The Division of MCH Workforce Development (DMCHWD), part of the Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB), prepares and empowers maternal and child health (MCH) leaders from diverse communities to promote health equity and wellness, and reduce disparities in health and health care. This month, DMCHWD highlights several of the ways that our programs support diversity and health equity.
The Division is also pleased to release the DMCHWD Diversity and Cultural Competency Fact Sheet, which provides information on DMCHWD's strategic investments and data collection. DMCHWD engages in a variety of activities to support diversity and cultural competency within the Division and its investments, including:
DMCHWD is proud to announce the 10 winners for Phase 1 of MCHB's Using Technology to Prevent Childhood Obesity in Low-Income Families and Communities Challenge.
Each Phase 1 winner was awarded a $10,000 cash prize and will move on to Phase 2 to develop their prototype and begin small-scale testing through July 2019. Using different approaches and technology platforms, winning designs aim to empower low-income families to achieve healthy lifestyles and improve the health of communities across the U.S. Phase 1 winners will be collaborating with different populations, including breastfeeding mothers, children ages birth to 19, Latino, American Indian and Alaska Native families, and families with children with intellectual and developmental disabilities. Challenge entrants included academics, health professionals, startups, community groups, faith-based organizations, and individuals.
In the November 2018 issue of the North Carolina Medical Journal, Dr. Savithri Nageswaran (a Healthy Tomorrows Partnership for Children Program [HTPCP] grantee), Ms. Aura Rosado, and Dr. M. Stockton Beveridge published a paper highlighting the transportation challenges faced by Latino children with medical complexity (CMC).
HTPCP funds the community care coordination program for CMC at Brenner Children's Hospital in Winston-Salem, NC. This community program is part of the Pediatric Enhanced Care Program , a special program for CMC. CMC are children with serious medical problems, they receive care from many doctors and other providers, and are admitted to the hospital frequently. As a result, their families have to navigate a complex healthcare system.
Our team is interdisciplinary and includes a physician, two nurses, a social worker and a patient navigator. Our social worker and patient navigator are Latina and are bilingual. Having two bilingual care coordinators enabled our team to serve Latino families and learn about the unique challenges faced by these families as they navigate the health system. Our coordinators have also been able to build strong relationships with these families.
In this study, we used the encounter logs that the two bilingual care coordinators maintained and identified the challenges faced by families of 70 Latino CMC. We found that these families had many difficulties as they navigated the complex health system for their children. We were surprised that transportation was a major problem. Many families had problems transporting children to hospitals and doctors' appointments, but they also had difficulty using transportation benefits that were entitled to their children. There were many reasons for this difficulty, but the main issue was the language barrier. These problems had serious consequences for children, including missing appointments and having delayed arrival at appointments, leading them to miss much needed medical care. In the future, we should find out the extent of transportation problems; and test whether addressing transportation problems can improve families' ability to keep appointments with doctors. Twelve states and Washington, DC have provided temporary drivers' licenses for unauthorized immigrants, but North Carolina does not have such a policy. We should evaluate whether states that have policies for temporary drivers' licenses have less transportation problems.
Having two bilingual Latina care coordinators has uniquely positioned our program to serve and address the unique needs of Latino CMC. In recognition of her service for Latino CMC, Ms. Rosado received the Notable Latino Award by the Latino Community Coalition of Guilford in 2018.
The Nemours Foundation of Wilmington, Delaware has developed a special visiting rotation for Under-Represented Medical (URM) students called the Pediatric Scholars Program. Nemours provides a travel stipend, and selects URM medical students who are interested in doing a month-long elective with Nemours. In addition to standard clinical rotations, Nemours offers a “health disparities research and advocacy” rotation, which is more of a non-clinical academic experience. During the health disparities research and advocacy rotation, Nemours gives the students an overview of its Healthy Tomorrows project as an example of a Population Health based approach to addressing social determinants. The Nemours Aces to Aces: Accelerating Community Engagement to Address Adverse Childhood Experiences (ACEs) project aims to ensure that every child in Delaware's ACEs "hot spots" has access to a trauma-informed medical home, access to neighborhood supports, and improved parental mental health.
The 2018 Association of State Public Health Nutritionists (ASPHN) Brief on Guidelines and Health Conditions Related to Timing of Early Infant Feeding includes the most recent findings and guidelines necessary for public health nutritionists, including:
The Children's Healthy Weight Collaborative Improvement and Innovation Network (CHW-CoIIN) includes Indiana as a state team focused on physical activity. Team lead Kelsey Barrick shared the following about Indiana's project.
