SARAH VERBIEST

Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
119 Posts


Making Change Happen in Florida

  Leah Barber-Heinz is the CEO of Florida CHAIN

Lost in all of the political wrangling over the Affordable Care Act is the fact that Florida’s women, an astounding 1.4 million of whom are uninsured, will see a huge positive impact thanks to these reforms.
The new law creates significant cost savings by eliminating annual and lifetime limits on how much insurance companies cover if women get sick, as well as prohibiting insurers from dropping women from coverage when they fall ill. Moreover, plans in the new health exchanges place a cap on how much insurance companies can force women to pay in co-pays and deductibles. Starting in 2014 women who cannot afford quality health insurance will be provided tax credits, and the Act will completely close the donut hole for prescription drugs by 2020.
The law also provides more and better health care options and ensures coverage of basic health services including maternity benefits. Maternity benefits are often not provided in health plans offered through the individual insurance market.
Also of particular relevance to women is the fact that the new law already prohibits insurance companies from denying children coverage based on preexisting conditions. Moving forward, it will prohibit insurance companies from denying any woman coverage because of a pre-existing condition, excluding coverage of that condition, or charging more because of health status or gender. Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.
The Affordable Care Act also aims to crack down on excessive insurance overhead by limiting how much insurance companies spend on nonmedical costs such as executive salaries and marketing. And insurance carriers must justify their premium increases in order to remain eligible for the health exchanges.  
The positive impact these reforms will have on Florida’s women and their families cannot be overstated. A recent report by Families USA found that more than 70 percent of consumers in the individual market will be eligible for financial assistance through the Marketplaces, because they either qualify for tax credits that will make their coverage more affordable or for Medicaid.
As a result of these and other important reforms included in the Affordable Care Act, fewer Florida women will delay needed care or be forced to give up basic necessities in order to get the health care they need.
Hello Blog World! My name is Callie Womble and I’m a Masters of Public Health student in the Health Behavior Department at the University of North Carolina Gillings School of Global Public Health. My graduate program focuses on the social and behavioral sciences as a means of understanding and improving the health of populations. One of my academic passions is minority women’s health. I enjoy brainstorming innovative ways to improve wellness and reduce disparity. I first got involved with women’s health in undergrad when I co-founded the UNC Chapel Hill chapter of the Office of Minority Health’s Preconception Peer Educator program and interned at NARAL Pro-Choice North Carolina. These experiences were invaluable to me because they introduced me to the Maternal and Child Health (MCH) field, and ignited my passion.

 

As a graduate student, I wanted to build on that foundation and gain more research experience. In May of this year I began my practicum at the UNC Center for Maternal and Infant Health. My main responsibility has been to disseminate the Women’s Voices Survey, and analyze its results. Working on the Women’s Voices survey was a great because it directly addresses health disparities (an issue near and dear to my heart) and has given me a chance to sharpen my data collection, management and analysis skills.
At the end of August we closed the Women’s Voices survey with 1,950 responses from women of all nine EWSE states and our sample truly represented a life course perspective engaging women of all ages. (How awesome is that?!)  Analyzing the data has been incredibly fulfilling – the survey validates the stories of women in our region. The daily lived experiences of Southeastern women matter, and this survey both affirmed the women as individuals and provided a space for them to share how they see the world.  For me, the most thought-provoking aspect of the data analysis was coding the qualitative responses to questions asking women what they need in order to improve their health. Some of the quotes that really got my attention included:
·         I need an accountability partner.  I have the tendency to procrastinate and put other’s needs before my own.  I need a gently forceful person to make sure I’m doing what I’m supposed to do.
·         More education and support on how to balance the many competing demands that women face today with work, family, friends, etc.
·          to have doctors treat me as a human and not just as a poor-Medicaid recipient.
·         A practitioner that listens.
·         A better job so I didn’t have to work so hard.  More time. I feel like a lot of my health issues stem from my lack of time to do things like prepare meals and exercise. I work a lot, so that doesn’t leave much time for me.
·         Access for the African American population, especially those in rural areas.  Transportation is an issue.  Fear is another issue.  Cost factors in.  Prescription costs prevent consistent medication being used.

