| Issue #2 - July 2010
Infant Safe Sleep — Leading the Way
What happens when a seemingly healthy baby goes to sleep but fails to wake up? There is still much we don't know about Sudden Infant Death Syndrome (SIDS), but we do know there are ways to reduce the risk. Since 1994 the North Carolina Healthy Start Foundation has played a pivotal leadership role in providing infant safe sleep training and public education across North Carolina to educate families, childcare providers, and healthcare providers about SIDS.
The importance of this commitment and the need for continued education efforts was magnified in the recent Charlotte Observer and News & Observer series on SIDS. While the series raised important questions about the diagnosis of SIDS versus suffocation/asphyxiation, it unfortunately left the wrong impression that the issues of SIDS diagnosis and prevention are not being addressed.
For almost two decades the North Carolina Healthy Start Foundation has led statewide and targeted public awareness campaigns and provided free educational materials to reduce infant mortality. Learn more about our latest education efforts in our Infant Safe Sleep section.
Women's Health
HIV... It Can Happen to Anyone
Anita was a mother with three teenage daughters…Tiffany was getting ready to go to college...Vicky was married. None of these North Carolina women thought they needed to worry about HIV until they received their diagnosis.
No one wants to face the possibility that they could become infected with HIV/AIDS, but the reality is the number of women in North Carolina who are testing positive for HIV is rising at an alarming rate. The North Carolina Healthy Start Foundation has developed three webisodes featuring women who share their powerful stories about the importance of practicing safe sex and getting tested for HIV. These webisodes are compatible with our “Keeping It Real” and, "VIH Una Realidad" (Spanish version) HIV/AIDS prevention and awareness messages and brochures.
Only about half of all North Carolina adults (18-64) say they’ve been tested for HIV. The Centers for Disease Control (CDC) estimates that 250,000 of the one million people living with HIV/AIDS in the United States are unaware of their status. Through education and raising awareness, the North Carolina Healthy Start Foundation wants women to know that HIV/AIDS can be prevented and the agency is empowering women to take a more active and responsible role in their sexual health by getting tested for HIV/AIDS regularly and following up on the results with their healthcare provider. NCHSF developed three webisodes :
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 Keeping It Real… Get Tested for HIV stresses the importance of getting tested and knowing your HIV status. This webisode features Anita Powell, a mother of three children, who found out she was HIV positive after trying to donate blood. “I got the letter from Red Cross, that’s when I found out and, trust me, my world crashed.”
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Keeping It Real… What Women Should Know About HIV covers important facts that all women should know about HIV and AIDS and how to prevent it. This webisode features Tiffany Frazier, who found out she was HIV positive after a routine pre-college physical. “I was numb. I really didn’t feel anything. I was in disbelief.” Tiffany tells the riveting story of how her one time dream of attending college was never fulfilled because she soon developed full blown AIDS. She encourages everyone to know their partner’s sexual history and HIV status before becoming sexually active.
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Keeping It Real …HIV and Pregnancy discusses the importance of knowing your HIV status during pregnancy and explains the North Carolina law that requires pregnant women to be tested for
HIV/AIDS. If a woman refuses to be tested, the law mandates that the baby will be tested at delivery. Early detection and treatment significantly reduces the risk of an HIV positive mother transmitting the infection to her baby. This webisode highlights the personal story of Vicky Hyman, a mother of three young children and how she discovered that she had become infected with HIV after her husband had sex outside of their marriage.
The Keeping It Real webisodes also contain current information and recommendations from local medical experts: Dr. Elizabeth Livingston, Duke Perinatal Center in Durham, North Carolina and Sharon Elliott Bynum, PhD, Executive Director of CAARE also in Durham. The videos are a collaboration between the North Carolina Healthy Start Foundation and the North Carolina Division of Public Health.
Infant Safe Sleep
Reducing the Risk of SIDS
Do you know how to reduce a baby’s risk of SIDS?
Do you know what a safe crib looks like?
Are you a BESST (Baby’s Easy Safe Sleep Training) trainer who wants a little refresher?
Sometimes it’s not enough to read about infant safe sleep in a brochure. The North Carolina Healthy Start Foundation now offers a new way to learn: a short, on-line, self-training consisting of a series of webisodes that you can do on your own time with the click of a mouse. Each video provides recommendations and detailed information for parents, caregivers and professionals about infant safe sleep practices.
The Baby’s Easy Safe Sleep Training (BESST) was originally developed in 2005 with funding from Blue Cross and Blue Shield of North Carolina to increase community-based opportunities to address how parents and caregivers can keep babies safer while sleeping, including:
- proper sleep positioning (placing baby on her back)
- the features of a safe crib and sleep area
- the link between secondhand smoke and SIDS
- the benefits of breastfeeding
- recommended room temperature
- risk of babies sleeping with others
Now all the information contained in the BESST training is available on-line at no cost. With travel budget cutbacks and everyone’s busy schedules, these webisodes are a perfect way to get the training you need. Each of the seven webisodes addresses a different topic and shows viewers hands-on ways to reduce the risk of SIDS.
