Our new WISH program for Targeted zip codes which
  have the highest fetal / infant deaths

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The WISH program Why?Zip Codes 33311and 33313
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The WISH programZip Codes 33311and 33313

• W Women's
• I Initiative
• S Start
• H Healthy

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The WISH programZip Codes 33311and 33313

• Incorporate Home Visits for every infant born in
  the targeted zip codes who is not linked with a
  home visiting program

• Provide services for Level II III participants
  to include group education and home visits

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The WISH programZip Codes 33311and 33313

• Invite every woman who has given birth in the
  targeted area to participate in the
  Interconceptional Counseling Program located at
  Lauderhill Mall

PROPOSED
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The WISH programZip Codes 33311and 33313

• Collaborate with existing programs that provide
  services in the targeted zip code to increase
  wrap services and build capacity in those
  programs

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The WISH programZip Codes 33311and 33313

• Proposed partnerships
• Love thy Labor Doula Services
• Healthy Families Broward
• Faith Based Organizations
• Urban League
• Work Force One
• Broward County Health Department
• WIC
• Family Planning
• STD/HIV Services
• Community Outreach

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Challenges for Interconceptional Counseling

• Teaching the staff to market the program
• Willingness of participants to accept the services

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Evaluation of Services

• Quality Assurance, Quality Improvement
• Monitored site visits
• Peer record review
• Satisfaction Surveys

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Interconceptional Counseling

• From July 2004 to date 30 of records reviewed
  had Interconceptional Counseling

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Broward Healthy Start Coalition
Thank You!
From Florida