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SISTERS UNITED: A community based initiative to reduce infant mortality in the African American community

Arkansas Department of Health Office of Minority Health & Health Disparities Family Health Branch 1

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MISSION  to

provide leadership in improving health outcomes by advocating for health equity for at-risk populations as defined by race or ethnicity, age, education, disability, gender, geographical location, income, and sexual orientation.

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OBJECTIVES  Describe

the burden of infant mortality in Arkansas’ African American communities.

 Describe

a state health agency role in reducing infant mortality.

 Describe

key components of an initiative aimed at reducing infant mortality.

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MINORITIES IN ARKANSAS  Consist

of 670,689 (23%) of the population:

 African-American

(15.4%)

 Latino

(6.4%)  Asian (1.2%)  American Indian/Alaskan Native (0.8%)  Native Hawaiian/Pacific Islander (0.2%)*  Multiple Races (2.0%)  Other (3.4%)

Source: www.2010.census.gov

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Age-Adjusted Mortality Rates by Cause, Race and Ethnicity Arkansas 2008-2012 – Based on Level of Disparity

Total

African American

White

Disparity Ranking

HIV

2.2

7.6

1.2

6.3

Homicide

7.5

21.1

4.8

4.4

Diabetes

26.2

57.6

22.9

2.5

Asthma

1.3

2.6

1.2

2.2

Cervical cancer

3.3

5.9

3.0

2.0

Infant mortality*

7.3

11.8

6.4

1.8

Colorectal cancer

18.5

24.9

18.0

1.4

Cerebrovascular disease

51.7

69.47

50.09

1.4

Cause of Mortality

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Infant Mortality Rate by Maternal Race, Arkansas Resident Births

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15.7

Per 1,000 Live Births

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14.7 13.7

12.0

12.7

12.8

12.8

12.4

12.3 11.3

12 8.2 8

12.3

7.6

7.3 6.4

8.3

7.2

8.8

7.7

9.4 8.1

8.0

7.1

6.3

8.3

6.8

7.5

7.1

7.3

6.9

7.0

6.4

6.0

6.4

6.3

5.9

2007

2008

2009

2010

2011

4 Total

White

Black

0 2000

2001

2002

2003

2004

2005

2006

Source: Linked Birth/Infant Death Files, Health Statistics Branch, Arkansas Department of Health

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ARKANSAS RISK FACTORS Infants: 

birth weights less than 3.3 pounds



born at gestational ages less than 32 weeks



birth defects



mothers had no prenatal care



mothers who smoked ≥ pack of cigarettes per day



mothers had at least one medical complication



African American

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ADDRESSING THE PROBLEM  Our

office was asked by the Branch Chief of the Family Health Branch to assist with addressing these disparities.

 We

suggested mobilizing graduate sorority chapters.

 Met

with key partners to determine the major focus areas of this new project.

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POTENTIAL FOCUS AREAS Low

birth weight Birth defects Immunization rates SIDS Breastfeeding Tobacco use

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Low Birth Weight 

Prematurity is the leading cause of African American death in the 1st year of life



African Americans have 3X s the rate of 28 week babies as other races



Preterm deliveries account for the vast majority of racial disparity

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Birth Defects  2nd

life

leading cause of death in the 1st year of

 About

1 in every 33 babies is born with a birth defect.

 Most

occur in the first 3 months of pregnancy.

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Flu Immunization During Pregnancy 

Flu Shot can: • decrease the chance of mother and baby dying from the flu by 50% • decrease the chance of mother and baby getting the flu and premature delivery by 70%



Pregnant women that received a flu shot Latino------------69% White----------------66% African Americans ----40%

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SIDS  Always

putting a baby to sleep on their back decreases SIDS by 50%

 Only

1 out of 3 Black Moms always put their babies to sleep on their backs

2

out of 3 White Moms always put their babies to sleep on their backs

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Breastfeeding Rates in Arkansas Women Who Ever Breastfed by Race/Ethnicity: Arkansas, 2008-2010 100 90.6 90 80

Percent

70

69.1

72.7

60 50

41.4

40 30 20 10 0 Total

White, NH

Black,NH

Source: Arkansas PRAMS

Hispanic

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Tobacco Use Smoking African

American Moms have low smoking rates • AR pregnant smoking average--------------------24% • AA AR Moms--------------12%

FOCUS AREAS 1 2 3

• Folic Acid

• Flu Shot • Breastfeeding • Safe Sleep 17

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Why Sororities?

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History of Fraternities and Sororities 

AA fraternities and sororities have roots in Masonry.



