N.C. Perinatal Health Strategic Plan: 2016-2020

Goal 2: Strengthening Families and Communities

Multi-Ethnic Families and Friends on Front Steps of Residential Building

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 Point 5. Strengthen father involvement in families

- 5A. Promote parenting and co-parenting skills and responsible strategies

  1. Expand Triple P, NC Prevent Child Abuse parenting curriculum, etc. to five additional community agencies
  2. Identify number of counties with an evidence-based parenting program
  3. Increase support for evidence-based programs by providing funding and technical assistance
  4. Identify successful fatherhood programs and resources/contacts by collaborating with local fatherhood task forces

- 5B. Improve/develop guidelines for the inclusion of men in preconception, prenatal, and interconception health services

  1. Incorporate PCH into the routine primary care of men
  2. Promote preventative health education for boys, adolescents and men, to include mental health and substance use, and the impact it has on childbearing and parenting by incorporating education into school, faith-based community and other community programs

- 5C. Use evidence-based strategies to promote healthy family relationships

  1. Broadly disseminate, through provider training, evidence-based programs that address healthy relationships / families / parenting, including trauma-informed care
  2. Educate providers on warning signs of conflict in relationships and previous trauma history and develop referral pathways

- 5D. Promote the role of fathers to change the culture

  1. Link local and regional fatherhood task forces to the NC Fatherhood Council
  2. Create / Implement messaging to build an evidence-based awareness campaign with messages tailored for fathers and male caregivers in NC by working with father-focused groups
  3. Incorporate the role of fathers into the current First 2000 Days of Life media campaign
  4. Support paid parental leave efforts

 Point 6. Enhance coordination and integration of family support services

- 6A. Promote agency and community coordination in providing services

  1. Improve the integration and collaboration of services and programs in the Division of Public Health/DHHS that impact women’s and children’s health by increasing cross communication, sharing what is known, and assessing strengths and challenges
  2. Create a DHHS plan to provide coordinated services across the across the life course continuum
  3. Share the lessons learned, plans and information collected through the increased communication and planning in #1 and #2 with the larger public health community in North Carolina to model innovation and set the pace for local groups
  4. Improve transitions of care / improved communication among clinical case managers

- 6B. Decrease fragmentation in the service delivery system to reduce burden on families

  1. Identify existing gap analysis models and review them for use in North Carolina with a focus on services and supports for families
  2. Support a pilot project / learning collaborative with agencies to conduct a gap analysis of their services for families
  3. Share findings of the learning collaborative along with recommendations for other agencies and counties to conduct their own analysis
  4. Utilize technology to better drive connectivity and sharing of information with and about families to improve service systems and utilization of resources
  5. Convene a stakeholder meeting to map out and understand the various systems that families must navigate

- 6C. Improve family and community driven service provision

  1. Conduct listening sessions with women, families and communities to learn more about how current systems are working for them and what might work better. Apply what is learned to system improvements.
  2. Review the evidence base for the use of community health workers and assess if and how they are being utilized in North Carolina. Encourage agencies and non-profits that are working in the same communities to consider pooling their resources / staff to hire from within high-need communities and potentially better coordinate efforts.
  3. Provide training to home visitors and people who are providing services to families and communities around cultural competency in order to prevent internalized racism / oppression and focusing on resilience and community building vs “I know best.”
    • Explore the Smart Start training model.
    • Assess current curriculum and training provided.
    • Develop online, reading and other materials to support ongoing learning.
    • Find resources to support retreats.

 Point 7. Support coordination and cooperation to promote reproductive health within communities

- 7A. Promote reproductive life planning

  1. Use evidence-based reproductive life planning tools
  2. Expand provider and consumer education and outreach by increasing the number of reproductive life planning trainings available to a variety of groups including faith communities, clinicians, case workers, and others
  3. Advocate for incentives to create reproductive life plans
  4. Use standardized evidence-based contraceptive counseling across NC’s perinatal case management programs

- 7B. Expand community stakeholder involvement and community engagement in service design and implementation

  1. Increase education and community support by presenting existing preconception health high school curricula to local decision makers
  2. Work with agencies and providers to develop and utilize community advisory groups inclusive of community members and consumers of services when developing and implementing services and programs

- 7C. Promote utilization of breastfeeding friendly policies and services in local communities

  1. Increase the number of facilities participating in NC Maternity Center Breastfeeding Friendly Designation or NC Breastfeeding-Friendly Child Care Designation Program or achieving a Baby Friendly Hospital Designation
  2. Advocate among the business community to adopt breastfeeding-friendly policies and practices by supporting use of breastfeeding-friendly designations

