Playing Match Maker

We all know that prenatal appointments and taking care of herself are high on the list of things pregnant women need. But what about the need to share a laugh about her expanding belly? Or a hug when the tears flow? How about just having someone to talk to? Isn't it important to have a friend that will be there during the fun, exciting and even challenging times?

It is always important to have the support of friends and family during new phases of life such as starting a new career, getting married or buying a house. Finding support during pregnancy is just as important. Researchers agree that social support promotes healthy pregnancies. For example, social support during pregnancy may inspire healthier behaviors and lifestyles that discourage behaviors such as smoking, substance abuse and poor nutrition. Pregnant women with high levels of social support may be more likely to receive treatment for diseases associated with low infant birthweight, such as high blood pressure, heart disease or sickle cell disease.

North Carolina Healthy Start Foundation's Friendship Project serves as a match maker. It helps groups find and pair pregnant women with friends in their local community. The project was launched in May 2011 with a webinar attended by 25 people who wanted to learn how they could implement it.

The Friendship Project is a low-cost model for local groups and organizations to follow as-is or adapt to their needs. It can be used by small groups as easily as by large groups. Coworkers or neighbors could become "friends" to a "mother-to-be" they know. Church congregations, sororities, civic groups or organizations could coordinate ongoing social support for pregnant women in their communities by having a Friendship Project. Both participants volunteer to be part of the project throughout the pregnancy and six weeks after the baby is born.

What does it take to get started? The Friendship Project Guide, a free resource provided by the North Carolina Healthy Start Foundation, has all you need to get started!  It is a how-to guide with ideas on how to recruit participants (friends and mothers-to-be) and how to keep the program going. The guidebook includes sample flyers and bookmarks that advertise the program. There are ideas on what friends and mothers-to-be can do together. Sample forms help outline expectations for participants. The forms also help explain that the Friendship Project is designed to provide social support, not health care services or financial assistance.

If you are interested in starting a Friendship Project in your area and you would like more information, please go to the Friendship Project website or contact the Education and Outreach Coordinator at Erica@NCHealthyStart.org.

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Consistent Sleep Practices

Could Save A Baby's Life

Many parents are well-informed about infant safe sleep and ways to reduce the risk of Sudden Infant Death Syndrome (SIDS), but not all caregivers may know what to do. Approximately 1 in 5 SIDS deaths occur while the infant is in the care of a non-parental caregiver. These deaths often occur in babies who routinely sleep on their backs at home but are placed on their stomachs by non-parent caregivers. Infants who regularly sleep on their backs are unaccustomed to tummy sleep and have a 6-9 times increased risk of dying from SIDS when put on their stomachs to sleep.

When talking with parents of newborns and infants, encourage them to ask where their babies nap when at grandma’s house or while they run an errand and leave their babies with neighbors. Many caregivers are unaware of the dangers of unsafe sleep for babies. Ask questions:

• Is there a safe crib or pack-n-play available?
• Do they put the baby down on an adult bed with pillows propped up to "keep her from falling off"?
• Does the baby have the same type of safe sleep space while spending time with others as she does while at home?
• Do they let the baby sleep on her tummy during naps "because she sleeps better" or say it doesn’t matter because "it’s only for a short nap"?

Consistency with infant sleep practices from home to childcare is very important and could save your baby's life. Even when they are not at home, infants always need a safe place to sleep. It's important for parents to share safe sleep tips with babysitters, grandparents, church nursery providers and others who care for infants.

Caregivers can create and maintain safe sleep environments for the babies in their care. By providing information about infant safe sleep, they will better understand their role in helping to keep sleeping babies safer. Some of the basics of infant safe sleep include:

• proper sleep positioning (placing baby on her back)
• information about 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

Do you know everything you need to about infant safe sleep? Make sure you have all the right information before you share it with others. If you want to test your knowledge, check out this short quiz and see how much you really know!

If you need a refresher, visit our Safe Sleep section or take a few minutes to watch the North Carolina Healthy Start webisodes about infant safe sleep.

