Graduate Student Internship Program

2008 Catalog of Internship Opportunities

This internship has been filled.

Intern Will Choose 1 of 3 Projects

A) Use of Folic Acid by Postpartum WIC clients
B) Breastfeeding Among Low Birth Weight Babies
C) Impact of the Deficit Reduction Act (DRA) on Initiation of Prenatal Care

Program: Office of Family Health Public Health Division, Portland, OR
Skill Area: Data Analysis and Monitoring

Agency Information

The Office of Family Health is Oregon’s Title V agency. It includes programs on Perinatal, Child, and Adolescent Health, School Health, Family Planning, Immunization, Oral Health and WIC. The intern will choose 1 of the following 3 internships: A) Use of Folic Acid by Postpartum WIC clients, B) Breastfeeding among Low Birth Weight Babies, and C) Impact of Deficit Reduction Act on Initiation Prenatal Care.

Purpose, goals, and objectives of internship

Project A: Use of Folic Acid by Postpartum WIC clients
Learning Objectives for the Graduate Student Intern: By completing this internship the student will be able to:
a. Increase proficiency in the use of statistical analysis software.
b. Critique different statistical tests to determine which are most appropriate for the type of data and project goals.
c. Develop an appreciation for mixing quantitative and qualitative techniques.
d. Feel more comfortable with developing interview and focus group questions.
e. Critically evaluate quantitative analysis results to determine the practical as well as statistical significance.
f. See self as important link in communicating epidemiological data in a manner meaningful to program staff.
g. Identify resources (publications, trainings, mentors) to continue learning after the internship.

Proposed Project to Support Student Learning Objectives:
Purpose: Previous work has shown that WIC clients are less likely to have taken periconceptual folic acid (PFA) than non-WIC clients. In 2002, the Oregon WIC program implemented a counseling protocol specific to promoting PFA. The purpose of this project is to determine whether this new counseling protocol has increased PFA intake among WIC mothers, strengthened local WIC staff’s ability to counsel on PFA, and increased knowledge of the importance of PFA in WIC clients.
Goal: Increase the proportion of Oregon WIC mothers who consume a daily source of folic acid.
Objective: Utilize a mix of qualitative and quantitative techniques to develop a better understanding of WIC’s current and potential impact on FA consumption among its postpartum clients.

Project B: Breastfeeding among Low Birth Weight Babies
Purpose: Assessment of breastfeeding among low birthweight infants. In the past, neonatal intensive care units (NICUs) generally gave infant formula to low birthweight infants; only in the past 10 years has it become clear that breastmilk is better than infant formula for low birthweight infants.
Goals: analyze Oregon PRAMS data; review literature.
Objectives: Assess whether NICUs need take steps to further encourage the use of breastmilk by low birthweight infants. Make recommendations to state health department about whether to provide additional resources to birthing hospitals (especially NICUs) to increase feeding breastmilk to low birthweight infants.

Project C: Impact of Deficit Reduction Act on Initiation for Prenatal Care
Purpose: Assessment of trends in prenatal care initiation resulting from changes required by the Deficit Reduction Act (DRA) in Oregon. The DRA requires additional documentation (including birth certificates) before enrollment in state Medicaid programs. The DRA requirements were implemented in Oregon on September 1, 2006.
Goals: analyze Oregon birth certificate data; review literature.
Objectives: Assess whether DRA implementation was followed by a decrease in the proportion of women who began their prenatal care in the first trimester. Make recommendations to state health department about what can be done to decrease the impact of the DRA for pregnant women.

Data or analytic tasks and activities

Project A: Use of Folic Acid by Postpartum WIC clients
a. The intern will use data from the Oregon PRAMS survey (1998-2005) about use of periconceptional folic acid (PFA). Analyst will particularly look at new mothers who had a live birth less than 24 months before the index birth and were WIC clients after the birth of earlier baby. We are interested in looking at trends over time in PFA and in correlating WIC education about folic acid (FA) with women subsequently taking PFA. Other data sources (including WIC client data and BRFSS) will be explored.
b. The intern will conduct a limited number of key informant interviews with WIC staff about current methods of educating post partum mothers about continuing daily folic acid intake. Staff will also be asked about perceived changes in folic acid education after the implementation of a specific counseling protocol in 2002.
c. The intern will assist with developing either interview or focus groups questions for WIC mothers to further explore their knowledge about folic acid sources (foods and pills), health benefits of folic acid, sources of information/counseling on folic acid intake, perceived need to continue taking folic acid when no longer pregnant or breastfeeding, and barriers to daily folic acid consumption.
d. The intern will summarize project findings for WIC and state health department program staff and make recommendations to the Oregon WIC program on how to increase the proportion of clients who get adequate FA daily.

Project B: Breastfeeding among Low Birth Weight Babies
a. analyze data from the 2004 and 2005 Oregon PRAMS survey comparing intake of breast milk by normal and low birthweight infants.
b. review literature and talk to people about breastfeeding of low birthweight infants.
c. write up findings for the state breastfeeding program.
d. summarize data for state and local health department program staff. Depending on the findings, perhaps prepare findings for presentation at national meetings and/or publication.

Project C: Impact of Deficit Reduction Act on Initiation for Prenatal Care
a. analyze prenatal care initiation data from the 2005-2007 Oregon birth certificates to see whether implementation of DRA was followed by a decrease in first trimester initiation of prenatal care by Oregon women. Analysis will begin by looking at monthly trend data (1/05-12/06) to seek changes in first trimester initiation of prenatal care. The same monthly trend data will then be examined to identify whether some groups of women (e.g., by race/ethnicity, insurance status, maternal education, rurality) were more affected by others.
b. review literature and talk to people about the effects of DRA.
c. write up findings for the state public health department.
d. summarize data for state and local health department program staff. Depending on the findings, perhaps prepare findings for presentation at national meetings and/or publication.

Data or analytic skills required

Some experience using SPSS or SAS is required. Experience or coursework in qualitative analysis is helpful but not required.

Supervisors

Primary supervisor will be Ken Rosenberg, MD, MPH, Maternal & Child Health
Epidemioloigst in the Office of Family Health.
Secondary supervisor depends on which project the intern chooses. For further information, contact the MCHIRC.

Internship begins

Starting time could be any time from February to July 2008.

Housing

We will be able to assist the student in locating and securing housing. Housing near the worksite is plentiful and inexpensive. Previous GSIP interns have found housing in private homes by responding to advertisements in the local daily newspaper.

Transportation

The worksite is easily accessible via public transportation from many neighborhoods.