- 7D. Promote utilization of evidence-based strategies to prevent all forms of violence and promote coordinated community response

  1. Increase awareness of the impact of toxic stress and exposure to violence on children’s health and development
  2. Broadly disseminate, through provider training, evidence-based programs that address healthy relationships / families / parenting, including trauma-informed care
  3. Educate providers on warning signs of conflict in relationships and previous trauma history and develop referral pathways
  4. Increase the number of nurses with Sexual Assault Nurse Examiner (SANE) qualifications

 Point 8. Invest in community building

- 8A. Create and improve transportation systems and infrastructure

  1. Establish collaborative relationships with Council of Governments, Department of Transportation, Division of Social Services and City Planning to develop a report to describe transportation issues and recommendations for young families in NC
  2. Assess access to prenatal and family planning services based on the report from the Institute of Medicine to learn more about the distance of primary care services and specialty services in and around rural areas. Review data and talk with women/men to assess if and why some women travel further for their care instead of visiting local providers (potential trust/discrimination issues)
  3. Convene a daylong meeting to review all of the information above along with any policies or procedures that may be impacting access to care (e.g. being able to bring a family member / baby along for an important visit) and develop a list of recommendations to improve services and ease of use
  4. Collectively advocate for changes in bus routes, bus stops, location of recreational facilities, availability of transportation services, etc. based on the recommendations made by the meeting described above

- 8B. Support capacity building in areas of concentrated disadvantage

  1. Use existing method of GIS mapping and other data resources such as Emergency Management to identify communities at high-risk for poor birth and child health outcomes (hot spot) to describe and prioritize their needs
  2. Establish collaborative partnership with community housing program (housing authority) and others to assess housing needs, impact on health (particularly young adults and young families), and push for local planning and funding strategies to improve safety and healthy housing options for families, including housing opportunities outside of neighborhoods of concentrated poverty
    • Review model programs from other states and programs that are doing this work – e.g. Healthy Start and Best Babies Zones
  3. Make free Wi-Fi available within disadvantaged housing to enable residents to apply for jobs, connect to resources in community and connect their children to online school resources
  4. Take inventory of communities in NC implementing promise zone like initiatives (taking multigenerational approaches to ensure the child’s success). Share their work, successes and challenges via a report or webinar or conference presentation so other communities can learn from their work. Collaborate with projects to provide support / expertise as needed to make sure that key services such as reproductive life planning are included / considered

- 8C. Improve environments to support healthy living

  1. Promote smoke-free/tobacco-free public housing and multi-unit housing through policy change and tax incentives
  2. Increase community gardens and support permaculture in low income neighborhoods
  3. Educate and inform decision makers to adopt the following evidence-based interventions:
    • Local regulations that make local government buildings, grounds, and public places tobacco free.
    • Smoke-free multi-unit housing that also bans e-cigarettes, including public housing, affordable housing and as resources allow, market rate housing. 
    • Tobacco-free community colleges and colleges.
    • Local tobacco-free mental health and substance abuse facilities along with evidence- based tobacco treatment provided by counselors
    • Tobacco-free child care centers for those who serve the 0-5 population
  4. Educate the public and decision-makers about how menthol added to tobacco products and promoted to populations impacts tobacco addiction, disease, and premature death for those populations that use menthol tobacco products
  5. Collaborate with environmental justice coalitions to promote access to safe water, clean air, and chemically toxic-free environment
  6. Continue partnering with local and state initiatives to educate communities about healthy living, including exercise and nutrition
  7. Collaborate with initiatives that focus on regular access to healthy foods and food security

- 8D. Create and promote local employment opportunities that provide at least a livable wage

  1. Support and encourage businesses that seek to provide jobs (with benefits, paid sick leave) as well as services in areas of concentrated disadvantage
  2. Collaborate with partners and organizations that advocate for living wage, community development, and community reinvestment

- 8E. Support civic participation through building community networks

  1. Partner with existing groups to make sure that MCH populations are registered to vote, know where to vote, have identification for voting, know how to access information about candidates and have transportation to the polls
  2. Bring the policy issues to the kitchen table – make politics both state and local understandable to busy, over extended young adults and families
  3. Provide information and education to MCH clients about the policy decision-making process, how local governments work and how they can collectively share their issues and concerns

Perinatal Health Strategic Plan

Last Modified: February 20, 2019