Inclusion was not welcoming to African Americans so a “black version” was created in the late 1700s.



The first white fraternity was established in 1776.



The first white was formed in 1867.

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History of AA Sororities

1908

1913

1920

1922

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Notable Members AΦА

ΔΣΘ

Alpha Phi Alpha Fraternity Founded in 1906 at Cornell University Rev. Martin Luther King, Jr Civil Rights Activist

Delta Sigma Theta Sorority Founded in 1913 at Howard University Dr. Joycelyn Elders Former US Surgeon General

AKА

ΦBΣ

Alpha Kappa Alpha Sorority Founded in 1908 at Howard University Phylicia Rashad Actor

Phi Beta Sigma Fraternity Founded in 1914 at Howard University Rep. John Lewis US Congressman

KАΨ

ZΦB

Kappa Alpha Psi Fraternity Founded in 1911 at Indiana University Johnnie Cochran Attorney

Zeta Phi Beta Sorority Founded in 1920 at Howard University Zora Neal Hurston Author

ΩΨΦ

ΣΓΡ

Omega Psi Phi Fraternity Founded in 1911 at Howard University Ronald McNair Challenger Astronaut

Sigma Gamma Rho Sorority Founded in 1922 at Butler University Victoria Rowell Actor

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Honorary Members

Former US President Bill Clinton Phi Beta Sigma Fraternity

Former First Lady Eleanor Roosevelt Alpha Kappa Alpha Sorority

Arkansas African American Sorority Graduate Chapters (2012) AKA CHAPTER’S Beta Phi Omega Chi Eta Omega Chi Nu Omega Delta Omega Omega Eta Sigma Omega Kappa Nu Omega Lambda Sigma Omega Mu Chi Omega Phi Alpha Omega Phi Zeta Omega Pi Chi Omega Sigma Beta Omega

ZETA CHAPTER’S Tjuana Byrd Philis L. Nichols-Anderson Laura M. Hunter Cynthia L. Bennett Jacqueline E.H. Young Genee' L. Gaines Bobbie Trible-Diamond Donna Faye Ross Ella Donnell Lambey Patricia Doss Glover Angela Marie Davis Sheryl Hamilton

Sherwood LR, Faulkner Malvern Pine Bluff Marianna Jonesboro Blytheville Helena Bentonville Magnolia West Memphis Camden

Alpha Mu Zeta Chapter Beverly Cook Eta Sigma Zeta Kathy Tatum Epsilon Zeta Zeta Juanita Cook Nu Omega Zeta Sabreana Hytche Sigma Gamma Zeta Aja Osler Upsilon Pi Zeta Treva Sanders Xi Sigma Zeta Sandra Taylor Psi Iota Zeta Carolyn Saterfield Pi Psi Zeta Shonta Williams Pi Chi Zeta Nashanda Brown Theta Gamma Zeta U. Jean Williams Iota Beta Zeta Marva Washington

Little Rock No. Little Rock Pine Bluff Arkadelphia Jonesboro West Memphis Forrest City Camden Stamps Lowell West Helena Osceola

DELTA CHAPTER’S Central Arkansas Alumnae Northwest Area Alumnae Blytheville Alumnae Forrest City Alumnae Fort Smith Alumnae Helena Alumnae Hot Springs Alumnae Jonesboro Alumnae Little Rock Alumnae Magnolia Alumnae Marianna Alumnae Pine Bluff Alumnae Southeast Arkansas Alumnae West Memphis Area Alumnae Texarkana Alumnae

Claudette Barbee Kimberly McGee Floyd Jean Moore Kristen Haynes Tiffinee C. Baker Tanya Greenberry Amanda Snowdan Kim McCray Angela Doyne Cheryl Stuart Janis Waddy Charlene Kelley Rhonda Rigell Sheri Lowe Patricia Anthony

Little Rock Fayetteville Blytheville Forrest City Fort Smith West Helena Arkadelphia State University Little Rock Magnolia Marianna Pine Bluff Monticello West Memphis Texarkana

SIGMA GAMMA RHO CHAPTER’S Little Rock -Theta Sigma Conway -Kappa Xi Sigma Pine Bluff- Kappa Psi Sigma

Carroll Brown Monika Miller Dorothy Penix

Little Rock Maumelle Pine Bluff

Data source: State Coordinators of African American Sorority Graduate Chapters

Arkansas African American Sorority Graduate Chapters

Data source: State Coordinators of African American Sorority Graduate Chapters

Alpha Kappa Alpha (1908) “Service to All Mankind” 

  

  

