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.
Boston Children's Hospital - Division of Developmental Medicine, 2nd year Fellow
Mei is interested in understanding how caregiver beliefs and practices impact childhood development in order to improve childhood outcomes, especially in underserved populations. Her research project “Caring in Adversity” explores the role of caregivers’ beliefs about early childhood development on developmental outcomes in the context of adversity.
Caring in Adversity - Significant adversity in the first years of a child’s life elevates the risk of lifelong problems in learning, behavior, and health. Caregivers who provide stimulation and responsive interactions positively impact children’s outcomes and buffer the negative impact of adversity. There is also increasing evidence that caregivers’ mindsets about intelligence contribute to their interactions with their children. Yet knowledge of how caregivers conceptualize childhood development and their own role in promoting their child’s development in the context of adversity is limited. This project, which is an interdisciplinary collaboration with the Laboratory of Cognitive Neuroscience and the Harvard Graduate School of Education, uses mixed methods to gain understanding of the relationship between caregiver beliefs and developmental outcomes in populations at-risk for adversity. Specific novel aims include: 1) To determine whether caregivers with different levels of education, age, mindsets, and exposures to adversity differ qualitatively in their reported beliefs about early childhood development and their own role in supporting their child’s development; 2) To determine quantitatively whether caregiver mindset and exposure to adversity interact to differentially predict children’s developmental outcomes, specifically skills in cognitive and socioemotional domains; and 3) To explore home language environment as a potential mediator in the relationship between caregiver mindset and exposure to adversity, and early childhood developmental outcomes.
Nutrition Trainee, University of Tennessee
Marissa Black is a Maternal and Child Health Nutrition Leadership Trainee from the University of Tennessee. Marissa is currently pursuing a Master of Science in Public Health Nutrition. She will begin her Dietetic Internship in January 2019. Marissa hopes to work with the MCH population as a registered dietitian.
This summer, I had the opportunity to lead an innovative youth development program at a local community center. The program, titled Youth Can! Grow in Communities, lasted for eight weeks with two one-hour sessions per week. The youth learned about nutrition, gardening, and advocacy. The lessons were designed to empower the youth to develop their own project to improve the health of their community using the produce from the community center’s garden. The youth came up with an idea to use the produce to cook healthy food for their community members. They had the opportunity to meet with their community leaders to discuss their project and how they could help their community. They developed an action plan to involve local gardeners, chefs, the health department, and city officials to help their plan come to fruition. During the community center’s end of the year presentation, the youth presented their action plan to the director of the program, their peers, and their family members.
Christopher “Kit” Hammar’s Va-LEND Leadership Project highlighted Va-LEND’s trainees who are persons with disabilities or family members of a person with a disability. View his final product to find out more about these trainees and the value they add to the Va-LEND program.
In May 2018, the Walker Art Center (Minneapolis, MN) launched Sensory Friendly Sunday (SFS), a monthly, free event for kids, teens, and adults with autism spectrum disorder or sensory sensitivities. SFS offers the opportunity for families to make art together, explore the galleries, watch a short film, or just hang out in a different setting. From 8 to 11 a.m. on the first or second Sunday of each month, the galleries are closed to all other visitors, allowing guests to enjoy the museum in a calm environment where accommodations such as quiet spaces, headphones, and fidgets can be provided.
SFS was spearheaded by Julia Anderson, who conceived the idea for the program as a LEND Fellow in 2016-17. Anderson applied LEND’s interdisciplinary approach to her program development process. For example, she created a Community Advisory Group of parents, self-advocates, and professionals (including past and current MNLEND families and trainees) to guide and inform the program. Additionally, Julia interviewed occupational therapists, art teachers, museum security guards and museum educators to learn a diversity of viewpoints. Walker staff, security guards, and educators received training from Autism Society of Minnesota and aimed to create a welcoming environment. While SFS is a new program, it is receiving positive input from the autism community and provides an example of community inclusion at work.
This past grant year (2017-2018), the University of Minnesota (UMN) LEAH program welcomed one of its largest and most diverse cohorts of trainees or fellows: 3 nursing fellows, 2 receiving their doctorate of nursing practice and one pursuing a PhD; 2 social work fellows with one pursuing her master’s degree, the other her PhD; and 1 public health fellow pursuing her master’s degree with an emphasis in maternal and child health. They were joined by 3 post-doctoral fellows funded through HRSA’s Interdisciplinary Research and Training in Child and Adolescent Primary Care grant: a general pediatrician and 2 PhDs, one in family social science and the other in epidemiology. Some will pursue careers in research and teaching within higher education; others are looking forward to leadership careers in the public sector. This thoroughly interdisciplinary cohort brought the best from their respective disciplines and, concurrently, opened themselves up to the perspectives and expertise of other disciplines. Now, nearly finished with their fellowship year, they reflect on what LEAH fellowship training has meant for their careers.
