1. A Program Offered by the OU College of Nursing Funded by the George Kaiser Family Foundation Healthy Women, Healthy Futures

2. Mapping Feto-Infant Mortality Tulsa County, All Eligible Babies, 2003-2007 Infant Mortality Rate (IMR)= 8.8 Maternal Health/ Prematurity 3.6 (41%) Maternal Care 1.5 (17.5%) Newborn Care 1.5 (17.5%) Infant Health 2.2 (28%)

3. What is HWHF? A multicultural, interconception women’s health project based in the life course perspective Targets non-pregnant women in poverty with children enrolled in four Tulsa Early Childhood Education Programs Provides services for up to three years

4. Mission Improve the physical, emotional, social, dental, and vision health of non-pregnant women living in poverty to reduce premature birth and infant mortality

5. HEALTHY WOMEN, HEALTHY FUTURES Risks, Interventions & Outcomes Women’s Environment of Poverty, Stress, Isolation & Lack of Support A Culture of Respect and Support Healthy Outcomes Decrease in Prematurity Decrease in Low Birth Weight Infants Decrease in Unintended Pregnancies Decrease in NICU Admissions Improvement in Women’s Knowledge, Behaviors and Health Indicators Medical Home and Dental Care Health Promotion Education Disease Prevention Disease Management Education Referrals for Mental Health and Treatment of Other Serious Health Conditions Assistance with Transportation and Translation Nurse Educators, Health Navigators & Collaborating Programs Behavioral Health Substance Abuse Domestic Violence Depression & Other Mental Health Issues Behavioral Health Chronic Health Conditions High Blood Pressure DiabetesAsthmaHigh Cholesterol Lifestyles Smoking Poor Nutrition Lack of Physical Activity Ineffective Contraception Dental Caries Dental and Vision Care Decreased Infant Mortality Increase in Healthy Birth Spacing/ Reproductive Live Plans

6. Program Elements Development of an individualized health plan by a “team” consisting of site nurse educator, health navigator, and woman through home visitation and risk assessment. Assist women to establish a medical home, and /or reduce barriers to access to health services through community collaboration. Provision of individual and group education on healthy lifestyles, illness prevention, health promotion and other content areas

7. Program Elements Address chronic psychological or biological responses to stress and learn stress control methods Individual responsibility with a reproductive life plan Peer social support Intervention and monitoring of women’s health status and health behaviors for up to 3 years.

8. Program Objective One & Outcomes Improve women’s knowledge of health promotion measures and disease prevention practices

9. Pre and Post Test Comparison

10. Participant Comments “ We learned information before, but didn’t change. We now have an understanding and can apply it.” “ That I am learning things (in detail) that I did not know before. I get amazed when I find out things that I can do to prevent diseases.” “The knowledge I have gained in the program will stay with me for the rest of my life.”

11. Program Objective Two & Outcomes Assist women to improve their health through development of healthy lifestyle practices, including a reproductive life plan, and by facilitating access to services.

12. Dietary Improvements 42% report eating low fat to very low fat diets. (change from 14%) 90% are eating low or moderate carbohydrate diets. 40% increased and have maintained their number of daily fruit and vegetable servings to 3 or more.

13. Lifestyle Changes Weight loss 37.5% have lost weight (5-23 pounds) (Avg 9.1) 18% changed BMI at least 1 point Exercise 32% increased and maintained weekly exercise of 3 or more days/week

14. Health Improvements More than 62% lost 10 or more points of total cholesterol typically through changes in diet and exercise. 58% improved their HDL (good cholesterol) Participants’ difficulty coping decreased from 33% to 24%.

15. Pregnancy Planning/Infant Outcomes to Date 18 women have become pregnant. All received first trimester care. 13 have delivered healthy term babies (37-41 weeks), weighing between 5lbs 9 oz and 9 lbs. 1 oz) 2 were born early, at 34-35 weeks weighing 4lbs12oz and 4lbs 15oz.

16. Contact Information Su An Arnn Phipps R.N., Ph.D., C.N.E Director-Healthy Women, Healthy Futures University of Oklahoma College of Nursing 918.660.3955 Su-Phipps@ouhsc.edu