These quotes remind me that women in our region often have many responsibilities. They are moms, daughters, friends, sisters, employees, students, church members, sorority members, girlfriends, wives and the proverbial list of “hats women wear” goes on and on. Subsequently, prioritizing others’ needs above their own is a current norm for most women. It also reminds me that the social determinants of health (e.g. where you live, work, play and pray) are REAL and they truly impact how women experience life and wellness. In order to create lasting change we as public health professionals need to strategize ways to make self-care for women the default choice, as well as ways to positively influence the social determinants of women’s health. Indeed, this is a tall order but it’s necessary to change the status quo.

As my practicum comes to close, I have started to reflect on all I have learned these past six months. While the technical skills are indeed significant to me, what resonates most to me about my practicum is the well-rounded nature of my experience. From meetings with stakeholders, to capacity development webinars, to daily in-office conversations with my supervisor and the fellow staff, this experience has been a total emersion in all things MCH. I’ve learned countless new jargon, discovered new thought leaders and followed intense political legislation alongside my fellow staff. 
The most meaningful part of my practicum has been interacting with professionals from different disciplines. It has been both informative and rewarding to hear about women’s health issues from their perspective and then share my thoughts from the HB point of view. These interactions have highlighted how all disciplines have significant expertise necessary for accomplishing our shared goal: improve the health of populations. By working together we are able to put the different pieces of the puzzle together, have a collective impact and achieve our shared goal. Although my practicum is ending, I am excited to continue this versatile experience of personal and professional development as a part of the EWSE leadership team.  As a North Carolina partner I am looking forward to continuing our work towards health equity in our region.


Last week I had the opportunity to travel to Gulfport, Mississippi to partner with EWSE Leadership Team member Juanita Graham and her colleagues on promoting the life course approach to reducing infant mortality.The focus of my trip was a presentation to the District 9 FIMR Teams (fetal, infant mortality review) coordinated by Mary Craig and Cheryl Doyle, both experienced and dedicated leaders on this project. Teams have now reviewed over 50 cases and 7 area hospitals have introduced some new policies and classes, particularly around SUIDS risk reduction. The group is now eager to expand their thinking about new approaches to preventing infant death. The meeting was very well attended, including several staff from the state health department in Jackson. The group had a lively discussion about life course and shared ideas about how it could be applied in Mississippi. 
Part of the trip included the chance to network with Juanita’s colleagues on behalf of the coalition. My visit happened to coincide with the MS Nurses Association Conference which was themed “Hunting for Evidence-Based Practice” (thus the camo gear). I had the great opportunity to go with them on an evening boat ride in the Gulf. The sunset over the Gulf was amazing and those MS nurses know how to have fun! I also had the chance to recruit some new members to the state team and learn about the MS Coast Interfaith Task Force which is doing some fantastic work on community resilience, access to health care, life planning for 8th graders and more.
While the landscape is lovely and the people are really warm, Mississippi faces many challenges, including poverty, obesity, few resources for programs and high rates of maternal mortality. Fortunately, the state also has a cadre of nurses and public health leaders who are determined to make change happen. Seeing how the community has rebuilt from two recent disasters (Katrina and the oil spill), it was clear that the people of Mississippi are resilient. Hearing that in 2012 Mississippi has achieved its lowest rates of infant mortality ever (while other Southern states have seen increased rates or stagnation) absolutely affirms that these leaders are making a difference. We look forward to connecting with new colleagues and continuing to build the  Mississippi Connection!

Savannah Cooksey, Connie Bish, Juanita Graham, Cheryl Doyle, Sarah Verbiest and Mary Craig (start top left to right)

Cecilia Sáenz Becerra is the field organizer with Raising Women’s Voices. She works with RWV’s state partners throughout the South and resides in Atlanta, GA.

