1. MCH Workforce Development
  2. Highlighting Diversity and Health Equity

Highlighting Diversity and Health Equity

The Division of MCH Workforce Development (DMCHWD) supports programs that address disparities and inequities, and their underlying causes, through development of curricula, research, learning and practice environments. This month, DMCHWD is pleased to share grantee and trainee highlights related to diversity and health equity.

Program Highlights

Healthy Tomorrows Partnership for Children Program

COMING SOON!! The Healthy Tomorrows Partnership for Children Program (HTPCP) funded by the Division of Maternal and Child Health Workforce Development in the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau will be releasing a recommendations report to guide HTPCP grantees in increasing the focus of health equity in their work. Achieving health equity for its program participants is a key component of HTPCP. The report will include HTPCP grantee insights into their work to advance health equity, including the impact of COVID-19 on current operational status, and opportunities and challenges. For more information visit the HTPCP program webpage.

MCH Navigator Launches New Resources Focusing on Diversity and Health Equity

MCH Evidence Center has launched a new landing page: Work Together with Equity Tools. Use this page to access specific approaches and tools that the Evidence Center uses to advance health equity and address social determinants of health.

The MCH Navigator, the National Maternal and Child Workforce Development Center, and the National Center for Education in Maternal and Child Health are pleased to present this spotlight of online trainings and resources for use by the Title V workforce in approaching diversity as a way to address health disparities, health equity, and removing barriers to care.

Awardee Highlights

Use of an Advisory Committee to Support Diversity and Health Equity in the Virginia Mental Health Access Program

Virginia Mental Health Access Program

The Virginia Mental Health Access Program is a statewide initiative that supports health care professionals who care for children and adolescents with mental/behavioral health conditions. VMAP recognizes that there is not equitable access to behavioral healthcare and we are committed to addressing and reducing the disparities by working toward health equity across the state.

In response to reducing pediatric mental health disparities, a health equity advisory committee was formally established in March 2021. Its role is to support the mission and vision of the Virginia Mental Health Access Program by ensuring diversity and inclusion by applying an equity lens to all policies, practices, and program services.

Specifically, the purpose of the advisory group is to: 1) ensure a health equity lens is applied to all VMAP work; 2) promote the use of data to drive program planning and implementation; and 3) provide recommendations on ways we can adjust to improve performance.

The activities of the advisory group include:

  • Assist the VMAP executive committee in ensuring program policy decisions are made though a behavioral health equity lens;
  • Advise the regional hubs and executive committee on ways to expand VMAP stakeholder and provider membership through diverse partnerships statewide;
  • Use program data to set goals with respect to behavioral health equity, monitor progress and provide recommendations as needed to make improvements in our approach;  and
  • Provide guidance through specific recommendations and program benchmarks where VMAP can make progress on behavioral health equity at both the regional hub level as well as within the state administration.

The Equity Corner

Delaware Child Psychiatry Access Program (DCAP)

Richard Margolis, MD Project Director

Joseph Hughes, Project Manager

Mindy Webb, Project Behavioral Health Care Coordinator

The Delaware Child Psychiatry Access Program (DCPAP) distributes a monthly newsletter to its registered participants, their support staff, potential participants, our advisory council, project partners, training attendees, friends, associates, and a wide range of community professionals. This publication offers general mental health, program and community information along with both provider and resource highlights.

Each month, recipients have access to our 4 corners feature offering updates for NAMI Delaware, the Mental Health Association of Delaware, COVID and Equity. Each Equity Corner focuses on national and state health equity issues and initiatives. Our goal is to increase provider knowledge of mental health needs, related challenges of around diverse populations and access to services and supports.

Health Equity Guide for Public Health Practitioners and Partners

Center for Trauma Counseling Mobile Hope Clinic – Accessible Mental Healthcare for Children & Families

Healthy Tomorrows Partnership for Children Program

Since 2012 Center for Trauma Counseling's mission is to ensure the immediate availability of cost-effective mental health services to serve the most "in need" in Palm Beach County impacted by trauma related experiences, regardless of socioeconomic status.

Center for Trauma Counseling's Mobile Hope Clinic (MHC) is providing Palm Beach County with its first mobile counseling center, brining high quality, affordable mental health care to underserved at-risk youth and their families. MHC provides a collaborative solution to enhance youth well-being, bridging gaps and foiling barriers to mental health services to provide early preventive intervention. MHC is complementing and coordinating with healthcare providers, families, and partnering community agencies to provide assessments and personalized therapy, and brought directly to underserved neighborhoods.  The solution of, The Mobile Hope Clinic, is to improve access to affordable, quality mental health services to economically disadvantaged and underserved at risk populations within Palm Beach County. With mental health and traumatic event exposure on the rise, CTC is a part of the solution by making mental health services accessible and equitable in our community. 

Mobile clinics physically drive into communities, reducing barriers by reaching out to the unserved populations.  MHC fits directly into the focus area of health access and diversity by offering a solution, affordable or free mental health services, to parts of the county that are otherwise unable to access affordable or free, evidence-based outpatient mental health counseling.  By bringing these services into more dire areas in the county, more economically disadvantage, underserved and at-risk children, adolescents, and families will have an opportunity for equal engagement in trauma-based counseling that other residents in the county already have access to.

Telehealth Manual: Resources for Healthcare Providers Working with Children, Adolescents, and Families

Rose F. Kennedy Leadership Education in Neurofevelopmental and Related Disabilities Program

While telehealth is not a new phenomenon, since the onset of the COVID-19 pandemic, it has increasingly become a modality that clinicians and patients have come to rely on. Telehealth has afforded many children/adolescents and their families access to treatment that may have otherwise been unobtainable. Despite numerous strengths to this modality, there also come challenges and the need for clinicians to think flexibly and creatively and to individually tailor the treatment and approach to the individual, particularly when working with children with a range of neurodevelopmental disabilities. As part of the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) fellowship at Montefiore Medical Center, Rose F. Kennedy, Children's Evaluation and Rehabilitation Center (CERC), psychology and social work trainees worked together to create a telehealth manual, providing resources that can be easily adapted to the clinical encounter. The objectives of the manual included providing clinicians with information on (a) a brief history of telehealth, (b) the shift to the use of, and increasing reliance on, telehealth in 2020-2021, during the COVID-19 pandemic, (c) tips for clinicians and patients who are engaging in telehealth practices, (d) activities and resources that can be implemented as part of telehealth sessions, organized by age and presenting concern (e.g., attention/executive functioning, social skills, anxiety, parent management), (e) crisis intervention resources with tips for implementation via telehealth, (f) resources for families (in English and Spanish), and (g) references, resources, and helpful links for clinicians. A presentation on the manual was provided to a group of LEND fellows and clinicians and the manual was made available to all clinicians employed at the clinic, including psychologists, social workers, developmental behavioral pediatricians, speech and language pathologists, a psychiatrist, an occupational therapist, a physical therapist, and LEND fellows from across these disciplines. Results from a survey completed by attendees revealed positive feedback on the usefulness of resources. Second Annual Transition Planning Webinar Series for Youth and Young Adults with Learning, Intellectual, and/or Developmental Disabilities Rose F. Kennedy Leadership Education in Neurodevelopmental and Related Disabilities Program Transition planning is an integral component of post-secondary planning for youth/young adults with intellectual, developmental, and learning disabilities. It can be a complicated, confusing, and intimidating process, yet one that is vital to ensure that adolescents and young adults make a successful transition out of high school and into adulthood. Transition planning is particularly important for youth/young adults with special needs. During the summer of 2020, CERC hosted a series of webinars on transition planning during the time of COVID. These webinars addressed topics regarding postsecondary transition planning for young adults including higher education programming, day programming, and community opportunities. Due to strong attendance and positive satisfaction ratings after the webinars, a second series of webinars was planned, incorporating attendees' suggestions and requests for future webinars. This 2021 webinar series targeted a range of transition related topics including: medical transition in youth with developmental disabilities (DD); medical issues in young adults with DD; special needs planning, guardianship, and supported decision making; and OPWDD eligibility, services, and self-direction. Youth/young adults, their families, and providers heard from speakers during each of three webinars with opportunities for questions and meaningful conversation after the webinars. Given a large Spanish speaking population in the Bronx, NY, separate webinars, on the same topics, were provided in Spanish, immediately following the English presentation. Attendees completed a survey at the end of each webinar, available in English and Spanish, allowing for analysis of consumer satisfaction and suggestions for future webinars. Tip sheets and resources on transition planning were made available to attendees, in both languages.

