00;00;05;07 - 00;00;07;11 Good afternoon and good morning to everyone. 00;00;07;11 - 00;00;11;10 Welcome to the DNPAO Seminar Series From Hospital to Community: 00;00;11;10 - 00;00;14;16 Monitoring, Promoting, and Supporting Breastfeeding. 00;00;14;18 - 00;00;18;21 Welcome to our webinar for today. 00;00;18;23 - 00;00;21;01 We have an exciting opportunity today 00;00;21;01 - 00;00;25;21 and will be offering this in English and Spanish. 00;00;25;23 - 00;00;26;16 Hi, everybody. 00;00;26;16 - 00;00;27;21 I'm Janelle Gunn. 00;00;27;21 - 00;00;30;12 Welcome to our DNPAO Seminar Series. 00;00;30;12 - 00;00;32;18 We have an excellent seminar today 00;00;32;18 - 00;00;35;18 on breastfeeding and are so glad that you have joined us to hear this 00;00;35;18 - 00;00;39;05 great information and stories from the field. 00;00;39;07 - 00;00;42;11 As a reminder, this seminar is being recorded. 00;00;42;11 - 00;00;45;11 It will be offered later on the DNPAO website. 00;00;45;16 - 00;00;47;06 If you've missed some past seminars 00;00;47;06 - 00;00;50;06 and are interested in them, you can find those on our website. 00;00;50;09 - 00;00;53;21 All of your lines are muted, but we want your questions and answers. 00;00;53;21 - 00;00;56;04 We'll have some time at the end for that. 00;00;56;04 - 00;00;59;17 And so please go ahead and submit them whenever they come to you and 00;00;59;20 - 00;01;02;15 we will try to get to as many as we can 00;01;02;15 - 00;01;04;28 during the time we have allotted today. 00;01;04;28 - 00;01;09;17 We have a truly outstanding set of speakers for you today. 00;01;09;17 - 00;01;12;10 I think you're going to really enjoy the information. 00;01;12;10 - 00;01;14;11 First, we have Lieutenant Kristin Marks. 00;01;14;11 - 00;01;17;03 She's with us here at 星空娱乐官网 in the Division of Nutrition, 00;01;17;03 - 00;01;18;28 Physical Activity and Obesity. 00;01;18;28 - 00;01;23;20 And she is a scientist officer for the United States Public Health Service, 00;01;23;22 - 00;01;26;21 and she's an epidemiologist on our maternal infant and toddler 00;01;26;21 - 00;01;28;10 nutrition team. 00;01;28;10 - 00;01;31;29 Next, we have Daurice Grossnicklaus, 00;01;32;04 - 00;01;35;26 and she's a health scientist also with us here at 星空娱乐官网. 00;01;35;28 - 00;01;40;19 And she works to improve maternity care practices, supportive of breastfeeding. 00;01;40;21 - 00;01;42;29 Then we'll have Harumi Reis-Reilly. 00;01;42;29 - 00;01;46;01 She's a lead program analyst at the National Association 00;01;46;01 - 00;01;50;12 of County and City Health Officials, otherwise known as NACCHO. 00;01;50;14 - 00;01;52;05 She's a public health professional, 00;01;52;05 - 00;01;57;18 nutritionist and international board certified lactation consultant. 00;01;57;20 - 00;02;00;24 She will be followed by Paulina Erices. 00;02;00;24 - 00;02;04;23 We have a special guest from 00;02;04;25 - 00;02;07;04 some doing some work in Colorado. 00;02;07;04 - 00;02;12;26 And she will also be joined by Lucy Guereca who will be sharing 00;02;12;26 - 00;02;17;17 some of her experiences and work in the Colorado area as well. 00;02;17;19 - 00;02;18;09 All right. 00;02;18;09 - 00;02;21;23 Our agenda for today is to review the Maternity Practices 00;02;21;26 - 00;02;24;26 and Infant Nutrition and Care survey, 00;02;24;27 - 00;02;28;22 also called mPINC. 00;02;28;24 - 00;02;31;16 Our work covering, supporting the U.S. 00;02;31;16 - 00;02;32;29 hospitals to provide safe 00;02;32;29 - 00;02;36;28 evidence based maternity care, supportive of breastfeeding. 00;02;37;00 - 00;02;39;22 Then we will hear an overview of NACCHO's work to advance 00;02;39;22 - 00;02;43;19 continuity of care in communities across the United States. 00;02;43;21 - 00;02;47;08 And then we'll hear from Cuenta Conmigo Cooperatives successful 00;02;47;08 - 00;02;51;23 efforts to advance continuity of care in Colorado. 00;02;51;25 - 00;02;53;12 So let's go ahead and get started. 00;02;53;12 - 00;02;56;16 I'm going to hand it over to my colleague, Lieutenant Marks. 00;02;56;18 - 00;02;59;16 Kristin. Good afternoon. 00;02;59;16 - 00;03;02;02 Thank you for the opportunity to share our team's work 00;03;02;02 - 00;03;06;02 on Maternity Practices in Infant Nutrition and Care. 00;03;06;04 - 00;03;10;03 Breastfeeding initiation rates have increased over the past two decades. 00;03;10;06 - 00;03;13;18 This considerable increase from 70 to 83% 00;03;13;22 - 00;03;18;01 is due in part to improved maternity care practices. 00;03;18;04 - 00;03;18;12 In the 00;03;18;12 - 00;03;21;17 United States, nearly all infants are born in a hospital. 00;03;21;20 - 00;03;26;05 Maternity care practices in hospitals in the first hours and days after birth 00;03;26;07 - 00;03;30;04 make a difference in whether and how long infants are breastfed. 00;03;30;06 - 00;03;34;11 Hospitals have an important influence on how infants are fed, as there are several 00;03;34;11 - 00;03;39;19 key supportive hospital practices that can improve breastfeeding outcomes. 00;03;39;21 - 00;03;42;21 Maternity care practices make a difference in breastfeeding. 00;03;42;21 - 00;03;46;19 So what is 星空娱乐官网 doing to monitor these practices? 00;03;46;21 - 00;03;51;08 星空娱乐官网 National Survey of Maternity Practices in Infant Nutrition and Care, 00;03;51;09 - 00;03;55;12 or mPINC, assesses maternity care practices and provides 00;03;55;13 - 00;03;57;04 feedback to encourage hospitals 00;03;57;04 - 00;04;00;27 to make improvements that better support breastfeeding. 00;04;00;29 - 00;04;05;06 About every two years, 星空娱乐官网 invites all hospitals across the country 00;04;05;11 - 00;04;10;04 with at least one birth in the past year to complete the mPINC survey. 00;04;10;07 - 00;04;11;11 星空娱乐官网 calculates the 00;04;11;11 - 00;04;16;07 total mPINC score for every participating hospital to indicate its overall level 00;04;16;07 - 00;04;21;19 of maternity care practices and policies that support optimal infant feeding. 00;04;21;21 - 00;04;25;11 Responses are scored using an algorithm that denotes the evidence and best 00;04;25;11 - 00;04;30;04 practices to promote optimal infant feeding within the maternity care setting. 00;04;30;06 - 00;04;33;05 Possible scores range from 0 to 100, 00;04;33;05 - 00;04;38;10 with higher scores indicating better maternity care practices and policies. 00;04;38;13 - 00;04;41;03 Sub scores further categorize maternity care practice 00;04;41;03 - 00;04;44;08 domains and are scored using the same approach. 00;04;44;11 - 00;04;46;27 These domains are immediate postpartum 00;04;46;27 - 00;04;53;02 care, rooming in, feeding practices, feeding education and support, 00;04;53;04 - 00;04;57;00 discharge support, and institutional management. 00;04;57;02 - 00;05;02;01 I've compiled data from 2018, 2020, and 2022 to show 00;05;02;01 - 00;05;05;01 mPINC scores over time for the total score 00;05;05;04 - 00;05;08;01 as well as the six domain scores. 00;05;08;01 - 00;05;11;14 Since 2018, the total mPINC score has increased from 00;05;11;14 - 00;05;17;12 79 to 81, and we see higher scores across most domains. 00;05;17;14 - 00;05;18;14 Consistently, the 00;05;18;14 - 00;05;22;14 domain with the highest national score is feeding education and support, 00;05;22;16 - 00;05;26;26 which covers items like identifying feeding cues and breastfeeding problems, 00;05;26;29 - 00;05;31;03 while the lowest domains are typically rooming in and institutional management, 00;05;31;05 - 00;05;34;13 which include items like rooming in safety protocols, 00;05;34;15 - 00;05;38;12 the assessment of staff competencies, and written policies. 00;05;38;14 - 00;05;42;07 In this map, state scores were calculated as the average of scores 00;05;42;07 - 00;05;45;19 for all participating hospitals within that state. 