Learning in an interdisciplinary setting brings growth and development.
One of the many strengths of this fellowship is that people with different backgrounds meet on even ground and share knowledge and experience on an even playing field. This fosters conversation that expands perspectives on adolescent health and helps fuel a sense of empowerment to pursue a career is this field. Being provided numerous opportunities in the fellowship to advance scholarship and knowledge around a core area of interest, and speak about it with other fellows from different disciplines, at conferences, and in the community has really strengthened the capacity to speak to the health and well-being of adolescents to a range of audiences. It is essential to experience the different yet complimentary perspectives that an interdisciplinary approach brings to addressing youth health disparities.
Interdisciplinary training broadens discipline-specific assumptions about young people.
In nursing, for example, conversations are often focused on holistic health and healing. In the fellowship, this perspective is included -- as are perspectives from prevention science, social work, public health, and clinical settings – into rich and meaningful conversations regarding young people, risk taking behaviors, and protective factors. Being in an interdisciplinary cohort is a reminder that not everyone views the world the same way as a community practice social worker or a nurse or a physician, even if they want to accomplish the same things. Learning with other professionals opens up a larger dialogue and allows for greater learning than when learning is within just one profession.
Interdisciplinary training is a value-added proposition.
This fellowship has changed the course of several fellows’ careers. Previously, teaching and research were on the periphery of careers; now, teaching and research have moved to the forefront. It also is valuable to learn about professional expectations for different disciplines, and how these expectations shape everything from teaching, to publishing, to the types of research that is deemed acceptable in various professions. Participating in this interdisciplinary training experience – through research, community engagement, teaching, and learning experiences – provides essential leadership skills for advancing the field of adolescent health.
The MCH Nutrition Peer Mentoring Network was created as a part of the MCH Nutrition Grantees’ Diversity Recruitment and Retention Learning Collaborative as a forum for trainees to share and learn about partnering programs and fellow trainee experiences, and to foster collaborative, peer and professional networks among funded trainees. Based on program director discussions, trainee feedback, and available resources, the MCH Nutrition Peer Mentoring Network was established in the spring of 2016. Since inception, trainees have planned and facilitated six quarterly conference calls to discuss collaborative projects, share leadership and training experiences, and promote trainee engagement across the various MCH Nutrition training programs. The trainees also collaboratively developed a MCH Nutrition Peer Mentoring Network mission statement. To supplement trainee conference calls, an online blog forum entitled A Day in the Life of a MCH Trainee was developed to enhance collaboration among trainees. A subcommittee of volunteer program directors and trainees, Marissa McElrone (University of Tennessee) and Noelle Yeo (University of Minnesota), was established to lead the online blog creation and management. An initial call was held to discuss blog platforms, administration, protocol, and management among subcommittee members. McElrone and Yeo were tasked with designing, managing, and disseminating the blog to other nutrition trainees. The online blog was launched through the existing MCH Nutrition Peer Mentoring Network as a collaborative project for all trainees.
McElrone and Yeo designed the blog format, generated sample blog posts, and developed a protocol, including the blog purpose and procedures. Following the blog protocol, McElrone and Yeo provided instruction to fellow trainees on a quarterly MCH Nutrition Peer Mentoring Network conference call regarding the purpose, procedures, and management of the online blog. Each training program selected a leader tasked with organizing and posting monthly blogs for their respective programs, following a blog-posting schedule. All trainees were encouraged to like and/or leave comments on posts to further peer interaction and discussion, enhance learning, and provide an avenue for peer and professional networking. Each year, a new trainee from each program will be selected as a blog leader to increase power-sharing, equitability, and ownership among trainees, and improve overall blog maintenance and sustainability. Eleven trainees have posted blogs since the launch in January 2018.
As an ongoing, iterative collaborative project, the Peer Mentoring Network serves as a way to connect MCH Nutrition trainees across the country. Additionally, it is an avenue to learn from peers, build professional relationships, recruit future trainees, and share the impact of their training grants on MCH populations nationwide. To read trainee posts from A Day in the Life of a MCH Trainee online blog visit https://mchnutritiontrainees.com.
Three years after I became a Registered Nurse, I applied to Doctors Without Borders (DWB) / Médecins Sans Frontières (MSF). As an Emergency Room (ER) nurse, with some leadership, volunteer and international work behind me, I felt I was ready to work with MSF. Soon I found out, no one is ever ready to work with MSF.
After a rigorous interviewing process, I was finally on the waiting list for my first assignment and I was ready to go wherever they would send me. In May 2015, I went on my first assignment to a rebel territory during the Civil War in South Sudan. My role extended from nurse educator, to the ER, rounding on patients, rotating on-call shifts with the only physician, working as the mission pharmacist, managing the inpatient department and nurses, nursing aides and hygienists.