Second Annual Transition Planning Webinar Series for Youth and Young Adults with Learning, Intellectual, and/or Developmental Disabilities

Rose F. Kennedy Leadership Education in Neurodevelopmental and Related Disabilities Program

Transition planning is an integral component of post-secondary planning for youth/young adults with intellectual, developmental, and learning disabilities.  It can be a complicated, confusing, and intimidating process, yet one that is vital to ensure that adolescents and young adults make a successful transition out of high school and into adulthood. Transition planning is particularly important for youth/young adults with special needs. 

During the summer of 2020, CERC hosted a series of webinars on transition planning during the time of COVID.  These webinars addressed topics regarding postsecondary transition planning for young adults including higher education programming, day programming, and community opportunities. Due to strong attendance and positive satisfaction ratings after the webinars, a second series of webinars was planned, incorporating attendees' suggestions and requests for future webinars.
This 2021 webinar series targeted a range of transition related topics including: medical transition in youth with developmental disabilities (DD); medical issues in young adults with DD; special needs planning, guardianship, and supported decision making; and OPWDD eligibility, services, and self-direction. Youth/young adults, their families, and providers heard from speakers during each of three webinars with opportunities for questions and meaningful conversation after the webinars.  Given a large Spanish speaking population in the Bronx, NY, separate webinars, on the same topics, were provided in Spanish, immediately following the English presentation.  Attendees completed a survey at the end of each webinar, available in English and Spanish, allowing for analysis of consumer satisfaction and suggestions for future webinars.  Tip sheets and resources on transition planning were made available to attendees, in both languages.

Rose F. Kennedy LEND program at Montefiore Children's Hospital "Preparing Back to School" multilingual Webinars

Rose F. Kennedy Leadership Education in Neurodevelopmental and Related Disabilities Program

This year may be a transition for families, as schools return to in-person learning. The change may bring up many questions, concerns and anxieties for children and parents. In order to support families through this transition, staff at Rose F. Kennedy LEND program at Montefiore Children's Hospital developed a webinar with helpful tips. Topics included:

  • identifying emotions and concerns,
  • coping skills,
  • dealing with uncertainties,
  • having play dates,
  • creating social stories,
  • visiting the school,
  • screen time,
  • healthy sleeping and eating habits.  

To serve our multicultural and ethnically diverse audience, multilingual staff developed the webinar, which is available in English, Spanish, French, Italian, Korean and Mandarin.

Attendees can complete a survey at the end of each webinar in each language.

Rose F. Kennedy LEND program Webinar

The Rose F Kennedy Children's Evaluation & Rehabilitation Center CERC/UCEDD The Children's Hospital at Montefiore Montefiore University Hospital for Albert Einstein College of Medicine

Promoting Diversity and Health Equity through Research, Training, Clinical Activities and Public Policy

University of California San Francisco Leadership Education in Adolescent Health

The Division of Adolescent and Young Adult Medicine at the University of California, San Francisco is actively working to promote diversity and health equity on multiple fronts.  

Leveraging technology to advance health equity

The following are two noteworthy projects:

Engaging Adolescents in Health Careers with Technology-Rich Personalized Learning

Primarily supported by an NIH Science Education Partnership Award (SEPA) in collaboration with North Carolina State University and the UCSF Office of Diversity and Outreach, with additional support by MCHB, Health Quest aims to address the underrepresentation of racial and ethnic minorities and women in health research and the health professions. A diverse biomedical, behavioral, and clinical research workforce would be significantly better equipped to serve the nation's health needs and it is imperative for all students to learn about the exciting careers in the field of health sciences. Health Quest is designed to increase middle school students' interests in health science careers by: 1) Allowing students to learn about the career paths of health professionals through interactive video interviews. Specifically, students will learn firsthand how professionals in biomedical, behavioral and clinical research fields became interested in their career fields and how they prepared for them while also getting to explore some of the day-to-day activities of these scientists; 2) Engaging students in a rich narrative driven health sciences adventure game where students can choose which science field to explore and then embark on a mission to help solve a scientific problem or answer a critical research question; and 3) Providing classroom teachers with the tools and resources they need to implement Health Quest in their classrooms. Health Quest Website

Health-E You / Salud iTu

Health-E You / Salud iTu is an innovative, interactive, individually tailored web-based mobile health application (app) in English and Spanish to promote equitable access to comprehensive contraceptive information and services for adolescents, to improve the delivery of patient-centered contraceptive care, and to reduce racial/ethnic disparities in unintended pregnancies. A cluster randomized control trial of 18 school-based health centers (SBHCs) with 1,360 Latina adolescents from the 2nd largest school district in the nation, were randomized to implement the app or to a control standard of care. Prior to their visit with a health care provider, participants completed a baseline survey, intervention participants then used the app, and then they proceeded to their visit. Participants received follow-up surveys 48 hours, 3- and 6-months after their recruitment visit. Health-E You significantly increased adolescents' sexual health knowledge; helped prepare adolescents to select a contraceptive method; and increased self-efficacy (in talking with their doctor about birth control, having the information to choose birth control and using birth control correctly). App user had greater increases in non-barrier contraceptive use from baseline (29% intervention vs. 30% controls) to 3 months (63% vs. 45%; OR = 3.29, 95% CI 1.04–10.36, p = 0.04) and 6 months (63% vs. 44%; OR = 5.54, 95% CI 1.70–18.06, p = 0.005). Providers and adolescents reported high app satisfaction and stated it improved visit quality. We are now implementing this intervention in 28 SBHCs representing 11 states across the country to promote health equity in access to adolescent-centered contraceptive information services and care. This project is funded by the Patient Centered Outcomes Research Institute (PCORI), DI-2020C2-20372. LINK:

Child and Adolescent Gender Center

The Child and Adolescent Gender Center (CAGC), is a collaboration between UCSF and community organizations. It uses a multidisciplinary approach to offer comprehensive, gender affirming care to gender diverse/transgender youth and adolescents. The UCSF CAGC Clinic is housed within the Division of Pediatric Endocrinology. Our clinic providers include pediatric endocrinology physicians and nurse practitioners, adolescent medicine physicians, pediatric psychologists, a psychiatry nurse practitioner, social workers, and administrative support staff. Our overarching goal is to provide medical and psychological care, as well as advocacy and legal support to all our patients. We help children and families connect to local resources and support groups, refer to counselors who are trained in the care of transgender youth, and provide legal and educational support. We support children and their families through their social, medical, and/or surgical transition. If and when children and their families are ready to pursue medical therapies, we prescribe and manage puberty blockers, menstrual suppression, and gender affirming sex hormones.

