happy children, mother and child, and expecting mother and father

Funded Projects

Grant Status: Active

Grant Title: Maternal Child Health Coordination Project

Web Site: Esperanza Health Centers Project Exit Disclaimer

Project Director(s):

Dan Fulwiler
Esperanza Health Centers
Chicago, IL
Phone: (773) 584-6130
Email: dcf@esperanzachicago.org

Problem:

New mothers and babies in Esperanza Health Centers' low-income, medically underserved neighborhoods are in need of supportive interventions which encourage breastfeeding, postpartum follow-up, and preventive screenings to reduce health disparities for children through 24 months of age

Goals and Objectives:

Goal 1: Ensuring that the medically underserved mothers and babies who seek care at Esperanza receive timely, culturally sensitive OB/GYN and Pediatric healthcare. Objective 1: Post- Partum Care - 66% of patients who have received prenatal care at Esperanza (defined as two or more visits in the third trimester) will receive post-partum care at our health center between 21 and 65 days after delivery. Goal 2: Promoting best practices in breastfeeding. Objective 1: Breastfeeding Initiation- 81.9% of new mothers delivering through an Esperanza provider will breastfeeding in the early postpartum period. Objective 2: Breastfeeding Duration -- 60.5% of new mothers delivering through an Esperanza provider will report breastfeeding their infants through six months of age. Objective 3: Breastfeeding Exclusivity -- 23.7% of new mothers delivering through an Esperanza provider will report exclusively breastfeeding through six months of age. Goal 3: Ensuring patient follow-up and assessing barriers to care through the provision of clinical case management visits, home visits, and appointment reminders Objective 1: Post Delivery Lactation Education Visits -- The Peer Lactation Educator (PLE) will conduct at least 200 lactation education and support visits with new mothers post-delivery at Saint Anthony Hospital. Objective 2: Case Management Contact by 12 Months of Age -- 75% of all mothers who delivered through an Esperanza provider will receive no less than five case management contacts (defined as in-clinic visits, home visits, and phone calls) by their baby's 12th month of life. Goal 4: Promoting best practices in postpartum care, and pediatric preventive health through patient education and support. Objective 1: Zero well baby visits by 15 months -- No more than 2% of patients will have zero well baby visits by 15 months of age. Objective 2: Developmental screening by 12 months of age - 80% of children will receive formal developmental screening by 12 months of age. Objective 3: Developmental screening between 12 and 24 months of age - 70% of children will receive developmental screening between 12 and 24 months of age.

Methodology:

We will engage in activities to ensure that women have received at least five points of contact during the pregnancy and post-pregnancy process in regards to breastfeeding. Activities will include education and promotion that occurs: During the new OB visit by our Peer Counselor in the 1st trimester; During the 3rd trimester OB visit by Peer Counselor; At Saint Anthony Hospital after birth by our Pediatric Nurse Practitioner; During the newborn clinic visit by a Pediatrician and Peer Counselor; A phone call one week after newborn visit by Peer Counselor. In addition, we will provide: Education on the importance of postpartum care, interconceptional care, and preventive pediatric healthcare provided during through visits by project staff at the time of care, as well as follow-up phone calls and home visits. Personalized linkage to timely postpartum follow-up (for mothers) and preventive screenings (for babies through 24 months of age). To monitor progress and identify areas for improvement, we will engage in quality monitoring activities to ensure that pediatric patients aged 24 months and younger receive well visits, developmental screenings, and vaccines recommended by the American Academy of Pediatrics Bright Starts guidelines. Our project team will also work to continuously identify additional resources and programming that can be utilized to address needs that emerge among mothers and children during the course of the project.

Coordination:

The Illinois Chapter of the American Academy of Pediatrics and Saint Anthony Hospital will provide oversight and direction throughout the project as members of the Project Advisory Board. Their work will include: identifying funding sources and community partnerships, designing and providing approval for the project's educational curriculum and materials, and developing strategies and activities which create a supporting breastfeeding environment at Esperanza and Saint Anthony Hospital.

Evaluation:

Project outcomes will be tracked and reported utilizing various data sources including: Patient appointment data and coded billing data from our electronic health records system; Chart reviews conducted and as part of our quality improvement review; Quality indicator data for Medicaid enrollees provided by Illinois Medicaid; Outcomes and processes will be reviewed monthly by the project's management team to discuss progress towards goals and any necessary changes that need to be made.

Experience to Date:

During the past year, we expanded our level of breastfeeding support services. First, we provided one-on-one education and support through the efforts of our Care Coordinator who served a peer counselor, and our OB and Pediatric providers who provided professional supports. Their work included providing at least 7 points of contact for education and support during the course of a mother's involvement in our program. In addition, we provided group support through a weekly peer support group led by our Care Coordinator at our clinic. We also added a monthly breastfeeding workshop held at our local public library. As a result of our efforts, we were able to engage in a number of media and research opportunities to promote breastfeeding. In terms of media, our Care Coordinator and a program participant were interviewed by Vivelo Hoy!, a major Spanish speaking outlet, to normalize breastfeeding in our community. Our Director of Quality wrote a blog post for Hispanic Heritage Month to raise awareness on the importance of breastfeeding in the Latina community. She also co-led a breastfeeding Twitter chat with Health Connect One for their Hispanic Heritage Month campaign. In addition, we created two posters to present our project outcomes. One poster was for the NCLR Health Summit in San Antonio, Texas, and the other was for the NACCHO Closing Grantee meeting in Baltimore, MD. For the meeting, our Director of Quality presented on a panel to discuss our program's successes.

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