Taking the pulse of progress toward preconception health: Preliminary assessment of a national OMH program for infant mortality prevention

Abstract

Infant mortality rates in the United States continue to be more than twice as high among African-Americans as Caucasians. The United States ranks 37th of 191 countries in infant mortality, well behind most industrialized and many developing countries. Preconception care has long been identified as a key intervention to improve birth outcomes. In 2007, the Office of Minority Health (OMH) of the Department of Health and Human Services (DHHS) launched a national program, A Healthy Baby Begins with You, to raise awareness about the disproportionately high infant mortality rates among African-Americans, and to promote preconception health behaviors as a key measure to help prevent infant mortality. This article discusses findings from an initial program assessment, focusing primarily on the peer education component. Findings highlight several factors that may aid or prevent the adoption of preconception behaviors, offer implications for program refinement, and provide useful insights for peer education and community-based communication designed to reach college and graduate students and vulnerable populations on this topic. Recurring themes within key findings include: the impact of chronic stress associated with a history of racial discrimination; the role of healthcare providers in preconception counseling; the role of men; and the significance of community involvement.

Keywords:

• Infant mortality
• African-Americans
• Preconception health
• Health communication
• Peer educators
• Community health
• Program evaluation

Acknowledgements

The authors would like to thank Mr Blake Crawford, Director of the OMH Division of Information and Education for his support of this project and his overall commitment to the program. We also would like to thank all Preconception Peer Educators who participated in program assessment.

Conflict of Interest Statement

This project was supported by funds of the US DHHS Office of Minority Health, which were administered via HeiTech. Data analysis was independently carried on by Strategic Communication Resources. The authors certify that there is no conflict of interest regarding the material discussed in this manuscript.

Additional information

Notes on contributors

Renata Schiavo

Renata Schiavo, PhD, MA is the Founding President and CEO of the Health Equity Initiative, a NY-based non-profit organization dedicated to building community, capacity, and communication resources for health equity. She also holds adjunct academic appointments at the CUNY School of Public Health at Hunter College, and New York University, where she is on the faculty of the MPH program. Dr. Schiavo is the author of a book on Health Communication: From Theory to Practice (San Francisco, Jossey-Bass, 2007) and several other publications in the public health field. She has significant U.S. and international experience on health equity, child and adolescent health, health communication, program planning and evaluation, and many other public health and disease areas.

Matilde Gonzalez-Flores

Matilde Gonzalez-Flores, MPH is a Program Analyst at the National Institute of Dental and Craniofacial Research, Office of Communications and Health Education, National Institutes of Health. Previously, Matilde served as Research and Social Marketing Specialist, U.S. DHHS Office of Minority Health Resource Center. Her interests lie in health education and health communication as it relates to improving the health status of minority and medically underserved populations.

Radhika Ramesh

Radhika Ramesh, BE, MA has served as Project Coordinator at Strategic Communication Resources. She earned her MA from New York University and her area of focus is the intersection of communication and global public health.

Isabel Estrada-Portales

Isabel Estrada-Portales, PhD, MS is the Director of Communications of the Office of Minority Health Resource Center, U.S. Department of Health and Human Services (HHS). She has been writing on issues of health, minorities, finances, and Latin American affairs and is the author of the book Retóricas, astucias, convenciones … Las ideologías profesionales de los periodistas cubanos (1994). Her research interests include issues of race, class, gender and health, and science journalism.