Transgender Youth Curriculum

Our Division is dedicated to training multidisciplinary providers to provide gender-affirming care to youth and young adults. Therefore, we have developed a comprehensive pediatric transgender curriculum for multidisciplinary clinical trainees comprised of online modules, an observership in a pediatric gender clinic, and standardized patient encounters. The interactive online modules have a primary care focus with topics regarding transgender terminology, taking a gender history, taking a psychosocial history, performing a sensitive pubertal examination, and developing psychosocial and medical plans. For the observership, trainees are exposed to real patients with an experience in a pediatric transgender clinic. The most recent addition to the curriculum is a standardized patient encounter half-day, which allow trainees to practice skills in interacting with transgender youth while being remotely observed by faculty who complete skills checklists. These encounters involve trainees taking a history and counseling an actor portraying transgender teens presenting with questions about medical transitioning. To date, our curriculum has trained over 150 pediatrics interns, psychiatry interns, medical students, and nurse practitioner trainees. Additionally, the curriculum has been rigorously evaluated and found to improve learner knowledge, skills, and self-efficacy in gender-affirming care.

Examining Mental Health Outcomes and Gender Affirmation for Transgender Youth of Color Study

This research is supported by Robert Wood Johnson Foundation and uses large datasets to quantify and document disparities experienced by Black and Latinx transgender youth. Using the California Healthy Kids Survey, which is a school-based survey administered to secondary students throughout the state of California, multivariable analyses are used to compare Black and Latinx transgender youth to two cohorts of peers: White transgender youth and Black and Latinx cisgender youth. This research found that that Black and Latinx transgender youth had similar levels of depressive symptoms and suicidality compared to White transgender youth but significantly higher than Black and Latinx cisgender peers. Additionally, compared to White transgender youth, Black and Latinx transgender youth had lower levels of school connectedness. Compared to Black and Latinx cisgender peers, Black and Latinx transgender youth experienced higher gender-based, race-based, and sexuality-based harassment. Furthermore, harassment and victimization were associated with higher odds of both past-year depression and suicidality among Black and Latinx transgender youth when controlling for demographic covariates.

Salinas Teen Health Study Understanding Latino adolescents' trajectories of risk and resilience

This research is conducted in partnership with colleagues from RTI, UC Berkeley, and the Monterey County Health Department, examines the relationship between gang violence, unintended teen pregnancies, and mental health in Salinas, California - a small, predominantly Latino community in California's rural central coast. Although some research has examined the association between violence and teen pregnancies in large urban centers, little is known about this association in rural communities. Formative work from this investigation highlighted the critical role that family plays in positive youth development and reproductive health knowledge. This formative work, and the community engagement associated with it, also revealed wide-spread concern about the mental health of Salinas youth. Current papers under development focus on immigrant-specific Adverse Childhood Events as well as the relationship between exposures to discrimination and mood disorders in later adolescence. This group just received additional NIH funding to follow the original cohort of 600 adolescents into young adulthood.

Supporting training, technical assistance, and program evaluation for Expectant and Parenting Youth (EPY) through the California Maternal Child and Adolescent Health (MCAH) Division, within the Department of Public Health

The Adolescent Family Life Program Positive Youth Development (AFLP PYD) Model provides comprehensive case management services to EPY throughout the state. AFLP PYD predominantly serves Latina adolescents and is focused on improving health equity and positive outcomes for both the mother and their offspring. AFLP PYD case managers meet with their clients in-person twice per month (over the course of a year and in many cases, longer). With youth-centered support, EPY and their children can draw on their personal strengths and community services and supports to achieve positive social, educational, health and economic outcomes. Case managers support youth in developing a sense of purpose, positive identity, and skills, such as resourcefulness and problem solving, to build resilience. During the Pandemic, Division faculty conducted a study is to showcase some of the challenges experienced with the transition to and implementation of tele-visits and to identify strategies both in terms of practice and policy that enhance case managers' ability to connect, engage and continue to support EPY.

Disparities in Access to Eating Disorder Therapy for Publicly Insured Youth and Youth of Color

Minorities in the United States have lower rates of access to most forms of health care, with particularly disparities in access to mental health care. Little is known about access to mental health care among minority patients with eating disorders, though these are among the most fatal metal health illnesses for teens. The objective of this study is to examine the association between insurance type and therapy received by racially/ethnically diverse youth in UCSF's outpatient eating disorders program. The UCSF Eating Disorder Program sponsored a summer research position for a Latina UCSF medical student, mentored by two Latina faculty members in Adolescent Medicine and Psychiatry as well as the medical director of the Eating Disorder Program. With mentorship the student conducted a retrospective chart review of youth ages 11-25 (N=1,060) presenting to our urban adolescent medicine specialty program for management of eating disorder symptoms between June 1, 2012 and December 31, 2019. Charts were reviewed for demographics, diagnosis, and therapy received. Bivariate and logistic regression analyses were performed for factors predictive of receiving indicated specialized mental health therapy within six months of evaluation. Results demonstrated that patients with private insurance were three times more likely to receive indicated therapy than patients with public insurance. Latinx and Asian patients were half as likely to receive indicated therapy as White patients. Overall, this study demonstrates that while access to mental health care is a necessary and important first step towards equity in eating disorder care, additional work is needed to dismantle systemic inequities that contribute to disparities in care for youth of color.

Supporting training and program development for the California Medical Association and regional hospital systems within the state of California to recognize systemic racism as it impacts racial and ethnic minority patients and providers

The California Medical Association (CMA) has been working to increase diversity, equity, and inclusion for the past 5 to 6 years. As part of this effort CMA established a committee entitled the Justice, Equity, Diversity and Inclusion Council (JEDI). To advise the CMA on recommendations for moving CMA to support additional pipeline programs to promote a diverse work force and address issues of health disparities and injustice. This committee sought expert advice from Dr. Raymond-Flesch related to structural racism as it impacts patients' health as well as workforce issues related to diversifying the medical education pipeline and creating more supportive and inclusive work environments for providers who are underrepresented in medicine. Dr. Raymond-Flesch has also advised regional medical systems within California on these topics including the Health Improvement Partnership of Santa Cruz County.

Diversity and Health Equity at Children's Hospital Los Angeles

Children's Hospital Los Angeles Leadership Education in Adolescent Health

In 2019, Children's Hospital Los Angeles (CHLA) was one of 9 institutions, and the only free-standing children's hospital, selected to participation in the Accreditation Council for Graduate Medical Education Pursuing Excellence Initiative. This initiative is focused on eliminating Health Care Disparities and one of our Leadership Education in Adolescent Health (LEAH) faculty is a key participant in this effort. As a result of our involvement in this initiative, CHLA incorporated equity goals as a cross-cutting theme across all components of the enterprise strategic plan. CHLA created a health equity dashboard and added equity measures to the organizational performance dashboard. Internal quality improvement training as well as standard tools and templates for root cause analysis and lean/six sigma now include equity principles and checklists. We created a teaching and learning collaborative to bring together interdisciplinary groups of staff, faculty, and trainees, to develop and implement education on cultural humility, structural competency, and personally mediated racism and bias.

The Division of Adolescent and Young Adult Medicine (DAYAM) has also been working on an internally focused diversity, equity, and inclusion initiatives and each program within the DAYAM has been developing concrete action plans and sharing it broadly with our peers and establishing accountability mechanisms. This work fits well into the hospital's global DEI initiative that has included improving data collection around race and ethnicity, improving SOGI data, reducing disparities in behavioral health emergency calls, and addressing disparities in patient satisfaction.

