+ The Well-Woman Project A Project of the University of Illinois at - PowerPoint PPT Presentation

+ The Well-Woman Project A Project of the University of Illinois at Chicago School of Public Health and CityMatCH Funded by the W.K. Kellogg Foundation APHN Annual Conference 2017, San Diego April 25, 2017 Presented by Denise Pecha, LCSW

+ The Well-Woman Project A collaboration between UIC-SPH & CityMatCH n University of Illinois School of Public Health n PI: Arden Handler DrPH n Co-PI: Nadine Peacock, PhD n Project Coordinator: Vida Henderson, PharmD, MPH n Graduate Assistants: Crissy Turino, MPH, MBA & Megan Gordon, MS n CityMatCH n Executive Director: Chad Abresch, MEd n Director of Programs: Denise Pecha, LCSW n Project Coordinator: Regan Johnson, MPH

+ The Goal To elevate women’s voices about what makes them healthy and able to receive well-woman care within the context of their lives, neighborhoods, and cities

Disparities in Women’s Preventive “well woman visit,” which the IOM Committee on Clinical Preventive Services Health Care Utilization Figure 21 s Eight in ten women have had a recent general check up, but rates are lower among some groups Share of women reporting they have had a checkup All Women: 82% in past two years: d Insurance status Private 88% , Medicaid 81%* Uninsured 60%* Poverty level 200% FPL or greater 89% Less than 200% FPL 72%* Health status Excellent, very good or 83% good health Fair or poor health 74%* NOTE: Among women ages 18-64. The Federal Poverty Level (FPL) was $19,530 for a family of three in 2013. *Indicates a statistically significant difference from Private insurance; 200% FPL or greater; Excellent, very good, good health, p<.05. SOURCE: Kaiser Family Foundation, 2013 Kaiser Women’s Health Survey. 2013 Kaiser Women’s Health

Well-Woman Project: + Objectives Attempting to leverage the focus on the Well-Woman Visit in the ACA and in MCH National Performance Measure #1 to build support for the Well-Woman Visit and Well-Women by: Gathering women’s stories with respect to Well-Woman Visit 1. n Paying close attention to the conditions of women’s lives that affect their ability to be Well-Women and seek Well- Woman Care Developing a profile of women’s health in each of eight 2. participating cities based on input from women Developing actionable recommendations to support well- 3. women and to support a women-friendly health system

Well-Woman Project: Participating Cities n Boston n Nashville n Chicago n New Orleans n Detroit n Oakland n Jackson n Omaha

Well-Woman Project: Capturing Women’s Voices Listening Sessions Blog & VOIP Line n Host two listening n Utilize a secure sessions in each of phone line and a the eight confidential blog participating cities where women nationwide can leave their stories

+ Well-Woman Project: Outreach to Women n Flyers n Distributed to partners throughout the United States including city partners n Memes n Distributed to partners throughout the United States including city partners n Magnets n Distributed at conferences and to city partners n Twitter Account n @Well_WomanStory n Recruitment & informational tweets

Listening Session Recruitment Flyer

English Meme for Blog/VOIP

Spanish Meme for Blog/VOIP

Results Listening Sessions Conducted in Website & Message Line Conjunction with 8 Urban Health Departments n Women were entered into a raffle for a $50 gift card. Additional incentives were offered during May and June 2016 n Women received Target or Walmart gift cards (ranging $25-$40) for their participation n 99 women shared their stories through the website and 4 shared over the message line n A total of 17 listening sessions were conducted in 8 U.S. cities: n Message line stories were downloaded Boston, Chicago, Detroit, Jackson, and transcribed. While the intended Nashville, New Orleans, Oakland sampling frame was women ages 18- and Omaha in either English or 45, all stories were analyzed excluding Spanish one woman who was > 64 years of age n 156 women (ages 18-47) n 102 remaining stories were annotated participated in Listening Sessions and memoed by four researchers n Audio recordings of sessions were n Stories were analyzed in Dedoose professionally transcribed using a hybrid of a priori and emergent codes n Listening Sessions were analyzed in Dedoose using a hybrid of a priori and emergent codes

Themes from Listening Sessions and + Stories

+ Theme #1: The healthcare delivery system is not woman-friendly.

+ Goal for 1. The healthcare delivery system is Theme #1 not woman- friendly.

The healthcare delivery system is not woman-friendly. Ø Adopt and promote a Charter which delineates the components of a women Recommend and family friendly health delivery system. City Health Departments Ø Engage in dialogue with large health to: systems and FQHCs to encourage increased availability of appointments outside of traditional hours, drop-in/walk- in appointments, more time per patient to facilitate patient-provider interaction, increase in on-line or phone consultation.

+ Theme #2: Women’s competing demands and priorities make accessing healthcare difficult.

+ Goal for 2. Women’s competing demands and priorities make Theme #2: accessing healthcare difficult. e

Women’s competing demands and priorities make accessing healthcare difficult. Ø Develop policy and educational materials focused on city-specific Recommend sick and personal leave policies. City Health Ø (As needed), create a city-wide task Departments force to include key stakeholders to to: consider adoption of paid sick leave for both public and private employees.

+Theme #3: Women weigh costs vs. benefits when deciding to access care.

+ Goal for 3. Women weigh costs Theme #3: vs. benefit when deciding to access care.

Women weigh costs vs. benefits when deciding to access care. Ø Partner with major health systems, FQHCs, and other key stakeholders to provide women and families with access Recommend to insurance navigators on a year round basis. Initiatives such as a city-wide insurance navigation hotline and on- City Health line insurance navigation support can help women Departments understand insurance and network options. to: Ø Develop a city fund to cover uninsured women and families and/or help women and families struggling with high deductibles for their privately obtained insurance. Ø Partner with major health systems and FQHCs to sponsor “One Day” Medicaid/free care several times a year for all.

+ Theme #4: Relationships with providers are key to women’s decisions about accessing care.

+ Goal for 4. Relationships with Theme #4 providers are key to women’s decisions about accessing care.

Relationships with providers are key to women’s decisions about accessing care. Ø Explore approaches to the development of a women-centered , consumer-driven mechanism to enable reviews of providers (similar to YELP) and enable women to recommend women-friendly provider sites. Recommend Ø Partner with major health systems to develop and offer training to City Health increase the cultural competency/humility of the clinical workforce. Departments to: Ø Partner with major health systems, FQHCs, and other key stakeholders to provide women and families with access to insurance navigators on a year round basis. Initiatives such as a city-wide insurance navigation hotline and on-line insurance navigation support can help women understand insurance and network options. Ø Explore approaches that enable women to have their health histories available on personal “apps” so that providers can readily access this information.

+ Theme #5: Health and insurance literacy empower women to advocate for themselves and others.

+ Goal for 5. Health and insurance literacy Theme #5 empower women to advocate for themselves and others.

Health and insurance literacy empower women to advocate for themselves and others. Partner with health systems and other key stakeholders to support and Ø develop health education campaigns, including the Show Your Love campaign, that focus on women’s understanding of the importance of their Recommend own health and health care. Ensure the availability of a city–wide Women’s Health Hotline as a go-to- City Health Ø resource for up-to-date information on changing health and health care recommendations and guidelines. Departments Ø Provide updated lists of available providers, including the types of to: insurance policies that they accept, as well as providers or healthcare sites that offer free or sliding scale services. Provide resources and trainings for women and families focused on how to Ø advocate for oneself/family with both providers and insurance companies.

+ Theme #6: Positive mental health is integral to being a “healthy” woman.

+ Goal for 6. Positive mental Theme #6 health is integral to being a “healthy” woman.