00;05;45;22 - 00;05;49;02 These were color coded as shown in the key at the top, with darker 00;05;49;02 - 00;05;53;23 blue indicating higher scores and lighter teal for lower scores. 00;05;53;25 - 00;05;57;20 This map shows total mPINC scores for 2022. 00;05;57;22 - 00;06;00;02 The national total score was 81, 00;06;00;02 - 00;06;05;04 and the range of state scores varied from 72 to 93. 00;06;05;06 - 00;06;09;00 We collect states data on maternity care practices for monitoring purposes. 00;06;09;00 - 00;06;12;21 But we also want mPINC data to be used for action. 00;06;12;24 - 00;06;15;09 These data can be used at a variety of levels 00;06;15;09 - 00;06;18;24 from the hospital to state and national levels. 00;06;18;26 - 00;06;23;07 Every two years we released national, regional, and state mPINC reports 00;06;23;07 - 00;06;24;22 to provide an overall picture 00;06;24;22 - 00;06;28;17 of maternity care supportive of breastfeeding in the US. 00;06;28;19 - 00;06;33;14 Together, these reports can be used to provide context for jurisdictions. 00;06;33;16 - 00;06;36;28 For example, our regional report shows state participation, 00;06;37;05 - 00;06;40;20 total score and domain scores by region. 00;06;40;23 - 00;06;41;23 This type of report 00;06;41;23 - 00;06;45;17 allow states to see how they are doing in relation to their neighbors. 00;06;45;20 - 00;06;49;09 We also provide individualized reports to each hospital 00;06;49;09 - 00;06;52;12 showing their total and domain specific scores. 00;06;52;12 - 00;06;55;25 In hospital reports, we provide average scores 00;06;55;25 - 00;06;59;07 among facilities of similar size in the same region 00;06;59;10 - 00;07;03;03 and among all participating facilities for comparison. 00;07;03;10 - 00;07;06;15 Participating hospitals receive their mPINC report roughly 00;07;06;15 - 00;07;09;15 every two years, but how did they use it? 00;07;09;20 - 00;07;11;27 First, hospitals often use mPINC 00;07;11;27 - 00;07;14;27 as part of quality improvement initiatives. 00;07;15;01 - 00;07;19;03 Hospitals use mPINC data to see how they align with baby friendly standards. 00;07;19;05 - 00;07;22;25 They use the mPINC questions to determine standards of care, and 00;07;22;25 - 00;07;27;08 they will based their quality initiatives off their lowest scoring questions. 00;07;27;10 - 00;07;27;26 Second, 00;07;27;26 - 00;07;30;26 hospitals use their mPINC reports for benchmarking. 00;07;30;26 - 00;07;33;23 They compare their own scores, cycle after cycle, 00;07;33;23 - 00;07;35;20 to see where they can make improvements. 00;07;35;20 - 00;07;38;26 And they also compare to other hospitals across their state 00;07;38;29 - 00;07;43;05 and can use that as leverage for practice changes. 00;07;43;07 - 00;07;46;06 Third, reports are used for staff motivation. 00;07;46;06 - 00;07;48;28 Hospitals highlight key areas where they did well 00;07;48;28 - 00;07;52;09 and post the report on bulletin boards for staff to see. 00;07;52;12 - 00;07;54;27 Staff motivation also comes from those regional 00;07;54;27 - 00;07;59;26 and national comparisons to validate and celebrate the work they're doing. 00;07;59;28 - 00;08;03;27 Lastly, mPINC scores are part are used as part of staff education. 00;08;04;00 - 00;08;06;25 Hospitals will use mPINC scores as a driver to provide 00;08;06;25 - 00;08;10;06 more staff education in low scoring areas. 00;08;10;09 - 00;08;13;07 We also want to share some qualitative data on how jurisdictions 00;08;13;07 - 00;08;15;08 use their mPINC reports. 00;08;15;08 - 00;08;17;23 First, state reports allow partners to advocate 00;08;17;23 - 00;08;22;20 for state policies based on where hospitals fall behind clinical standards. 00;08;22;22 - 00;08;24;20 Second, benchmarking. 00;08;24;20 - 00;08;28;17 State and regional reports allow states to compare their scores 00;08;28;17 - 00;08;33;17 to others in their region or compare their own scores cycle to cycle. 00;08;33;19 - 00;08;35;17 Lastly, we've heard that mPINC reports 00;08;35;17 - 00;08;38;17 are used when applying for funding opportunities. 00;08;38;19 - 00;08;41;10 And how is mPINC used by breastfeeding coordinators. 00;08;41;10 - 00;08;45;10 mPINC reports allow breastfeeding coordinators to consult with hospitals 00;08;45;10 - 00;08;49;04 to see where they can improve staff education and patient education. 00;08;49;06 - 00;08;52;29 mPINC reports are also great for local outreach. 00;08;53;02 - 00;08;56;03 Coordinators can share their state鈥檚 mPINC scores with other groups 00;08;56;03 - 00;08;59;27 specializing in breastfeeding, including WIC, Head Start, 00;09;00;02 - 00;09;04;07 childcare providers and coordinated care organizations. 00;09;04;10 - 00;09;07;19 I'd like to take a step back and highlight a unique aspect of mPINC 00;09;07;19 - 00;09;11;02 that you've probably gotten a sense for as I've been speaking. 00;09;11;05 - 00;09;14;22 You may know 星空娱乐官网 for putting out data known as surveillance. 00;09;14;24 - 00;09;17;20 Surveillance is the ongoing systematic collection 00;09;17;20 - 00;09;21;28 of health related data to inform public health practice. 00;09;22;00 - 00;09;24;26 星空娱乐官网 uses mPINC to get a picture of maternity care 00;09;24;26 - 00;09;28;21 practices supportive of optimal infant feeding across the country. 00;09;28;23 - 00;09;32;10 But mPINC can be used for more than that as hospitals take the mPINC survey 00;09;32;15 - 00;09;34;28 and then later when they receive their hospital report. 00;09;34;28 - 00;09;39;11 mPINC raises awareness among hospitals of best practices 00;09;39;19 - 00;09;43;14 and any gaps in their maternity care practices and policies. 00;09;43;17 - 00;09;47;22 This feedback mechanism is pretty unique among other large surveillance systems, 00;09;47;22 - 00;09;50;00 which typically passively collect data 00;09;50;00 - 00;09;53;08 and don't necessarily report it back to participant. 00;09;53;11 - 00;09;58;02 In contrast, mPINC provides an opportunity to learn and take action. 00;09;58;04 - 00;10;01;14 As I've said, mPINC can function as both a surveillance tool 00;10;01;14 - 00;10;05;19 and to inform interventions, especially at the hospital level. 00;10;05;22 - 00;10;09;11 I've pulled some open text responses from hospitals who participated 00;10;09;11 - 00;10;15;00 in the 2022 mPINC survey to demonstrate how hospitals use mPINC data. 00;10;15;02 - 00;10;17;16 Respondents seem to appreciate the available 00;10;17;16 - 00;10;21;07 the ability to see their scores improve over time, saying 00;10;21;07 - 00;10;25;12 things like 鈥淲e've worked very hard to improve our scores and are very proud 00;10;25;12 - 00;10;29;27 of our accomplishments.鈥� On the awareness raising and intervention side of things, 00;10;29;29 - 00;10;34;17 respondents say 鈥淚t raised awareness of what we should be doing and measuring鈥� 00;10;34;19 - 00;10;38;24 as well as 鈥淭he questions provided insight into areas we can improve upon 00;10;38;24 - 00;10;43;08 as well as measure better.鈥� These comments suggest that hospitals use 00;10;43;08 - 00;10;44;16 the mPINC survey 00;10;44;16 - 00;10;48;24 as an opportunity to make improvements to their maternity care practices. 00;10;48;27 - 00;10;52;05 In summary, whether your work is at the hospital, community, 00;10;52;05 - 00;10;55;29 or governmental level, there are steps you can take to use these data 00;10;55;29 - 00;10;59;23 for action to improve the health of infants and families. 00;10;59;26 - 00;11;03;00 First, know your hospital or state mPINC scores 00;11;03;08 - 00;11;06;07 and share them with key people in your organization. 