HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

HRSA Office of Women's Health

SABRINA MATOFF-STEPP: Well, thank you all for staying. I know this has been a long afternoon and I’m the last one, and it’s great to see you all. I’m Sabrina Matloff-Stepp, again, and I’m the Director of the HRSA Office of Women’s Health. And I think it’s telling that, I think this is our wrap up session, because I think the HRSA Office of Women’s Health is really all about partnership, and we’re all about looking at women’s health from a life span perspective. So, I think it’s really, it’s a good place for us to bring this all together and to talk a little bit about the unique features of my office, which is quite a little bit different than what you’ve been hearing all afternoon. So, as Maribeth was just saying, I think it’s really important to look at women as the leaders in their families, their communities, and we like to say that healthy women build healthy communities; that our unofficial, sort of, motto that we like to promote within the office.

Here is our mission. You’ve been hearing a lot about missions this afternoon, but I think it’s important to look at how the HRSA Office of Women’s Health is really about building towards comprehensive culturally component quality healthcare, and really unifying these services in support of women’s health and wellness. We take this role very seriously and try to provide leadership on behalf of Dr. Van Dyck for the bureau, but really coordinating across all of HRSA. I think it’s very important to also consider that we are known as the HRSA Office of Women’s Health, which gives us a cross coordination role that we’re trying to integrate women’s health across all of HRSA and it’s various programs.

So, that’s a good segway into this slide, we, here are some of our functions. We coordinate health education and women’s health policy at HRSA. We have a women’s health coordinating committee that convenes on a monthly basis. And we serve as the liaison with other federal women’s health and private sector organizations. We are women’s health at the agency level. As many of you know, there is a hierarchy in HHS and there is also a department office on women’s health. Some of us are of women’s health; others are on women’s health. There’s no rhyme or reason to that. But you may know Dr. Wanda Jones who is the department office on women’s health, Director, and we coordinate quite a bit with her and support the efforts that come out of the department when it comes to women’s health, and children, and families.

Some of the collaborations we do, and again this goes towards partnership. We’re all about partnerships in the Office of Women’s Health. As Michael Kogan was saying earlier, and have props, some of my colleagues had dancing things, I have props. One of our latest books that we’ve come out is this, the Women’s Health USA Data Book, 2005. There will be copies here at the meeting for you, if anyone wants this copy before I leave; you’re welcome to it. This is our annual data book that takes a real snap shot of women’s health at the national level and gives you some quick facts, figures, graphs, pie charts, about indicators of women’s health. We particularly like to show sex and gender disparities, as well as race and ethics disparities in this, just to give you those quick snap shots that you may need to use in your presentations or slides, as you do your work. So, again, this is available. It will be available at the meeting. We also have this at our website and the website’s at the end of this presentation.

We’ve tried to do, over the past of couple of years; some mapping of all of the different HRSA related women’s health grants. So that, again, thinking across HRSA, any project that is focused on women’s health, we try to map that to show, again, all of the funds that go towards helping women live healthier lives, at HRSA. We have a number of projects that, again, we work with other bureaus in agency, looking at how women’s health is integrated into health professions, curricula, and some of those reports focused on medical, dental, nursing, and soon to come women’s health in the public health school and women’s health in pharmacy school. So, if you’re interested in curricular development, we have a number of reports that have looked at how schools are integrating women’s health into those curricula.

We also do some things, just right in our own midst. I mean, we need to be healthy as well as help promote women’s health across the country. So, we try to promote and acknowledge and recognize the importance of women, even in our own work place. And so we have on-going walking club, and we also are working on an HIV AIDS Memorial quilt that recognizes the impact of HIV AIDS on women. Again, thinking cross coordination, we coordinate a lot of these different activities out of my office.

You heard Chris and you heard Maribeth talk about Bright Futures, briefly. And again, this our, you can say bread and butter, in the HRSA Office of Women’s Health. Maybe not bread and butter, maybe fruits and vegetables. This is our mainstay. Unlike, again, some of what you’ve heard all afternoon, the HRSA Office of Women’s Health does not have a grant program. What we do more, again, is the policy coordination and building on materials and resources that hopefully you can use, your communities can use, professionals, consumers can use, and we really are interested now in partnering more and more our own Bright Futures for women’s health and wellness so, again, this a really great opportunity to talk about this a little bit this afternoon, but this builds on the first Bright Futures for Children, Infants, and Adolescents whereby we took that idea and kind of changed it a little bit. We didn’t want to just develop materials for professionals and for families; we really wanted to develop the materials for women, themselves. For adolescent females, themselves, how could they get involved in this decision making process of living healthier lives? So we took a little bit from them and then we developed our own sort of way of doing this, and we call it Bright Futures for Women’s Health and Wellness. And again, we’re doing the business here of trying to develop some materials, some resources, that can be used. Some really active participation in women’s health and wellness. So, we’re supporting three different, let me back up there a minute, we’re supporting the community here, we’re supporting women, and we’re supporting professionals. So, it’s a really three part partnership in trying to help women lead healthier lives.

Here’s some of our goals. Some broad goals here, about preventive health, encourage shared decision making, practicing prevention, increasing the practitioner knowledge and utilization of preventive health guidelines. There’s a lot of guidelines out there. Some of them are used more than others. We’re trying to find the best evidence based guidelines to help women know about and help practitioners use when they’re counseling women. And all in all, of course, everything comes down to the community level. If you don’t have the communities supporting this, it’s going to be hard to get the women to take part as well.

