MCHB ALL GRANTEE MEETING

Divisions and Offices (continued)

October 4-7, 2004

SABRINA MATOFF: Okay. Well, while that’s getting loaded I just want to thank everyone for coming. Again, I’m really glad to be here. I’m really kind of new to this meeting. I’ve been in this position for just about a year, and I remember when Dr. van Dyck said to me about a year ago would you like to be the acting director, when they say acting you know that means a lot of work, so it’s been a really interesting experience, really good experience for me. It’s really broadened my horizons and made me learn a lot. And, I’m really pleased to get to know some of you and hopefully show you some of the kind of neat things that the HRSA Office of Women’s Health does that can hopefully benefit you, it’s still coming up. One of the things I wanted to clarify because I think it is worth making the distinction, Marybeth’s shop is a grant functioning, a grant making part of the maternal child health bureau, and in contrast the HRSA Office of Women’s Health does not have a grant authority, but what we do is we really service that coordination and policy and collaboration and partnering type of organization part of MCHB that really can help bridge across the entire agency.

So we do a little different kinds of work, but we have a wide reach and so for that I think we’re really a good partner to have perhaps with some of what you do. It’s still coming up. Okay, well, grab a--double click Ann, whoops, no, let me start again. It did. I did. I did double click on it. There we go, okay. So, anyways, okay, let’s get started here. As this picture shows, I think the picture really tell a thousand words, the HRSA Office of Woman’s Health really takes a lifespan approach to women’s health. You can see a real diversity, a real age span, and we’re really about making sure that all of our audiences remember that women live a whole lifetime. They have a very important time when they’re in their reproductive age, but they also have hopefully many, many years afterwards when they live long and healthy lives. So, we’re really about that lifespan approach as well. And, our sort of working theme in the HRSA Office of Women’s Health is healthy women build healthy communities.

Okay. This is our mission and you can certainly read it for yourself, but we’re really about providing that cross cutting and unifying focus for reducing gender disparities in support of women’s health and wellness. So, we’re working across the agency to accomplish this both in MCH and also across the other HRSA bureaus. These are some of our sort of broad functions as you’ve heard, as John mentioned, we’re really working across the agency and every bureau has some little or some big, in some ways programs that deal with women. We convene a HRSA Women’s Health Coordinating Committee, which is comprised of representatives from across HRSA that we get together once a month and we do some planning and policy work and activities that focus on women’s health, and we really have a very unique role also in being part of a larger network of women’s health in the Department of Health and Human Services. As some of you may be aware, there is a department office on women’s health, some of us are called of woman’s health, some of us are called on woman’s health. We’re of. But there is a department office on women’s health, which is headed by Dr. Wanda Jones, and they really have the departmental level focus on woman’s health, and they asked me and I agreed, because I thought it would be really important to share with you if you don’t already know, they have two really wonderful websites that focus on women and adolescent girls, and I have some of these with me today.

They have two websites one of them is www.forgirls.gov, a really pretty sort of postcard and there’s a complimentary one also called www.forwomen.gov, and it’s a really great gateway to all of what’s going on in the department for women’s health. So, I’ll leave those out at the resource table for you. These are some examples for you of some of the ways that my office works to try to incorporate woman’s health into a variety of different programs. We certainly contribute to the MCHB Strategic Plan. We have our own strategic plan. We contribute to what’s known as the Moyer Table, which is an annual report to Congress on women’s health expenditures. We’re involved in an ongoing Surgeon General’s Report on osteoporosis and bone health. And, several years ago we were part of a submission that went to Congress on women’s health activities in the department. So, as you can see we really work within HRSA as well as within the department. These are some examples again of different things that we’ve done over the last year, some of them have been mentioned in previous talks. The Women’s Health Data Book, Women’s Health USA Data Books that Dr. Cogan mentioned.

The 2004 Data Book hopefully will be available very soon. We did some work around women and girls in HIV AIDS in an adolescent newsletter. We have a series of GIS maps that are going to be available on our website looking at how woman’s health investments are funded across the agency, and we have a number of other activities you can see, including some work that looks at how woman’s health is taught in health profession’s training, which may be of interest to you as well. Now, the big thing that I’m just really pleased to share with you now and Chris mentioned and Marybeth mentioned, but this is really, instead of grants, you could say this is sort of our signature piece that was started about three years ago, and this is our Bright Futures for Woman’s Health and Wellness Initiative. This came about really as a way to focus the same kind of ideas of preventive health and guidance for woman, modeled after what has been so successfully done for infants, children, and adolescents. But within that framework we decided we’d take a little different take. We wouldn’t just develop references and manuals, which may not be as appropriate for woman, but we would try to develop more easy to use, user-friendly types of materials and tools.