00;11;06;12 - 00;11;09;21 Use that information to identify both areas of success 00;11;09;24 - 00;11;13;05 as well as areas for improvement to inform future work. 00;11;13;08 - 00;11;17;20 Second, you can also encourage hospitals to participate in mPINC. 00;11;17;23 - 00;11;20;11 The more participants, the more accurate a picture 00;11;20;11 - 00;11;23;26 it provides of maternity care practices across the US. 00;11;23;28 - 00;11;26;29 And lastly, look out for the mPINC 2024 survey, 00;11;27;00 - 00;11;30;00 which is scheduled to launch in early 2024. 00;11;30;05 - 00;11;35;00 You can join our mPINC listserv to receive periodic updates about the survey. 00;11;35;02 - 00;11;37;28 If you would like to sign up for our listserv, please email 00;11;37;28 - 00;11;42;12 mPINC@cdc.gov with your name and email address. 00;11;42;14 - 00;11;46;03 Thank you and I am pleased to pass the mic over to my colleague Dr. 00;11;46;03 - 00;11;47;21 Daurice Grossniklaus. 00;11;47;24 - 00;11;50;03 Thank you, Kristen, and hello everyone. 00;11;50;03 - 00;11;52;25 I will be giving an overview of our quality 00;11;52;25 - 00;11;56;03 improvement efforts to support hospitals to provide 00;11;56;05 - 00;11;59;21 evidence based maternity care supportive of breastfeeding, 00;11;59;23 - 00;12;03;09 the optimal form of nutrition for most infants. 00;12;03;11 - 00;12;06;08 Evidence shows that hospitals play a critical role 00;12;06;08 - 00;12;09;15 in helping families to start to practice breastfeeding 00;12;09;17 - 00;12;13;26 and in connecting breastfeeding families to community resources. 00;12;13;29 - 00;12;16;09 The Surgeon General's Call to Action to Support 00;12;16;09 - 00;12;20;06 Breastfeeding was released in 2011 in a call for hospitals 00;12;20;06 - 00;12;24;15 to do more to implement the ten steps to successful breastfeeding. 00;12;24;18 - 00;12;28;27 These ten steps are a set of evidence based maternity practices 00;12;28;29 - 00;12;33;12 that, when implemented together, result in better breastfeeding outcomes. 00;12;33;15 - 00;12;36;27 The ten steps form the foundation of UNICEF and the World 00;12;36;27 - 00;12;40;12 Health Organization's Baby Friendly Hospital Initiative, 00;12;40;14 - 00;12;44;15 which recognizes those hospitals globally that implement the ten steps 00;12;44;23 - 00;12;48;27 and adhere to this high standard of maternity care. 00;12;48;29 - 00;12;51;19 Baby Friendly USA is the national authority 00;12;51;19 - 00;12;55;22 and in this role confirms the baby friendly designation to U.S. 00;12;55;23 - 00;12;58;10 territorial hospitals. 00;12;58;13 - 00;12;59;22 or facilities. 00;12;59;22 - 00;13;03;17 Why is 星空娱乐官网's quality improvement work so important? 00;13;03;19 - 00;13;07;22 In 2011, when we started this work only 5% of U.S. 00;13;07;22 - 00;13;11;13 infants were born in baby friendly designated facilities. 00;13;11;15 - 00;13;16;07 The majority of infants were born in facilities that were not practicing 00;13;16;07 - 00;13;22;08 maternity care or infant feeding routines that fully supported breastfeeding women. 00;13;22;10 - 00;13;26;07 afternoon, I will describe our collaboratives, including two aimed 00;13;26;07 - 00;13;30;12 at supporting hospitals to become baby friendly designated, two 00;13;30;12 - 00;13;35;05 aimed at building maternity staff capacity to support breastfeeding, and our newly 00;13;35;05 - 00;13;40;18 funded project aimed at improving breastfeeding supportive maternity care. 00;13;40;20 - 00;13;44;21 Best Fed Beginnings was our first collaborative focused on achieving 00;13;44;21 - 00;13;45;27 designation. 00;13;45;27 - 00;13;50;13 It was successful in 76 of the 90 hospitals reached our goal. 00;13;50;15 - 00;13;53;28 We estimate that an additional quarter of a million infants 00;13;53;28 - 00;13;58;18 born each year received optimal breastfeeding support. 00;13;58;20 - 00;14;00;17 EMPower Breastfeeding was our second collaborative 00;14;00;17 - 00;14;02;21 focused on becoming designated. 00;14;02;21 - 00;14;07;26 It was also successful in 72 of the 93 hospitals reached the goal. 00;14;07;28 - 00;14;11;23 We estimate that an additional 157,000 infants 00;14;11;23 - 00;14;15;08 each year received optimal breastfeeding support. 00;14;15;11 - 00;14;16;13 What did we learn? 00;14;16;13 - 00;14;20;00 These projects have ambitious outcomes to be accomplished 00;14;20;00 - 00;14;23;10 in a short amount of time, and we learned that with support, 00;14;23;10 - 00;14;27;15 hospitals could achieve designation in a three year time period. 00;14;27;18 - 00;14;31;08 Support included training and tailored technical assistance 00;14;31;08 - 00;14;35;14 provided by QI and or breastfeeding experts to coaches 00;14;35;16 - 00;14;41;04 using QI methods such as planned use study cycles and small tests of change 00;14;41;07 - 00;14;45;01 to make sure that practice changes that were being implemented 00;14;45;04 - 00;14;48;19 actually resulted in improvements in maternity care. 00;14;48;22 - 00;14;52;22 We also learned the importance and value of having well-trained maternity 00;14;52;22 - 00;14;57;05 staff at the bedside to help breastfeeding families 24 seven 00;14;57;07 - 00;15;02;14 and the challenges hospitals faced in providing this training to their staff. 00;15;02;16 - 00;15;06;07 We use the lessons learned to inform our next funding opportunities 00;15;06;07 - 00;15;12;06 and focus on helping hospitals overcome the training related barriers. 00;15;12;08 - 00;15;14;14 EMPower Training was a two year collaborative 00;15;14;14 - 00;15;19;29 that focused on training maternity staff in the 5 hours of breastfeeding skills. 00;15;20;02 - 00;15;24;16 This project was successful in meeting the goal, and 81 of that 00;15;24;18 - 00;15;29;14 81 of the 85 participating hospitals reached the training goal. 00;15;29;17 - 00;15;32;18 This translated to more than 3600 staff 00;15;32;18 - 00;15;36;19 receiving over 18000 hours of training. 00;15;36;22 - 00;15;39;00 EMPower Best Practices is our current collaborative 00;15;39;00 - 00;15;43;01 that began in 2020 and runs through September of 2024. 00;15;43;03 - 00;15;47;19 The goal is to train staff in those hands-on breastfeeding skills 00;15;47;22 - 00;15;51;16 to better address disparities in breastfeeding rates. 00;15;51;19 - 00;15;55;09 The EMPower Team developed training related to health equity. 00;15;55;12 - 00;15;59;19 This training is designed to help maternity staff navigate their own 00;15;59;19 - 00;16;04;06 implicit biases and provide culturally competent care. 00;16;04;08 - 00;16;07;25 The EMPower Training is delivered an e-learning platform 00;16;07;27 - 00;16;11;23 and it is organized in modules with a module for each of the ten steps 00;16;11;23 - 00;16;15;16 and a module to dedicated to communication skills. 00;16;15;18 - 00;16;20;02 Each module includes learning objectives and performance indicators, case 00;16;20;02 - 00;16;21;13 studies, self-reflection 00;16;21;13 - 00;16;25;20 activities, knowledge checks and relevant resources and job aids. 00;16;25;22 - 00;16;30;24 This is an image of Lorraine, who serves as a virtual trainer and mentor. 00;16;30;26 - 00;16;33;13 This is an example of one of the case studies. 00;16;33;13 - 00;16;36;05 This particular case study focuses on building 00;16;36;05 - 00;16;40;04 the skills needed to communicate effectively across cultures. 00;16;40;07 - 00;16;44;09 There are case studies for each of the ten steps, and each case study includes 00;16;44;12 - 00;16;48;08 brief background information to provide some context, 00;16;48;11 - 00;16;51;18 a scenario that staff would likely encounter in their day to day 00;16;51;18 - 00;16;57;00 work and questions to answer with the help of Lorraine, the Virtual Trainer. 