RWV2logoWhat about health care reform is exciting for you?
As October 1 draws arrives, I am excited that thousands of people across the nation who previously did not have health care will finally have the opportunity to get covered through the Affordable Care Act (ACA)! Specifically, I’m excited about mobilizing women, women of color, immigrants, and LGBT folks to enroll for affordable insurance options – especially in the southern states where we know the highest percentage of uninsured populations reside, many of whom don’t earn enough to be able to buy private insurance and aren’t eligible to be covered by Medicaid. Another exciting aspect about ACA is how it’s making insurance improvements. For example, no more gender rating (women will no longer have to pay more simply because they are women), no more lifetime or annual limits, no more pre-existing condition bans, and no more taking away insurance when you get sick!

To help women learn about the new options ahead of us, Raising Women’s Voices for the Health Care We Need and the Ms. Foundation have collaborated on a campaign that will complement, support, and amplify state level ACA outreach and enrollment efforts. The campaign, women 4 health care (@Women4HC), premiered on October 1 and includes an array of resources, tools, and materials for organizations engaging in this work, including Facebook and Twitter. Get the latest updates on Women 4 Health Care and learn more about how to get involved by filling out this simple form – click here.

What worries you / keeps you awake at night?
The new health care law will bring peace of mind and security to millions of Americans, but I worry about the people who will still fall into gaps that remain – some of which directly affect some of the people I’m closest too.

In many Southern states, conservative politicians have so far refused to accept federal funds that would allow them to provide insurance coverage through state Medicaid programs to more low-income people living and working in their states. This is a heart-breaking missed opportunity that will leave many people with no affordable way to get health insurance, like my partner. And according to economic experts in states that have done the analysis, it’s also a fiscal mistake because using federal money to expand Medicaid eligibility could actually save money for states, support well-paying health care sector jobs, and generate new tax revenues. It’s not too late, though, and I hope we’ll be able to make this worry go away by persuading more states to accept the federal funds and cover the new eligible populations.

Another gap that exists throughout the country is that undocumented immigrants, like my mother, are not allowed to buy insurance on the marketplace (even if they have the money and are able to pay full price). Immigrant youth who have filed for Deferred Action for Childhood Arrivals (DACA) are also not eligible, despite being recognized as “lawfully present” in the U.S. And even immigrants with documentation will face some barriers because of the five-year ban making them ineligible for the financial help they might need to make insurance affordable in the Marketplaces. People who can’t get insurance because of these gaps will have to rely on the same, limited sources for care that were available before the new law, including community health centers, which did at least get some new funding, thanks to the ACA.

For the millions who are eligible to buy insurance in the Marketplaces, I worry that women, women of color, and LGBT folks might not get the information they need to make informed decisions about plans that will meet their health care needs. These are constituencies that historically have been ignored and marginalized and, in the South and other rural states (like Montana), often face additional access challenges. To make sure they do get the necessary information, there will have to be outreach that’s specifically designed to overcome these challenges — taking the information directly to these communities — in their homes and by phone — and to places where people from various underserved communities are already coming together — like at community events, festivals, using social media channels where people congregate virtually.

Yet, there isn’t a challenge out there that doesn’t come with great opportunity. The need to do this targeted outreach creates space for organizations big and small to come together for a common goal. And there are some great organizations that are targeting these populations and engaging in outreach in the ways I just mentioned, like RWV, Out2Enroll, Enroll America, along with a slew of local and state-wide organizations. These are the challenges we face, that for one keeps me worried, but it’s also motivating to know there is a lot collaborative work being done.

What charge might you issue to women in the South about what we should be doing now?
I would give women in the South a charge of three things to do right now:

  1. If you’re uninsured, get ready to enroll by identifying your health care priorities
  2. Draw on local available help to figure out which health insurance plan fits your budget and meets your needs, and sign up!
  3. Whether you have insurance or not – find formal and informal ways to talk with friends and community members about these exciting changes and share the tools that are available with your networks.

To expand on number one, you really have to think about what is important for you in an insurance plan. Does the plan include the doctor, clinic or hospital that you use? Does it cover your medical needs? Which plan best fits your budget? You can get more information and other thought provoking things to keep in mind in the Choosing a Plan section of the RWV website.

If you have enrollment questions you want to ask to a person, Healthcare.gov suggests you visit LocalHelp.HealthCare.gov to find help in your area, and you can also contact one of RWV’s Regional Coordinators if we have one in your state. We are always looking to expand our Southern partners, contact me if your organization is interested.

