Online Registration for 2017 is OPEN!
6:30AM FREE Parking opens at the Indianapolis Zoo, 1200 West Washington Street, Indianapolis, Shuttles available
On-site registration and Check-in open, 3rd Floor, JW Marriott Grand Ballroom Foyer
Light breakfast available
Exhibitors and Poster Sessions available
8AM General Session Program begins
Welcome, Jim Shella
Kristina Marie Box, MD, Commissioner, Indiana State Department of Health
Jim McClelland, Executive Director for Drug Prevention, Treatment, and Enforcement State of
Paul E. Jarris, MD, MBA, Chief Medical Officer, The March of Dimes Foundation
Michael C. Lu, MD, MPH, Associate Administrator for Maternal and Child Health, Health Resources and Services
Administration, U.S. Department of Health and Human Services
Michael Warren, MD MPH FAAP, Deputy Commissioner for Population Health at the Tennessee Department of Health
Maria Del Rio Hoover, MD, Medical Director, St Vincent Center for Children
Jennifer Walthall, MD, MPH, Secretary, Indiana Family and Social Services Administration
1:45-4:45PM Afternoon Focus Sessions
Women Infants Children
Leslie Hulvershorn, MD and Dr. Teresia Mbogori
1:45-3PM Concurrent Breakouts
Best Babies Zone Near Eastside: Implementing Collective Impact
The Best Babies Zone approach-a place-based, multi-sector initiative that strives to decrease racial disparities in infant mortality by recognizing a multifaceted method to address root causes of infant mortality. The mission of Best Babies Zone is to give every baby born in a Best Babies Zone the best chance in life with the vision that every baby is born healthy, into communities that enable them to thrive and reach their full potential.
Taking a look at the BBZ and Kohl’s Care initiative to increase capacity and quality for infant care and provide the evidence for initiating such programs, attendees will follow the journey of a child care provider participating in a local initiative to not only improve child care, but to positively impact economic development and infant mortality in their neighborhood.
Nancy Swigonski, MD, MPH
Kara Casavan BS
Whitley Wynns, BS, John H. Boner Community Center
Breaking Stigma: What if we treated Substance Use Disorders like other chronic illnesses?
A multifaceted approach to breaking stigma regarding Substance Use Disorders (SUD) including Opioid Use Disorders beginning with an exercise to address how personal experiences and language affect our perception of the brain disorder and a brief look at historical perspectives clouding our view of Substance Use Disorders. This stigma both affects how we deliver care and why persons with these disorders do not access treatment at the same rate of other chronic illnesses. To the extent that knowledge changes attitudes and stigma we will briefly explore the science of Substance Use Disorders as brain disorders. We will examine the accepted definition of Substance Use Disorders and basic neuroscience. In this process, we will compare SUD to other chronic illness. The last portion of this session will be based on how stigma affects many aspects of the care that is provided with individuals with SUD. We will discuss the treatment that is available and what may be in limited supply because of stigma. We will briefly explore how stigma possibly affects NAS, access to Medication Assisted Treatment, and practice of harm reduction strategies.
George Brenner, MS, LCSW, LMFT, LCAC
Naloxone Administration Training
Attendees will walk away with a better understanding of the burden of the opioid epidemic for the United States and Indiana, knowledge of the Indiana laws that are related to naloxone, how to recognize the signs and symptoms of an opioid overdose, how to use naloxone and how to provide continued support to the opioid overdose victim. This session will include hands-on training to practice preparing and administering naloxone.
Murray Lawry, ISDH Prescription Drug Overdose (PDO) Project Manager
Lauren Savitskas, ISDH Prescription Drug Overdose (PDO) Community Outreach Coordinator
The State of the Child: Implications for Infant Mortality and Health Disparities
Having access to and understanding the data on children is essential for action and impact. Participants will be provided with key data and information on child well-being in Indiana with an emphasis on infant mortality and health disparities. This session will provide data from the 2017 KIDS COUNT® in Indiana Data Book and County Snapshots, results of a recent statewide project completed in collaboration by Indiana Youth Institute and faculty from Butler University, and best practice research on successful approaches to key issues. Participants will be provided with data, insights, and tools to help them with their efforts. The session will include a robust discussion on both problems and solutions.
Katie Kincaid, Research and Data Analyst, Indiana Youth Institute
Charlie Geier, Director of Evaluation, Indiana Youth Institute
Dr. Suneeta Kercood, Professor of Special Education, Butler University
How to be ‘SAFE’ - Indiana’s Sleep and Feeding Experts
Indiana State Department of Health will share some ways you can help to implement best practices in your communities. Whether your “community” is a hospital, a physician office, a child care provider or other health agency, there are tools to help you. ISDH will also share some of the efforts at the national level to shift the paradigm from giving recommendations to having conversations. This also includes national and state efforts to combine the messages promoting safe sleep and breastfeeding for optimal health.
