1. Healthy Generations: Volunteer Health Educators in the African American Community CityMatCH Annual Conference August 2007 Linda Short Archer, RN, MSN Brenda Burnett, RN, MSN

2. Purpose of the Healthy Generations Project To utilize a train-the-trainer model to empower African-American volunteer health educators to disseminate information related to healthy life-style choices, risk factor reduction, and community resources to other African-American women within their social networks.

3. Infant Mortality Rates: El Paso County & Colorado YEAR Rateper1000Rateper1000 (Colorado Dept. of Public Health & Environment Health Statistics Section)

4. Infant Mortality Rates by Race/Ethnicity: El Paso County YEAR Rates per 1000Rates per 1000 (Colorado Dept. of Public Health & Environment Health Statistics Section)

5. 2005 Perinatal Outcomes in El Paso County Number of Births in 2005 (8,658) White Non- Hispanic (5,870) White Hispanic (1,741) African- American (628) Late Prenatal Care 22 % 37% 34 % Low Birth Weight 9 % 10% 16 % Pre-Term Birth 11 % 10% 13 % Very Low Birth Weight 1 % 2% 3 % No Prenatal Care 1 % 2% 2 % (Colorado Dept. of Public Health & Environment Health Statistics Section)

6. Other Health Disparities Among the African-American Population Colorado State average per 100,000 people African-American age adjusted death rate HEART DISEASE 191 / 100,000 238.8 / 100,000 STROKE 56.2 / 100,000 72.3 / 100,000 DIABETES 18.3 / 100,000 36 / 100,000 BREAST CANCER 23.3 / 100,000 100.5 / 100,000 (Colorado Dept. of Public Health & Environment Office of Health Disparities 2005)

7. African-American Women’s Health Care Focus Groups Purpose: To elicit and communicate key issues related to the health care concerns of African-American women.

8. Results from the Focus Groups Perception of discrimination can assume multiple forms: race, gender, economics. Perception of discrimination can assume multiple forms: race, gender, economics. African-American women are important sources of information regarding their own health care. African-American women are important sources of information regarding their own health care.

9. Healthy Generations Project Goal Provide an opportunity for African- American women to teach other women the importance of making healthy lifestyle choices for themselves and their babies.

10. Healthy Generations Objectives Identify best practices for population- based health behavior education Identify best practices for population- based health behavior education Select health related topics based on racial and ethnic disparities Select health related topics based on racial and ethnic disparities Develop curriculum for a train-the-trainer program Develop curriculum for a train-the-trainer program Enlist volunteer health educators to disseminate health information within their social networks Enlist volunteer health educators to disseminate health information within their social networks

11. Recruitment of Participants Recruited 11 African-American women who voluntarily participated in the health educator project Recruited 11 African-American women who voluntarily participated in the health educator project

12. Retaining Participants Developed a binder that included all presentations, various handouts and a community resource guide Developed a binder that included all presentations, various handouts and a community resource guide Each participant received a “tool kit” containing materials specific to each module Each participant received a “tool kit” containing materials specific to each module

13. Nuts & Bolts Three 4-hour classes where experts presented information about health related topics Three 4-hour classes where experts presented information about health related topics Participants disseminated portions of what they learned to other women within their social circles Participants disseminated portions of what they learned to other women within their social circles Coordinators made monthly contact with participants Coordinators made monthly contact with participants Participants and coordinators came together quarterly to report progress, ask questions, restock tool kits Participants and coordinators came together quarterly to report progress, ask questions, restock tool kits

14. Healthy Generations Project Curriculum Risk factors for pregnancy complications and poor birth outcomes Risk factors for pregnancy complications and poor birth outcomes Healthy lifestyle choices for women Healthy lifestyle choices for women Chronic disease management Chronic disease management Delivering the message and developing your delivery style Delivering the message and developing your delivery style

15. Module 1: Risk Factors For Pregnancy Complications and Poor Birth Outcomes Smoking Cessation Smoking Cessation Alcohol and Substance Use/Abuse Alcohol and Substance Use/Abuse Weight Gain During Pregnancy Weight Gain During Pregnancy Domestic Violence Domestic Violence Preventing Preterm Labor Preventing Preterm Labor

16. Module 2: Healthy Lifestyle Choices Breast Health Breast Health Cervical Cancer Screening Cervical Cancer Screening Nutrition Nutrition Preconception /Interconception Health and Health Care Preconception /Interconception Health and Health Care

17. Module 3: Chronic Disease Management Hypertension Hypertension Diabetes Diabetes Depression Depression Coronary Artery Disease Coronary Artery Disease Asthma Asthma

18. Delivering the Message & Developing Your Delivery Style Provided participants with various types of educational tools as each topic was presented Provided participants with various types of educational tools as each topic was presented Provided participants with information about presentation tips, training approaches, motivation to learn and adult learning principles Provided participants with information about presentation tips, training approaches, motivation to learn and adult learning principles Participants worked in groups to develop a presentation outline of their own Participants worked in groups to develop a presentation outline of their own

19. Delivering the Message Venues Women’s Wellness Summit – Celebrating Women of Color Women’s Wellness Summit – Celebrating Women of Color Good Love – Relationship Workshop For Young Adults Good Love – Relationship Workshop For Young Adults Concerned Citizens as Education Advocates Concerned Citizens as Education Advocates Community Networks and Events Community Networks and Events The Spirit of Women Hospital Health Education The Spirit of Women Hospital Health Education NAACP Expo African-American Health Fairs Juneteenth African American Voice Churches Women’s Resource Agency Local High Schools and Area Colleges

20. Community Feedback How can I get involved in this project? How can I get involved in this project? Is this just for the African-American community? Is this just for the African-American community? What if I am interested in attending a Lunch and Learn workshop? What if I am interested in attending a Lunch and Learn workshop? Can this be expanded to other groups such as teens, Asians, Latinas, men, grandparents raising children? Can this be expanded to other groups such as teens, Asians, Latinas, men, grandparents raising children?

21. Launched! Held an awards luncheon honoring our participant volunteers, community experts and nurse researchers Held an awards luncheon honoring our participant volunteers, community experts and nurse researchers Participant satisfaction rating of 4.8 on 5- point scale Participant satisfaction rating of 4.8 on 5- point scale Use rapid-cycle method (Plan, Do, Study, Act) to assess strengths, weaknesses and change the program as needed Use rapid-cycle method (Plan, Do, Study, Act) to assess strengths, weaknesses and change the program as needed Explore options for sustainability of the program Explore options for sustainability of the program

22. Outcomes All nine volunteers completed the training All nine volunteers completed the training Volunteer educators provided education to over 1,250 women within the African- American community Volunteer educators provided education to over 1,250 women within the African- American community Volunteers participated in more than 16 unique venues during the 8 month project. Volunteers participated in more than 16 unique venues during the 8 month project.

23. Sustainability Options Partner with local Schools of Nursing to incorporate the project into community health clinical practicum Partner with local Schools of Nursing to incorporate the project into community health clinical practicum Participants continue the project serving as volunteer facilitators Participants continue the project serving as volunteer facilitators Organizations facilitate training workshops Organizations facilitate training workshops

24. “If we are to eliminate these disgraces, we must work with communities-not on them.” Higginbotham, 2005

25. Contact Information Linda Archer, RN, MSN, CNS-BC (719) 578-3103 lindashort@epchealth.org Brenda Burnett, RN, MSN (719) 575-8514 BrendaBurnett@epchealth.org 301 S. Union Blvd. Colorado Springs, CO 80910