For number three, even if you don’t feel like an expert, remember that the best messenger for these very personal issues is often a person we know. You can use the RWV Fact Sheets to help your friends and family members learn about the changes that are coming, and share the 10 ways to get ready for the Health Insurance Marketplace with anyone you know who doesn’t have insurance!

             


I’ve heard this phrase many times when describing my current situation.  I’ve just graduated from UNC Chapel Hill with my Masters degrees in Social Work and Maternal and Child Health.  I’m finishing up my internship at the UNC Center for Maternal and Infant Health, and am in the process of house hunting, job hunting, and moving out of state.  While this time in my life is certainly exciting, it’s also mildly terrifying. 
The job search is currently occupying most of my thoughts.  News outlets have been warning me for years now that my generation will have more trouble gaining employment than any previous generation.  They assure me that my competition is expertly qualified and that there are simply not enough jobs to go around.  If this is true, what does it mean for my job search?   
I’ve been listening to any and all the advice people have to give about getting a job—and there’s a lot of it out there.  I’ve found information that ranges from completely obvious to totally ludicrous.  One website warns interviewees not to show up with a drink in hand because, amongst other things, you could spill your drink on your interviewer. There seems to be a business in this kind of interview-related anxiety. There are books published on how to dress and sit, how much to smile and how to talk about yourself (a recent study shows that people with narcissistic personality disorder are disproportionately hired over those without the diagnosis, so apparently you’re supposed to speak pretty highly of yourself).  I wish I could roll my eyes at all of it, but I understand the worry.  Job interviews are one of the few interactions in which both parties involved openly admit that one is judging the others’ abilities, intelligence, and likability.  If having these tips makes people feel more confident in job interviews, then they’ve done their job.  Many professionals agree that confidence is the most important quality in an interview.
Most people encourage me to network, network, network. So far, this has been pretty successful.  For the most part, people in my field are eager to help in any way they can, especially if we have a personal connection in common.  I’m thrilled to be making connections with professionals that are doing amazing work, but I can’t help but be reminded of how privilege plays into every aspect of our lives, and the job search is no exception. Many of my connections have come through my parents’ friends (or my friends’ parents). Networking within my social network has allowed me access to a unique group of people, many of who are quite successful in their field. It is a constant reminder that becoming successful in this country is so much more complicated than simply “working hard,” it is inextricably linked to do with who you know, and what those people have access to. 
The past few months have felt like a lot of “hurry up and wait.”  Possible future rental properties and employers have told me that I should just wait a bit and be in touch soon.  While waiting patiently has never been my forte, I’m glad to have the opportunity to slow down and enjoy this time of exceptional change. There are certainly lessons to be learned from experiencing and reflecting on this transition and the new situations I’m finding myself in. After all, it’s such an exciting time.
   
Alisha Wolf, MSW, MPH
Note: Alisha would love to find a job in Baltimore and can start on October 1st – let us know if you have any connections! 

What brought you to the organization and your current work?