After the Children's Healthy Weight Collaborative Improvement and Innovation Network (CHW-CoIIN) In-Person Meeting in January 2018, Indiana's team acquired two interns from the University of Indianapolis to help research best practices related to adapting physical activity to students with special needs. The result of their work was a list of professionals in Indiana that focused their work in this area. Their findings also informed Indiana about what other states were doing regarding adapted physical activity projects.
In March, Indiana team leads Jessica and Kelsey attempted to convene a work group of professionals across Indiana who specialize in serving students with special needs. After consulting with professionals at Indiana University Bloomington, Jessica and Kelsey tried to recruit special needs advocates -- parents, educators, school professionals, after school providers, etc. Unfortunately, there was no traction with this work group.
In May, Jessica and Kelsey partnered with special needs professors at Indiana University Purdue University Indianapolis (IUPUI) and focused on regional work regarding adapted physical activity. The result of this partnership led to awarding scholarships to local districts in order to send one professional to a semester-long training, for intensive, hands-on learning for adapted physical activity.
The Adapted Movement Programs at Indiana University Purdue University Indianapolis School of Health and Human Sciences houses the Adapted Movement Programs (AMP). The mission of AMP is to provide high quality adapted physical activity programming to families and individuals with disabilities in conjunction with educating Kinesiology students on best practices. Individuals applying to the grant program will be involved in one of the two clinics during the academic year, Motor Activity Clinic (MAC) or Ability Fitness Clinic (AFC). Children that engage in MAC are between the ages of 3 to 15 years and have various disability characteristics. The focus on MAC is to provide motor development and motor skill training in the gymnasium and aquatic setting. Adults participating in AFC are from ages 16 to adulthood and have various disabling conditions.
Those applying to the grant will work one-on-one or two-on-one with a child or adult under the supervision of Dr. Katie Stanton and Mrs. Amy Oliver, MS. Both Dr. Stanton and Mrs. Oliver have expertise in adapted physical activity and considerable experience teaching and working with people with disabilities in various settings. Grantees can expect to gain skills in assessment, activity modification, appropriate planning and motor skill development, and experience in writing Individualized Education Planning goals and objectives. Grantees will also work with Dr. Stanton and Mrs. Oliver on how to apply skills gained in their own school/organizational setting.
The University of Minnesota's Leadership Education in Adolescent Health program (UMN-LEAH) is fortunate to be housed with several other adolescent health-focused programs; key among these is the Healthy Youth Development-Prevention Research Center (PRC) funded by the Centers for Disease Control and Prevention (CDC). So, when LEAH Social Work faculty member, Paul Snyder, isn't teaching and mentoring LEAH trainees, he is directing the PRC's core research study, Partnering for Healthy Student Outcomes (PHSO). And the UMN-LEAH trainees are benefiting as well.
Launched in 2014, PHSO has been working with 3 middle schools to address academic and health disparities, particularly for the most disengaged learners. Central to the program is an innovative and effective year-long teacher professional development (PD) program developed by Snyder and PRC colleague, Abigail Gadea. Years ago, both Snyder and Gadea committed themselves to more deeply understanding issues of equity and diversity, including their own unconscious or implicit biases; both are graduates of the University of Minnesota's Leaders in Equity and Diversity program. With these lenses, they quickly recognized how teachers' unconscious biases were impeding effective engagement with their students. Subsequently, they integrated into the PD program a session that encourages teachers to explore these biases so they can implement equitable teaching practices that address the needs of all students in their classroom. The evaluation of the PD program developed by Snyder and Gadea was so positive, they have translated that work into a free-standing PD program called Whole Learners©.
Snyder and Gadea brought their training on unconscious bias to the faculty and staff of the Division of General Pediatrics and Adolescent Health, where both the LEAH program and the PRC are housed. This training was so well received, they created a seminar for UMN-LEAH trainees: Examining Unconscious Bias. In this seminar, Gadea and Snyder strive to create an inclusive, open, and safe training environment by working with the trainees to establish grounding assumptions – agreements for how they will act toward and support one another during the seminar. Through individual exercises, personal stories, a video, verbal presentation, and large group and pair activities, Snyder and Gadea define unconscious bias, encourage self-reflection, provide research evidence, ask questions about trainees' personal experiences, request one verbally expressed take-away from each participant, and provide resources for further exploration.
Everyone has unconscious biases, and unconscious bias influences our actions and decisions. When we are working with others – whether that be in our teaching, planning or implementing research, recruiting or hiring new faculty or staff – only when we take the time to become aware of our unconscious biases and become actively mindful of their influence can we begin to create and support equity.