One webisode in Spanish is designed to provide Latino parents and caregivers information about how to set up a safe sleep environment for their baby. Another one helps English-speaking providers work with the Latino families they serve. Take a look, share this link with others and spread the word about ways to reduce infant sleep-related deaths in your family or community.
- SIDS articles (News and Observer/ Charlotte Observer)
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SIDS rulings mask clues to infant deaths
N.C.Medical Examiner defends SIDS findings
When the autopsy said SIDS, investigation stopped
DA is serious about suspicious infant deaths
Safe Sleep cuts the risks
Couple doubts SIDS findings
RICHES
Healthy Eating, Limited Budget
It’s no surprise that a nutritious balanced diet is essential to staying healthy and living longer. However, what’s widely known … is not always widely practiced. Sometimes there is a lack of knowledge, lack of will or a perceived lack of resources that cause people to fall into poor eating habits. Community organizations across the state are finding creative ways to teach families how to make better food choices. Find out what one of our RICHES (Resources in Communities Help Encourage Solutions) partners is doing in Buncombe County.
Sharon Carter, Nutrition Program Assistant of  the Expanded Food and Nutrition Education Program (EFNEP) at the N.C .Cooperative Extension of Buncombe County, teaches families at local homeless shelters, drug rehab centers and at a community college how to eat healthier. . Carter said many of the women and men she serves face barriers to providing a healthy lifestyle for their families due to financial issues, health problems, family issues, abuse and mental health problems. To break those barriers, Carter is motivated and supported by RICHES to connect with resources that include faith-based and community based organizations.
For nearly 20 years Carter has partnered with the Asheville-Buncombe Technical Community College’s (ABTCC) ASPIRE program. ASPIRE, Assessing Strengths Promoting Integrity Retaining Employment, is a career building program for the unemployed. In addition, this program, a collaboration between ABTCC and WorkFirst, aims to improve the eating habits of its participants. Carter leads a six-week course in which she teaches participants how to cook nutritious, inexpensive meals for their families.
“Participants learn effective meal planning, how to prepare healthier meals and food safety practices,” she said. “It’s important to incorporate healthy eating habits into their everyday life. You won’t be able to provide for your family if you’re unhealthy.”
Carter has seen an increase in her class size due to the downturn in the economy; the success rate of EFNEP has been high among the ASPIRE participants. “Last year 95% showed improvement in nutrition practices and 91% showed improvement in food safety practices.”
Carter, who works with approximately 90 families a year, said her greatest joy is seeing participants graduate from her program. “What I like most about my job is working with all types of people and seeing the smiles on their faces when they accomplished something,” she said.
Through RICHES, Carter is eager to work with other agencies dedicated to helping families achieve healthier eating habits. “I’m motivated by networking options, excited about the possibilities and empowered by the “can do” attitude of the committee and its members,” she said.
“As a RICHES network member I will be able to share the knowledge and activities I use to educate and support women in my community in adopting healthy lifestyles.”
RICHES is an informal network of agencies across the state that partner with the North Carolina Healthy Start Foundation to build the capacity of community-based organizations to address the health and health-related needs of women of reproductive age they serve. If your agency is working to improve the health and nutrition of families in your community we want to hear from you. Become a fan of our Facebook page so we can highlight your success and share it with other community organizations across the state.
Latina Health
Pregnancy: Planned or Oops?
Do women plan their pregnancies? How do women feel when they get the news that they are pregnant? What influences how many children women want to have and when to have them? How is their partner involved in planning a family? These were some of the questions we set out to answer in a qualitative study (2009 to 2010) to look at pregnancy intention from the perspective of women’s everyday realities. Responses from all participants can be found at: Understanding Pregnancy Intention in North Carolina Read here to learn what the Latina participants said.
Latinas need and want the tools to plan their families. Those who work with Latinas should take the time to find out what ideas their clients have about family size and ask them what would help them achieve their goal. Don’t be frustrated if at first your clients seemed confused by your questions. It may be that you are the first to ask them what they want. Give your clients time to think through your questions and inform them of when you will be available to continue the discussion.
Consider this advice from the Latinas we talked with:
- Planning a pregnancy is difficult if you don’t have all the information.
Sex is not discussed in most Latino families. "You don’t even say the word" said one of our study participants. Many Latinas go into relationships not knowing how to prevent a pregnancy or how to talk to their partner about sex. For many of our participants, planning their family started after their first pregnancy, once they felt more comfortable bringing it up with their partner. Participants suggested that women should get more information through "charlas" or talks about family planning when they go in for routine gynecological visits, pap smear testing, or take their child for immunizations.
- Women have to "take care of themselves."
The participants in our study expressed that a husband will tell his wife "take care of yourself" to prevent a pregnancy. Even if a woman can talk with her partner about planning future children, she needs to figure out how to prevent the pregnancy. Without the right information about birth control and pregnancy planning women will still face a barrier. Participants asked for more opportunities to ask questions from their doctors and for family planning programs to provide information to men, as a way to get them more involved in the family planning process.
- Planning means you can give your children everything.
