Embed Size (px)
Citation preview
1
Increasing Breastfeeding Among African American Women
2008 NCQA Recognizing Innovations in Multicultural Health Care
Presented by
Linda Hines, RN, MS
July 15, 2009
2
Understanding The ProblemBreastfeeding rates differ substantially by race, socioeconomic level, and other demographic factors
Racial Groups
VPHP Population
Mix
Breastfeeding Mix
Asian/Pacific Islander
2% 2%
African American
44% 30%
Hispanic 5% 5%
White 45% 61%
Unknown 4% 2%
Total 100% 100%
3
Challenges & Barriers• Loss of Medicaid eligibility sixty (60) days postpartum
• 38% of pregnant eligible members are enrolled in VPHP in the last trimester of pregnancy which limits the time for prenatal breastfeeding education and encouragement
• Cultural barrier to breastfeeding in the Medicaid population – members feel that breastfeeding is for “poor people” without options
• Working mothers that do not have the support or time on their jobs to continue breastfeeding
4
Goals and Rationale
• Increase the rate of breastfeeding among African American women in Richmond City and the county of Chesterfield from 22% (12/06) to 40% (4/30/07)
• Increase the length of breastfeeding efforts to at least four (4) weeks
• Educate members on the merits of breastfeeding such as improved health outcomes for their newborns
• Address barriers and the stigma of breastfeeding in the African American community
5
Intervention and Implementation• The Department of Medical Assistance Services
(DMAS) sent letters to providers and hospitals introducing the initiative and requesting their support in educating and referring members for breastfeeding
• A universal breastfeeding referral form was developed to communicate service needs to community partners
• All African American women who chose to breastfeed received a home visit within several days of delivery for an initial assessment, support, education and possible community referral
6
Intervention and Implementation
• Breast pumps were supplied to members at no cost to the participant to eliminate interruption to breastfeeding when separated from their infant
• A breastfeeding hotline was established that was linked to a RN nurse triage system so that after hours’ calls were routed to a nurse
7
Intervention and Implementation• Members were referred to
lactation consultants as needed
• All members received a free breastfeeding video
• All members were offered to enroll in a breastfeeding class through their regional hospital
8
Virginia PremierHealth Plan
Member
Hospitals
ResourceMothers
Health Dep’t
CHIP
Department of Medical Assistance
Services (DMAS)
WIC HealthyFamilies
Elizabeth Project
9
Evaluation MethodsMeasures
• Breastfeeding Percentage
All Virginia Premier African American mothers of live births in Richmond & Chesterfield who attempted to breastfeed
All Virginia Premier mothers of live births in Richmond City & Chesterfield
• Length of time members breastfeed
• Evaluation of postpartum HEDIS rates
Data Sources• Medical Claims
• Medical record reviews
• Case Management System (CCMS)
• Member interviews/assessments
10
Impact
22%
40%
51%
0%
10%
20%
30%
40%
50%
60%
Baseline (7/06-12/06)
Goal Outcome(4/30/07)
2008
37% sustained the effort >1month
54%
56.69%
62.53%
48%
50%
52%
54%
56%
58%
60%
62%
64%
2005 2006 2007
Postpartum HEDIS RatesBreastfeeding Results
11
Moving Forward
• All interventions maintained and expanded to entire membership
• Community agencies continue to assist with efforts
• Initiated postpartum incentive
• Outreach visits to members in the hospital
12
Sustained EffortsPostpartum HEDIS Rates
54%
56.69%
62.53%62.04%
63.26%
48%
50%
52%
54%
56%
58%
60%
62%
64%
2005 2006 2007 2008 2009
13
Sustained EffortsBreastfeeding Rates Among African American Women
22%
51% 50%
54%
0%
10%
20%
30%
40%
50%
60%
2006 2007 2008 2009 YTD
% B
rea
stf
ee
din
g
14
Questions
Linda Hines, RN, MSVice President, Medical Management
Virginia Premier Health Plan, Inc.600 East Broad Street, Suite 400
Richmond, Virginia [email protected]
(804) 819-5163