Mailman Center for Child Development
Department of Pediatrics
University of Miami, Miller School of Medicine
MCH leaders in the 21st century require a remarkably diverse set of skills to be able to improve the health and well-being of children with neurodevelopmental disabilities such as autism spectrum disorders (NDD/ASD). MCH leaders must be well trained in the disciplinary skills of their everyday work; they must be family-centered and culturally competent as they adapt to an increasingly diverse population; they must be able to partner with individuals and organizations, especially those with different goals and professional backgrounds; they must be able to recognize how larger systems-level issues affect MCH; they must be innovative in using (and creating) evidence-based solutions to address individual and public health problems; and they must be focused on outcomes that matter to families and to communities.
With these key principles in mind, the overarching goal of the Leadership Education in Neurodevelopmental and related Disabilities (LEND) training program at the Mailman Center for Child Development (MCCD) is to develop leadership in MCH faculty and practitioners to improve the health and well-being of families and children with NDD/ASD, especially those who experience high levels of health disparities because of race/ethnicity. In response to new evidence and the changing needs of this population, we have designed our LEND to focus on improving health outcomes at the intersection of disability and other minority status, such as race and ethnicity.
Teacher using assistive technology with child
One way we do this is by training a diverse workforce. Over the last 5 years, we have graduated 384 long-term trainees (LTTs) in 13 disciplines, 65% of whom are ethnic/racial minorities. Our 126 Hispanic LTT represent approximately one-quarter of all Hispanic long-term LEND trainees in the US. Long-term follow-up surveys demonstrate that 84% of our LTTs report family-centered, interdisciplinary practice in an MCH setting, and 75% demonstrate leadership through organizational leadership, research and publications, or other activities designed to improve systems of care. Our impact is both regional and national; half of our LTTs remain in Florida; the other half work in three countries, 21 other states, and Puerto Rico. Our graduates hold or have held regional, state, national, and international leadership positions.
A second approach is our focus on improving health in underserved communities. We are committing resources to support training and leadership capacity in two “communities of focus” (Overtown and East Little Havana) —neighborhoods adjacent to MCCD that are culturally diverse, economically challenged, and underserved by health and education professionals despite having extremely high levels of morbidity and mortality. Over the last two years, for example, we have extended three MCCD-based programs by training staff of community partners to provide behavioral health interventions, family navigation, and implementation of assistive technology. A further goal is to assist our partners in obtaining grant funding and governmental appropriations themselves, so they will have future program sustainability and opportunities for innovation. Our vision is to address population health outcomes and develop trainees who can plan community-based interventions to improve systems of care, then translate this process to other communities.
Approximately 50 faculty, staff, and trainees from the LEND, Maryland Center for Developmental Disabilities (MCDD), Center for Diversity in Public Health Leadership and Training, the Center for Innovation & Leadership in Special Education, and Senior Management of the Kennedy Krieger Institute attended a three-day, on-site technical assistance program, Embedding Cultural Diversity and Cultural and Linguistic Competence, presented by the University Center for Excellence in Developmental Disabilities (UCEDD) at Georgetown University and the Center for Child and Human Development faculty, including: Tawara Goode, Wendy Jones, and Vivian Jackson. Kennedy Krieger Institute was one of four programs that were selected from 14 UCEDDs that applied for this on-site technical assistance. Other UCEDDs selected were Alaska, Louisiana, and New Mexico. This interactive program addressed the following topics: Cultural Diversity and Competence and Linguistic Competence: Definitions, Conceptual Frameworks, and What it Means for Your Center; Envisioning a Culturally and Linguistic Competent Organization; Aligning Cultural and Linguistic Competence Values with Organizational Policy; Embedding Project Tools, Ethical Issues and Challenges; and Essential Areas of Knowledge and Skills for Aspiring and Practicing Professionals in Developmental Disabilities.
Participants of the Embedding Cultural Diversity and Cultural and
Linguistic Competence technical assistance program.