On my second day, 35 soldiers were flown into our hospital compound for war wounds. Immediately, my ER skills kicked in and though I was in a village without vehicle transportation, surrounded by the 2nd largest swamp in the world, sweating in a tent, I felt this is where I belonged. Working alongside 5 other expats and 20 local nurses and nursing assistants, we built a team that I could rely on, trust in and feel supported by as we all aimed to ensure the health of the population we were working within, whether civilian or soldier, ethnic minority or ethnic majority. With a wide range of infectious diseases, war wounds and malnutrition, I had a very steep learning curve, which required daily problem-solving. After six months in South Sudan, I felt even more determined to continue working with vulnerable populations both abroad and nationally and desired to combine the skills and knowledge of a pediatric nurse practitioner (PNP) with a public health emphasis; so, I applied to graduate school in the early mornings before our morning conferences.
While I awaited school to begin, I took another assignment with DWB and this time went to Monrovia, Liberia to work as the manager of the ER and Intensive Care Unit (ICU) in a pediatric hospital for children 5 years and younger. Here I experienced a drastic shift in culture, including the education level of the national staff and a population devastated by Ebola and years of civil war. I was there during the post-Ebola mission to help support the healthcare system. During this tour, I held more of a managerial role, which helped me recognize my greater interest in not only being clinical but using my clinical skills to influence population health. My role focused on supporting the national nurses and nursing assistants through continued education and team collaboration. It was an incredible partnership in which I trained one of the national nurses to take over my position as ER supervisor when I left the assignment. Being a part of a team that helped to support national staff and allow for growth was an incredibly inspiring part of my job.
Working with MSF is one of the best decisions I’ve made throughout my career. Their values of neutrality, impartiality, independence and speaking out are what kept me going through difficult situations and challenging times. It is more than a job and more than an experience; working with MSF has changed me both as a nurse and a humanitarian. I will continue to believe in the values that represent MSF, as they should be the core values of any healthcare professional.
Kayla Percy RN
Leadership Education in Adolescent Health (LEAH) Nurse Trainee
Johns Hopkins School of Nursing
Johns Hopkins Bloomberg School of Public Health
Doctors Without Borders (DWB) / Médecins Sans Frontières (MSF)
Arizona LEND trainee, the Associate Director of the Autism Society of Southern Arizona (ASSA) and a mother of a child diagnosed with autism spectrum disorder. Brie is the first contact families make when they contact ASSA. She provides families with resources to help them navigate services, programs and healthcare options. When families know she has walked in their shoes, they feel an instant connection. Her latest project included creating informative videos interviewing experts on autism to help families understand the system without being overwhelmed. Her time is dedicated to working with the community to facilitate autism awareness trainings. She is actively providing schools and doctors with CDC materials on early childhood milestones.
Brie also plays a large role in managing the Annual Autism Walk & Resource Fair. The April event is the largest autism event in Southern Arizona serving 2,000 participants and features 50 community service providers. Brie works with the ASSA Board President to secure corporate sponsorships for the event and this year has confirmed an annual program partnership with a leading behavioral health provider. The LEND program has provided a core foundation of knowledge in neurodevelopmental disabilities, created professional partnerships that have enhanced the ASSA’s programs and enhanced Brie’s understanding of culture and family dynamics.In a conversation with Brie, she shared, “I will never forget the day I received my child’s diagnosis. My mission from that day forward would be to maximize my son’s potential. I am passionate about equipping families with knowledge on what is out there to help their family. I want to provide hope, lead families to resources and services and let them know they are not walking alone.”
MNLEND Fellow, Alice Kraiza (Masters student in Public Health Administration and Policy at the University of Minnesota), housed in the Institute on Community Integration at the University of Minnesota, is collaborating with leaders of the Latino Childcare Providers Network (La Red), a Family, Friend, and Neighbor (FFN) provider group based out of Richfield and Bloomington, Minnesota. La Red/The Network’s Director, Ruth Evangelista, and Alice are developing a new training program on early developmental milestones and signs of Autism using “Learn the signs. Act Early.” (LTSAE) materials and resources for the wider Latinx FFN network. Per Evangelista, “I believe this training is good for La Red. The greatest contributions are to break the language barriers, understand what autism is in the Friend, Family and Neighbor community and how to go hand in hand with FFN providers.” In Spanish: “Creo que este entrenamiento esta bien para la Red y la gran aportación es romper las barreras de lenguaje y entender que es el AUTISMO en la comunidad FFN y como ir de la mano con las familias amigos y vecinos.” Alice is working closely on this project with guidance from both her MNLEND mentor, Dr. Robin Rumsey, and Dr. Jennifer Hall-Lande, MNLEND Faculty and Act Early Ambassador to Minnesota.