I have been in my current position as Project Manager for Following the Life Course with the Barren River District Health Department for about a year now, having relocated from Portland, Oregon to Bowling Green, Kentucky. I have been working in public health for the last five years or so.
What are you most excited about or what is your favorite aspect of your project on reproductive life planning?
One of my favorite aspects of our project on reproductive life planning is that it allows us to collaborate with partner agencies, such as area hospitals or local mental health agencies. I think that it’s great that we want to engage in capacity building, and that the grant challenges us to move beyond our traditional programmatic “silos.” I think that it is easy for us to focus on personal accountability in our daily practice, whereas this project seems to encourage us to balance the recognition that behavioral change and personal responsibility are important with a deeper understanding of the ways in which behaviors and choices might be structured.  
What do you anticipate will be the biggest challenge with this project?
I anticipate that the project will bring with it a few different challenges. The first has to do with the comparative dearth of literature on the social marketing and programmatic instruments and tools that have been used out in the field, along with their reception by the patient population. I still find myself wanting to know more about what kinds of slogans other programs have used, what kinds of questions or items have been utilized in other survey instruments, and what types of resources have been offered. I would love to know more about the contexts in which these programs have been deployed (e.g. target audience demographics, geographic region(s), capacity of pilot site(s), etc.).  
As with other areas of public health, I think that it can prove challenging to develop a cogent narrative or “story” around an issue as complex as the Life Course, especially given its many attendant concepts (e.g. trajectories, adverse programming, etc.) This is the type of challenge that pervades our lives as public health practitioners, however – in other words, how to “re-frame” the clinical conversation in a way that is both nuanced and easily digestible by a larger audience. As a corollary, I think that it can prove challenging to inspire one’s peers to address some of these more distal factors, especially amidst the constraints and exigencies of ever shrinking public health budgets and staffing shortages. Change can be intimidating enough, even in the most secure of times. In this way, I feel that addressing concerns – however well-intended, misplaced, or unfounded – about the evidence base undergirding such an approach (e.g. in staff involved, time spent, impact, etc.) becomes very important.  
I think that some misperceptions might also exist about the receptiveness or initiative of some audiences to this information. For this reason, I believe that it’s crucial to structure one’s content in such a way that it is tailored to the intended audience, and speaks to peoples’ lived experiences. One area of thought that I find to be particularly apt in this regard is popular education. As it is related to public health, this notion of popular education encourages people to try and understand the root causes of poor health, using techniques such as cooperative learning.  
Can you share any books, articles, websites that help with your work?

One Key Question http://www.onekeyquestion.org/

Levis DM, Westbrook K. A content analysis of preconception health education materials: characteristics, strategies, and clinical-behavioral components. American journal of health promotion. 2013;27:S36

Frey KA, Files JA. Preconception healthcare: what women know and believe. Maternal and child health journal. 2006;10:S73-77. link to free article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592249/

This past June 2013 I had the opportunity to spend 8 days with a wonderful group of 15 and 16 year old young women on a service learning trip to rural Nicaragua. During our time in country we hiked in rainforests and learned about the challenges of preserving this precious ecosystem. We helped plant school gardens working side by side with parents in the community. The girls spent time with high school students practicing Spanish/English and sharing about each others’ lives.  Supporting rural schools is a cornerstone program for the organization we traveled with and the girls spent time with young school children and their teachers, witnessing how people in other countries value as education as a gift and essential investment in the future. We played with children at the Los Pipitos clinic who had a range of serious physical, developmental and behavioral challenges whose mothers brought them 3 hours each way on foot to receive 2 hours of therapy a few times a year. The difference in the demand for services and availability of care was stark while the intense commitment of these parents to their children was humbling.

One of the more thought provoking visits on our journey was to the Casa Materna – a small home where women from remote areas could spend the last few weeks of their pregnancy and deliver their baby at the nearby health department. This is so important as one out of every 300 women die in childbirth in Nicaragua and their infant mortality rate is 3 times that of the US.  During the visit the girls met a 16 year old who was due in a few weeks. In contrast to our perception of teen pregnancy, this young woman had planned her pregnancy and was looking forward to the way her new role as mother would impact her status in the community. A different looking glass to consider… We also learned that most women leave the health department pretty quickly after giving birth followed by a ride home on a crowded, bumpy bus or a long walk home. Women are strong and mighty indeed.

We also saw the positive impact of micro enterprise investments in women owned initiatives…and helped support those women by purchasing their lovely products while learning about their innovative business models. We witnessed the importance of entrepreneurship – be it business, social or just thinking outside of the box (as did the fabulous Peace Corp volunteer at Casa Materna). Finally, across the board as a group we loved the neighborliness of everyone we met. People in Nicaragua make time to stop and talk with each other. They gather in squares and on front porches. Homes may be tiny but hearts are big. Life might be hard but there is time to share. 

The joys and challenges of being a Girl Scout leader is a topic for a different blog, but my decade investment in building leadership with my scouts (including my daughter) has been worth every second. I feel great hope for the future when I look at these young women and see how they embrace a world much bigger than the one they live in every day. They are smart, have cultural humility and recognize the interconnectedness of their life and those of women and girls around the world. And they aren’t afraid to get messy, try new things, support each other and believe that the world is full of endless possibilities!