00;16;57;03 - 00;16;59;03 A unique aspect of this collaborative 00;16;59;03 - 00;17;03;26 is that an equity community of practice grew organically from the work. 00;17;03;29 - 00;17;06;26 Staff identified a need for help 00;17;06;26 - 00;17;11;04 with how to integrate equity principles into maternity care. 00;17;11;06 - 00;17;16;23 Activities include regular webinars to learn from experts and peers to share 00;17;16;27 - 00;17;19;27 challenges and solutions across hospitals, 00;17;19;29 - 00;17;23;16 and to share equity related resources. 00;17;23;19 - 00;17;27;25 The E-learning platform provides a forum for ongoing discussion. 00;17;27;27 - 00;17;30;10 I wanted to share successes that we have seen 00;17;30;10 - 00;17;33;19 in our current collaborative EMPower Best Practices. 00;17;33;21 - 00;17;37;27 The first is a quote from a nurse and international board certified 00;17;37;27 - 00;17;42;19 lactation consultant at the University of North Carolina Hospital. 00;17;42;22 - 00;17;46;05 This hospital was the first in the nation to be successfully assessed 00;17;46;05 - 00;17;49;05 on the new Baby Friendly USA 00;17;49;09 - 00;17;51;24 training criteria. 00;17;51;24 - 00;17;55;11 Another hospital, AdventHealth Fish Memorial, 00;17;55;14 - 00;17;59;00 was able to create a report summarizing their participation in 00;17;59;02 - 00;18;01;28 and the impact on the families they served. 00;18;01;28 - 00;18;03;26 They shared it with their hospital leadership 00;18;03;26 - 00;18;07;24 and other partners to show the value of their work. 00;18;07;26 - 00;18;11;15 These are two examples of the importance of our quality improvement work 00;18;11;18 - 00;18;15;00 and how these efforts impact improvements in families. 00;18;15;03 - 00;18;17;06 So what has been accomplished? 00;18;17;06 - 00;18;22;14 We've added the progress made since 2011, which is indicated by the orange line. 00;18;22;17 - 00;18;26;02 The percent of births occurring in designated hospital grows 00;18;26;02 - 00;18;31;11 from 5% in 2011 to almost 29% in 2021. 00;18;31;14 - 00;18;33;29 Our work with the Best Fed Beginnings and EMPower 00;18;33;29 - 00;18;38;10 breastfeeding hospitals contributed in part to this increase. 00;18;38;12 - 00;18;42;23 However, this graph also reflects the contributions of other organizations 00;18;42;23 - 00;18;47;08 and facilities and the dedication and hard work of many people. 00;18;47;10 - 00;18;51;15 For example, it reflects the Best Fed Beginnings and EMPower hospitals 00;18;51;18 - 00;18;54;18 that have successfully maintained their designations and/or 00;18;54;21 - 00;18;58;12 achieved re-designation and those in our training collaboratives 00;18;58;12 - 00;19;02;13 that have gone beyond the expectations to achieve designation. 00;19;02;15 - 00;19;06;18 We have contributed in part to more than a million infants each year receiving 00;19;06;26 - 00;19;11;15 maternity care that supports breastfeeding and optimal infant nutrition. 00;19;11;18 - 00;19;14;10 As a nation, we have made remarkable progress. 00;19;14;10 - 00;19;16;28 But there's still work to be done. 00;19;16;28 - 00;19;19;26 To continue this work, we awarded funding to the Center 00;19;19;26 - 00;19;24;06 for Health Equity, Education and Research at Boston Medical Center. 00;19;24;09 - 00;19;27;09 They will begin work in September of 2023 00;19;27;16 - 00;19;31;18 and will enroll 100 hospitals to take part in a collaborative. 00;19;31;20 - 00;19;35;01 The Collaborative is designed to increase the use of culturally 00;19;35;01 - 00;19;40;05 competent approaches to improve breastfeeding supportive maternity care. 00;19;40;08 - 00;19;44;09 星空娱乐官网 is committed to continuing our work to support hospitals 00;19;44;15 - 00;19;47;25 and to ensure equitable access 00;19;47;27 - 00;19;52;21 so that all individuals and families receive optimal breastfeeding support. 00;19;52;24 - 00;19;58;11 This work has a profound impact on the health of families across our nation. 00;19;58;14 - 00;19;58;16 Thank you 00;19;58;16 - 00;20;01;16 for the opportunity to share our work with you. 00;20;01;20 - 00;20;03;15 I'll now turn it over to Harumi. 00;20;03;15 - 00;20;05;22 Thank you again. 00;20;05;22 - 00;20;08;16 Hi, everyone, and thank you Daurice, 00;20;08;16 - 00;20;13;16 and thanks to DNPAO for having us here in the last day 00;20;13;16 - 00;20;17;16 of this very important month and very important week. 00;20;17;18 - 00;20;21;11 So we just heard from 星空娱乐官网 a lot of what's happening 00;20;21;11 - 00;20;26;03 with breastfeeding in the hospital and how hospitals have improved. 00;20;26;05 - 00;20;29;28 Many of the ten steps which then result in this great 00;20;29;28 - 00;20;33;26 increase of the breastfeeding initiation rates, it's awesome. 00;20;33;29 - 00;20;38;29 We heard from Lieutenant Kristen that most births happen in the hospital. 00;20;39;05 - 00;20;41;14 And as we like to say here in NACCHO, breastfeeding 00;20;41;14 - 00;20;42;27 usually starts in the hospital, 00;20;42;27 - 00;20;47;09 but most of the breastfeeding journey actually takes place in the community. 00;20;47;12 - 00;20;50;25 Hopefully this journey lasts for at least the next two years 00;20;50;25 - 00;20;53;22 after the hospital discharge. Right. 00;20;53;22 - 00;20;58;04 But if the community infrastructure does not enable breastfeeding, 00;20;58;04 - 00;21;02;10 we won't see breastfeeding duration and exclusivity rates increase 00;21;02;10 - 00;21;05;10 so much like we saw with the initiation rates. 00;21;05;15 - 00;21;09;00 So how do we build the same supportive environment 00;21;09;00 - 00;21;14;05 that we have in baby friendly hospitals, also in the community? 00;21;14;08 - 00;21;17;07 So this is mostly what we do here at NACCHO 00;21;17;07 - 00;21;20;10 and I'll be sharing some of the highlights of the best 00;21;20;10 - 00;21;25;04 five years of our program that we have done with support from DNPAO. 00;21;25;07 - 00;21;29;15 It's like steps three and ten of the ten steps and beyond, 00;21;29;17 - 00;21;33;07 way beyond the hospital walls into the community. 00;21;33;10 - 00;21;35;23 Well, I鈥檒l start just talking a little bit about us. 00;21;35;23 - 00;21;39;27 NACCHO鈥檚 mission is to improve the health of all communities. 00;21;39;29 - 00;21;44;27 We have several different public health programs here to help advance our mission. 00;21;44;29 - 00;21;48;21 Our program is within the maternal child and adolescent health team. 00;21;48;23 - 00;21;54;09 NACCHO is a national organization, but with a local community reach. 00;21;54;12 - 00;21;58;13 Our team has been working with 星空娱乐官网 for nearly ten years, 00;21;58;16 - 00;22;01;14 but NACCHO as an organization, has partnered 00;22;01;14 - 00;22;05;08 with 星空娱乐官网 for the past 50 years in different programs. 00;22;05;10 - 00;22;06;22 Current current. 00;22;06;22 - 00;22;10;29 We are in the final year of the six year project. 00;22;11;02 - 00;22;14;20 We operate with the mission to advance continuity of care. 00;22;14;20 - 00;22;19;03 To enable breastfeeding should be the easy default choice in our communities, 00;22;19;05 - 00;22;21;07 especially those communities where breastfeeding 00;22;21;07 - 00;22;24;22 is not a feasible option for many families. 00;22;24;24 - 00;22;28;02 So you're going to see our goals in the next slide 00;22;28;05 - 00;22;30;28 that are to increase the operational capacity 00;22;30;28 - 00;22;35;15 of local public health systems to advance continuity of care. 00;22;35;18 - 00;22;40;11 It is also to identify and amplify local successes and best practices 00;22;40;11 - 00;22;45;15 to increase specifically the breastfeeding duration and exclusivity rates, 00;22;45;17 - 00;22;49;19 and also strengthen partnerships to advance the first thousand days 00;22;49;19 - 00;22;54;01 nutrition So we do that through this activities. 