12 chapters Oldest Chartered Chapter: Beta Pi Omega (1937) 699 combined members 6 websites 4 Facebook accounts Over 800 combined Facebook contacts 1 Chapter has past experience in infant mortality

Delta Sigma Theta (1913) “Intelligence is the torch of wisdom”       

15 chapters Oldest Chartered Chapter: Pine Bluff Alumnae (1944) 860 combined members 6 websites 2 Facebook accounts 203 combined FB contacts 1 chapter has past experience in infant mortality

Zeta Phi Beta (1920) “A community conscious, action-oriented organization”

12 Chapters (9 responses)  Oldest Chartered Chapter: Alpha Mu Zeta (1940)  203 combined members  2 websites  1 Facebook account  128 combined FB contacts  5 chapters have past experience in infant mortality 

Sigma Gamma Rho (1922) “Greater Service, Greater Progress”       

3 Chapters Oldest Chartered Chapter: Theta Sigma (1932) 29 combined membership 0 Facebook account 0 Combined FB contacts 0 websites 1 Chapter has past experience in infant mortality

SISTERS UNITED POTENTIAL IMPACT

      

42 Chapters 1,762 combined members 7 Chapters have past experience in Infant Mortality 23 counties 315,986 AA’s in counties Over 1,100 combined FB contacts 14 websites / 7 Facebook accounts

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SISTERS UNITED  Invited presidents of African American Sorority

graduate chapters to attend leadership meeting.  Asked for

their help by joining SISTERS UNITED.

 31 out of 42 chapters joined and committed to send

representatives to attend an 8 hour training.

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WORK GROUP MEMBERS 3 members from each chapter Prefer MDs, PhDs, Nurses, Public Health professionals

Able to attend meetings during work hours At least one member > 50 (grandmother)

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SISTERS UNITED GOAL To

increase awareness among African Americans about infant mortality and share prevention methods to disseminate throughout the community.

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SOCIAL MEDIA

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FACEBOOK

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EVALUATION 2

- flu shot  1- folic acid  1- breastfeeding  2 - safe sleep

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TRAINING 

58 sorority members from the 31 chapters attended a train-the-trainer conference



The attendees received name badges with the title SISTERS UNITED TRAINER



Session included mock interviews to learn how to deliver effective media messages.



Participants received a binder with handouts, flash drive, evaluation forms, talking points when scheduling media interviews and youtube videos.

BRANDING

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MINI-GRANTS  NICHD released RFA to conduct

community outreach and education aimed at reducing the risk of SIDS within the AfricanAmerican community.  Our office encouraged each SU

chapter to apply for these funds.  A total

of 29 organizations awarded grants and 21 of those were SISTERS UNITED chapters.

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PORTRAIT UNVEILING

“The artwork entitled, Sisters United, is a representation of African-American Greek sororities united on a campaign to address the community on information to help reduce the infant mortality rate in the state of Arkansas. The globe in the artwork represents the future of our world as these sororities come together to ensure the safety and future potential that our children have in making this world a better place. By reducing the infant mortality rate, our children will thrive to become educated individuals destined to change this world.” 47

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Total = 970

2013 Community Survey

RESPONSE SUMMARY

PRE TEST

POST TEST

1. The illness caused by the flu virus is worse in a pregnant woman

79%

76%

2. The flu can cause a very mild illness in a pregnant woman

32%

30%

3. It is harmful for the baby if the mother receives a flu shot during pregnancy*

24%

9%

4. A flu shot taken during pregnancy can be harmful for the baby*

27%

7%

5. A flu shot during pregnancy can protect an unborn baby*

63%

88%

6. A flu shot during pregnancy can protect the baby after birth*

39%

57%

7. A flu shot can protect a pregnant woman's life*

50%

63%

8. A flu shot can put a pregnant woman's life in danger*

12%

4%

9. Folic acid intake is harmful for a pregnant*

12%

3%

10. Folic acid intake helps prevent some birth defects in the baby only if mom takes it for at least 3 months before getting pregnant*

56%

73%

11. Folic acid should be taken by a pregnant woman before/during pregnancy

74%

76%

* Statistically significant; Two Sample z-test

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2013 Community Survey Results RESPONSE SUMMARY