The 8th annual Room to Grow: Journey to Cultural and Linguistic Competency conference was held on Tuesday, September 18th at Johns Hopkins Hospital. During the morning session, presenters included Shelly Choo, MD, MPH, Senior Medical Advisor for the Baltimore City Health Department who spoke on B'more for Healthy Babies: A Path to Child and Family Health in Baltimore City; Michael Lu MD, MS, MPH Senior Associate Dean for Academic, Student, and Faculty Affairs at George Washington University Milken Institute School of Public Health and former Associate Administrator of the Health Resources and Services Administration's Maternal and Child Health Bureau (2012 - 2017) who spoke on Leading Change; and, Daniel E. Dawes, J.D., a nationally recognized leader in the movement to advance health equity among under-resourced, vulnerable and marginalized communities who spoke on The Danger of Futility: Creating a Sea Change for Health Equity in America. In the afternoon, Dr. Rafael Luna, Associate Dean in the Morrissey College of Arts and Sciences, Director of the Pre-Health Program, and Director of the Gateway Scholars Program for STEM conducted a workshop on Telling a Story: The Art of Scientific Writing for trainees, residents, and students. In addition, Dr. William T. L. Cox, social psychologist and currently an assistant scientist in the Department of Psychology at the University of Wisconsin - Madison, conducted a workshop on Empowering People to Break the Prejudice Habit: Creating Inclusion and Reducing Bias. Over 160 trainees, residents, students, faculty, clinicians, and community members were in attendance.
In order to reduce health disparities in children at-risk for developmental delays in rural regions within Arizona, ArizonaLEND has joined forces with the Arizona chapter of the American Academy of Pediatrics (AzAAP) on a project to promote the CDC “Learn the Signs. Act Early.” Campaign, as well as to increase the number of practices that use standardized developmental screening tools in their well-child visits. The two second-year LEND fellows involved in this project, Azucena Perry and Bianca Demara, hope to engage rural and community health practices from across the state and along the Arizona-Mexico border in an effort to reach not only rural providers, but also providers who serve individuals with unique socioeconomic, cultural, and linguistic needs.
Azucena Perry (left) and Bianca Demara (right)
One of the main goals of the project involves recruiting practices statewide to promote and track the use of the CDC's “Learn the Signs. Act Early.” milestone tracker application, which not only enables parents to learn about the milestones their child should be reaching between the ages of 2 months and 5 years of age, in either English or Spanish, but also helps parents keep track of pediatrician appointments for their children and gives them the option of printing out milestone checklist results for their child so that they can discuss these results with their pediatrician in further detail. Bianca and Azucena will also work with each participating medical practice to design a workflow individualized to each of them and find ways to incorporate data collection on medical staff promotion and patient use of the application in ways that aim not to overburden the busy schedules of pediatricians and their support staff.
The second goal of this project is to engage more medical practices to use developmental screening and surveillance in order to aid in early identification of the 1 in 6 children with a developmental delay or disability, so they can benefit from early intervention services. By recruiting practices to enroll in the ArizonaLEND Developmental Screening Technical Assistance Program, not only will practices be engaging in crucial developmental screening and surveillance, they will be doing so with the additional assurance that they can count on ArizonaLEND to support them with the implementation and maintenance of these initiatives.
With this project, the goal is to reach as many underserved communities as possible within Arizona, including Hispanic families who, on average, obtain autism diagnoses--and therefore services for their children--later than non-Hispanic, white children. The ArizonaLEND trainees ultimately hope to support the empowerment of all families so that these families can learn about the various facets of their child's development from as early as two months of age and therefore feel more prepared to discuss any developmental concerns they may have with their child's healthcare providers. In sum, this project seeks to increase health equity by improving the early detection of developmental disabilities and delays in families from underserved and diverse communities across rural Arizona.
I grew up in Baghdad, Iraq in a very loving, supportive family with socially and culturally literate parents who are both physicians. My father is a psychiatrist who embraced mental health in a community that did not recognize mental and emotional health needs. My mother is an ophthalmologist in a community where few distinguished females have succeeded in balancing career and cultural demands. I always thought I was different, even back there. I wrote poetry, had loud opinions -when I could- and dreamt of becoming a journalist. Life took an alternate path or maybe I matured enough to realize that my best options to excel were what my culture then offered to me. Medicine became the smart cultural choice for me.
My generation was born in a war and came of age in two wars. Most of us graduated from professional schools during the fighting. I was never discouraged by these circumstances, because I was not any different from my classmates. After graduating medical school, my husband and I decided to come to the US. We willingly signed many legal documents to become “legally different.” Years passed and now we are both US citizens and have a wonderful two-and-a-half-year-old son, born here in America. I decided to become a developmental-behavioral pediatrician following my training in pediatrics.
There are times when it is challenging to explain that my experiences growing up were not ideal, but I am making the best of it. My heart and brain have learned new dialogue to accommodate the difference. However, living day-to-day is unconsciously exhausting. It is like constantly trying to belong, but despite many moments of achievement, there's the feeling of never getting to stop or have a break. My husband and I are privileged to have friends and work with people who understand diversity. On both professional and personal levels, we are accepted, acknowledged and appreciated. While we still have to check the “other” racial category on official documents, that feeling of support has removed much of our initial sense of confusion and fear of being classified as "different."