Since fall 2017, Alice has contributed Minnesota LTSAE materials, as well as assisted in designing a business plan for the organizational outreach efforts of La Red. The team is ensuring the trainings and outreach will be relevant, appropriate, and informative. The community trainings will be delivered in Spanish, and they anticipate about 45 childcare providers from across the Twin Cities metro area will attend the first April 2018 training.
For his MNLEND project, MNLEND Fellow (2017-2018) Derjaun (DJ) Strons, who is also a M.S.W. student at the University of Minnesota, joined with the Autism Society of Minnesota (AuSM ) to provide social supports to individuals with autism. He took the opportunity to work alongside AuSM program specialists who teach social skills, both informally and formally, to children, teens, and young adults on the spectrum. The goal of the social skills classes is for the participants to practice and use social skills in day to day situations while being involved in activities in which they want to develop new skills or have an interest. As part of his contribution to AuSM, he conducted a research review of recent evidence-based social skills activities that are intended for or could be adapted for young people on the autism spectrum. Strons has also volunteered during some AuSM events and he plans to join in supporting youth groups over summer. While Strons already had a strong background in youth development, he feels his current project at AuSM has given him valuable firsthand experience to learn to support people with autism. He plans to apply his new knowledge and skills to his future role as a youth-oriented social worker.
Stephanie Emperly, the 2017-2018 LEND Intern in the area of Self-Advocacy (mentored by Chuck Roberts, LEND Core Faculty in Self-Advocacy), presented at New Views on Diversity for the Developmental and Behavioral Pediatrics section at OUHSC, entitled "A glimpse into my life with autism.” She charmed the audience with her real stories and her wit. She gave an interesting and informative talk and answered questions from the audience to provide perspective on how she has felt growing up. She included discussions of the challenges she has encountered and the coping strategies she uses.
Stephanie said, “I feel like they gained a lot of insight into how a person with autism thinks. I did not expect them to cry. I know I shattered one of the stereotypes (autistic people can’t be funny). It is flabbergasting to think that people can learn from just talking to me. I’m just glad that my perspective can help people.”
SUNY - Albany Catalyst Trainees Kathryn Mishkin and Wayne Lawrence have been selected as 2017-18 fellows for the American Public Health Association’s (APHA) maternal and child health (MCH) section. SUNY-Albany SPH Interim Dean Laura Schweitzer said that the duo will benefit greatly from the guidance and training provided by their fellowships. “These opportunities are structured to provide significant work experience, and fellows often assume responsibilities to become fully immersed in their field,” she said. “We are so pleased that two of our students were selected for this prestigious honor and wish Kate and Wayne the best as they embark on this journey.” Read the full article here
Third year UCSD DBP Fellow Dr. Sai Iyer is highlighted in Pediatric News for her research on the 10-item Early Literacy Assessment Tool (ELSAT), which is used to screen preschool children for delayed literacy skills.
Policy Briefs developed by participants of the Emerging Leaders in MCH Nutrition Training Institute.
Current and former trainees from Maternal and Child Health Bureau funded training programs met on April 23-24, 2015 in San Antonio, Texas on for the fifth annual Making Lifelong Connections meeting.
Watch on YouTube
Three LEND trainees received honors at the 2015 Early Hearing Detection and Intervention (EHDI) Meeting in Louisville, Ky. These audiology graduate students, all of whom are completing their fourth year externships at Boston Children's Hospital, won the Outstanding Poster Award for Overall Impact. Read more...
Mailman Center LEND Trainee Nominated Student Social Work of the Year (FL LEND) Mailman Center LEND trainee, Rocio de la Grana, received the 2015 Student of the Year Award from the National Association of Social Work (NASW) - Florida Miami Dade Chapter. Ms. de la Grana joined the Mailman Center as a LEND trainee and a social work intern in the Division of Pediatric Immunology and Infectious Diseases, in the Spring semester of 2015. Read more...
Lisa Mays - University of Minnesota School of Public Health
Lisa Mays is an aspiring registered dietitian who has a passion for policy and the ways which legislation affects nutrition and health. This year, she was a key member of the planning team for the Minnesota Academy of Nutrition and Dietetics (MAND) Day at the Capitol.
Jason Champagne - University of Minnesota School of Public Health
SPH student Jason Champagne harnesses the healing power of food.
The Phillips Neighborhood Clinic: Addressing Health Disparities in Central Minneapolis
Julie Arndt, Carrie Dent, Mikaela Robertson are graduate students in the Coordinated Masters Program in Public Health Nutrition, University of Minnesota, Minneapolis.