Indiana Breastfeeding Coalition will talk about connecting communities, addressing disparities, and sharing ways that coalitions can help engage partners to normalizing breastfeeding in Indiana. They will also talk about some things on the agenda in Washington DC and how you can help advocate for mothers and families.
Eric Beers, Director of the Indiana Healthy Weight Initiative
Ann Marie Neely – IBCLC - Lactation Specialist
Kathy Detweiler, Indiana State Department of Health/ Maternal and Child Health, Breastfeeding/ Perinatal Coordinator
Gretchen Martin, Indiana State Department of Health, Director Child Fatality Review and FIMR
Towards a culture of safety: optimizing and standardizing intrapartum fetal assessment, interpretation and management through an inter-professional approach
Intrapartum electronic fetal monitoring (EFM) has been an essential component of the intrapartum landscape for decades. Not only has the technology been available since the late 1970s, its use is widespread. In the U.S., it is estimated that every year nearly 3.5 million women undergo electronic fetal surveillance during labor, making it one of the most common procedures laboring women experience.
Despite the prevalence and experience with EFM, several areas of concern exist. In 1997, and then again in 2008, the National Institute of Child Health and Human Development (NICHD) clarified and standardized definitions of fetal heart rate patterns and proposed categories of fetal patterns. However inconsistent application of those definitions continues among obstetric team members. Strikingly, most birthing facilities do not require ongoing fetal monitoring competency of all team members or inter-professional learning.
Beth McIntire, MSN, RN, WHNP-C, C-EFM, Director Riley Maternity and Newborn Health Outreach
What about the Kids? Improving outcomes for the children born into addiction
Through a community-based, comprehensive healthcare and social services collaboration, we strive to build a network throughout southern Indiana to identify expectant mothers who are addicted to opiates and other substances. We embrace the mothers and their families to provide:
· Education throughout the pregnancy
· Treatment for their babies at birth
· Support network for the family at home
· Mentor children born to addicted mothers throughout their formative years
Through this collaboration we hope to prevent:
· Breakdown of the family
· Intervention by law enforcement and other agencies
· Relapse behaviors by the mothers/parents to improve overall outcomes for children.
Cynthia G. Nassim, MD, Senior Partner, All IN Pediatrics
The Least, Last, and Lost of a US Public Health Crisis: Pregnant Women with Opioid Use Disorder
Why can't she just stop? She can't care about her baby.... She's just replacing one drug for another... In this session, these, and other myths about Opioid Use Disorder in pregnancy will be debunked. This session will also offer a concise review of the history of the modern day U.S. opioid epidemic and an overview of the neurobiology of addiction. It will impart information on the management of Opioid Use Disorder during pregnancy, and present the barriers and challenges faced in providing care for this vulnerable population.
Tara Benjamin, MD, MS – Maternal Fetal Medicine physician
Emily Scott, MD – Pediatric Hospitalist
Getting a Head Start on Living Tobacco Free – Empowering Organizations to Promote Healthy Homes and Families
The Indiana Tobacco Prevention and Cessation Commission’s locally funded partners and Head Start sites around the state have collaborated via the Getting a Head Start on Living Tobacco Free program to impact typically hard-to-reach populations with three key messages – Secondhand smoke hurts everyone; Secondhand smoke costs you and your family; and You can quit smoking. Presenters will discuss the components of the Getting a Head Start on Living Tobacco-Free program and provide examples of how it has been implemented at two local sites.
At least 9 out of 10 families enrolled in each Head Start program must be financially eligible, or meet the federal poverty guidelines. In Indiana, over 35% of adults with an income of $15,000.00 a year or less reported smoking in the last 30 days, nearly double the overall adult smoking rate (2015 BRFSS). This program has the potential to reach a priority population for reducing infant mortality, and presents an opportunity to positively affect the entire family unit, in addition to women of childbearing age. Federal Head Start curriculum requirements provide tobacco control coalitions a unique opportunity to build and sustain partnerships.
In 2016, Head Start updated their standards to include a requirement that programs offer parents opportunities to learn about the health risks associated with secondhand smoke, including health and developmental consequences, and things they can do to keep their homes safe. In the 2016-17 school year, local tobacco control coalitions partnered with 44 Head Start centers throughout the state, serving approximately 4,180 Head Start families.