00;22;54;04 - 00;22;55;22 We fund local organizations 00;22;55;22 - 00;22;59;27 and their partners to advance continuity of care in their communities. 00;22;59;29 - 00;23;04;01 In this project period, we funded about 35 communities 00;23;04;02 - 00;23;06;18 and we will be funding some more soon. 00;23;06;18 - 00;23;09;08 We also provide training and technical assistance to communities. 00;23;09;08 - 00;23;12;08 We have provided over 400 hours 00;23;12;09 - 00;23;17;02 of technical assistance to grantees and also the 星空娱乐官网 REACH recipients. 00;23;17;05 - 00;23;22;14 Another activity is fostering partnerships at the local, state and national level. 00;23;22;16 - 00;23;26;02 For example, at national level, we convene the Breastfeeding Public Health 00;23;26;02 - 00;23;29;28 Partners in 2014, which is a group of about ten 00;23;29;28 - 00;23;32;27 national organizations, and we are still very active. 00;23;33;02 - 00;23;36;06 And finally, we have developed the Continuity of Care Blueprint 00;23;36;06 - 00;23;39;06 that just turned two years old last week. 00;23;39;08 - 00;23;42;04 So the blueprint is the systems approach 00;23;42;04 - 00;23;46;10 for communities to consistently provide this continuous, 00;23;46;12 - 00;23;50;07 high quality lactation support and supportive environments for families. 00;23;50;09 - 00;23;54;12 It was designed to build a safety net for families before 00;23;54;12 - 00;23;59;00 and after the hospital delivery throughout the first thousand days of life. 00;23;59;03 - 00;24;04;02 So the centerpiece of the blueprint are the 43 strategies to improve care, 00;24;04;02 - 00;24;08;16 coordination and communication among providers and the establishment of 00;24;08;16 - 00;24;13;16 proactive, supportive policies, systems and environments throughout the community. 00;24;13;18 - 00;24;17;09 So since the launch, there were over 2000 downloads 00;24;17;09 - 00;24;19;02 from every state in the country. 00;24;19;02 - 00;24;23;25 And surprisingly, we also had downloads from other 20 different countries. 00;24;23;28 - 00;24;27;21 Also in this map, you see the red stars representing grantee communities 00;24;27;21 - 00;24;29;11 that implemented the blueprint. 00;24;29;11 - 00;24;32;08 Grantees were a mix of local health departments, community 00;24;32;08 - 00;24;38;12 based organizations, FQHCs, breastfeeding coalitions and some hospital systems. 00;24;38;15 - 00;24;42;04 So here are some of the trainings that we did for the past two years. 00;24;42;04 - 00;24;44;15 We having an accredited continuity of care series. 00;24;44;15 - 00;24;47;21 And each webinar showcase speakers from communities 00;24;47;21 - 00;24;50;20 that were successful implementing the strategies. 00;24;50;21 - 00;24;54;02 We had great participation and you can still watch 00;24;54;02 - 00;24;57;23 the recording and claim most of this continuing education credits. 00;24;57;25 - 00;25;01;15 And on the next slide, you're going to see a bit of history 00;25;01;15 - 00;25;04;26 of the grants that we put together through the past five years. 00;25;04;29 - 00;25;09;01 The last three cycles, we're related to the blueprint implementations 00;25;09;07 - 00;25;14;02 and also a note there that from 2018 to 2023, we also worked 00;25;14;02 - 00;25;18;09 with REACH recipients implementing continuity of care in their communities. 00;25;18;12 - 00;25;21;01 Finally, you're going to be able to see here 00;25;21;01 - 00;25;24;17 the outcomes from the past well the preliminary outcomes 00;25;24;17 - 00;25;27;16 from this past two years of blueprint implementation. 00;25;27;16 - 00;25;31;14 Collectively, grantees increase capacity and diversify 00;25;31;16 - 00;25;34;16 the lactation workforce in their communities. 00;25;34;16 - 00;25;38;26 They have also conducted community lactation specific assessments 00;25;38;28 - 00;25;42;08 to understand gaps in continuity of care in their communities, 00;25;42;08 - 00;25;46;23 and then to focus efforts where they need the most. 00;25;46;25 - 00;25;49;22 They have also improved breastfeeding policies, systems 00;25;49;22 - 00;25;53;27 and environments in many, many, many, many settings in the community. 00;25;53;29 - 00;25;58;08 So they increased the availability of supportive environments 00;25;58;08 - 00;26;03;07 throughout the spaces where families live, work, play and raise kids. 00;26;03;09 - 00;26;07;06 And finally, at the heart of our project is to foster local partnerships, 00;26;07;06 - 00;26;08;26 because this is a must to advance 00;26;08;26 - 00;26;12;24 continuity of care, since no one can do continued care alone. 00;26;12;27 - 00;26;16;16 So there are lots of partnerships formed or strengthened, especially those 00;26;16;16 - 00;26;20;10 collaborations with agencies that address social determinants of health. 00;26;20;12 - 00;26;23;11 So they provide care for the family holistically 00;26;23;11 - 00;26;26;24 and not just solely focused on latching baby to breast. 00;26;27;01 - 00;26;30;15 Also a great success for many grantees, is that they improved 00;26;30;15 - 00;26;36;15 their referral systems and strengthened their handoff policies and procedures. 00;26;36;17 - 00;26;40;23 Finally, a grant is also focused on building authentic relationships 00;26;40;23 - 00;26;45;04 with families through family centered care father engagement projects. 00;26;45;06 - 00;26;47;17 So there's a lot to describe in one slide. 00;26;47;17 - 00;26;51;25 I hope you'll go check out their stories in the continuity of care website. 00;26;51;25 - 00;26;57;13 And for the next steps, you'll see that we launched, we just launched our request 00;26;57;13 - 00;27;01;17 for application for the third cohort to implement the blueprint. 00;27;01;19 - 00;27;04;12 And this time we are also looking for applicants 00;27;04;12 - 00;27;08;07 who proposed strategies to also improve child nutrition security. 00;27;08;10 - 00;27;15;06 So check out our RFA and in the same website and the link is on the chat box. 00;27;15;08 - 00;27;19;21 And next, thank you so much DNPAO for having NACCHO 00;27;19;21 - 00;27;23;20 and I'll turn it over to our amazing grantees in Jefferson County. 00;27;23;22 - 00;27;27;13 Lucy and Paulina were part of our last grant project 00;27;27;13 - 00;27;31;12 and we had the chance to visit their community last month. 00;27;31;19 - 00;27;35;23 We're so amazed by all the work they do to build continuity of care 00;27;35;23 - 00;27;37;12 for the Latino community. 00;27;37;12 - 00;27;40;13 And I'm sure you all are going to be just as inspired. 00;27;40;15 - 00;27;45;02 Gracias and beinvenidos Lucy and Paulina. 00;27;45;04 - 00;27;45;25 Hello, everybody. 00;27;45;25 - 00;27;50;03 Thank you so much for the invitation to join today. 00;27;50;05 - 00;27;53;22 We are delighted to share about how we're knitting networks of care 00;27;53;28 - 00;27;58;00 and support for our families after the hospital discharge in community. 00;27;58;06 - 00;28;02;05 So this is, we鈥檙e in Colorado and this is how people think of Colorado. 00;28;02;06 - 00;28;05;24 It is gorgeous, just like our families and our communities. 00;28;05;24 - 00;28;11;00 This is where we live where we learn, where we grow, we play, where we pray. 00;28;11;02 - 00;28;15;12 For us doing this work that it's important to have another perspective. 00;28;15;14 - 00;28;16;24 Because not everybody 00;28;16;24 - 00;28;21;05 gets to play in this mountains and no matter how close they are to them. 00;28;21;07 - 00;28;24;07 And this is a map of the Child Opportunity Index, 00;28;24;10 - 00;28;28;10 which shows disparities in opportunities for children in the Denver metro area. 00;28;28;17 - 00;28;31;18 The lighter colors show where our communities, 00;28;31;18 - 00;28;35;15 our children have less opportunities and the darker colors show 00;28;35;15 - 00;28;39;09 a abundance of opportunities for them. 00;28;39;11 - 00;28;40;26 This is where we work. 00;28;40;26 - 00;28;45;17 We work in the lighter areas, the color, the lighter blue areas. 