2. MomsFirst A Helping Hand for Your Pregnancy… and Your Baby Cleveland Department of Public Health 75 Erieview Plaza Cleveland Oh, 44114

3. What is MomsFirst? A program of the Cleveland Department of Public Health, the Cleveland Healthy Start Project, MomsFirst, was first funded in 1991. Originally known as Healthy Family/Healthy Start, the project’s purpose is the reduction of disparities in infant mortality and poor birth outcomes experienced by African Americans in the City of Cleveland.

4. Who does MomsFirst serve? Pregnant women and teens in the city of Cleveland Women/teens who have experienced a pregnancy loss Women/teens who are incarcerated, residing in shelters, or enrolled in an inpatient chemical dependency treatment program

5. Service Providers The Project funds 37 Community Health Workers and 9 Case Managers who are trained to provide the Project’s core services. These staff range from paraprofessional level to masters prepared. Staff are based out of seven neighborhood settlement houses, a community-based social service agency, and Northeast Ohio Neighborhood Health Services, NEON.

7. MomsFirst Core Services Outreach Case Management Health Education Interconceptional Care Services Perinatal Depression Screening

8. Service Delivery Each participant receives at least two face-to-face contacts and one phone call per month. At least one of the face-to-face contacts must take place in the home. In 2009, 2,373 families received MomsFirst services.

9. Health Education and Health Promotion Goal is to ensure that our moms and moms-to-be are healthy before, during, and after their pregnancy MomsFirst utilizes “Partners for a Healthy Baby” curriculum, Baby Basics, and is a Text4Baby partner.

10. Partners for a Healthy Baby Curriculum A Comprehensive curricula providing monthly guidance for home visitors working with pregnant women and their families. Addresses perinatal health, baby’s development, self-esteem and self-sufficiency, pregnancy concerns, and preparations for baby's arrival. Also promotes healthy behaviors such as Family Planning, Medical Home, Effects of Drugs and Alcohol on the body and Exercise and Nutrition

11. Baby Basics A low literacy, culturally and linguistically tailored prenatal care guide and program for at-risk pregnant women. During home visits the expectant mom is taught how to find information in the book about her pregnancy, understand the information, make appropriate health decisions regarding her pregnancy and develop questions to ask her doctor. Supplemental reinforcement of the health messages contained in the book transpire through MomsClubs.

12. Text4Baby MomsFirst has been sharing information about this free mobile information service that provides timely health information to pregnant women and new moms through the baby’s first year.

13. Neighborhood Consortia Engaging the Community and Providers - Bringing together “both sides of the equation” has been imperative to the Project’s success Unprecedented cooperation and sharing of information Giving community a voice - consortia members identify areas of concern in their neighborhood and plan activities to address these items. Examples include: Housing and Jobs

14. Interconceptional Care MomsFirst, has focused on Family Planning and Reproductive Life Planning this past year, not just in the interconceptional period, but throughout the pregnancy. Efforts have continued to increase community awareness around family planning and increase condom use.

15. Partnerships within the Community Cleveland Dept of Public Health  Free immunizations and health screenings Planned Parenthood  Staffs the HealthMobile 4 afternoons per week providing HIV/STD testing/counseling Center for Community Solutions (Title X)  Provides free condoms and staff training on family planning Help Me Grow  Reciprocal participant referrals

16. Infant Mortality Rates Two Year Groups

17. Combined IMR 2001-2008

18. Participant Survey Responses I needed someone to talk to and she was there for me. Kept me from feeling alone. She motivated me. Everything was less stressful. Gave me assurance that someone cared. Made me feel more positive about my situation. She helped me with the emotional roller coaster that you go through when you have a baby. Loved the attention and support I received from my worker and her supervisor. My MomsFirst worker helped support me in many ways. Helped me understand my health information and my doctor visits. She just supported me in any way she could. I love my MomsFirst worker, she was just like a mom to me.

19. Conclusions There is no single intervention that can dramatically reduce infant mortality rates. However, effective implementation of core service components, system linkage, interagency collaboration, and acceptance of responsibility for personal health around and during pregnancy (self-efficacy) positively impacts birth outcomes.

20. Lisa Matthews Project Director Cleveland Department of Public Health MomsFirst 75 Erieview Plaza Cleveland Ohio 44114 (office)216-664-4281 (fax) 216-664-2501 lmatthews@city.cleveland.oh.us www.clevelandhealth.org