Talking Race, Kids & Health

Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP)

Maryland Behavioral Health Integration in Pediatric Primary Care Telepsychiatry Access Program (BHIPP TAP) is a Pediatric Mental Health Care Access (PMHCA) awardee that provides support to pediatric primary care providers in addressing the behavioral and developmental needs of their patients.

The state of Maryland has considerable diversity in sociocultural determinants of health, health outcomes, and demographic characteristics across jurisdictions. MD has one of the highest opioid overdose rates in the nation, and quite a few counties have overall health outcomes and overall health factors in the bottom-ranked quartile in the state, with several others in the bottom half. With respect to sociodemographic makeup of residents, MD has one of the fastest growing Latino populations in the US, and several counties have a higher proportion of African American residents than the state as a whole. Given these unique and varying characteristics which impact health and health disparities in a myriad of ways, BHIPP utilizes numerous approached to address health disparities at the individual and community levels.

As part of a series of interactive, web-based learning sessions called BHIPP Resilience Breaks, BHIPP recently featured a webinar on Talking Race, Kids & Health, presented by Jacqueline Douge, MD, MPH, FAAP. These Resilience Breaks are designed as a virtual space for pediatric primary care and behavioral health providers to connect, learn and share about strategies, practices, and resources to promote mental health and resilience among children and families as well as providers. Throughout this presentation, Dr. Douge highlighted strategies to increase cultural and linguistic competence and improve diversity and health equity in the pediatric primary care setting. Learning objectives focused on 1) the role of pediatric health care providers in addressing race and racism, 2) how healthcare providers can develop cross-sector collaborations to improve health outcomes and 3) using books to open and further the conversations about race with children. To access archived webinars, please visit BHIPP Resilience Breaks.

Additionally, BHIPP recently launched an Anti-Racism Resources page on our website which highlights resources specific to families, healthcare providers, coping with community violence and racial trauma, and mental health resources for black, indigenous, and people of color.

MCH Diversity, Equity and Inclusion

University of North Carolina MCH Center of Excellence

The UNC Center of Excellence in Maternal and Child Health Education, Science and Practice and the UNC Department of Maternal and Child Health is committed to fostering inclusive excellence. In 2020, the Department implemented new guidelines that require all faculty and staff complete 8 hours of Diversity, Equity and Inclusion (DEI) trainings each year, and formed a DEI Workgroup comprised of faculty, staff, and student representatives. DEI training topics include race and cultural competence; special populations; sexual orientation/gender expression; mental health; sexual assault/intimate partner violence; employment equity. The DEI Workgroup is committed to transparency in the process of meeting, organizing, and taking action steps toward antiracism and inclusive excellence.

The initiatives implemented by the UNC Department of Maternal and Child Health align with the commitment and initiatives already established by the University and the Gillings School of Public Global Health. At Carolina, diversity and inclusion are about building understanding across differences, creating conditions to ensure the equitable educational and social benefits of diversity and cultivating an inclusive and supportive environment for undergraduate, graduate and professional students, faculty and staff – where every person feels valued and has an opportunity to add value.

UNC Center of Excellence in MCH Leadership Panel

University of North Carolina MCH Center of Excellence

The UNC Center of Excellence in Maternal and Child Health Education, Science and Practice will be hosting a virtual Leadership Panel on October 5, 2021 via Zoom Webinar. The theme of this year's panel is Leading for Equity in MCH: Collaborations between practice and research to enhance the health of MCH populations. The effects of the pandemic have exposed disparities in equitable access to quality health care and resources in our communities, the U.S. and across the globe. It is times like these leaders in MCH push even harder to close the gap. Three talented groups of panelists comprised of maternal and child health leaders from academia, state government, and non-profit organizations will demonstrate how they effectively collaborate to advance equity in MCH practice, policy and or research.

Summary of Advancing Health Equity Through Reproductive Justice Syllabus

University of North Carolina MCH Center of Excellence

Ariel Lewis, MPH developed a syllabus titled Advancing Health Equity Through Reproductive Justice for the UNC Gillings School of Global Public Health. The syllabus is also featured as a MCH foundations resource by the Association of Teachers of Maternal & Child Health (ATMCH). This 4-credit elective course introduces graduate-level public health students to the history, theory and practice of reproductive justice within the context of the United States.

Advancing Health Equity Through Reproductive Justice is designed to provide students with foundational knowledge and skills to become informed anti-racist and reproductive justice advocates who lead with compassion and ensure the dignity of all people. Learning objectives for this course correlate with the following competencies: MCH substantive knowledge, MCH leadership, and health equity, social justice and human rights. As such, this course can be cross-listed between the Maternal, Child and Family Health concentration and the Health Equity, Social Justice and Human Rights concentration offered by the Gillings School of Global Public Health.

There is increasing engagement with reproductive justice (RJ) within the public health sphere. A review of the MCFH core curriculum reveals an opportunity to enhance content on the following communities and topics for the U.S. specifically: anti-racism praxis, LGBTQ-GNCNB (Lesbian, Gay, Bisexual, Transgender, Queer and Gender Non-Conforming, Non-Binary) communities, BIPOC (Black, Indigenous and People of Color) communities, historical reproductive injustices in the U.S., the disability community and disability justice, and domestic policy advocacy. Advancing Health Equity Through Reproductive Justice is therefore a unique and timely offering for students in the MCFH Concentration and other graduate-level public health students at Gillings seeking to gain a deeper understanding of health equity, social justice and human rights in the context of sexual and reproductive health in the U.S.

Boston LEAH Brings Sexual Health Education to At Risk Youth, Emphasizing Identity and Autonomy

Boston Leadership Education in Adolescent Health

EXPRESS Yourself is a Boston LEAH Fellow led experience designed to embolden diverse young people in the community to take charge of their sexual health through an interactive educational curriculum. The program is rooted in human rights principles, drawing upon expertise from advocates, educators, and medical providers with tailored content according to the developmental capacity and lived experiences of the adolescents and young adults in attendance. The youth are insufficiently served by school-based sexual and reproductive health education models as a result of inconsistent school attendance, homelessness, trauma history, and other unique barriers. Through this program, Fellows engage with the community in a meaningful way while learning the basics of sexual health education through observation and participation. Partners include Boston HIV Adolescent Provider and Peer Education Network for Services (HAPPENS), Bridge Over Troubled Waters, and ROCA. Priscilla Portugal-Moreno, Boston HAPPENS Health Services Advocate and EXPRESS Yourself Outreach Coordinator, developed and teaches the program curriculum. Priscilla and Drs. Alexandra Edwards and Sydney Hartman-Munick, two senior fellows in the Boston Children's Hospital LEAH Program, have taken the lead to develop this experience for current and future trainees.