 
Senior Girl Scout Troop 514
 
To learn more about Sister Communities of San Ramon Nicaragua visit http://san-ramon.org/
Renee Parks-Bryant, Health Education Specialist, Durham County Dept of Public Health
Shinel M. Stephens, MSN/FNP-C, Student Health & Counseling Services, North Carolina Central University
Tell us about your current work role.
Renee: I have been working for 19 years in the area of maternal/child health at the Durham County Health Department.  I was originally hired to start a Lamaze childbirth program for minority women.  Since then, hundreds of minority women have benefited from that program.  Over the years, many of my job duties have centered on improving birth outcomes.  In the past, I coordinated the now defunct infant mortality reduction committee.  That project was funded by Centers of Disease Control under the Perinatal Periods of Health program.  During that period, Durham County had unacceptable infant mortality rates but over the years the rates have reduced and have aligned with North Carolina’s rate. I’ve instructed parenting classes for expectant mothers in partnership Federal Correction Prison as part of its pre-release program.  In addition, I coordinated an infant car-seat program for the Health Department in my early years of employment.  I have served as a grant writer and on many different committees. My job is varied and I like it. 
Shinel:  I have been in my current position as a family nurse practitioner at North Carolina Central University for 10 years and adjunct faculty in the Department of Nursing, in the area of maternity, for 11 years.  I previously worked as a registered nurse in labor and delivery, as well as at Saint Augustine’s College Student Health.  My love for students and women’s health brought me to North Carolina Central University.  I wanted the opportunity to engage young minority adults in making healthy lifestyle choices and to become role models in their families of healthy living.
In my current role as a nurse practitioner, I provide primary health care to our students; which includes a large percentage of gynecological concerns.  I wanted to expand my work beyond the examination room and look at ways that we could support our pregnant students in making healthy lifestyle choices.  One of the goals of this initiative was to retain students who may become pregnant while enrolled at the University.  In pursuit of this effort, I met with Renee, to see how we could collaborate to provide beneficial resources for our students.  We then realized that equally important are the needs of our women during the preconception period and following delivery as parents; consequently the Cradle Me 3 Project was birthed.
What are you most excited about or what is your favorite aspect of the Cradle Me 3 project?
Renee:  The most exciting part of the project has been working with students and increasing their knowledge of the life-course model and preconception health concept.  I greatly enjoy observing students accept preconception health educational tasks, then demonstrate their knowledge of the concepts and share their knowledge with fellow students thru on campus activities and efforts.
Shinel:  The Cradle Me 3 Project will afford so many opportunities for our students.  I am most excited about how it will increase our student’s awareness of the importance of reproductive life planning using a peer education model and curriculum infusion in the personal health course, a required course for all students at the University that is most often taken during the freshmen year.  In addition I look forward to the impact that the inclusion of the life course model will have in our nursing and public health education curriculums. At North Carolina Central University we continue to soar and we look forward to taking the lead in sharing best practices in a college/university setting that will have an impact in decreasing infant mortality rates.
What do you anticipate will be the biggest challenge with this project?
Renee & Shinel:  The project’s biggest challenge has been administrative demands and procedures!
Can you share any books, articles, websites (or any great resources you’ve found) that help with your work?
Renee:  I just recently read an article by Judith Lothian called Do Not Disturb: The Importance of Privacy in Labor (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595201/). It reminded me about how important it is to protect mothers at this special time. My other go to book is The Labor Progress Handbook by Penny Simkin and Ruth Ancheta.
Shinel:  I really like www.EveryWomanNC.com as a reference on preconception health and resources here in North Carolina. I also really like learning about the epidemiology of preconception health and recommend this article: Xaverius, Pamela & Salas, Joanne, Surveillance of Preconception Health Indicators in Behavioral Risk Factor Surveillance System:  Emerging Trends in the 21st Century Journal of Women’s Health (2013) 22: 203-209.