Our challenges shaped us well and made us the resilient people we think we are. I know in a few years I can share these personal experiences with my son and he should know it is ok that his parents do not speak as beautifully as he and his friends do, or have different beliefs in life, but he can still belong. It's now easy for me to talk about diversity, because I have known what it is to feel like “the other.” But through the years and particularly through my life in this country, I have come to know people who celebrate neighbors and colleagues of varied backgrounds, races and religions. From my point of view, diversity is a growing part of the American community and American experience and thanks to those who endorse and teach it, I am no longer different.
I was fortunate to work first at New York - Presbyterian Brooklyn Methodist Hospital, then at The Center for Children with Special Needs at Tufts Medical Center. In both programs, diversity is the culture. I couldn't hope for a better practice to nurture the diversity in me every day.
Embrace it if you have it, it is a gift.
Sincere love and gratitude to the culturally blessed hearts of W. B., L. S., C. C., R. L., M.B., C. C-G., K.M., M. U, C.S. and E.P.
You made me belong.
Returning to graduate school for a PhD mid-career is an interesting experience. To have a set of professional skills that are suddenly only marginally overtly useful, rusty math skills, no familiarity with contemporary academic technology, classmates (and some faculty) who are a generation younger, and a somewhat fuzzy career path after graduation is the perfect storm for imposter syndrome and existential angst. As a result, I am particularly grateful for the mentorship of faculty in two different MCH LEAH programs as I've embarked upon this path.
Prior to starting the PhD program in Health Services Research at the University of Washington, I had twenty years of experience working in health and mental health services, first as a medical and mental health social worker and then as a program manager in HRSA-funded HIV, school-based health, and maternal child health programs. I applied to the PhD program hoping to conduct research to assess and address gaps I was worried might emerge in the Ryan White HIV/AIDS care system after implementation of the Affordable Care Act. However, as I sat through presentations at the national Ryan White conference two weeks before the program started, I realized I was not alone in this concern - and that I was about five years too late in starting down a path to address it.
In envisioning a path forward, I reflected on how many people were focused on improving health and public health systems for populations with HIV, and how few were focused on populations with other stigmatized health conditions. I thought about populations with mental health conditions currently excluded from mental health parity laws, and how that may have affected me when I needed treatment for anorexia nervosa at 15, 17, 18 and again at 24; how I likely would not have survived to be this age at all, much less contributed to society in the ways I hope to have contributed. I realized that I might be able to bring a useful perspective to the research and public health communities interested in structural approaches to addressing barriers to care for eating disorders from my experiences working in public health systems. So, I decided to see if there was a way to forge this path during my doctoral training.
My first step was to reach out to my mentor at Kaiser Permanente Washington Health Research Institute. My mentor connected me to her colleague, Laura Richardson, a LEAH program faculty member at Seattle Children's Hospital (SCH). Dr. Richardson invited me to participate with the LEAH program as a medium-term trainee, allowing me the opportunity to attend LEAH seminars, meet with her to discuss research ideas, and participate in the redesign of their outpatient eating disorders program. I am so grateful that the SCH eating disorders team has embraced me as a colleague and an emerging scholar. I look forward to opportunities to grow and contribute to improving access to care for youth with eating disorders in our region. Also during my first year, I reached out to S. Bryn Austin, a social epidemiologist and the director of the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) at another LEAH program site, the Harvard T.H. Chan School of Public Health and Boston Children's Hospital. I contacted Dr. Austin out of the blue, aware of her only through her research and involvement in the Academy for Eating Disorders. She responded that afternoon, and since then, she has encouraged my fairly constant stream of ideas, shared her time and expertise in working with me on papers, and embraced my professional skills. She has entrusted me to meet with state and federal epidemiologists as well as CDC branch chiefs in order to explore opportunities for primary and secondary eating disorders prevention in federal public health programs, provide public comments at a CDC Community Preventative Services Task Force meeting, and co-facilitate a breakout session during a STRIPED symposium. I am incredibly grateful for Dr. Austin's openness to working with me from afar and for involving me in STRIPED.
Through the mentorship and opportunities provided by my engagement with the faculty of these two amazing LEAH programs, I have been able to bridge professional skills that initially felt “only marginally overtly useful” with skills that will be critical to the next stage of my career – one filled with research, advocacy, and applied roles that I hope will help to bridge public health systems research with primary and secondary prevention of eating disorders.
