1 Identifying and Connecting Preconception Health through Life Course within Existing Systems. Mary A Balluff, MS, RD Douglas County Health Department June,2011

What is the Life Course Perspective? Your Mother’s/Father’s Life Your Life Next Generation A complex interplay of biological, behavioral, psychological, and social protective and risk factor contributes to health outcomes across the span of a person’s lie.

Life-Course Perspective/ Poor Pregnancy and Birth Outcome The issues of low birth weight, preterm birth and infant mortality has always been explained by the quality, frequency of prenatal care and inter- conception care. In contrast, the life course suggests that poor birth & disparities in birth outcome results from differences in protective and risk factors in an individual or between groups of women over the course of their life. As a result, the health and socioeconomic status of one generation directly affects the health status of another.

Protective And Risk Factors Socioeconomic status, race and racism, neighborhood conditions, health care, disease status, stress, nutrition and weight status, birth weight, and a range of behaviors are some of the key protective and risk factors

What Does It Mean? We need & kids need more “protections” than “risks” to lead healthy lives Influencing healthy behaviors now, leads to a lifetime of wellness The Life Course Perspective gives bigger context to your work What does it mean for you?

People and Places: Girls Inc.Hope Center YMCASalvation Army Camp Fire Boys and Girls Club Middle School Learning Center Initiative (MSCLI) Omaha Fire Department Greater Omaha After School Alliance (GOASA) Omaha Healthy Start Omaha Public Schools Reached over 150 Participants

What Are Developmental Assets? Developed in 1990, Search Institute’s Developmental Assets represent the qualities young people need to avoid risks and thrive. The Gap—The average young person experiences fewer than half of the 40 assets. Boys experience three fewer assets than girls (17.2 assets for boys vs for girls).

Studies of more than 2.2 million young people in the US show: more assets = less likely to engage in high-risk behaviors. fit all young people, regardless of their gender, economic status, family, or race/ethnicity. Levels of assets = prediction of high-risk involvement and thriving than poverty or being from a single-parent family. The Power of Assets

40 Developmental Assets External Assets – 20 assets positive experiences youth receive from the world around them Support – need to be surrounded by people who love, appreciate, and accept them Empowerment – need to feel valued and valuable i.e. youth feel safe and respected Boundaries and Expectations – need clear rules, consistent consequences, and encouragement Constructive Use of Time – need opportunities outside of school to enjoy themselves, develop new skills, and build positive relationships with other youth and adults Internal Assets – 20 assets characteristics/behaviors from positive internal growth and development. Commitment to Learning –need a sense of the importance of learning & belief in own abilities Positive Values – need strong guiding values or principles to help them make healthy life choices Social Competencies – need skills to be able to interact effectively and cope with new situations Positive Identity – need a sense of their self-worth, power, purpose, and promise.

Power of Assets: Protecting Youth

Power of Assets: Promoting Positive Attitudes and Behaviors

The Project Study Question: Are there adequate similarities between the concepts of the Lifecourse model and the 40 assets framework to successfully create a single approach to build youth skills and abilities especially related to healthy lifestyle choices? Method: Using evaluation results from two Lifecourse trainings with representatives from 25 youth serving agencies, 90% of the participants stated that they would incorporate the Lifecourse model in their daily work. Further analysis highlighted a lack of strategy to perform such incorporation. Utilizing the process known as consensus building, health and public health professionals along with youth serving agency representatives identified shared concepts. Results: 10 shared assets were identified which can serve as the bridge between youth development paradigm and the Lifecourse model. Conclusion: Practical application of a synergistic approach to youth development and Lifecourse provides the promise of youth entering their child bearing years in optimal health. Implication: Improved health trajectory of adolescents by developing pro-social behaviors and diminishing problematic behaviors.

Top 10 Assets # 31 Restraint - Young person believes it is important not to be sexually active or to use alcohol or other drugs # 32 Planning and decision making - Young person knows how to plan ahead and make choices #35 Resistance skills - Young person can resist negative peer pressure and dangerous situations #37 Personal power - Young person feels he or she has control over "things that happen to me“ # 39 Sense of purpose - Young person reports that "my life has purpose“ # 40 Positive view of personal future - Young person is optimistic about her or his personal future # 1 Family Support - Family life provides high levels of love and support # 2 Positive Family Communication - Young person and parents communicate positively, and young person is willing to seek advice and counsel from parents # 3 Other adult relationships - Young person receives support from 3 or more nonparent adults #30 Responsibility - Young person accepts and takes personal responsibility

Developmental Assets Total # Assets link to CDC indicator CDC Recommendations to Improve Preconception Health xxxxxx x 7 1. Individual Responsibility across the Lifespan x 1 2. Consumer Awareness xx xx 43. Preventive Visits xxxxxx 64. Interventions for Identified Risks xxxxxxxx 85. Interconception Care xxxxxxxx 86. Pre-pregnancy Checkup x 1 7. Health Insurance Coverage - Low Income Women 8. Public Health Programs and Strategies x x 29. Research 10. Monitoring Improvements

What’s on the Map? Identify youth development agencies to review the top 10 Assets to see which assets exist in their current programs/curriculum Develop checklist for agency to utilize in the process Decide how they can justify

# 31 Restraint Young person believes it is important not to be sexually active or to use alcohol or other drugs Seize opportune moments to talk, such as after watching a movie or show together that contain content about sexual relationships (even those consider “family” shows often do)

# 32 Planning & Decision Making Young person knows how to plan ahead and make choices Be intentional about letting kids make plans for a family party or event. Let them help make guest lists, plan the budget, shop for food and decorations, and enlist family members to make the event a success

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Thank You