And, we also took a little different standpoint in focusing on three specific audiences, both the women their communities and their providers. So, we’re approaching everybody in sort of a woman’s life. Just a little bit about the organizational development, Dr. van Dyke gives us support for this, which we’re very grateful and he leads an executive management committee, which is comprised of representatives across HRSA. We also have a steering committee that’s all non-federal representatives with two co-chairs, Dr. Karen Scott Collins and Dr. Karen Carlson, and we also partner all across the department and with some of affiliated organizations of our steering committee. It’s very timely to be talking about Bright Futures here because our first domain of interest that we’ve been building these first set of tools around is physical activity and healthy eating, and as this meeting is focused on that eat healthy move more, these tools really fit well with that. Some of what’s on this slide is really some of the developmental work that we went into. We were very concerned about making sure that Bright Futures for Women’s Health and Wellness always had an evidence-based support for it.

So, we really did quite a bit of work for the first year-and-a-half to two years, making sure that we knew what the evidence said to support the tool development. We did key informant interviews, discussion groups, as well as guideline comparisons. We built into Bright Futures from the outset some pilot evaluations, so some all of these tools have been tested in a variety of different sites. We have a logic model that we’re working with to make sure that we meet our process impact and outcome measures. And, as the tools get released, we’re going to do a perspective evaluation, hopefully that will get awarded early in 2005 fiscal year, so that we know as they get released how they’re being uptaked and how they’re being used in actual settings. The tools themselves, the physical activity and healthy eating tools, I would love to have examples of them here at this meeting, unfortunately, I don’t, and that’s just a matter of just clearances and various things in the department that sometimes hold things up, but they will be available soon, I’m really, really hopeful.

So, I can tell you a little bit about them, and there’s also going to be a handout in the Child Health Day packets tomorrow that talk specifically about the adolescent tools. We’ve divided up, when we talk about lifespan, we’ve divided up the lifespan sort of arbitrarily into adolescents and adult women, and we did that primarily because the evidence for this particular topic, Healthy Eating and Physical Activity, did not support having more than really two broad groups of age for the guidelines for these two topics. So, the tools themselves, what they will include will be a self-assessment guide, an adolescent wallet card, a community tool kit, some tip sheets, and some provider training and counseling. As Marybeth mentioned, we’ve also begun talking about mental health and wellness, and specifically also a perinatal mental health and wellness tool. The adolescent tools themselves, again, this goes into a little bit more detail for you, the goal here is to really encourage a dialogue between adolescent female patients and their health care providers, and to help them set realistic behavior change goals.

This is also very much in line with what the Secretary Steps To A Healthier US is about, if you’ve heard about that initiative, if you’ve seen some of the commercials or some of the website. It’s all about setting easy manageable steps to eat healthy and move more. And, we kind of thought of this first maybe, but we’re glad that it really fits in with what else the department’s doing. But it really gives the patient a chance to assess their behavior while they’re in the clinic, then have a dialogue with their provider, and then hopefully work together to set some goals. As I said, there’s a wallet card for the adolescent girls to kind of take home, reference, as a reference material. The tools themselves will be available through HRSA Information Center , as well as on our website, and we’re going to do some outreach to various outlets. This is probably a little bit hard to see, but what this is and I have this, I can send it to anyone, it’s a Power Point slide that I can easily send, but it’s kind of an idea of how we envision the flow of using these particular tools in a clinic setting.

So, how we’ve envisioned it is that a patient would check in at her clinic at the front desk, she’d get the tool, there’s about 15, 16 questions. She’d fill them out asking her about her current physical activity and healthy eating behavior, just check boxes, very easy to do. She goes back, she gets her weight, her height and her BMI, that BMI is very important as we all know to check to make sure she’s in that proper weight to height ratio. Then she has her dialogue with her provider. They talk about ways that she can improve her healthy eating and physical activity, and she sets some reasonable goals while she’s there. She takes this reference material with her. She’s got it there to come home with her, and she checks out. And, she has this information right there with her that’s been endorsed, so to speak, by her provider.

And, we hope that this will engage woman and adolescent girls in hopefully setting some healthy eating and--and physical activity goals. So, this is sort of how we’ve envisioned it and we’ll see if it actually works this way. Some of our next steps, we have to continue to go through some clearances with these tools, we have some meetings set up with our steering committee and we’re going to make sure these tools are available in Spanish as well. I have a very small office. If you were going to look on the organizational chart we’d be this little sort of poof of smoke, like Mt. St. Helen ’s right now that’s kind of off of Dr. van Dyck, but we do a lot of work. We’re the owl as Ann says, which is good, we’re wise and we use our time, resources, and staff wisely, but there really is only three of us. But I think we really work together well, Ream Kondur will be here tomorrow and you’ll be able to meet with her as well. This is how you get in touch with us and we’re really pleased to be part of this, so thank you very much.