Each webisode is a short video with detailed information to educate parents, caregivers and professionals about infant safe sleep. These videos are an excellent resource for parents and caregivers of infants who want to learn more about SIDS risk reduction and infant safe sleep.  Each of the seven webisodes addresses a different topic and shows hands-on ways to reduce the risk infant sleep related deaths. Take a look, share them with others and spread the word about ways to keep the babies in your life safer while they sleep.

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Partnering With A Purpose

While the "R" in RICHES really stands for resources, it could just as easily stand for roundtables. Both were on the agenda at this spring's RICHES regional meetings. As in the past, the meetings were held at RICHES-member sites, this year in Moore, Duplin, Forsyth, Halifax, Buncombe and Iredell counties.

Starting off with roundtable discussions, organizations from similar and surrounding counties shared ideas on how to help women within their communities. The more than 60 participating organizations and agencies were as diverse as the issues they brought to the table. Participants represented health departments, YWCAs, domestic violence programs and church groups, among others. And the issues ranged from infant mortality to obesity, from teen pregnancy to partner abuse, from unemployment to depression. However, the two common issues at all meetings were the lack of mental health services and declining resources.

As a result they came up with plans on how to partner with a purpose including networking, marketing each other' programs and services, and sharing best practices and success stories with one another.

"Recognizing the recent downsizings across the state, it is important during this time for organizations to come together and be a resource to one another," said Ava Crawford, Women's Health Program Manager for the North Carolina Healthy Start Foundation and RICHES Project Coordinator. "Where one lacks another one may carry."

Additionally, in response to members' requests for community health education programs, participants received training on the new Choices That Matter Tool Kit. The portable, easy-to-use flip chart binder has information and activities on a variety of health topics including relationships, domestic violence and STIs. The tool kit also includes family planning flashcards, a visual reference to use when talking with women and men about birth control methods and effectiveness.

Each participating organization received a free tool kit, English and/or Spanish flashcards and ideas on how to incorporate them into their existing programs either in a small group or one-on-one setting.

Rhonda Ferrell, Health Promotion Coordinator at the Duplin County Health Department, is excited to share both materials with staff and clients. "I plan to share the flashcards, tool kit and teaching handouts with our prenatal and general clinic staff," she said. "Both materials are perfect for a clinic setting."

If your organization was unable to participate at this year's regional meetings but would like to receive training on the Choices That Matter Tool Kit and family planning flashcards a webinar on these materials will be held in the months to come. RICHES also is providing training to new members on the My Health Journal Tool Kit, introduced at last year's regional meetings. This free online training is offered in a three-part train-the-trainer webisode series.

RICHES is dedicated to improving the health of women, particularly minorities and those living in low-wealth communities, by creating opportunities for community-based organizations to educate, encourage and support women in adopting healthier lifestyles and behaviors. If you are interested in joining RICHES, visit www.NCHealthyStart.org/RICHES for more information.

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Finding Cures Despite Obstacles

The use of traditional and alternative medicine among Latino immigrants

In the United States, Latinos face major barriers to health care, including lack of health insurance. In North Carolina, 65% of Latinos lack health insurance and 29% reported that they could not see a doctor due to cost. How then are Latino immigrants addressing their health care needs? One way, documented by several studies, is using a combination of healing practices, including herbal or home remedies, with care from traditional healers and prayer.

The use of alternative healthcare services varies considerably among Latinos. Usage depends upon factors such as length of time in the U.S., place of origin, age, education level, social economic status and level of acculturation. Traditional medicine has its origin in the indigenous cultures of Latin America and is a combination of beliefs, concepts and practices that has evolved over centuries. At its core is the relationship between the universe and the body-mind-spirit interaction. Illness is seen as a breakdown in the balance of this relationship and a change in the body's balance of hot and cold.

Some Latinos turn to traditional medicine seeking treatments that are natural and "more gentle to [the] body." For others, the use of home remedies and teas is a normal cultural practice that has been handed down generation to generation.