Somali Development Center (SDC)
Since 1996, the SDC has been the lifeline to vital educational and social services for Boston’s growing Somali refugees and immigrant community. SDC was founded by a group of Somali-Americans who came to the U.S to obtain higher education. In 1991, when full-scale civil war started in Somalia, it forced millions of people to flee from the cities in Somalia into Ethiopia and Kenya. As a result, the United States, through its refugee resettlement program, settled thousands of Somalis in the US. My project is designed for the Somali community where intellectual and developmental disabilities (I/DD) and mental health issues are met with stigma. One goal of this project is to educate and work towards ending stigma surrounding I/DD so that my community can be more inclusive. A second goal is to help Somali parents learn what to look for in a child who may have a developmental delay, to promote early detection, and early intervention. In recent years, there has been a high number of Somali children diagnosed with autism. During my time at the SDC, I have been a housing search assistant; a strong support, especially for the families who have children with disabilities; and I have helped with interpretation, translation, and I also participated in newcomer and acculturation activities. I facilitated workshops and I created a parent support group, meeting monthly.
My goal was to expand my knowledge of disabilities other than autism and to push myself outside of my personal and current professional circle. Through LEND I found support (mentors) to increase my knowledge about disabilities and I learned about the services that are available to support families. I learned how ethnic organizations such as SDC give tremendous support to their clients and do so for less. I found helping African immigrants and refugees to be incredible and extremely rewarding.
What I gained from this experience
LEND completely changed my life in so many ways. It has been an invaluable experience. Through the weekly seminars, I learned a great deal about services, health policy, and other issues related to neurodevelopmental disabilities, as well as the disability community. Also, LEND gave me networking opportunities. I want to bring our voice to the community and teach the parents new ways to engage.
I had the pleasure of being welcomed into two wonderful organizations: Horizons for Homeless Children and The Somali Development Center. While volunteering for 6 months at a local homeless shelter for mothers and children experiencing homelessness, my role as a PAL allowed me the wonderful opportunity to re-learn the power of play by engaging with children in the playspace on a weekly basis. Through this experience, I learned more about the intersections of trauma, privilege, oppression and disability and influences they have on families. Simply having a safe space with toys to play with is something often overlooked. For these children, it was the highlight of their days, and I enjoyed opportunities for parallel play with the children as well as creating corrective experiences around mental health and expression of emotions.
The Somali Development Center allowed me to work in collaboration with our LEND Diversity Fellow Asha Abdullahi to normalize, raise awareness and reduce stigma of mental health disabilities in local Somali/East African refugee communities. I learned how to hone myself as instrument to outline a collaborative curriculum for a Somali parent support network that focuses on the importance of culturally sensitive and trauma informed self-care practices. I gained valuable insight around challenges this population experiences, including assimilation into American culture as well as the importance of culturally sensitive mental health services in order to validate varying lenses of understanding mental health disabilities (depression, psychosis).
The LEND Program at Boston Children’s Hospital has been a catalyst to personal and professional development as a clinician working with individuals experiencing developmental, intellectual and mental health disabilities. LEND’s holistic, family centered, social justice approach enriched my learning of the many valuable services available to children and families with disabilities as well as the gaps or challenges in service delivery.
Physical Therapy Residency Program
I was privileged to be able to participate in the LEND program in conjunction with the Boston Children’s Hospital Pediatric Physical Therapy Residency Program. The residency experience provided me with the opportunity to achieve advanced and intensive training in pediatrics in a variety of clinical settings across the continuum of care. The LEND program was a perfect complement to the hands-on training I achieved throughout each of my rotations. Through my experiences in each clinical setting and the discussions and lessons provided each week during LEND, my awareness and knowledge of the varying needs of patients with disabilities and their families has increased. I am confident that the knowledge and experience I have gained will carry over into my career as a physical therapist and be a consistent reminder of the importance of working within a multidisciplinary team.
Threshold Alumni Program
My colleagues and I began a ‘Neighborhood Stroll Group’ through the Alumni Center of the Threshold Program. The Threshold Program is a college-based program at Lesley University for adults with learning challenges. Our meetings included weekly get-togethers in Cambridge where we engaged in a casual stroll for 45-60 minutes with the alumni members. During these strolls we would often engage in conversations emphasizing wellness but for the most part we discussed issues experienced in life in general. The lessons learned on our end were invaluable!