PRE TEST

POST TEST

12. Breastfeeding increases the risk of chronic disease in the baby

7.4%

8.5%

13. Breastfeeding is harmful to the mother's health

14.1%

13.0%

14. Breastfeeding is the beginning of healthy eating for the baby

88.2%

86.7%

15. Breastfeeding builds a loving relationship between mom and the baby

69.4%

71.3%

16. Breastfeeding is important for moms who cannot afford formula*

44.1%

53.8%

17. Breastfeeding reduces the chance of SIDS by 50%*

49.1%

68.0%

18. A baby should be laid down on his/her side to sleep*

17.2%

3.2%

19. A baby should be laid down on his/her stomach to sleep*

14.4%

4.4%

20. A baby should be laid down on his/her back to sleep*

77.0%

94.1%

21. It is safer for a baby to sleep in the same bed as the parents

2.7%

2.3%

22. It is safer for a baby to be wrapped in several blankets for sleep

4.1%

2.1%

23. It is safer for a baby to sleep in their own crib#

97.1%

97.9%

* Statistically Significant; Two Sample z-test

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WORK PLANS (Level 1) Goal: Increase awareness among the African American community about infant mortality and share prevention methods they can use to disseminate throughout their respective communities. Objective: Increase Education and Expand Outreach. To reach 30 African Americans and provide education about the importance of folic acid, getting an annual flu shot during pregnancy, breastfeeding, and safe sleep methods. Key Action Steps: Target Outcome Measure Time Frame Promote National Birth Defects Prevention Month

Post message on chapter FB page about the benefits of folic acid and share YouTube video

January 7, 2014

Promote National Breastfeeding Month

Post message on chapter FB page about the benefits of breastfeeding

August 1, 2014

Promote Infant Mortality Awareness Month

Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours.

September 1, 2014

Promote SIDS Awareness Month

Post message on chapter FB page about SIDS Prevention

October 1, 2014

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WORK PLANS (Level 2) Promote National Birth Defects Prevention Month

Post message on chapter FB page about the benefits of folic acid and share YouTube video

January 13, 2014

Conduct Folic Acid Presentation at Chapter Meeting

10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

February 2014

Promote National Breastfeeding Month Conduct Breastfeeding Presentation at Chapter Meeting

Post message on chapter FB page about the benefits of breastfeeding 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

August 1, 2014 August 2014

Promote Infant Mortality Awareness Month

Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours. Post message on chapter FB page about SIDS Prevention

Sept 1, 2014

Promote SIDS Awareness Month

October 1, 2014

Conduct Safe Sleep Presentation 10 SU Pre/Post Surveys on Folic Acid, Fax at Chapter Meeting forms to Cicely at 501.661.2414

October 2014

Conduct Flu Shot Presentation at Chapter meeting

Nov 2014

10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

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WORK PLANS (Level 3) Promote National Birth Defects Prevention Month

Post message on chapter FB page about the benefits of folic acid and share YouTube video

January 13, 2014

Conduct Folic Acid Presentation at Chapter Meeting SIDS Walk Run

10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

Feb 2014

50 SIDS Grant Pre/Post Surveys on Safe Sleep. Submit forms to NICHD according to guidelines.

May 2014

Promote National Breastfeeding Month Conduct Breastfeeding Presentation at Chapter Meeting Promote Infant Mortality Awareness Month

Post message on chapter FB page about the benefits of breastfeeding 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

Aug 1, 2014

Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours. Post message on chapter FB page about SIDS Prevention 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

Sept 1, 2014

10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414

Nov 2014

Promote SIDS Awareness Month Conduct Safe Sleep Presentation at Chapter Meeting Conduct Flu Shot Presentation at Chapter meeting

August 2014

Oct 1, 2014 October 2014

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42 African American Sorority Graduate Chapters, 2014

SISTERS UNITED

Source: State Coordinators of African American Sorority Graduate Chapters

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SUCCESSES

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STATE REPLICATION  List

of chapters in your state  Contact chapter presidents  Convene leadership meeting  Form SU action group  Provide training  Develop work plans  Follow-up with chapters  Utilize social media  Evaluation tool  Consider chapter sustainability

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RESOURCES https://www.facebook.com/arsistersunited http://www.youtube.com/watch?v=c4IlmpQ54Y4 (Intro) https://www.youtube.com/watch?v=f0Nxhsx9Iok (Folic Acid) http://www.youtube.com/watch?v=MAiLaNgarb4 (Flu Shot) http://www.youtube.com/watch?v=PIAycz8DYJk&feature=plcp (Breastfeeding) http://www.youtube.com/watch?v=wfudqfhjVgs (Safe Sleep) http://vimeo.com/22659669 (Crisis in the Crib) www.aka1908.com http://www.deltasigmatheta.org/ http://www.zphib1920.org/ http://www.sgrho1922.org/home http://www.youtube.com/watch?v=kvtfJjw4_g4 (Impact Video)