The women in our focus groups, mostly of Mexican descent, were focused on giving their children a better life. It was not only about material things, but also about affection and life opportunities. Several participants mentioned that they wanted their children to study and go to college. Only 17% of our participants had completed high school. The women were motivated to have small families
(2-4 children) so they could provide a better future for their children.
- Girls "should not be playing house so young"
Teen pregnancy was a major concern voiced in all of our focus groups. Many of the participants became mothers at a young age and wanted to be sure that their daughters or other teens did not experience the same. Latina participants thought that American parents are very open with their children on the topic of sex and many participants stated that they should strive to do the same. One participant summed it up "it is bad information [to talk about] seeds, stork…" Participants wanted help and guidance through parenting classes which included opportunities for the parents and youth to participate together.
Read the full report: Understanding Pregnancy Intention in North Carolina. For specific tips on talking to your client about contraception read How Can You Help Your Latina Client Choose a Contraceptive Method.
Foundation News
20 Years of Dedication
With an issue as complex as infant mortality – a social issue with medical consequences – it can feel that there is never enough time or resources to do everything. While North Carolina has faced many challenges, a lot has been accomplished over the past 20 years since the North Carolina Healthy Start Foundation was established in January 1990. What has changed in North Carolina in the past 20 years?
- 34% increase in the number of babies born each year
- Significant increase in Latino babies born (now 16% of NC births)
- 35% decrease in the infant mortality (death) rate
- Significant decrease in the rate of babies dying of Sudden Infant Death Syndrome (SIDS)
- Reduction of babies dying of SIDS in childcare settings from more than 2/3 of all deaths there to 0 to 1 a year.
Here’s a quick look back on major accomplishments and milestones:
1990 – Executive Order #99, signed by Governor Jim Martin, created the Governor’s Commission on the Reduction of Infant Mortality.
Leadership for the Governor’s Commission and coordination of its activities was made possible with the establishment of the North Carolina Healthy Start Foundation as a private, nonprofit agency. Initial funding was a five year pledge of $5 million from then Glaxo, Inc.
1990-1995 – Accomplishments included:
- Forging partnerships with and engaging business and industry
- Building local infant mortality coalitions with social service, public health, political, governmental, school, religious and medical agencies
- Increasing awareness through a public education campaign and media (First Step Campaign)
- Providing $2.3 million in grants to local communities to address specific issues in their neighborhoods that most contributed to infant deaths
- Researching underlying issues such as the service needs and prevalence of drug and alcohol use during pregnancy in N.C.
- Implementation of the N.C. Back to Sleep Campaign to reduce the risk of SIDS
1995 – 1998 – The Foundation’s primary program was the First Step Campaign whose initial focus was to raise public awareness about healthy behaviors and access to care for pregnant women. The nationally recognized Minority Infant Mortality Reduction Awareness Campaign was created in 1996 to reach African Americans in culturally appropriate ways. The Foundation worked hard to secure sufficient funding from the North Carolina General Assembly to continue, and expand, its initiatives.
1998 – The Foundation expanded its mission to include “… improving the health of young children” and partnered with the N.C. Division of Public Health to promote the state’s publicly funded child health insurance programs (Health Check and NC Health Choice for Children).
1999 – 2002 – The Foundation administered the NC Family Health Resource Line (1-800-FOR-BABY); strengthened outreach to Latinos through its linguistically and culturally appropriate Ana María Campaign; collaborated with the N.C. Folic Acid Council; increased outreach for the child health insurance programs; expanded messaging to improve the health and behaviors of women before, during and after pregnancy and provided another $1.6 million in grants to community-based agencies.
2003 – 2004 – Restructured the Foundation’s board of directors and revised bylaws. Founding directors Dr. Charles Sanders, W. Travis Porter, Dr. Stuart Bondurant and Dr. Howard Fitts became Directors Emeritus. Advised legislators on ways to reduce child deaths in child care resulting in the 2003 Prevent SIDS Law. Started the four-year ITS-SIDS Project ( infant safe sleep training for childcare providers) which became state mandated resulting in the reduction of SIDS deaths in childcare setting from the highest cause of deaths to a rare event.
2005 – 2009
- Continued core programs such as the First Step Campaign, the Health Check/ NC Health Choice Outreach Campaign; partnered with the N.C. Folic Acid Council and the state’s Family Planning Waiver Program; established hospital-based infant safe sleep initiative
- Collaborated on initiatives such as HIV/AIDS and pregnancy, sickle cell education and testing, qualitative research on women’s knowledge of health-promoting behaviors and use of health-promoting services, Latino acculturation
- Shifted the agency’s educational emphasis to improving the health of all women of reproductive age in line with the Centers for Disease Control and Prevention’s recommendation.
- Formed and supported a statewide network of more than 200 community-based agencies to build their capacity to improve the health of women of reproductive age and to network and strengthen their access to available resources
2010 – Survived serious state budget cuts in 2009 and became a leaner, more efficient agency. Initiated a variety of social media and electronic strategies and created on-line videos to reach and educate more people on a variety of important health topics. Accepted by the State Employees Combined Campaign for 2010 pledges (choose # 3760 or find us alphabetically).
We are proud of our accomplishments and foresee further progress in the next 20 years.
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