Different types of treatments may be used for different types of illness or for care at different points in the illness. A few examples are:

• chamomile (taken as a tea for nausea, colic, anxiety)
• verbena (used for indigestion)
• aloe vera (for burns, ulcers)

Some plants are used to treat chronic illnesses, such as diabetes. Examples are:

• nopal (prickly pear cactus – eaten)
• sábila (aloe vera – drunk as a juice)
• nispero (loquat or Chinese plum – leaves made into a tea)

A curandero or folk healer may be consulted to address illnesses such as susto (fright), nervios (nerves) or mal de ojo (evil eye). These illnesses are often treated with a combination of prayer, herbs and/or limpias (traditional cleansings). Prayer may also be used to prevent illness or in assistance in curing illnesses.

A study focused on healthcare-seeking behavior of Latinos in Los Angeles found that most study participants turned to traditional medicines (such as herbs and teas) as a first course of action or for preventative purposes. Similarly, participants in a study of Latina Health in North Carolina reported using herbal teas and other home remedies as a first line of defense in the event of an illness. Likewise, many reported self-medicating as a primary method of care.

Understanding Latinos' perceptions of the western medical system, their use of other types of medicine and how these influence them to seek care and treat illness can help you better serve them.

Some tips for discussing use of traditional and alternative medicine with clients:

• Be non-judgmental: One study revealed that willingness to reveal use of traditional and/or alternative medicines was related to perceiving a non-judgmental attitude of the healthcare provider.
• Ask: When it comes to the use of traditional and alternative medicines, many patients will not mention it unless their healthcare provider asks. Knowing what other medicines, herbs or teas a patient is currently taking can be important to avoid drug-herb interactions and assist in developing a treatment plan.
• Offer options: Although most traditional remedies have few side effects, there are a few that may be harmful to the patient. Cases have been recorded of acute lead poisoning in children caused by the use of azarcon or greta (powders with high lead content) to treat empacho (indigestion). If remedies being used may be harmful to the patient, it is important to discuss possible alternatives.
• Create trust: Don't worry if you don't know a lot about the alternative medicines patients might be taking. They do not expect you to be an expert, but initiating a discussion in a nonjudgmental fashion can be a way of showing your respect for the patient and her culture and gaining confianza (trust).

Resources

Ransford HE, Carrillo FR, Rivera Y. Health Care-Seeking among Latino Immigrants: Blocked Access, Use of Traditional Medicine, and the Role of Religion. Journal of Health Care for the Poor and Underserved. 2010; 21: 862–878.

Latina Health in North Carolina: Knowledge, Attitudes and Practices

Mesoamerican Traditional Medicine in the Context of Migration to the United States of America - This bilingual publication provides definitions of different traditional medicine practices.

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We Asked, You Answered

As is standard practice for the North Carolina Healthy Start Foundation, within a year after developing something new we try to assess its effectiveness, whether it is serving its intended purpose and how it could be improved. In May 2011, we distributed an on-line survey to subscribers to assess Healthy Start Happenings – the Foundation’s e-newsletter started in June 2010. Your responses are greatly appreciated.  

The majority of subscribers responding were health/human service providers or public health administrative or program staff. Most read all of Happenings most of the time, although some selectively read a few articles.  Without question, the Women’s Health section is the most popular section, followed by Infant Safe Sleep. RICHES and the Latina Health sections are tied for third. Other topics were suggested with respondents preferring articles with a specific focus rather than a general overview.

We know everyone is busy these days and we were concerned about the length of the articles. Nine out of ten said article length was “just right” with one out of ten saying they were too long.  Almost half of respondents said they’d like more educational information in the form of graphs, maps or tables but most were very happy about the writing style, layout and graphics. We noted that 25-30 percent wanted more photos and videos.

We will try to accommodate as many of these suggestions as possible and keep the newsletter manageable. Almost all respondents said the newsletter loaded quickly on their computer and that’s important to us. We know your time is valuable and we want Healthy Start Happenings to fit into your busy schedule.

The number of survey responses we received was in-line with similar surveys. However, if we missed getting yours and you want to give us your thoughts or suggestions about Healthy Start Happenings, please email us at information@nchealthystart.org.

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 N.C. Healthy Start Foundation | 1300 St. Mary's Street, Suite 204 | Raleigh, NC 27605 | 919-828-1819
Information@NCHealthyStart.org