From left to right: Priscilla Portugal-Moreno, EXPRESS Yourself Outreach Coordinator and Boston HAPPENS Health Services Advocate, Alexandra Edwards, MD, Boston LEAH Adolescent Medicine Fellow, Sydney Hartman-Munick, MD, Boston LEAH Adolescent Medicine Fellow

Teen CHWs Bring Health Resources to Communities of Color

HRSA Healthy Tomorrows: The East Side Community Center: A Hub of Health and Empowerment for Youth and Community YWCA New Britain; New Britain, CT

In Photo from Left to Right: Itzel Colon, Yeyris Ortiz, Danyelix Echevarria, Asli Aden

Teens from New Britain High School completed a Community Health Worker (CHW) training course (90 hours) and are focusing on Health Equity for their 1,000 hour Fieldwork requirement to become state certified CHWs. Teens helped organize a 'Summer Bash' at Chesley Park which focused on bringing health resources, including COVID19 vaccinations, to New Britain, CT's East Side community.  Teens surveyed 63 residents regarding: hesitancy surrounding the COVID19 vaccine, resources and education services that were needed as a result of the pandemic, and what (if any) mental or physical effects the pandemic had on local families.  Community based organizations were present to talk with the community regarding: rental & housing assistance, mental health services, alcohol & opioid addiction, neighborhood safety, and more.  The Community Health Center brought their mobile vaccine clinic, and at the completion of the event, vaccinated 14 people.  Regarding her CHW training course, Danyelix stated, "We learned about people- how to treat them and communicate with them.  If people don't trust you, they're not going to listen to you.  Being able to talk with somebody is the most important thing. We also learned a lot about health.  I feel like not judging people is the most important thing.  Instead of seeing someone and judging them, as yourself, 'How do I help that person or reach that person'."

Diversity Scholars Leadership Program - Supporting Students of Color through Mentorship

Center of Excellence in Maternal and Child Health at Boston University School of Public Health (BUSPH)

Higher education represents academic and professional growth and increased opportunities. However, it is costly and taxing for Black, Indeginous, and people of color (BIPOC) or first generation students. Predominantly white institutions often leave BIPOC and first generation students feeling isolated and overwhelmed. These students have unique challenges - providing emotional and financial support to their families and navigating microaggressions that permeate social and classroom interactions. These experiences tax students' health and well-being and compromise their ability to flourish. 

To address the challenges BIPOC and first generation students face, BUSPH Center of Excellence in Maternal and Child Health created the Diversity Scholars Leadership Program (DSLP).1 DSLP offers support and community among students with shared experiences through: 1) mentorship, 2) tuition support1, and 3) community building among scholars, alumni, and faculty.

A core aspect of DSLP is the alumni mentorship. Each DSLP scholar is matched with a BIPOC mentor who supports scholars from professional development and navigating academic and professional settings as BIPOC individuals, to sharing lived experiences and building connections over shared passions.

"One of the best things about being a part of DSLP is the ability to build community through shared experiences and affirmations! I've had much of my experiences validated which has empowered me to strengthen my mission to pioneer change in my lineage. Also, being paired with a mentor who support and elevates my initiatives on this effort has been rewarding and therapeutic. There's just something about growing and elevating each other in the process that bring so much healing and internal harmony." - current DSLP scholar.

Mentors also offer valuable advice, drawing from their experiences in the MCH and greater public health space.

"My DSLP mentoring experience has been empowering. She is an incredible role model and has really opened my eyes to all the opportunities available in our field. I've been able to approach every conversation with honesty and curiosity, and that alone has had a tremendous impact on my personal, academic, and professional life." - current DSLP scholar.

DSLP creates a space that validates and affirms students' experiences, encouraging authenticity and allowing them to thrive.

Virtual DSLP Dinner in February 2021 with current
scholars, alumni, faculty, and mentors.

Promoting Diversity and Health Equity: UNC Greensboro Names 10 Undergraduate Scholars for the LEAD in MCH Traineeship

The UNC Greensboro School of Nursing accepted 10 pre-licensure BSN students to the Leadership, Education and Diversity in Maternal Child Health (LEAD in MCH) scholar program this summer. To promote diversity in nursing, student scholars were recruited from culturally diverse, underrepresented, and underserved backgrounds and demonstrated a passion for maternal child health and/or public health. The program aims to address the health disparities gap by bringing socioeconomic, racial and ethnic diversity to the maternal child health workforce. The LEAD in MCH program offers student scholars the opportunity to complete enhanced MCH coursework, attend monthly seminars specific to MCH leadership competencies, as well as participate in tutoring, advising and MCH focused simulations. Student scholars also participate in an MCH internship and have expanded clinical options as part of the program.

This is the first year for the LEAD in MCH program at UNCG. The LEAD in MCH program is led by Carrie Hill, PhD, RN, Director of the RN to BSN Program and Audrey Snyder, PhD, RN, Associate Dean for Experiential Learning and Innovation at UNCG School of Nursing.

San Ysidro Health - Improving the health and well-being of the communities we serve with access for all

Healthy Tomorrows Centro De Salud La Comunidad De San Ysidro Inc (San Ysidro Health)

Born out of the civil rights movement in 1969, San Ysidro Health (SYHealth) was founded with diversity and inclusion in mind. From its humble beginnings, SYHealth's focus has been to provide the highest quality of care to families and individuals with the utmost compassion. As the organization's growth continues throughout San Diego County its priority to provide access to care for all, without exception remains at the forefront.  With the commitment and determination to advance its diversity, equity and inclusion efforts, SYHealth strives to ensure all are welcomed when entering any of its clinics.

Today, SYHealth stands on the shoulders of its founding mothers, staff and volunteers who have left a  lasting impact through the support and care provided to its 108,000 patients.  As a trusted community messenger, SYHealth hires within the communities it serves to ensure its team is reflected of the community it serves. The COVID-19 pandemic has disproportionately impacted the families SYHealth serves in Central, South, East and Rural San Diego County. Data showed that infection rates were rampant in communities made up of essential workers that did not have an opportunity to work from home and are employed in high-contact and high exposure jobs. To support San Diego County's COVID-19 recovery efforts, SYHealth has been on the frontlines providing COVID-19 vaccination, testing, resources while continuing to provide comprehensive care services. To date, SYHealth has provided more than 50,000 vaccines to individuals in neighborhoods affected most by the pandemic. SYHealth continues to lead vaccination efforts by going to locations that are most convenient for individuals. "Even though most vaccination stations are offering walk-ins, patients are still being referred to us internally to help them schedule COVID vaccines through the county which is a reflection of the need that there still is to reach certain members of our community and how our resource centers are essential in filling the gap for populations with greater limitations and access to health care". Daniel Ramirez, Program Manager. COVID-19 vaccines, testing and routine care services are available to all individuals, specifically targeting essential workers, many of whom are Latino and reside in the South Region.

Although the COVID-19 pandemic hindered routine care for individuals, it did not disrupt SYHealth's ability to stay open and continue providing the highest quality of care with compassionate.

Healthy Tomorrows Partnership for Children Program – Enhancing Family Engagement

Earlier this year, the Healthy Tomorrows Partnership for Children Program (HTPCP) grantees had the opportunity to compete for a $5,000 stipend to strengthen family engagement activities in their respective projects. Below are a compilation of stories from HTPCP grantees across the U.S. sharing successes they have seen in their projects by incorporating family engagement activities. The following HTPCP projects involved families in their projects through activities such as Advisory Board participation, reviewing materials and resources produced by the project for cultural/linguistic competence and health literacy levels, leading family support groups, and participating in the development of staff trainings.

New York-Presbyterian Hospital's Turn 2 Us Family Engagement Stipend Project brought mental health focused workshops to caregivers of New York-Presbyterian Hospital's Ambulatory Care Network pediatric patients

New York-Presbysterian Hospital's Turn 2 Us – Healthy Tomorrows Partnership for Children

New York-Presbyterian Hospital (NYP)'s Turn 2 Us (T2U) is a school-based mental health promotion and prevention program, serving elementary schools in Northern Manhattan, NYC. T2U promotes mental health and academic success in at-risk children. We hope to empower the entire school community (students, caregivers, and school staff) to engage in healthy lifestyle practices that promote wellbeing. The program aims to enhance the mental health literacy of school personnel and caregivers, so they are equipped to ensure our youths' progress emotionally, socially, and academically. T2U aims to also raise awareness of the importance of mental health, even in the absence of mental health conditions, and decrease the stigma associated with mental health.