Katelin Rupp, M.A. , Director of Program Evaluation, Tobacco Prevention and Cessation Commission, ISDH
Tanya S. Shelburne, MPH, CHES, Consultant/Project Manager, Representing Health Ed Pros
Dr. Holli Seabury, CEO, McMillen Health
Karesa Knight-Wilkerson, Executive Director/Tobacco Control Coordinator, Intersect, Inc.
3-3:30PM BREAK, visit our Exhibitors, Sponsors
3:30-4:45PM Concurrent Breakouts
Collaboration of Established and Developing Fetal Infant Mortality Review Teams to Address Infant Mortality in Southwestern Indiana
Infant Mortality for Region 10 has been an ongoing health care concern. Regional infant mortality rates have been as high as 11.4 per 1000 live births with 5 year averages for individual counties ranging from 3.9 to 8.6. The southwestern region has urban and rural areas with unique disparities. These disparities include racial and socioeconomic factors impacting access to care. Factors influencing infant mortality in all regional counties include maternal drug use, smoking rates, entry to prenatal care, marital support, and safe sleep practices.
From the 1980’s, Vanderburgh County has implemented Fetal Infant Mortality case reviews for Warrick, Posey and Gibson counties but the remaining counties in Region 10 lacked resources for review teams. Stakeholders in southwestern Indiana felt that Fetal Infant Mortality Review (FIMR) teams throughout Region 10 would identify trends and focus interventions to lower infant mortality.
Daviess County Health Department met with the established Vanderburgh County FIMR team to develop a plan and began reviewing cases in 2016. Initially using the platform of Child Fatality Review, cases were presented to the community team with the support of the local hospital, regional birthing hospitals in the Evansville area and Indiana State Department of Health (ISDH). Within months, a FIMR team was established with area counties of Martin, Knox, Pike and Dubois joining the reviews. Stakeholders have now reached out to Spencer and Perry counties to assure review of all fetal and infant deaths greater than 20 weeks gestation.
The goal of the review teams is to establish quarterly FIMR team meetings throughout the southwest region. With a regional approach to FIMR team meetings, the goal is to reduce infant mortality for Region 10.
Lynn Herr BSN, RN, CPN, Vanderburgh County FIMR/CFR Coordinator
Kathy Sullender BSN, RN, Daviess County FIMR/CFR Coordinator
Collective Impact through Partnership: Fresh Start Recovery Center and Nurse-Family Partnership Providing a strong Continuum of Care for Opioid Using Pregnant Women
The Fresh Start Recovery Center (FSRC), operated by Volunteers of America, is the only residential addictions treatment program in the state that allows children to live with their mothers while mothers receive intensive treatment. Nurse-Family Partnership is an evidence-based community health program, in which a low-income woman is visited by a nurse during pregnancy until the child turns two.
Governor Holcomb’s focus on the opioid epidemic and the ISDH priority on addressing infant mortality led to opportunities for FSRC and NFP to collaborate on a pilot to serve larger numbers of women in Indiana.
This pilot program will allow mothers to access much needed addictions services early in pregnancy, and remain in the treatment center after her infant’s birth and the first few months postpartum. The enhanced pilot program will include supportive services from NFP, providing visits from a registered nurse both in the treatment center, continuing in the home following the mother’s discharge.
Safety PIN funding allows NFP to enroll both first-time mothers, and those having subsequent children in Marion County. In the first evaluation of this kind in the country, NFP Indiana and Fresh Start will be able to support women in a long-term relationship with the nurse, VOA program staff, and community resources. This collaboration improves the chance for success in recovery.
Lisa Crane, MSN, RN, Senior Director, Nurse-Family Partnership of Goodwill of Central & Southern Indiana
Shannon Schumacher, MSW, LSW, LCAC, Executive Vice President, Strategic and Clinical Services
Volunteers of America of Indiana
Culturally Relevant Birth Practices – Birth in “her” world
Cultural relevance is an issue that has gained the attention of educators, as well as business, public health and medical professionals. There are disparities that exist in the African American and White breastfeeding initiation and duration, as well as infant and maternal mortality rates, signaling the need for major alterations in best practices. (Insert data regarding disparities) There are major, multiple issues facing minority and underserved populations that inevitably become barriers to patients and obstacles to providers. Providers are often faced with what can be perceived as inadequate time available to engage in effective conversation with patients. In an attempt to see many patients, providers’ instructions may be curt and vague, placing further distance between patient and provider. Another obstacle for providers is having little or no understanding of the patient’s emotional state or cultural norms beyond what is necessary for care of immediate physical issues. This chasm is where many problems such as non-compliance, missed appointments, and eventually declining health begin. Additionally, the use of medical jargon, and unfamiliar terminology during a relatively brief visit can prove problematic to a patient that may struggle to trust medical professionals.