00;28;45;23 - 00;28;50;10 This is where our immigrant communities live and also the historical 00;28;50;12 - 00;28;53;07 geographical locations of red lining. 00;28;53;07 - 00;28;55;08 This grant has allowed us to dream. 00;28;55;08 - 00;28;58;15 To start thinking about how we rebuilt connections 00;28;58;15 - 00;29;03;01 so those opportunities become available for everybody in our communities. 00;29;03;03 - 00;29;06;16 We have been able to imagine and build a community where groups 00;29;06;22 - 00;29;10;17 with different knowledge, information and power start connecting. 00;29;10;17 - 00;29;14;16 In our study, we did a qualitative qualitative study 00;29;14;19 - 00;29;18;16 of the experiences of families after discharge. 00;29;18;18 - 00;29;21;27 We hear that when families leave the hospital, even baby friendly 00;29;21;27 - 00;29;25;26 hospitals, they have no connections of support in their communities. 00;29;26;03 - 00;29;28;18 They experience profound isolation. 00;29;28;18 - 00;29;32;27 So our job has been to create those networks to weave neighbors 00;29;33;00 - 00;29;36;22 in neighborhoods and networks so everybody who have someone 00;29;36;22 - 00;29;40;14 in their closest contact that can give them information and support 00;29;40;20 - 00;29;45;18 related to lactation, breastfeeding and nutrition, infant nutrition. 00;29;45;22 - 00;29;47;26 We have not done this on our own. 00;29;47;26 - 00;29;50;25 We're also weaving networks between organizations. 00;29;50;25 - 00;29;53;28 JCPH supported us through funding mechanisms 00;29;53;28 - 00;29;58;01 and helping us to align our work with the health priorities of the county. 00;29;58;08 - 00;30;03;06 Then Edgewater Collective help us to build our structure, organizational structure. 00;30;03;06 - 00;30;04;29 And we, Cuenta Conmigo, we 00;30;05;01 - 00;30;06;07 were able to bring local 00;30;06;07 - 00;30;10;01 knowledge and experience to make this happen. 00;30;10;03 - 00;30;11;07 We make connections. 00;30;11;07 - 00;30;12;17 We are those touchpoints 00;30;12;17 - 00;30;16;14 between the resources, the organizations, and our families. 00;30;16;17 - 00;30;19;23 In the next week, we are celebrating at national level 00;30;19;29 - 00;30;24;29 the Latino Lactation Week, and we'll be celebrating across the country. 00;30;24;29 - 00;30;28;16 In a couple of weeks, our team will be traveling to Arkansas 00;30;28;18 - 00;30;34;00 to also share our experiences to train on clinical lactation at community level 00;30;34;03 - 00;30;37;05 so other communities can also start creating their own 00;30;37;05 - 00;30;40;05 networks of support at local level. 00;30;40;09 - 00;30;43;22 Thank you so much, Lucy, your turn. 00;30;47;22 - 00;30;58;27 Thank you Paulina. We increase the capacity of our community by speaking the language of their heart. 00;30;59;18 - 00;31;02;02 We are culturally sensitive. 00;31;02;08 - 00;31;11;03 Our community feels included and that motivates them to move forward and put into practice what they have learned within their families and for their families. 00;31;11;14 - 00;31;12;10 Slide please. 00;31;15;16 - 00;31;28;23 This is possible because we provide community preparedness training, safe infant feeding in emergencies, breastfeeding clinic, 00;31;28;23 - 00;31;38;09 breastfeeding friend notifications to child care providers, and we have monthly study sessions. It is a local participants 00;31;38;09 - 00;31;45;06 with real cases where we are learning. 00;31;47;27 - 00;31;58;26 We are increasing the presence of families with in-person and virtual groups in cafes where we listen, talk, and support their 00;31;58;26 - 00;32;05;14 needs in the areas of breastfeeding, nutrition, health, and others. 00;32;05;14 - 00;32;15;06 In alliance with other entities and with the same objective, we work and reflect on the interests of families 00;32;15;06 - 00;32;19;02 with a broad vision from our experience and connection. 00;32;23;05 - 00;32;42;10 We know that that personal contact lies in dealing with families culturally and directly. Having one-on-one visits is an effective way to build trust. By removing language barriers, we are able to actively listen in-person, virtually, or by phone. 00;32;42;10 - 00;32;49;14 Families feel more understood when accompanied, and we create very significant bonds of trust. 00;32;49;14 - 00;33;00;06 We conduct interviews and expand our 鈥渞ole鈥� knowing that the transition from the hospital to home is overwhelming and sometimes even traumatic. 00;33;00;06 - 00;33;07;10 Being a mother is a very exhausting job because we don't know what to do when we are alone with the baby. 00;33;07;10 - 00;33;10;26 There may not be anyone who can support their immediate needs. 00;33;10;26 - 00;33;20;10 We let them know that we are there to accompany them in those difficult moments from a cultural perspective, in the same 00;33;20;10 - 00;33;28;08 language, with the same sentiment, and with a deep perspective from our experience and understanding. 00;33;31;29 - 00;33;39;16 We know that it is working because we are constantly listening and reflecting on what families want. 00;33;39;16 - 00;33;49;14 We created a connection network with other entities to support the breastfeeding, nutrition, health, and well-being needs of families in our community. 00;33;49;14 - 00;34;01;27 We are navigators and respond to their interests. We support them with available resources and teach them the skills needed to learn how to do it. We are empowering families, 00;34;01;27 - 00;34;13;05 and they are developing the confidence to do it themselves. During the small moments of breastfeeding, we listen culturally. 00;34;13;05 - 00;34;20;20 We listen to their experience in the hospital, how breastfeeding is working, their health and well-being right now, and even what their future expectations are. 00;34;20;20 - 00;34;28;27 We continue to build trust, stay connected, and respond to families in the community. 00;34;31;10 - 00;34;40;09 Here is our information in case you want to contact us, and thank you very much for the opportunity. And now I pass it on to Janelle. 00;34;47;28 - 00;34;52;02 Thank you to our panelists for our wonderful presentation today. 00;34;52;02 - 00;34;56;00 Before we move on to the questions and answers, I want to remind folks 00;34;56;00 - 00;34;59;13 and to stay connected with us here at 星空娱乐官网, 00;34;59;15 - 00;35;03;16 we have both a Twitter and Facebook account. 00;35;03;16 - 00;35;05;28 If you're not following us, go ahead and follow us. 00;35;05;28 - 00;35;07;14 And wanted to also share. 00;35;07;14 - 00;35;10;15 We have some great resources, including those 00;35;10;22 - 00;35;14;08 related to breastfeeding and our State and Community Health Media Center 00;35;14;10 - 00;35;17;18 and also great data on our Data, Trends and Maps. 00;35;17;20 - 00;35;25;01 So I invite all of my panelists to turn their cameras on and we will do some Q&A. 00;35;25;03 - 00;35;27;13 First question is for you Daurice. 00;35;27;13 - 00;35;32;22 Are the training materials being used in the EMPower Projects publicly available? 00;35;32;24 - 00;35;37;08 Yes. The training materials that are that were used in the first EMPower 00;35;37;08 - 00;35;41;07 training project, our collaborative, are publicly available. 