I have been serving as Program Director in my current position for the Duval County Health Department’s Family Planning Program, for the past eight years. I was given an opportunity to come to the health department to work for a new community outreach program in Jacksonville, Florida, after working for a national Healthy Families / Healthy Start Initiative in Cleveland, Ohio. The opportunity to move to a warmer environment was also an incentive!
In my new job I am most excited about using an effective intervention model known as the Popular Opinion Leader that teaches young people, between the ages of 18-24, to engage their friends and colleagues in conversations around reproductive life planning. This enables them to build upon their conversation and communication skills in everyday settings, which also improves upon their leadership skills as they plan for their future. I am also thrilled about involving males in this process, as they are an important part of addressing this issue and play a key role in the prevention and education effort. It is exciting to take an innovative idea that we first tried within a small community setting and expand it throughout the city!
I find that one of our biggest challenges is that the population we serve does not necessarily take the time to “plan” their families. They come from communities where they face many obstacles and day-to-day challenges. Many of them reside in impoverished areas and oftentimes their decision about preconception health takes a back seat to other issues in their lives. In fact, oftentimes, the health of these communities is dependent upon many other different factors, including the quality of health care, individual behavior, education and jobs, and the environment. So, we find that we must tap into other resources with our community partners to engage them in our efforts around preconception / reproductive life planning. This is where our faith-based organizations are a plus, while at the same time, we try to get everyone focused on the goal at-hand.

From Gloria McNair…
I’ve been a Community Outreach Health Educator for three years; however, I’ve been a member of the MCH Family Planning Team for six years. Prior to working at the Health Department, I was an Environmental Health Officer for the U.S. Navy where my specialty was Preventive Medicine. After retirement, I wanted to find a job that would provide the same level of satisfaction in serving the community.
In thinking about what I’m most excited about with my work, this is going to sound corny but I enjoy all aspects of the project. Our teens and young adults are the country’s future. That future can be so much brighter and filled with promise if they are allowed to make informed decisions regarding their health. Working with our Peer Health Advocates (PHA) gives me the opportunity to provide positive, factual and appropriate information to a community of at-risk young adults.
The biggest challenge ahead is that our PHAs are from the Faith-based community. Learning to speak openly about Sexual and Reproductive Health presented some challenges for the group as a whole. They have started to come out of their shells but I do know that they will need my continued mentoring.
As far as my favorite resources, honestly what has helped me the most is training from the Centers for Disease Control and Prevention on the Diffusion of Evidence Based Interventions; especially the Popular Opinion Leader (POL)  intervention which we are now using in our project.
From Autumn Gaines…
I am a recent hire with the Florida Department of Health in Duval County under Maternal and Child Health Division as the Community Assistance Specialist for Every Woman Southeast.  In the process of completing my Bachelor of Science in Health degree I found myself in an unusual place.  I felt as if I was missing the hands-on training, the ability to put my knowledge and skills to the test.  Not long after I received a mass e-mail for a volunteer position with the former Duval County Health Department as an educator to adolescent males about sexual health, STDs, HIV/AIDS, etc. I have volunteered with the health department since December 2011.  Early May of this year, I received an e-mail for a current position as the Community Assistance Specialist. After a successful panel interview, within a week I received a phone call and later a letter in the mail congratulating me as a new member of the Florida Department of Health in Duval County team.
The most excitement I get from this job is being in the community speaking with individuals and groups on the importance of physical health, unplanned pregnancy prevention, and disease prevention.  When you are in the field trying to understand the community’s way of thinking, what provokes their actions (good or bad), you learn how to cater the message to their personal needs, which ultimately leads to one less person becoming a part of a negative health statistic. 
I believe my biggest challenge will be getting acclimated with the transition into taking a more lead role with the different churches of Every Woman Southeast Peer Education for the Soul.  Other than that, I am excited about working with the peer health advocates and influential leaders in the church.
Throughout the public health program at the University of North Florida I was exposed to many great resources. For instance, scholarly/peer-reviewed health journals (American Association for Health Education), websites (Center for Disease Control and Prevention, The National Program to Prevent Teen and Unplanned Pregnancy, and Healthy People), and research databases (CINAHL: Cumulative Index to Nursing and Allied Health), which I definitely recommend to others. 

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