The Family Engagement Stipend Project aimed to support caregivers in the community, reaching beyond our targeted audience of the local school community. Workshops were promoted amongst caregivers of patients in NYP Ambulatory Care Network's pediatric outpatient practices. T2U held three workshops: 1) Identifying and Managing Stress in Children; 2) The Real Impact of Social Media on Youth and; 3) Self-Care is Essential for Caregivers. Workshop participants completed a mental health literacy survey to gauge the mental health literacy of participating caregivers; after completing the survey, participants received a $25 gift card. The mental health literacy survey allows T2U to better understand the needs of the community and tailor programming to meet those needs. This project allowed T2U to expand services, reaching more community members during a time with increased mental health needs.

New York-Presbyterian Hospital's CHALK Jr Family Engagement Stipend Project brought early childhood center parents together to lead wellness workshops for their peers

Healthy Tomorrows Partnership for Children, New York-Presbysterian Hospital CHALK Jr

New York-Presbyterian Hospital (NYP)'s CHALK Jr program partners with early childhood centers in the Northern Manhattan, NYC, to increase access to healthy lifestyles for children and their families. Northern Manhattan's predominately Latinx community is tight-knit and faces high rates of childhood obesity and food insecurity. The neighborhood was hard hit by the COVID-19 pandemic.

As residents and community-based organizations come together to support families in need, NYP CHALK Jr launched the Family Engagement Stipend Project to amplify the voices of early childhood center parents and caregivers. Three parent leads received a stipend and $850 budget to train and then lead wellness workshops for their peers. Workshop themes included healthy eating (MyPlate), sugar-sweetened beverages, physical activity (dance and yoga), and childhood stress and resilience. Each parent tailored their workshops to respond to the unique needs, interests, and strengths of their early childhood center communities.

In their words:

"I love these types of programs that affect the community directly. This is definitely something I would love to do again."

"It was so great to meet two new people who will continue to be my partners!"

"There were times I was scared and wanted to back out, but I'm glad I didn't. I liked all the topics and am now offering my son milk or water each morning instead of juice."

NYP CHALK Jr will continue to champion this approach, offering paid opportunities for community members to engage in leadership roles. Thank you to our early childhood center partners and parent leads!

Consumer Empowerment in HealthCare!

Skagit County Public Hospital District #304 a Healthy Tomorrows Partnership for Children Program

As part of our work to initiate the HealthySteps program in a local pediatrician's clinic in rural Skagit County, Washington, AAP provided a Family Engagement Stipend to work with the Family Advisory Council at our local pediatric clinic. With the support of our clinic staff, we were able to work with a group of 10 parents. The first thing was to determine how to make the most of this opportunity. The parents decided they wanted to create a Patient Experience Survey. Their goal was to create a survey that would empower patients and parents to evaluate their healthcare journey, while providing important feedback to the Skagit Pediatrics' staff regarding their consumer experience.

Through discussion, research, and negotiation the work group members created a Patient Experience Survey with questions encouraging reflection and evaluation of the patient's experience with the established health care process. There was much concern expressed regarding language and diversity. Our community has many indigenous speaking families which requires an oral option for communicating. Concerns about equity and accessibility also arose regarding internet access and literacy. English and Spanish were determined to be the primary languages spoken in our community, so the survey was created in those two languages. The work group also decided to provide an electronic assistive device for accessing the internet survey and for the option to use "text to speech" functionality for non-readers. They also purchased a banner, ink pens, and 200 coloring books all inscribed with the tag line "Your opinion counts, take our survey!" (In both English and Spanish) to inform patient families about the survey and create some excitement.

This was a wonderful experience which illustrated the importance of providing parents/patients with a path to empowerment that directly involves them with their family's medical care. Developing a Patient Experience Survey and marketing plan provided these families with a sense of accomplishment. It strengthened their faith in the power of the consumer and in the sincere caring of their chosen healthcare provider.

Trainee Highlights

Austin C. Edwards, BS

University of Florida Pediatric Pulmonary Center

In Summer 2021 semester, I completed a long-term traineeship with the University of Florida (UF) Pediatric Pulmonary Center Leadership Training Program as a Public Health trainee. I am pursuing dual Master's degree programs at UF, in both Public Health and Family, Youth and Community Sciences.   During my time with the PPC, I shadowed the interdisciplinary team at the Cystic Fibrosis, the Severe Asthma and Pediatric Sleep Disorders Clinics. The patients I met had varied health conditions and many came from lower socioeconomic backgrounds and/or underserved communities as North Central Florida has a high percentage of families at or below the poverty level. The patients and families also came from diverse backgrounds. The PPC interdisciplinary team provides social work, psychology, and nutrition services to patients in addition to medicine and nursing.  The interdisciplinary approach enables patients and their families to receive much needed services in a central location (either in person or via telehealth).   This interdisciplinary, coordinated, family-centered care helps reduce health disparities as there is a greater likelihood that patients seen in these clinics will receive the care and follow- up they need. My PPC public health traineeship allowed me to view the "real-life" scenario of individual children, adolescents, and their families with pulmonary and sleep disorders. This will assist me in the future as I complete my Masters' programs and work in community or public health.

 During my traineeship, the UF Pediatric Pulmonary Center also presented a 6-session Project ECHO series on Sleep Health in Children.  This series was designed to raise awareness about pediatric sleep issues among providers in underserved communities so that they would be better able to serve children with sleep issues. As a participant, I was able to view the challenges providers in Florida's underserved communities face in providing specialty care. My traineeship at the Pediatric Pulmonary Center helped me to grow both personally and professionally. It provided me with skills and knowledge that I will use in my future career. l am grateful and appreciative that I was presented with the opportunity to complete my traineeship at the UF Pediatric Pulmonary Center. The experiences that I had during my traineeship have inspired me and strengthened my desire to work to decrease health disparities in our communities.

Edith Brignoni Pérez

Stanford University School of Medicine Developmental-Behavioral Pediatrics

Dr. Edith Brignoni Pérez' is a third-year Postdoctoral Fellow at Stanford University School of Medicine and an intermediate trainee. Her research interests are focused on human brain- behavior early development and how experience or environment modulates infant and children mental health and neurocognitive outcomes, both in typical and atypical trajectories, with an emphasis on populations of disadvantaged backgrounds. She holds a Ph.D. in Neuroscience from Georgetown University School of Medicine and a B.A. in Psychology from the University of Puerto Rico, Río Piedras. Dr. Brignoni Pérez joined the Departments of Psychiatry and Pediatrics at Stanford in July 2019, co-advised by Drs. Heidi M. Feldman and Katherine E. Travis.

We recently found significant disparities in Kangaroo Care (KC) (parent-infant skin-to- skin holding) for premature infants in the Neonatal Intensive Care Unit (NICU). I investigated whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the rate, frequency, and duration of KC in the NICU at our local hospital in Stanford, California, compared to preterm infants of higher SES or primarily English-speaking families. Our participants (N=116) were infants born very preterm (<32 weeks of gestation). We found that infants in the lower SES or Other language group experienced KC in reduced rates, lower frequencies, and shorter durations than infants in either the higher SES or English language group, revealing significant disparities in the NICU as a function of both SES and language. Moreover, SES and Other language groups made independent contributions, specifically to one metric of KC: duration (min) per day. Such disparities reduced infants' access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize such health care disparities.