Linking Hands: Never underestimate what a family is going through. In a clinical setting we treat the patient’s needs, and often move on to the next patient. The experience of being welcomed into the home of an individual with a disability and their family outside of a clinical setting was powerful for me. It was life-changing to hear the stories of patients and their families, to hear their points of view and to engage in very candid discussions regarding active issues they have faced and are currently dealing with on a daily basis. The real life barriers they encountered and how we could change the system to meet their needs was very instructive and absolutely invaluable to my development of a better understanding of our health care system.
Resources: Being a resource for a patient and their family is a never-ending process. The most impactful thing I took away from the lecture series and talks was the importance of my own awareness of the vast amount of resources available and also where the holes in the system are currently. I hope to take the knowledge I have developed to inform and empower each family I come across in my career.
Policy: The power of your voice can be transformative. Attending the Disability Policy Seminar was intimidating at first; however, I learned how much the power of one person’s voice can bring about change. This experience opened my eyes regarding many issues surrounding disability, healthcare and other issues related to my profession.
My goal in LEND was to expand my knowledge about disability, as a parent of a child with a disability. I was surprised to discover that I got back my confidence and was able to return to my profession as a radio talk show and television host. As a Latina, I have reached out to many parents with similar issues to my own. I was also able to help more parents through the radio show.
On the radio show, I am raising awareness of families and people with disabilities and am continuing to educate, inform and share knowledge. It is important to me to be available to help others who may not know where to start or who have just received a diagnosis. My main goal is to reach out to people in the Latinos Communities who feel suppressed and intimidated by the barrier of the language and are afraid to reach out for help or assistance. Many are unaware of all the help they can get. I want to let them know that they are not alone and there are many resources to help. On the radio show, we talk about the community and resources that are available. We bring in various organizations, both public and private, businesses, and companies to share information about programs, products, and technology that can benefit people with special needs.
My time at LEND has been wonderful and an invaluable experience. The LEND program changed my life by giving me the opportunity to learn more about neurodevelopmental disabilities, and for giving me back my confidence in my profession in communication. As a mother of a child with cerebral palsy, behavioral issues and many medical needs, the skills I have gained in the LEND program have prepared me to better support my son with special needs, parents, and the Latino Hispanic communities.
I LEARNED IT IS NEVER TOO LATE TO START, and to follow your dream!!!
PHOTO: Yetunde Akingbemi (left) and Noelle Yeo (right).
This blog post describes the experiences of two MCH nutrition trainees, Noelle Yeo and Yetunde Akingbemi, while attending the Making Lifelong Connections meeting in Tampa, Florida this spring. Noelle and Yetunde are second year students in the coordinated MPH Nutrition program at the University of Minnesota, Twin Cities. They have both been MCH nutrition trainees since August 2017.
Making Lifelong Connections is a meeting for all MCH trainees to connect with current and former trainees, share and learn from each others' work, and practice and learn leadership skills. All current and former trainees are selected to attend this meeting to demonstrate a form of leadership through giving an poster or oral presentation, hosting a roundtable discussion, introducing speakers, or other forms of leadership activities. Noelle and Yetunde – along with Marissa McElrone from the University of Tennessee, Knoxville – originally applied to present their work on creating and administering the MCH Nutrition Trainee Blog . We were selected to host a roundtable discussion during the meeting entitled “Leadership Colors” where we led our respective tables in completing the activity to discover our leadership styles. We discussed how to apply our various leadership styles to our current work, and also examined how our strengths could benefit different work environments during our future careers. Here is more about our experiences at MLC:
Noelle: Attending MLC this spring was a great experience. We had the opportunity to meet and learn from so many people in different disciplines across MCH training programs. At the beginning of the meeting, we were all given a ring of cards with our information on it to hand out as we were talking to new people. It was immediately clear (as from the name of the conference) that networking would be a large part of the conference, but the cards and the activities made it easy and fun! I really enjoyed getting outside of the nutrition realm and learning about the work that current and former trainees are doing in other programs. Some of my favorite presentations were about about making public places (particularly restaurants and the Cleveland zoo) more accessible and welcoming for people with various mental abilities. We also were able to support two of our classmates from the UMN Center for Leadership in MCH who presented their work with the Lactation Advocacy Committee and researching sexual activity among LGBTQIA+ youth experiencing homelessness. Overall, the meeting was an awesome opportunity. I hope to attend next year and would encourage anyone interested in applying as well!