00;35;41;09 - 00;35;44;23 And I believe that we drop the 00;35;44;25 - 00;35;50;15 email or the URL and the webinar chat box. 00;35;50;17 - 00;35;55;05 They're available on the UNC Chapel Hill 00;35;55;07 - 00;35;57;27 website and we are currently working 00;35;57;27 - 00;36;01;29 with our partners to make available after the conclusion 00;36;02;04 - 00;36;06;11 of our current project EMPower Best Practices 00;36;06;13 - 00;36;09;22 the the training materials. 00;36;09;25 - 00;36;12;10 Does that answer the question? It does. 00;36;12;10 - 00;36;14;06 Thank you. 00;36;14;06 - 00;36;16;12 The next question is for Harumi. 00;36;16;12 - 00;36;19;15 Have you identified some commonalities among grantees 00;36;19;15 - 00;36;23;14 that were very successful? 00;36;23;16 - 00;36;23;28 Thanks. 00;36;23;28 - 00;36;25;11 Thanks, Janelle. 00;36;25;11 - 00;36;28;26 Yeah, there's we're still analyzing all that data, 00;36;28;26 - 00;36;32;06 but I think one of them that stands out 00;36;32;06 - 00;36;36;00 is the grantees like Jefferson 00;36;36;00 - 00;36;40;06 County here, that they already had this partnerships in place. 00;36;40;06 - 00;36;46;07 So they weren't trying to build trust and collaborate during a nine month project. 00;36;46;10 - 00;36;49;19 So the ones that were already 00;36;49;21 - 00;36;50;21 already had those 00;36;50;21 - 00;36;53;21 relationships in place were 00;36;53;27 - 00;36;54;23 more successful. 00;36;54;23 - 00;37;00;03 I think another factor that comes to mind now is the ones that really worked 00;37;00;10 - 00;37;05;15 with the community, co-created with the community, got community input 00;37;05;19 - 00;37;09;27 or even onboarded a community member 00;37;09;27 - 00;37;13;27 as that community expert advisor. 00;37;13;29 - 00;37;16;29 So they've really created 00;37;17;05 - 00;37;18;22 services that really fit 00;37;18;22 - 00;37;21;22 the needs of the community they're serving. 00;37;21;27 - 00;37;24;27 I think those two that comes to mind now. 00;37;25;02 - 00;37;27;10 Thank you, 00;37;27;10 - 00;37;27;25 Kristen. 00;37;27;25 - 00;37;30;25 The next question is for you. 00;37;30;29 - 00;37;34;19 It's about mPINC data and how can the public access 00;37;34;19 - 00;37;39;29 mPINC data and is individual hospital data available? 00;37;40;01 - 00;37;41;02 Thanks for that question. 00;37;41;02 - 00;37;45;08 So hospitals will receive their individual reports, 00;37;45;08 - 00;37;48;18 which are confidential and not publicly available. 00;37;48;20 - 00;37;53;01 They'll be sent out to the hospitals at the conclusion of our survey. 00;37;53;03 - 00;37;55;19 We do have national, regional and state reports 00;37;55;19 - 00;37;58;04 that are publicly available on our website. 00;37;58;04 - 00;38;03;09 And for researchers looking to use mPINC data to answer research questions 00;38;03;09 - 00;38;06;09 or state health departments who are looking to use 00;38;06;09 - 00;38;09;15 mPINC data for the development of public health programs, 00;38;09;18 - 00;38;12;14 we have data available and those folks can email 00;38;12;14 - 00;38;18;11 mPINC@星空娱乐官网.gov to learn more and receive a data request form. 00;38;18;13 - 00;38;19;06 Thank you. 00;38;19;06 - 00;38;21;06 And then Paulina and Lucy. 00;38;21;06 - 00;38;23;13 And the next question is for you. 00;38;23;13 - 00;38;26;02 How can communities support each other in breastfeeding 00;38;26;02 - 00;38;29;20 decisions? 00;38;29;22 - 00;38;31;02 That's a beautiful question. 00;38;31;02 - 00;38;33;16 I actually would love to know as well. 00;38;33;16 - 00;38;39;12 What we what we know is that a, people are asking for information. 00;38;39;14 - 00;38;41;24 People are asking to be able to make decisions. 00;38;41;24 - 00;38;44;29 They want to have a trusted partner that can give them the information 00;38;44;29 - 00;38;48;12 that they need, not just about, oh It's so good that you're breastfeeding. 00;38;48;18 - 00;38;49;18 Just go ahead and do it. 00;38;49;18 - 00;38;54;07 But actually, what do they solve the day to day challenges to make that happen. 00;38;54;14 - 00;38;58;00 So I think that supporting each other with decisions has to do with 00;38;58;00 - 00;38;59;17 what are the possibilities? 00;38;59;17 - 00;39;03;16 What are the visions that people and community are building together 00;39;03;23 - 00;39;10;15 in order to fulfill their goals in this journey of breastfeeding? 00;39;10;18 - 00;39;12;27 And then there's a follow up. 00;39;12;27 - 00;39;18;06 Folks are interested in what meeting you'll be at an Arkansas. 00;39;18;09 - 00;39;21;26 Teaching, one of our clinical and 00;39;21;28 - 00;39;24;02 curriculums in Arkansas, 00;39;24;02 - 00;39;27;09 in Springfield, in the University of Arkansas. 00;39;27;09 - 00;39;30;08 It's going to be a week long 00;39;30;08 - 00;39;32;01 training with an amazing group. 00;39;32;01 - 00;39;34;03 We met them yesterday, actually. 00;39;34;03 - 00;39;38;22 A they it's all going to be in Spanish and be very culturally based. 00;39;38;25 - 00;39;41;16 We tend to discuss those challenges 00;39;41;16 - 00;39;45;10 that are specific to our communities as well as the celebrations that we have. 00;39;45;10 - 00;39;48;18 There's so many strengths in our community that help us build up 00;39;48;18 - 00;39;52;25 solutions in ways that are way easier to see and explore 00;39;52;25 - 00;39;57;08 and advance When we're there with community. 00;39;57;10 - 00;39;58;23 Thank you for those questions. 00;39;58;23 - 00;39;59;20 Yeah, thank you. 00;39;59;20 - 00;40;02;19 And keep the questions coming in. 00;40;02;20 - 00;40;03;05 Harumi, 00;40;03;05 - 00;40;05;10 there's a question for you. In your work, 00;40;05;10 - 00;40;08;10 how do you see hospitals as supporting community programs? 00;40;08;16 - 00;40;17;19 And do you have any stories of hospitals implementing the blueprint? 00;40;17;22 - 00;40;20;02 Yes. Yes, we definitely have. 00;40;20;02 - 00;40;24;01 I would say about one third, maybe of our grantees, 00;40;24;01 - 00;40;27;01 our hospital systems. 00;40;27;07 - 00;40;31;24 I can give some examples of the past year or two years. 00;40;31;26 - 00;40;36;24 We had university of Chicago Medical Center. 00;40;36;24 - 00;40;40;10 So I think they really provided that consistent 00;40;40;12 - 00;40;43;06 constant care because they're a university hospital. 00;40;43;06 - 00;40;46;28 So they actually hired a community 00;40;47;00 - 00;40;50;18 To be in contact from pregnancy 00;40;50;24 - 00;40;53;18 through postpartum 00;40;53;18 - 00;40;57;07 with their patients instead of them seeing different providers 00;40;57;07 - 00;41;00;09 all the time. 00;41;00;10 - 00;41;04;02 The other one the Cincinnati Children's Hospital. 00;41;04;02 - 00;41;09;00 They are a group of so much experienced physicians and community. 00;41;09;00 - 00;41;12;08 They the great community clinic partnerships. 00;41;12;10 - 00;41;15;09 So they've really worked on improving their warm 00;41;15;09 - 00;41;20;11 handoffs from the hospital to the community and also they focused 00;41;20;11 - 00;41;23;11 on the really increasing 00;41;23;11 - 00;41;25;25 the supportive environment in the community. 00;41;25;25 - 00;41;30;13 So I think they have a quality improvement going on with a bunch of their 00;41;30;16 - 00;41;33;09 early care and education settings. 00;41;33;09 - 00;41;36;17 And finally, the other one that we have 00;41;36;17 - 00;41;41;00 was the MedStar Hospital, that it was current grantee in Baltimore, 00;41;41;00 - 00;41;45;11 and they did a fascinating partnership with City of Refugee 00;41;45;12 - 00;41;49;06 that is a resilience center for the Baltimore community. 