I presented the results of our study in the form of a talk at the 34th Annual Graven's Conference on the Environment of Care for High-Risk Newborns in March 2021 and a poster at the Annual Meeting of Society for Developmental and Behavioral Pediatrics in October 2020 and the Stanford's 12th Annual Pediatrics Research Retreat in April 2021, all experiences that expanded my knowledge in health care inequities in the NICU and nursery. A peer-reviewed manuscript of this study is provisionally accepted for publication in the Journal of Developmental-Behavioral Pediatrics. This study has also led to the implementation of new strategies to improve our current practices at our local hospital, and we hope that others follow a similar example upon the official publication of our study.

Lawryn Fowler

Drexel University Dornsife School of Public Health MCH Catalyst Program

Being a Maternal and Child Health (MCH) trainee at The Drexel School of Public Health (DSPH) MCH Catalyst Program has given me the leverage to participate in a multitude of MCH related opportunities towards enhancing diversity and health equity. I am passionate about dedicating my future career to advocate for Black mothers and lessen the inequities that exist in the maternal mortality rates in the United States. The Catalyst Program has certainly given me the platform to explore all of the ways I can be involved, and use my voice.

I have had the opportunity to work as a Graduate Research Assistant with Dr. Irene Headen. This work has focused on the City of Philadelphia, and aims to address the maternal health disparities that exist. This work has allowed me to completely emerge into the landscape of the Black-led and Black serving maternal organizations in Philadelphia aimed at empowering and supporting Black mothers. Conducting this work gave me the opportunity to present at the MCH symposium. I was able to present the work that had been conducted so far to other MCH professionals.

Another opportunity that I received from being a part of the Catalyst Program was becoming a Title V Summer MCH Intern. I was paired with Washington, D.C., and had the pleasure of working with Dr. Jasmine Bihm. The work as a Title V intern was focused on improving women's health in Washington, D.C. by increasing well-woman's visits and prenatal care visits among Black and Hispanic women ages 18 to 44. I completed a community scan including all community-based and primary clinic programs, resources, and campaigns. I also completed a literature review of social media approaches and the use of digital tools to help increase access. This literature review helped to develop suggested social media strategies and messages.

The experience gained in my first year has been immeasurable. These opportunities have allowed me to apply lessons learned in the classroom to real life situations. The DSPH MCH Catalyst Program involvement has given many great experiences and truly helped me solidify my future career goals in field of MCH.

Brittani Lamb, MSW

University of Minnesota Leadership Education in Adolescent Health

The unjust death of George Floyd here in Minneapolis in May 2020 made it painfully evident the University of Minnesota's Leadership Education in Adolescent Health (UMN LEAH) Fellowship Program needed to do more and meet the urgency of the moment. A committee was formalized to elevate the focus and guide efforts on antiracism and equity. I joined the Committee shortly after becoming a social work fellow that September. The Committee's goal of creating a roadmap to guide how the UMN LEAH could bring an antiracism lens to its programs and practices coincided with my degree requirement to complete a program evaluation. I subsequently took the lead on the implementation and analysis of an assessment to identify the UMN LEAH's strengths and opportunities for growth related to antiracism. The study, completed in spring 2021, utilized an anonymous online mixed methods survey to explore program actions and practices, as well as members' beliefs, perceptions of the program culture, and competencies.

Findings were shared with fellows and faculty during the annual summer 2021 fellowship retreat. UMN LEAH's strengths included members' commitment to antiracism work, a safe space to talk about (anti)racism, and efforts to teach fellows about antiracism and antiracist research methodologies. Areas for growth include publicly committing to antiracism with stated accountability measures, incorporating standards for antiracist practice into career development, increasing workforce diversity, and creating a program culture that reflects the value of antiracism.

Given the continued work ahead of us, it is encouraging to see fellows and faculty engaged in and committed to addressing racism. The Committee and UMN LEAH are capturing this momentum and have already begun to act by identifying core values and developing a mission statement and strategies to institutionalize our antiracism work. The Committee also aims to become a conduit to the UMN LEAH on tools and resources available to inform individual and fellowship-wide efforts, such as this position statement from the Society for Adolescent Health and Medicine. As we look forward to another productive year, this assessment will guide these ongoing efforts and provide concrete evidence for UMN LEAH's next steps.

Delia Giselle Melendrez Gomez

UCLA Center of Excellence Maternal & Child Health Training Program

I am going into my second year of my Masters in Public Health in Community Health Sciences and serve as the Communication Chair in the Maternal and Child Health Student Interest Group, member of the UCLA Fielding School of Public Health (UCLA FSPH) Equity, Diversity, and Inclusion Committee, and a graduate student researcher for two social justice projects. My interests are racial equity in child and adolescent health, the relationship of mental and physical health, chronic stress, and reproductive health. My interests are all rooted in an intersectional approach to further understand BIPOC community disparities where I actively seek to engage in work that prioritizes equity. I am a research assistant for a mixed-methods project that aims to explore BIPOC attitudes to the COVID-19 vaccine to inform future ways of engaging BIPOC communities. Additionally, I assist with interviews and data analysis on a qualitative project that explores the curriculum at the UCLA Fielding School of Public Health to identify the facilitators, barriers, and opportunities for improvement regarding the introduction, implementation, and institutionalization of health justice courses.

This summer, I was a Public Health Advocacy Intern with California Latinas for Reproductive Justice (CLRJ) focused on supporting the policy platform and the housing justice campaign. I conducted legislative visits with California Council members and participated in coalition calls to advocate for reproductive justice bills AB 65 and SB 245. Part of my summer work in community outreach has been to educate community members and garner support for the implementation of a Rent Control Ordinance in Bell Gardens, a city with no access to reproductive services. My experience interning at CLRJ was insightful and solidified my passion for maternal and child health work. In this work, I advocate for housing as a reproductive issue given that housing is a human right and unsafe and unstable living conditions hinder the opportunity to start a family and/or raise a family in suitable conditions. I am beyond grateful to the team at CLRJ for the guidance and work culture rooted in respect and advocacy to empower communities of color.

Time with TAGTrainee Ambassador Group

Nikki Waltrich

I didn't fully realize it at the time but entering graduate school in 2017 as a MCH trainee and newly minted AmeriCorps VISTA alumni would become the cornerstone of my career. AmeriCorps afforded me hands-on experiences working with families involved with DCFS and gave me a foundation into understanding how systems operate. These families were often up against a system riddled with contradictions that created more barriers than not. The UIC School of Public Health, Center of Excellence in Maternal and Child Health taught me frameworks to understand and name what I witnessed--systemic and environmental racism, disinvestment, reproductive injustices, poverty. My training program also became the foundation of my professional network, made up of individuals who devoted their lives to dismantling these injustices. I chose public health and specifically maternal and child health to join the workforce of change makers. Colleagues and I often tease that once you receive education in public health, you will never see the world the same again. You can no longer ignore, misunderstand, or misconstrue what is undeniably true about the conditions and environments around you; but you can change them.

Fast forward to 2021—We have been through one year, four months, and 9 days of the COVID-19 pandemic. I am working at a Medicaid Managed Care Organization that serves almost 400,000 individuals and families who are disproportionally impacted by the pandemic. Working with an interdisciplinary team, we are designing and executing interventions and procedural changes that protect, educate, and support our membership. We are advancing maternal and child health initiatives to ensure all families have access to immunizations, pre- and post-natal care, midwives, contraception, and all other critical services despite the pandemic. Meanwhile, I am expanding my network through TAG, finding my unique voice in the MCH landscape, and creating a platform for advocacy, shared learning, and growth. These are the experiences that a career in public health and maternal and child health affords you. Although you will no longer be able to ignore, misunderstand, or misconstrue what is undeniably true about the conditions and environments around you, you will change them.