Yetunde: The MLC meeting far exceeded my expectations this spring. As soon as the conference began, I was astonished by the number of training programs that were represented, many of which I wasn't aware existed! It was wonderful to meet such a wide variety of people – of different races and ethnicities – that were involved in MCH in some capacity. As was mentioned previously, the networking ring of cards was a very creative way to get to know and connect with people! Many specific moments at MLC especially stuck with me. I really liked a presentation given by a social worker on how he applied his MCH training to reduce violence at the public school at which he worked. Another was about using mHealth (mobile health) interventions to improve prenatal care and birth outcomes in the US. Overall, it was clear that each speaker had a passion for the topics they were presenting, and many even told their personal stories and journeys, which was very inspiring to hear. Attending this meeting fueled my love for MCH even further, and I am already looking forward for the opportunity to attend next year!
2018 MLC Meeting Attendees
If you are interested in learning more about becoming a DMCHWD intern, see the Student Internship Opportunities webpage for more information. Applications for the 2019 summer internship should be received by 11:59 P.M. on January 25, 2019.
My name is Leila Raminpour. I was pleased to have the opportunity of interning in the Division of Maternal and Child Health Workforce Development (DMCHWD) in Summer 2018. During my time at the division, I was in the middle of my Master of Public Health program at George Washington University. With the help of my preceptors and supervisors, Samantha Croffut and Rita Maldonado, and the friendly and welcoming staff of DMCHWD, I felt very at home at the division. I worked on a range of tasks and projects from creating professional enhancement education content to assisting in revision of publicly available maternal and child health history.
During my time at the division, I presented on the impact of the opioid crisis on America's children in respect to Neonatal Abstinence Syndrome and the foster care system for DMCHWD monthly “brown bag” sessions. Along with a handful of other DMCHWD staff members, I attended the annual LEND meeting in Rockville, MD. I helped provide revisions for a relaunch of DMCHWD's MCH Timeline and MCH Leadership Competency guide. I attended the West Virginia Block Grant Day and Maternal Mortality Summit on site. I attended a wide variety of division specific meetings and learned a great deal about public health work at a federal agency. I aspire to use the knowledge and skills gained from my time at DMCHWD to further my knowledge and career in working to improve the health and well-being of the nation's mothers, children, and families.
When you're a child your imagination runs wild, and I was no different. Though my imagination ran wild, my family tells me that the underlying theme was helping others. This came as no surprise to me when the time came to decide my major in undergrad – healthcare. Such a broad field, but the key focus remains the same, helping others. As I took the time to evaluate my healthcare interests, I naturally gravitated to the health of women and children. It wasn't until later that I found the name of this interest, maternal and child health.
There is something so innocent about a child that it makes you want to protect them at all times. Aside from my parents one of my other prominent protectors while growing up was my pediatrician. Dr. Bellamy had a way with both my sister and I to explain everything in a way that we would understand, but also make us feel comfortable to share any concerns we had with her. That was what I longed for in my career, to make my patients feel so comfortable with me that they could view me as another protector looking out for them.
As I grew older, I began to research more healthcare topics that applied to me personally such as reproductive health. I found that as an African American woman my health outcomes for not only childbirth, but other health ailments were statistically shown to have greater adverse outcomes for my demographic than my counterparts.
As I came upon my junior year at Spelman, I began to research graduate programs that focused on public health and maternal and child health. These two areas of healthcare became my passion. Once accepted to the Drexel University Dornsife School of Public Health, I began to focus on my maternal and child health interests with my class selections, assignments, and extracurricular activities. It was during this time that I found not only peers that shared my interests, but also professional organizations such as the American Public Health Association (APHA) and the Association of Teachers in Maternal and Child Health (ATMCH). A maternal and child health professional world that I never knew existed. It was through my APHA Maternal and Child Health fellowship during the second year of my graduate program that I found out about HRSA. It became apparent to me that HRSA has a multitude of resources for public health professionals across the country, such as the Trainee Ambassador Group (TAG).
Once accepted to the TAG program I was impressed by the background of my fellow ambassadors. When reading their bios, I began to make note of the many different avenues that the field of public health and maternal and child health could allow me to go in the future. I have worked with two colleagues to develop and present at the Making Lifelong Connections conference, collaborated to develop a social media strategy, and aided in the planning of an event at the Annual Meeting for APHA.
The TAG program has been an opportunity for me to work diligently with fellow colleagues around the country that share similar interests. I have been able to develop and foster professional relationships by sharing ideas, strengthening my collaboration and presentation skills, and networking. I highly recommend the TAG program to any current or former MCH trainees that have a desire to work among a group of their likeminded colleagues and develop professional relationships that will last well beyond their time within the TAG program.