Promising Practice: Men in MCH

1. CityMatCH Conference 2008 September 20-23, 2008 Albuquerque, NM Healthy Start, Inc. Pittsburgh/Allegheny County, PA Promising Practice:Men in MCH Michael Caliguiri, M.S. Field Manager Benjamin Davis Program Specialist Healthy Start, Inc.  is supported in part by Project No. CFDA #93.926E from the Healthy Start Initiative, Division of Perinatal Systems & Women’s Health, Maternal & Child Health Bureau, Health Resources & Services Administration, and Department of Health & Human Services.

2. The Problems (Pittsburgh/ Allegheny County) • African American (AA) infants dies at almost 4 times the rate of whites while representing just over 10% of the total births* • 80% of AA births are to unmarried women [almost 40% for whites]* • 2xs as many LBW for African American as for Whites* • Teen birth rate (15-17yrs) for AA is 8 times higher than Whites (45/ 5.6)* *PA Dept. of Health EPIQMS (2003-05)

3. The Mission The mission of Healthy Start, Inc. is to focus primarily on the reduction of infant mortality and low birth weight babies in Southwestern Pennsylvania in such a way as to make valuable use of its resources, preserve its flexibility and continue to offer seamless services with the intent of improving the quality of life of infants, toddlers, youths, siblings, parents, and grandparents.

4. The Purpose • To create and coordinate a comprehensive system that ensures infants are born healthy into homes where they will be nurtured and valued. • To demonstrate innovative ways to reduce infant mortality in some of the areas with the highest infant mortality rate in the country.

5. Men Need What Women Need – Comprehensive Teams and Services • Care Coordination - Outreach Workers • Health Screening & Education - Nurses • Depression Screening & Referral - PHQ-9 Assessment Tool by Pfizer, Inc. • Targeted Case Management – CACs • Program Evaluation – MIS • Indigenous Personnel – HR

6. Successful Program Strategies • Indigenous Employees • Holistic in Approach • Community-Based & Culturally Sensitive • Multi-Disciplinary • Speak to Male-Specific Topics • Collaborative Across Systems • Outcomes-Oriented

7. IMPACTS (-)… “Children who live absent their biological fathers are, on average, at least 2 to 3 times more likely to be poor, to use drugs, to experience educational, health, emotional and behavioral problems, to be victims of child abuse, and to engage in criminal behavior.”

8. IMPACTS (+)… “Children with involved, loving fathers are significantly more likely to do well in school, have healthy self-esteem, exhibit empathy and pro-social behavior, and avoid high-risk behaviors such as drug use, truancy, and criminal activity.” – -NFI; Father Facts, 4th Ed.

9. Male Initiative Program (MIP) • The purpose is to inform male partners and spouses of how influential they are to the outcome of a pregnancy and the ongoing health and well-being of their babies.  • Fathers/ male caregivers receive identical services to those of enrolled women, while individualizing plans to meet male-specific needs.

10. Child Education Job Self Sufficiency Access to Care Housing Transpor-tation Medical Home Insurance Male Initiative Program Case Management

11. Core Services for Men: The Basics • Male Friendly Language, Literature & Materials • Male Role Models & Examples • Male Staff • Activities & Events • Flexible Schedule • Skill Enhancement & Support

12. Depression Screening & Referral for Men • PHQ-9 (Pfizer) Self Assessment Tool • Specialized Training for Outreach Workers (Lay/ Non-Professional) on: • Counseling Techniques of Dialectical Behavioral Therapy (DBT) • Where to Turn for Community Services and Referral Procedures • Administering and Scoring the PHQ-9

13. Depression Screening & Referral for Men • Referral System • Community based SW • Health Start, Inc. SW *DBT developed Marsha Linehan, M.D., Univ. of Washington *DBT Training Developed in Conjunction with University of Pittsburgh, Western Psychiatric Institute & Clinic, Katherine Wisner, M.D

14. Build a Referral Network for Men! • Local Health Providers • Employment & Training • Housing Authorities – City/County • Local/ State Health Department • Mental Health/ D&A Treatment Centers and Systems • Family Planning • Child Protection Services

15. Evaluation • Participant Information Management System (PIMS) • Referral & Enrollment Database • Case Management Forms

16. Life Skills Groups • “FAMILY” Focus Night • Monthly education forums for fathers/ male caregivers as well as mothers, children, and support persons • Promotes peer to peer (man to man) learning and discovery • Increases empathy and understanding specific to gender roles and responsibilities

17. Life Skills Groups • Interactive Health Learning Mechanisms • Roundtable Discussions

18. Building Blocks for Programs • Provide economic, social, and emotional support for parents • Use screenings, assessments, and evaluations to monitor well-being and plan next steps • Build on strengths of participants • Educate staff and advocate for further research

19. Linkage Across Services

20. Promoting Responsible Fatherhood Grantee 2006-2011 Three Primary Components • Case Management/ Care Coordination for Fathers/ Male Caregivers • Healthy Marriage/ Cooperative Parenting Counseling • Domestic Violence Counseling and Education

21. Responsible Fatherhood Projected Impacts • Increase case management/ care coordination service capacity by 350 • Expand eligibility and scope of participants • Strengthen parental involvement for 300 couples • Decrease in parental conflict via Prevention (education) and Intervention (counseling)

22. Challenges • Literacy • Mentality • Parenting • Employment • Depression • Advocacy • Sustainability

23. Strategic Sustainability Planning • Should be a written document with specific steps and outcomes • Include evaluation as part of planning (# of months/ years) • Identify resources large and small and of various systems (local/ federal; philanthropic) • Assure that outcomes meet the mission of the funding sources you approach • Sustainability is just as much collaboration and partnership as much as financial

24. Sustainability Evaluation(s) • Quantitative & Qualitative assessments to determine impact of male-based programs on MHC outcomes (see poster display!) • National Healthy Start Association Dad’s Matter Cohort (Ken Scarborough) • National Responsible Fatherhood Clearinghouse • Low/ No Cost strategies, tools, approaches • Timely submission of grant and other required reports • Knowledge Dissemination across systems

25. Sustainability Successes • Grantee for federal PRF/HM • Community Development Block Grant (5K) – marketing • Department of Community & Economic Development (30K) – personnel • Heinz Foundation – non-federal match and commitment to child health and development outcomes • DV, FQHC, Faith-based Partnerships (collaborative agreement + financial) • Family Support/ Head Start Center in-kind support and shared program capacity

26. Lessons Learned • Strengthening entire families, especially fathers, are proven strategies associated with childhood success. • Healthy Start has shown that local communities can, with support, develop and implement innovative approaches to reducing infant mortality

27. Healthy Start, Inc. For more information about us, call the Healthy Start, Inc. Helpline at: (412) 247-1000 or (724) 425-1799 or visit our website at: www.healthystartpittsburgh.org Healthy Start, Inc.  is supported in part by Project No. CFDA #93.926E from the Healthy Start Initiative, Division of Perinatal Systems & Women’s Health, Maternal & Child Health Bureau, Health Resources & Services Administration, and Department of Health & Human Services.