Sa'Nealdra Wiggins - Adaptation and Implementation of an Online Health Promotion Intervention with Black Women

Sa'Nealdra is from Clarksville, Tennessee and moved to Knoxville to pursue a graduate degree in nutrition, after receiving an undergraduate degree in public health from Middle Tennessee State University. She was inspired to seek a career in the health field at an early age. She wanted to impact the health of those from underserved populations so, Sa'Nealdra began to build upon her nutrition minor and applied for the graduate nutrition program at the University of Tennessee. Throughout her graduate career, Sa'Nealdra developed a deeper passion for health equity as it relates to nutrition programming in the Black community. Fueled by this passion, Sa'Nealdra tailored her dissertation research to implement nutrition education courses with Black women and hopes to continue this work in some capacity in the future.

Background: The Black community is plagued by many different chronic diseases and many Black individuals were not only being hospitalized but were dying at high rates early during the COVID-19 pandemic which may have been attributed to the prevalence of these chronic diseases. A report from the National Center for Health Statistics found that Black women have the highest obesity rates in the country further highlighting the need to intervene with this population. An online health promotion intervention was needed to educate Black women on nutrition and physical activity concepts not only because of the high obesity rates but also because women are often the primary meal preparers in the home. Thus, a curriculum was identified, adapted, and used to conduct an eight-week randomized controlled trial with a wait-list control group and quasi arm intervention in which women met once a week for classes delivered via Zoom.

Project objectives:

  • To identify and adapt a curriculum to be used online during a national pandemic with Black women
  • To test the effectiveness of the adapted, Eat Healthy Be Active curriculum with Black women


  • There were statistically significant improvements in self-efficacy and health-related knowledge scores. Additionally, women reported increasing fruit and vegetable intake, decreasing sodium intake, and walking more. Factors such as social support, convenience, and relatability (of the facilitator) were important to the program's success.

Future Implications:

  • Future research should seek to create successful programs that allow for multiple delivery methods for times when in-person meetings are not possible.
  • Future practitioners should be educated to be not only culturally competent but relatable to their priority population.

2021 Making Lifelong Connections (MLC) Reflections

Alana Cordeiro, Joyce Afueh, and Alexandra Vohs

You developed a plenary session with two other Ambassadors who you had never met before. What was your experience like collaborating virtually?

Alana: Working with Alex and Joyce was great! We were the first subcommittee to have their project due and it ended up being a breeze. We coordinated our schedules well and met our group/individual deadlines to make sure the project was done in time. 

Alex: It was a wonderful experience working with Alana and Joyce! The Trainee Ambassador Group (TAG) met as a large group to brainstorm ideas for the MLC plenary session before Alana, Joyce, and I met as a subcommittee. As a subcommittee, we met several times over Zoom to refine the topics proposed in the TAG whole group meeting to develop the presentation. We also worked together in Google Drive and via email to refine the presentation. In our Zoom meetings and over email, we were all conscientious of each other's time, respectful of each other's suggestions, and highlighted each other's strengths. 

Joyce: Working with Alana and Alex was a very inspiring and educational experience. Both Alana and Alex have a variety of experiences with working within the maternal and child health field and their contribution to developing the presentation for the plenary session was invaluable. We met and coordinated several times over a couple weeks to put together an amazing presentation!

How did the skills you acquired in your MCH training program help prepare you for the TAG presentation?

Alana: I was a MPH student at Drexel University when they were awarded their grant to develop a MCH curriculum. I was able to take MCH-focused courses and was encouraged to give feedback on the class and other campus MCH activities. It was really great to see it being developed and to work alongside professors who were doing amazing MCH-related work.Group collaboration was a huge part of my experience and those are skills that I still use today.

Alex: My involvement with Maternal and Child Health (MCH) began in 2019 at the University of Tennessee Health Science Center (UTHSC), Center on Developmental Disabilities, where I was a Leadership Education in Neurodevelopmental and Related Disabilities (LEND) trainee while completing my post-doctoral fellowship in child psychology. As a LEND trainee, I facilitated a discussion on a research article with my cohort. That experience helped me to refine my skills in developing a presentation and facilitating a discussion with others. Additionally, my LEND training director suggested that I attend the 2020 MLC conference during my training year. Attending MLC last year helped me to conceptualize the presentation when thinking about the audience and structure of the conference.

Joyce: I was an MPH student at Emory University, Rollins School of Public Health. As part of the MPH program, I was also getting a certificate in Maternal and Child Health from Emory Maternal and Child Health Center of Excellence. As part of this certificate program, we often engaged and collaborated with other students to develop reports and presentations for different classes, or plan events for students and professors. Having this experience in the certificate program was very helpful when it came time to prepare for the TAG presentation. Alex, Alana, and myself were easily able to collaborate to develop a meaningful presentation for the MLC conference. 

What factors did you consider when developing the TAG presentation?

Alana: The current climate of the pandemic was where we built this presentation from. All of us have had to adapt to working from home/remote and juggling new work requirements. Although each of our experiences of this was different, we were all needing to readjust and realign our work/life balance. I think most MLC attendees (myself included) found at least one tidbit that was helpful to incorporate into our "new normal".

Alex: There were several factors that we considered while developing the TAG presentation. The main factor that we considered was the theme of the MLC conference when developing the presentation. The theme of the conference and the titles of other presentations served as a springboard for landing on our topic of the work/life balance in a pandemic. As current trainees and early career professionals, we also factored in what other trainees and early career professionals would benefit from most.

Joyce: Considering we were still actively working/going to school during a pandemic, we considered relatability and feasibility when working to develop the presentation. Alana, Alex, and myself were able to call on our own personal experiences of managing work, rest, staying engaged, and communicating with others all while working from home. When developing the presentation, we all focused on different aspects of managing work-life balance while working from home and provided recommendations that were easily adaptable and accessible for attendees to consider.

What did you like the best about attending the virtual MLC sessions?  

Alana: My favorite part of the MLC conference was the Mentor/Mentee connection. I was able to connect with one of my mentees during the conference and again a few weeks later. We are actually planning to connect every other month or so.

Alex: My favorite part of the MLC conference was the emphasis on connecting with other attendees. Before the conference, there was a platform (Whova) to connect with others and to network. During the conference, there were several protected times to meet with mentors and mentees as well as times after presentations to reflect on the content and learn from other participants from various disciplines. Joyce: I really enjoyed the mentorship sessions. Because we were attending the conference virtually, it was great that there were sessions dedicated to learning and engaging with others in the field in a more intimate setting. I was able to serve as a mentor during the conference and was able to attend as a mentee during another session. Being able to experience both sides of mentorship and establish connections with other MCH trainees was very insightful.

Would you recommend MLC to other trainees in the future?

Alana: I would! It was a great conference and it was really great to hear from other MCH-professionals across the country. It was rewarding to learn and connect with each other, even if virtually. I am looking forward to when we can be in-person together again.

Alex: Without reservation! Attending both the 2020 and 2021 conferences was a wonderful experience that fostered my learning, connection with other professionals, and personal growth as a MCH trainee. While I wish I could have attended both conferences in person, the design of the conferences was engaging and allowed for virtual connections.

Joyce: Absolutely! Being able to learn and connect from other MCH trainees was an amazing experience. In my opinion, having the conference on a virtual format was actually able to encourage more engagement among trainees than I originally anticipated. I'm sure that as the yearly conference continues, MCH trainees will always look forward to attending the well crafted sessions presented by MLC!

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