So, we have three active domains right now that we’re focusing on, and again, very timely because I know during this meeting, on Tuesday, one of the focus is on physical activity, obesity, over weight, etcetera, when our first domain in Bright Futures has been on that exact topic. And, I have a number of props, materials here, to show you what we’ve been doing on that, to sort of support that. Our second domain that we’ve been focused on is mental health and wellness. Again, in the broad context of women’s health across the lifespan and as you heard from Maribeth, her division is specifically focusing on the time of a woman’s life when she may or may not be considering pregnancy and sort of the issues that come up around being mentally well during that pregnancy period. So, our three target audiences, again looking across the lifespan, are adult women and adolescent girls, the primary care provider and the community itself. This is an initiative that we started back in 2001. We’ve done a lot of organization development with it. Dr. Van Dyck is our funder and our executive management committee leader, and gives us a lot of moral, financial, and wonderful support for this. This initiative is really thanks to his leadership. We have two co-chairs who are not federal employees. They’re private sector clinicians. Dr. Karen Carlson and Dr. Karen Collins, and we have a number of non-federal panels and expert groups that help us with this initiative, and we’re always interested in getting feedback from more people who can help us understand the issues that may be going on around these different topics. We’re also well aware of the importance of evaluation and we built in evaluation to all of Bright Futures from the outset. So, we’re going to hopefully know how things are being used, taken up, and making changes as they happen.

So, I’m going to talk very briefly and show you a few examples. Again, some of these materials are available at this meeting. They are available through the HRSA Information Center, the 1-88-ASK-HRSA number, as well as on-line. You can get these materials. So, the first thing I want to focus on, just really again quickly here, what is very relevant to all of your work, is looking at physical activity and healthy eating for adolescent girls. This is very important. We all know that the importance of eating well and being active, the sooner you start the better, teaching healthy habits. So, one of our first activities, or one of our first materials, was developing this self assessment guide for adolescent girls, themselves, with a little accompanying wallet card. The colors are adolescent girls colors. We did not chose these. They love pink and yellow, we found out through focus groups. So, this is a guide, a self assessment guide, that sort of gives girls a chance to answer some questions, have a discussion with their provider, set some goals, and have some tools then to go home and act on these goals. It’s really very much about doing something, as well as getting more information. We also have in development, and hopefully these will be out very soon, some provider training materials on how to integrate this into a clinical setting and we have, this is also a new component of the physical activity and healthy eating family of tools, a community tool kit that can be used at the community level to again integrate healthy eating and physical activity into your community. All of Bright Futures tools are culturally competent. They’re at a Sixth grade reading level. We’ve done a lot of work making sure that pictures, stories, testimonials, activities, are all very much, women can see themselves in here. We have diversity. We have women with various physical challenges. Again, we’re really trying to encompass women in their real communities through Bright Futures tools. So, I just talked about the guide and the wallet card for young women. We’re also coming out with an adult women’s version of a self assessment guide as well as some tip sheets to accompany those. And those, hopefully, will be available very soon.

We also have the second domain that I briefly mentioned, where we’re focusing in on mental health and wellness. And, this is also a unique sort of domain because we’re not focusing on illness here. We’re focusing on a unique sort of caveat whereby wellness here. How do we define it, how do we measure it, what is wellness about? And, we’ve done a lot of background work thinking about how you define wellness. About coping, about resiliency, about what makes women strong to deal with stressors. And so we have a whole domain around mental health and wellness that we have been working on since 2003. We have a non-federal expert panel. We’ve done a lot of background work, again because we didn’t really know what was out there. We didn’t know if others were, you know, developing materials about wellness or if most of the information was still focused on illness. So, we’ve done a lit review, a lot of environmental scans, and a lot of talking with professionals, experts, with women themselves, about what is this sort of nebulous but very important construct called mental wellness. This is a, what we are working with, is our working definition of wellness. It certainly is a working definition and we’re up for changing it as needed, but just to draw your attention, briefly, to some of the constructs that we found from all of our background work, our lit review, and some of the work that has come out of the last couple of years. Really, what we’re talking about with wellness here, is the importance of connection with one’s community, about developing rewarding activities, about having healthy emotional habits, about a strong sense of self, compassion, adapting, and the really important part of spiritual and cultural beliefs, traditions, and practices. And, again, some of this may seem a little odd, a little different. You know, we think mental wellness is kind of out there a little bit, but it really is, we’re finding, there is a small but growing evidence base around the important of mental wellness and of course we all know that it’s not just about physical health, it’s about the holistic mental and physical health together. And, how can we support women in that, in the development of more strength, about more mental wellness in their lives? So, we’re working towards the development of, again, a series of materials and tools that can be used by women, by professionals, by communities, to help them achieve and get to whatever their level of wellness is. And, it does include more than just physical. Hopefully it includes some level of wellness at the mental health level.

As Maribeth just talked about, we work with her office on Bright Futures related to maternal wellness. I was at a meeting just about a month ago, not quite a month ago, where she had her expert group talk about the work they’ve done to date and some of the interesting literature that they have found. Some of the themes that come out around wellness for women experiencing or considering pregnancy, or issues around body changes, body image, the need to normalize pregnancy, integrating a child into the life, and the importance of social support. So, some of the themes that her group is finding, I think can sit very nicely again with the positive side of wellness. How we support women making positive changes, and giving them tools and resources to make those changes. So, Maribeth will be working on that with her office and, again, everything will be coming under this new kind of take on Bright Futures, the Bright Futures for Women’s Health and Wellness Initiative that we’re working on. So, again, really fast I realize, but again I think we are really interested in partnering with all of you as much as we can. Again, we’re a little different but I think we have a lot of resources and expertise that we can offer to you with the materials we developed, with the programs that we’re part of, and that we integrate with at the department level, so please feel free to contact me. I would love to talk with all of you and help you out with your programs so that we can continue to help women across the lifespan. Thanks.