Historically, African American and other minority groups have been the target of unethical testing and suffered the affects of malpractice, to their detriment and in some cases, their demise. Cases such as the Henrietta Lacks and Tuskegee Airmen experiments have driven a wedge between providers and clients that are exacerbated by the lack of cultural awareness and sensitivity that are vital to the success of the doctor/patient relationship. Having knowledge of a patient’s cultural norms can mean the difference between understanding and compliance and failed communication, untreated issues and declining health. This lecture will provide insight, information and strategies to providing culturally relevant birth practices.
Kirstin Champer, Community Health Doula, Community Wellness Partners
Kelli Brien, Maternal Child Health Coordinator, Community Wellness Partners
Public Health and Public Safety: Healthy Communities are Safe Communities
Attendees will learn about the ongoing evolution of the role of the first responders in public health and how this holistic model can be used within infant mortality work. Presenters will share a short history of this changing framework in public safety and public health and projects that have combined efforts of both. Participants will then learn about current projects that are taking place within Marion County from a public health perspective, first responder perspective, and community health worker perspective. Presenters from WeCare Plus (an infant mortality initiative funded by Safety PIN) will provide information about barriers, lessons learned and accomplishments as these programs are being implemented.
In addition, there will be a discussion about how a quality improvement framework can be invaluable in implementing infant mortality programs, enhance collaboration across sectors, and increase sustainability capacity. Finally, participants will have the opportunity to ask questions of the presenters representing both public health and public safety.
Kara Casavan B.S.
Debra K Litzelman, MA, MD, Indiana University School of Medicine; Regenstrief Institute
Julie Fidler, OWDS
Naloxone Administration Training
During this session, attendees will walk away with a better understanding of the burden of the opioid epidemic for the United States and Indiana, knowledge of the Indiana laws that are related to naloxone, how to recognize the signs and symptoms of an opioid overdose, how to use naloxone and how to provide continued support to the opioid overdose victim. This session will include hands-on training to practice preparing and administering naloxone.
Murray Lawry, ISDH Prescription Drug Overdose (PDO) Project Manager
Lauren Savitskas, ISDH Prescription Drug Overdose (PDO) Community Outreach Coordinator
Maternal Treatment Program: Integrated methods to addressing Trauma and Addiction
The Meridian Health Services Maternal Treatment Program (MTP) is a collaborative effort between community partners Meridian Health Services, Delaware County Prosecutor’s Office, Delaware County Department of Children Services, local OBGYN offices, IUH Ball Memorial Hospital, and other community stakeholder in an effort to reduce the number of babies born in Delaware County with Neonatal Abstinence Syndrome. The MTP collaborative is also focused on improvement of the lives of women, infants and children experiencing the devastation of opiate use, abuse, and addiction. The MTP collaborative promotes the development of healthy families by assisting mothers with opiate addiction issues through systems of caring, focused on whole health rejuvenation, including helping addicted babies through the first stages of life.
The MTP program model is based in a model of intensive outpatient care of 9-12 hours of treatment per week, along with other hours focused on prenatal or new mother care, and when needed supervision from legal entities. The treatment model focuses on two primary treatment modalities to service whole person health- the Centering Pregnancy Model, and the Substance use treatment model of Seeking Safety. These two program models will be integrated throughout the process of treatment to ensure clients are gaining a new whole person perspective of substance use, personal care, family enrichment, and positive child development.
During this session, attendees will learn how Meridian started this important program and the steps we recommend taking for getting the program started elsewhere.
Amelia Clark, MA, Regional Vice President, Meridian Health Services
Heidi Monroe, MPA, Director of Children’s Services, Meridian Health Services
Caring for the Preterm Infant with Neonatal Abstinence Syndrome: A Neonatal Advanced Practice Provider’s Perspective Opioid-dependent women and their newborn infants with Neonatal Abstinence Syndrome are a complex and vulnerable population that require comprehensive and interprofessional collaborative care and treatment, which often translates to extended length of hospital stay.
For preterm medically fragile infants, Neonatal Abstinence Syndrome adds another layer of complexity for the healthcare team. Increasingly, in Neonatal Intensive Care units across the nation, neonatal advanced practice providers, including nurse practitioners and physician assistants, are an integral part of the clinical management team. Subsequently, neonatal advanced practice providers have a significant role in caring for infants with NAS, as well as supporting and influencing their mothers and families during extended hospital stays.