00;41;49;09 - 00;41;52;08 And they they provide 00;41;52;08 - 00;41;55;08 food, food, fresh foods, 00;41;55;08 - 00;41;59;10 career advancement opportunities and diaper bank. 00;41;59;10 - 00;42;05;07 So they co-located their lactation support in this diaper bank. 00;42;05;10 - 00;42;10;13 So it's really, really rich and holistic and the way they are providing care. 00;42;10;15 - 00;42;12;06 So I think those three come to mind. 00;42;12;06 - 00;42;16;11 But check our stories in the Blueprint website that you're going 00;42;16;11 - 00;42;22;05 to see way more ways that hospitals have been supporting communities. 00;42;22;08 - 00;42;23;23 Thank you. 00;42;23;23 - 00;42;26;06 Lucy, the next question is for you. 00;42;26;06 - 00;42;29;06 Do you have any lessons from the COVID time period 00;42;29;06 - 00;42;39;02 and best connecting with communities 00;42;39;04 - 00;42;40;04 Si. 00;42;40;04 - 00;42;45;00 I think that COVID brought a great lesson to us all. 00;42;45;00 - 00;42;51;05 The community that I live in, which is the Hispanic community, 00;42;51;05 - 00;42;59;04 was very underserved and there were many resources in the community to which we did not have access. 00;42;59;04 - 00;43;09;28 COVID came to open doors so that people could realize that these programs are possible and within reach. 00;43;09;28 - 00;43;23;11 What the community needs most is direct one-on-one contact, and I think that is the lesson that COVID has brought us. Thank you. 00;43;26;04 - 00;43;28;02 Thank you, 00;43;28;02 - 00;43;29;03 Kristen, 00;43;29;03 - 00;43;30;23 the next question is for you. 00;43;30;23 - 00;43;35;26 And it's about when will the next mPINC survey take place? 00;43;35;28 - 00;43;37;13 So we are planning to launch 00;43;37;13 - 00;43;41;16 the 2024 mPINC survey starting in early January. 00;43;41;19 - 00;43;45;10 So folks can stay up to date on the survey's progress by subscribing 00;43;45;11 - 00;43;49;04 to our listserv and checking the blue update boxes 00;43;49;04 - 00;43;51;13 that we put on the top of our mPINC website. 00;43;51;13 - 00;43;55;03 And maybe someone can drop the link to the mPINC website in the chat 00;43;55;05 - 00;43;58;27 as I'm speaking, but will be periodically sending updates 00;43;58;27 - 00;44;03;06 through both our listserv and posting those on the website. 00;44;03;08 - 00;44;05;20 And I will say it takes a little bit of time to reach out 00;44;05;20 - 00;44;09;09 to all hospitals across all the states and territories. 00;44;09;09 - 00;44;14;00 So hospitals in your area may not be contacted until closer to February, 00;44;14;02 - 00;44;15;05 but if you have any questions 00;44;15;05 - 00;44;19;00 about the survey or would like to request a previous hospital report 00;44;19;00 - 00;44;24;27 or mPINC data, like I said before, you can reach out to mPINC@cdc.gov. 00;44;24;29 - 00;44;27;08 Thank you. Daurice, 00;44;27;08 - 00;44;31;25 If hospitals in my state are interested in taking part in the newest initiative, 00;44;31;28 - 00;44;35;23 how would they learn more? 00;44;35;26 - 00;44;37;00 Thanks for the question. 00;44;37;00 - 00;44;40;22 I think the guidance would be to check out 00;44;40;22 - 00;44;43;22 the cheer website 00;44;43;29 - 00;44;49;06 and I think we have that in the chat chat and also 00;44;49;08 - 00;44;53;03 you can send an email to cheer at the gmail account, 00;44;53;03 - 00;44;57;16 which is also on there in the chat and on their home page. 00;44;57;18 - 00;45;01;03 Their period of performance begins at the end of September, 00;45;01;03 - 00;45;06;23 so they may not start recruiting hospitals until little bit later than that 00;45;06;23 - 00;45;09;23 because they have some planning to do and that sort of thing. 00;45;09;24 - 00;45;12;23 But again, watching for updates on their website 00;45;12;23 - 00;45;15;23 around October. 00;45;15;26 - 00;45;17;02 Thanks. 00;45;17;02 - 00;45;19;01 Thanks. 00;45;19;01 - 00;45;22;14 And Paulina, our last question will go to you. 00;45;22;14 - 00;45;25;10 What do you see as some of the biggest opportunities 00;45;25;10 - 00;45;30;21 and challenges for organizations like yours to promote breastfeeding? 00;45;30;24 - 00;45;31;24 The opportunities is 00;45;31;24 - 00;45;35;12 that we have communities who are 00;45;35;15 - 00;45;37;21 really accepting and caring. 00;45;37;21 - 00;45;40;21 I'm very concerned about the health of our families and children. 00;45;40;27 - 00;45;43;16 And so I think that we have the ground 00;45;43;16 - 00;45;47;19 a very it's a very has been cultivated, right. 00;45;47;24 - 00;45;49;12 We are there ready. 00;45;49;12 - 00;45;51;24 I I am not finding an argument. 00;45;51;24 - 00;45;54;13 I don't have to argue about how beneficial this is. 00;45;54;13 - 00;45;55;01 Right? 00;45;55;01 - 00;45;57;17 People are ready to jump in and start doing it. 00;45;57;17 - 00;46;01;21 There may be some cultural barriers sometimes because there's a misalignment 00;46;01;21 - 00;46;05;21 of how we're presenting the context, how we're presenting our values. 00;46;05;21 - 00;46;10;24 But there's so much work that we can in we can do creating some congruent 00;46;10;28 - 00;46;14;18 congruence in like equivalent meaning. 00;46;14;20 - 00;46;18;17 I will say that we can bring together these goals 00;46;18;19 - 00;46;21;18 and now in terms of challenges, I think that the work, 00;46;21;18 - 00;46;23;03 some of the work that we do, 00;46;23;03 - 00;46;24;23 there's no funding for this kind of thing. 00;46;24;23 - 00;46;27;03 We are piecing together things. 00;46;27;03 - 00;46;28;24 We are like thanks to NACCHO, 00;46;28;24 - 00;46;32;01 this really help us set up on this structure that then will 00;46;32;01 - 00;46;35;11 allow us to launch this into the next steps. 00;46;35;13 - 00;46;39;12 But we have families who work with families actually more than Spanish. 00;46;39;12 - 00;46;42;18 We have also seen Vietnamese families and they come to us 00;46;42;18 - 00;46;46;10 because we have an understanding of immigration experience, 00;46;46;10 - 00;46;49;28 of refugee experience that many other that other communities 00;46;49;28 - 00;46;53;03 or I would say the more dominant cultures do not have. 00;46;53;06 - 00;46;57;05 So some of the challenges is that this work is extremely important. 00;46;57;07 - 00;47;01;06 I think that we at that moment and that link between everything 00;47;01;06 - 00;47;05;13 that our institutions are trying to accomplish in what is a real community 00;47;05;13 - 00;47;09;10 experience where right there in the middle. And unless we get funded, 00;47;09;14 - 00;47;13;11 unless we get a recognition and support for our lactation counselors, 00;47;13;11 - 00;47;16;19 for navigators in the community, we do it all right. 00;47;16;20 - 00;47;18;16 We're not just lactation counselors. 00;47;18;16 - 00;47;22;20 We have to do navigation on housing, on food access, on education, 00;47;22;26 - 00;47;26;12 and everything comes and we will take it and run with it, 00;47;26;12 - 00;47;28;09 because that's what our families need. 00;47;28;09 - 00;47;31;22 So a recognition that this role is essential 00;47;31;25 - 00;47;34;28 to build this infrastructure, and needs to happen. 00;47;34;28 - 00;47;39;22 And I think that's the biggest challenge that we're facing right now. 00;47;39;25 - 00;47;41;11 Thank you. 00;47;41;11 - 00;47;44;15 Well, if everyone can please join me in a virtual applause 00;47;44;15 - 00;47;46;26 for our outstanding panel today. 00;47;46;26 - 00;47;49;15 We're so glad that we were able to spend this last day 00;47;49;15 - 00;47;53;10 of breastfeeding month with you all and really appreciate 00;47;53;10 - 00;47;57;15 all of the great content and resources that were shared today. 00;47;57;17 - 00;47;59;20 This seminar, as with our others, 00;47;59;20 - 00;48;02;22 will be posted on the DNPAO website. 00;48;02;24 - 00;48;04;11 And thank you all for joining us.