University of North Carolina at Chapel Hill

UNC OLD WELL

Name of Program

Department of Maternal and Child Health
Gillings School of Global Public Health
University of North Carolina at Chapel Hill

Contact Information

Anita Farel
anita_farel@nullunc.edu
919-966-5983
135 Dauer Drive
Chapel Hill,NC 27599
http://www.sph.unc.edu/mhch/

Mission of the Program

The mission of the Department of Maternal and Child Health is to promote the health of the population locally and globally by improving the health of women, children, youth, and families through sustained excellence in research; program and policy development, implementation, and evaluation; and education to support current and future MCH leaders and advocates. Our goal is to lead the field of maternal and child health through a transdisciplinary approach to excellence in teaching, research, and practice.

Degrees and Certificates Offered:

Two residential master’s degree programs

  • Master of Science in Public Health (MSPH)
  • Master of Public Health (MPH)

Three Dual Degrees with the School of Social Work and the Department of Allied Health (MSW/MSPH; MSW/MPH; DPT/MSPH)

One doctoral degree

  • PhD Doctor of Philosophy

Examples of Current Research

Research conducted in the Department of Maternal and Child Health contributes to the School’s mission of improving public health, promoting individual well-being, and eliminating health disparities across North Carolina and around the world. The following examples convey the some of the breadth and impact of this research.

Breastfeeding-friendly Hospitals. The Carolina Global Breastfeeding Institute (CGBI) studies breastfeeding support in hospitals serving low-wealth populations. Information from this study is being used to create a toolkit and training materials for hospitals that will be posted on the project website (www.sph.unc.edu/breastfeeding). MCH Department graduates and current graduate students provide key programmatic, technical and training support. A 2011 PhD graduate from the MCH Department is examining existing datasets to illuminate the relationship between breastfeeding support approaches and breastfeeding outcomes. Preliminary findings show that supported hospitals are more likely to reach their breastfeeding goals.

The National Longitudinal Study of Adolescent Health (Add Health), housed at the Carolina Population Center is an ongoing study of a nationally representative sample of over 20,000 U.S. adolescents in grades 7-12 during the 1994-95 school year who have been followed into adulthood with four waves of data collection. A fifth wave of interviews will begin in 2015 when the Add Health Cohort will be in their 30’s, marking 20 years of study participation. Two MCH faculty members, Carolyn Halpern and Jon Hussey, have played key roles in the study for the past 10 years (Halpern as Deputy Director and Co-Investigator; Hussey as Satellite Research Group Coordinator and Co-Investigator), and have the same central roles in the newly funded Wave V program project.

Add Health combines longitudinal survey and biomarker data on respondents’ social, economic, psychological and physical well-being with diverse and multi-level contextual data, allowing researchers to characterize individual experiences and the social, physical and health environments across the life course in ways that are not possible in other studies. The goal of the Wave V Program Project is to understand the early life precursors of chronic disease by tracing the cumulative and integrated biological, behavioral, and psychosocial processes hypothesized to operate across the life course. Add Health is a global data resource for over 10,000 Add Health researchers. Add Health researchers have obtained nearly 600 independently funded research grants and have produced nearly 2,000 peer-reviewed research articles that appear in over 300 different journals. Carolyn Halpern is the PI for the subproject: “Early Life Precursors of Chronic Disease” and Jon Hussey is the PI for the “Birth Records” subproject.

Directed by faculty members Dr. Vijaya Hogan and Dr. Diane Rowley, the Collaborating Center for Health Equity in Mothers and Children (CHEMAC) completed an equity evaluation report for the W. K. Kellogg Foundation national First Food breastfeeding program. As a part of WKKF’s service to assist vulnerable children, the First Food initiative ensures that more babies will benefit from breast milk as their first form of nutrition. This evaluation examined how grantees conceptualize and operationalize equity, and the extent to which the current portfolio will likely achieve equity in breastfeeding. The report presents a typology of equity approaches and summarizes the strengths and limitations of the grantees with respect to their equity capacity.