Few studies have explored the impact of NAS on neonatal advanced practice providers. The purpose of this presentation is to describe neonatal advanced practice provider’s perspectives on: 1) Their experiences addressing the clinical challenges caring for preterm infants with NAS; 2) Experiences addressing and meeting the social and psychological needs of the mother; and 3) The impact caring for an infant with NAS had on them personally and professionally. Additionally, this presentation highlights the unique position of neonatal advanced practice providers in addressing the clinical needs of infants with NAS, but also in communicating with the mother, providing consistent information about the infant’s condition, which is instrumental in fostering positive parenting and maternal attachment.
Anne M. Jorgensen RN, MS, NNP, Neonatal Advanced Practice Providers, Director of Professional Practice, Education,
and Research, Riley Hospital for Children
Kiam Germani RNC, MSN, NNP-BC, Neonatal Advanced Practice Provider , Riley Hospital for Children
Promoting Safe Sleep and Breastfeeding Together in your Maternity Center
Newborn care providers work every day to promote safe sleep practices and exclusive breastfeeding. Both significantly impact infant mortality rates and the health outcomes of the newborn. Both exclusive breastfeeding and safe sleep practices are endorsed by the American Academy of Pediatrics (AAP). However, concerns have been raised that some practices that support the initiation of breastfeeding in the newborn nursery may lead to unsafe sleep practices and infant harm. Skin to skin care and “rooming-in” have particularly been scrutinized for their safety. In this workshop, we will explore the AAP recommendations for safe sleep and breastfeeding. We will review literature on how both practices contribute to the prevention of infant mortality and improving health outcomes. Through small group discussion, we will discuss barriers newborn care providers face in promoting these practices. We will review a recent AAP clinical report detailing how to practice breastfeeding-friendly care in the newborn nursery while maintaining a focus on safe sleep promotion. Small groups will brainstorm ways to implement practices in their own hospitals. The workshop will end with discussion of ways to advocate for both safe sleep and breastfeeding at the local, state and national level.
Emily Scott, MD, FAAP, Assistant Professor of Clinical Pediatrics, Indiana University School of Medicine
Newborn Medical Director, IU Health Methodist Hospital Maternity Center
Kim Schneider, MD, FAAP, Assistant Professor of Clinical Pediatrics, Indiana University School of Medicine,
Pediatric Hospital Medicine, Riley
Tony Giaquinta, MD, FAAP, Vice president, Indiana Chapter of the American Academy of Pediatrics
Using Strategic Frame Analysis to Communicate about Infant Mortality: Insights from the Hispanic/Latino Population in Indiana
Latino(a) children in Indiana bear a disproportionate burden of risk for infant mortality. We used a community-based participatory research approach to design a culturally-inclusive messaging strategy to reduce infant mortality in Latino(a) populations in Indiana. In collaboration with the Northern Indiana Hispanic Health Coalition, we used strategic frame analysis which is an evidence-based methodology to map how the public currently thinks about an issue, identify gaps in the public’s understanding that need reframing, and develop a messaging strategy more in-line with effective solutions.
Specifically, we collected qualitative data (10 in-depth interviews with members of the Hispanic/Latino public) to learn how the community perceives the causes of infant mortality; generated candidate messages to address roadblocks or cognitive holes in understanding; tested candidate messages through rigorous evaluation (two focus groups with members of the Hispanic/Latino public and an additional four in-depth interviews); and leveraged the results to provide evidence-based communication recommendations for community, medical, and governmental stakeholders to use in their communication messaging to advance the Hispanic/Latino(a) public’s understanding of infant mortality (in the form of a virtual toolkit, including a two-minute video).
In this process, we learned that many people in the Hispanic/Latino(a) community linked infant mortality to child abuse and did not connect prenatal health with postpartum outcomes. We also discovered that it is important for the messaging strategy to explicitly emphasize the continuum of interconception, prenatal, and infant health and safety. To address these concerns, we developed a productive, relatable, and memorable messaging strategy based around a metaphor of planting a seed (specific to growing a seed, we need to first “care for the soil” by maintaining a healthy weight prior to pregnancy; we don’t plant prior to planting season by using protection when having sex; and we plant in a sunny area by cultivating happy relationships, etc.).
Jean Marie Place, PhD, Assistant Professor of Community Health Education, Ball State University, Department of Nutrition and Health Science
Linh Littleford, PhD, Associate Professor of Psychological Science, Ball State University, Department of Psychological
4:45-6:30PM Reception (final bus returning to Zoo departs at 6:30PM)