1. Healthy Weight in Women of Reproductive Age Action Learning Collaborative

2. Purpose of the Women’s Health Partnership Identify and promote unique state and local MCH roles and opportunities to ensure and improve women’s health before and between pregnancies.

3. Lifecourse Framework “Pregnancy outcomes are shaped by social, psychological, behavioral, environmental, and biological forces that may occur at many stages in a woman’s life.” Association of Maternal and Child Health Programs and CityMatch’s Women’s Health Partnership. 2006 “Some of the most powerful influences on pregnancy outcome are related to influences on women’s health that occur long before pregnancy begins.” Misra and Grason. Women’s Health Issues 2006

4. Initial Goal of WHP Develop state and local partnerships to promote healthy weight among women of reproductive age to improve maternal health and birth outcomes.

5. Rationale Obesity in pregnancy linked to maternal and infant morbidity and mortality Research and best practice information and guidelines are available Obesity impacts a large number of women and thus our efforts could affect a large number of pregnancies Identified as a priority by both agencies’ member base

6. Adverse Outcomes Associated with Maternal Obesity Infertility Pregnancy, labor & delivery complications Fetal, neonatal death Birth weight/prematurity Birth defects Gestational diabetes Decreased breastfeeding Childhood obesity

7. RFA for ALC, Summer 2006 Team composition: State Title V/MCH director MCH leadership from local health department Data/analytic specialist Professional from an existing community-based health initiative Nutrition and/or physical activity and/or chronic disease professional

8. ALC Teams Selected Los Angeles County, CA Sonoma County, CA Maricopa County, AZ Salt Lake Valley, UT Douglas County, NE Minneapolis, MN Boston, MA Duval, Leon & Orange Counties, FL

9. HW ALC Activities Kick off October 2006 1 st on site meeting, December 2006 in Atlanta, GA 2 nd on site meeting, June 2007, in Salt Lake City, UT All ALC technical assistance calls Lifecourse Framework, RE-AIM, Focus Groups, peer exchange 3 rd on site meeting, February 2008, in Washington, D.C.

10. HW ALC Next Steps Teams continue to implement, monitor and evaluate their selected strategies Evaluation (within teams and of the ALC overall) Dissemination & Recommendations

11. Team Strategies

12. Maricopa County, AZ Conducted a Nutrition Environmental Measures Survey in food stores in the South Phoenix area to address accessibility, quality and cost of healthy foods. Contact: Donna Thompson, RD, MPH Office of Nutrition Services; Maricopa Dept. Of Public Health DonnaThompson@mail.maricopa.gov OR Margaret Tate, MS, RD Arizona Department of Health Services tatem@azdhs.gov

13. Los Angeles County, CA Integrating with existing programs via communication tools & strategies for consumers and providers, worksite wellness, and leadership development. Contact: Cynthia Harding, MPH Los Angeles County Public Health, MCAH charding@ph.lacounty.gov OR Suzanne Haydu, MPH, RD California Department of Public Health/MCAH Suzanne.Haydu@cadph.gov

14. Sonoma County, CA Promotores de Salud and health providers support behavior change to increase healthy eating and active living; Families eat a “balanced plate” including more vegetables; Engage youth to increase daily physical activity. Contact: Rebecca Munger, RN, PHN, CNM Sonoma County, Department of Health Services, MCAH rmunger@sonoma-county.org OR Suzanne Haydu, MPH, RD California Department of Public Health/ MCAH Suzanne.Haydu@cadph.gov

15. Duval/Leon/Orange Counties, FL Developing statewide curriculum of best practices for healthy weight in postpartum women. Contact: Helen Jackson, PhD Division of Community Nutrition Services, Duval Co Health Dept helen_jackson@doh.state.fl.us OR Laura Levine, BSN Florida Department of Health, Infant, Maternal,and Reproductive Health laura_levine@doh.state.fl.us

16. Boston, MA Develop a community-informed report on healthy weight in reproductive aged women, focusing on black and Latina women, drawing from: a review of existing data, examination of promising practices and programs and key informant interviews and focus groups with women from the target communities. Contact: Kathy Cunningham, MEd, RD, LDN Boston Steps, Community Initiatives Bureau; Boston Public Health Commission kcunningham@bphc.org OR Karin Downs, RN, MPH Division of Perinatal Health, Early Childhood; MA Dept of Public Health karin.downs@state.ma.us

17. Minneapolis, MN Addressing healthy weight in women of childbearing age through partnerhips: local health dept., state health dept., Univ. of Minnesota, Healthy Start & STEPS. Strategies: Presentations to professional groups Materials (research brief for professionals and one page fact sheet for general public) Develop new partnerships Develop logic model for intervention pilot with post-partum women at local clinics Seek resources Contact: Megan Ellingson, MHA; MCH Initiatives; Minneapolis Dept of Health and Family Support megan.ellingson@ci.minneapolis.mn.us

18. Douglas County, NE Expanding an existing preconception pilot project to a brief intervention and referral to a social support group tailored to help young women achieve & maintain a healthy weight. Contact: Mary Balluff, MS, RD, LMNT Community Health and Nutrition; Douglas County Health Dept Mary.balluff@douglascounty-ne.gov OR Jennifer Severe-Oforah Lifespan Health Services; Nebraska Dept of Health and Human Services Jennifer.severeoforah@dhhs.ne.gov

19. Salt Lake City, UT Gathering information from WIC professionals and participants to determine the best way to integrate weight & reproductive health into WIC activities. Implementation of the Bright Futures for Women’s Health and Wellness Program (HRSA) into 3 Salt Lake County clinics. Contact: Audrey Stevenson, MSN, FNP, MPH Family Health Services; Salt Lake Valley Health Department astevenson@slco.org OR Lois Bloebaum, BSN, MPA Reproductive Health Program; Utah Department of Health lbloebaum@utah.gov