  • Implemented an equity approach integrated into a state health department activities and infrastructure by completing an institutional equity toolkit for the Michigan Department of Community Health. Practices to Reduce Infant Mortality through Equity (PRIME) is a program to enhance the capacity of the Michigan Department of Community Health’s (MDCH) Bureau of Family, Maternal and Child Health (BFMCH) to reduce racial disparities in infant mortality between Blacks and Whites and between American Indians and Whites in Michigan.  The toolkit was created as a component of the PRIME educational program and practice model. It was administered as a Learning Lab designed to increase knowledge of applied approaches to promoting equity and to promote incorporating equity thinking, perspectives and action into day-to-day work. The WIC staff participated in 3 week-long training sessions over the course of 6 months, advocating for changes within the community institutions that influence people’s everyday lives.
  • Organized and conducted a community conference in Jackson MS, focused on defining strategies for achieving health equity in Mississippi. The Mississippi Roadmap to Health Equity, Inc. is a community-based project that focuses on raising awareness leading to community action where health and social disparities exist. The mission of the Mississippi Roadmap to Health Equity is to achieve healthy equity in Mississippi by defining approaches to address the needs of Jackson’s children ages 0 to 5 years, to ensure that the environments where they live, play, shop, learn, and seek help always support and never inhibit their health and well-being, and promote the attainment of health, success and social equity.

Drs. Vijaya Hogan and Diane Rowley also recently launched a pilot study in Durham, NC entitled LACES (Leadership and Advocacy for Child Equity Strategies), a local community organization. LACES will collect pilot data to develop an appropriate methodology for implementing the Smart and Secure Children (SSC) Curriculum as a component of an existing community program in Durham. SSC was developed by the Morehouse School of Medicine to teach parents about child development between the ages of 0 and 5 years old and to work on advocacy skills for promoting early child development policies.

Under a cooperative agreement with the Maternal and Child Health Bureau (MCHB), Division of Workforce Leadership Development, the Department launched the National MCH Workforce Development Center. Dorothy Cilenti is the Center’s PI. The Center brings together faculty and staff from the School’s Departments of Maternal and Child Health, Health Policy and Management, Public Health Leadership Program, and the NC Institute for Public Health with the National Implementation Research Network (NIRN) at the Frank Porter Graham Child Development Institute and the Renaissance Computing Institute (RENCI) to provide training and technical assistance to state Title V professionals and partners as they implement health reform. Faculty offer state and territorial leaders training, collaborative learning opportunities, coaching and consultation in implementing health reform using a variety of learning platforms.

Tools and resources to strengthen capacity and skills in the following 4 core areas are available through the National Center.

  1. Improving access to care;
  2. Using quality improvement tools;
  3. Developing systems thinking to foster integration within public health and across sectors including primary care, mental health, early intervention, and community-based service delivery and financing systems; and
  4. Furthering change management, including effective collective impact skills that will lead to health improvement for MCH populations.

Following the Center’s first Intensive Workshop (June 16-18, 2014) for 8 states, 50 participants recorded increased confidence in:   (5-point scale, Strongly Disagree [1]—Strongly Agree [5])

  • Identifying Systems Integration tools/techniques/models for their project (mean=4.58);
  • Monitoring state implementation of health reform using Access to Care State Assessment Tool (mean=3.80);
  • Generating and collecting project-related measurements (mean=4.19);
  • Using Action Learning Sets to improve personal leadership (mean=4.08);
  • Using QI skills and tools in state Title V program/agency (mean=4.41);
    • Intensive Workshop participants indicated elevated self-perceived capacity to play a more active role in health transformation at the state level;
    • Intensive Workshop participants acknowledged that Center team activities and initiatives built relationships and strengthened partnerships with other state public health systems, e.g., Medicaid, Accountable Care Organizations

Global Initiative for preventing Maternal and Newborn deaths. The World Health Organization (WHO) Collaborating Center for Research Evidence for Sexual and Reproductive Health, based in the Department of Maternal and Child Health and directed by Dr. Bert Peterson, has been providing assistance in supporting the UN Secretary General’s Global Strategy for Women’s and Children’s Health. The goal of the Global Strategy is to dramatically accelerate progress in preventing maternal and newborn deaths in the 49 countries in which most such deaths occur. The Department helps address challenges in the implementation of life-saving interventions that have been widely and successfully used in developed countries, but are far more challenging to implement in the low-resource settings where 99% of maternal deaths occur. The Collaborating Center is working closely with WHO to develop a conceptual framework for this effort in collaboration with UN agencies and other partners.