Arhealth Ventures Inc

HEALTHY START INITIATIVE - PROJECT DIRECTOR: DR. PEARL MCELFISH, PAMCELFISH@UAMS.EDU ADDRESS: 4301 W MARKHAM ST., LITTLE ROCK, AR, 72205 TOTAL REQUEST: $5,499,995 THE PURPOSE OF THE EMBRACE: EMPOWERING MOTHERS AND BABIES, REDUCING ACCESS CHALLENGES AND ELIMINATING DISPARITIES - HEALTHY START PROJECT (EMBRACE HEALTHY START) IS TO IMPROVE HEALTH OUTCOMES BEFORE, DURING, AND AFTER PREGNANCY AND TO REDUCE RACIAL/ETHNIC DIFFERENCES IN RATES OF INFANT DEATH AND ADVERSE PERINATAL OUTCOMES. ARHEALTH VENTURES, INC. (ARHEALTH) WILL SERVE AS THE LEAD APPLICANT AND FISCAL AGENT OF THIS COLLABORATIVE. ARHEALTH AND OUR LONG-STANDING COMMUNITY CONSORTIUM HAVE DEVELOPED A WORK PLAN AND CONTINUUM OF SERVICES WITH TWO FOCUS AREAS: 1) PROVIDING DIRECT AND ENABLING SERVICES AND 2) CONVENING A COMMUNITY CONSORTIUM COMPRISING DIVERSE MULTI-SECTOR PARTNERS TO ADVISE AND INFORM ALL EMBRACE HEALTHY START ACTIVITIES. EMBRACE HEALTHY START WILL TARGET AFRICAN AMERICAN/BLACK PREGNANT, PRECONCEPTION, AND INTERCONCEPTION WOMEN; FATHERS/PARTNERS; AND INFANT(S) AND/OR CHILD(REN) LESS THAN 18 MONTHS IN THE COUNTIES OF ASHLEY, OUACHITA, AND UNION IN ARKANSAS. THE TARGET POPULATION WAS CHOSEN BECAUSE THEY ARE EXPERIENCING THE HIGHEST HEALTH DISPARITIES. THE THREE-YEAR (2019-2021) LOW BIRTHWEIGHT RATE IN THE THREE COUNTIES IS 15.85 PER 100 LIVE BIRTHS, 15.32 PER 100 LIVE BIRTHS, AND 14.61 PER 100 LIVE BIRTHS, RESPECTIVELY, AND 15.05% COMBINED (=12.5% AND =1.5 TIMES THE NATIONAL AVERAGE). THERE WERE 160 LOW BIRTHWEIGHT BIRTHS DURING 2019-2021. ALL THREE COUNTIES ARE DESIGNATED AS RURAL, AND THERE IS ONLY ONE BIRTHING HOSPITAL IN THE PROJECT AREA. TO IMPROVE PERINATAL OUTCOMES AND REDUCE INFANT MORTALITY RATES, EMBRACE HEALTHY START WILL PROVIDE SERVICES AT THE INDIVIDUAL, GROUP AND COMMUNITY LEVELS. WE WILL INCREASE UPTAKE OF HEALTHY BEHAVIORS BEFORE, DURING AND AFTER PREGNANCY BY PROVIDING GROUP PRENATAL CARE AND HEALTH EDUCATION THROUGH MOBILE CENTERINGPREGNANCY TO 250 PREGNANT WOMEN AND FATHERS/PARTNER S EACH YEAR. WE WILL INCREASE THE USE OF HEALTHY AND SAFE INFANT AND TODDLER CARE PRACTICES BY PROVIDING GROUP PARENTING AND POSTPARTUM AND INFANT CARE, EDUCATION AND SUPPORT THROUGH MOBILE CENTERINGPARENTING TO 70 POSTPARTUM WOMEN AND FAMILIES (TOTAL OF 320 IN GROUP-BASED EDUCATION). WE WILL INCREASE RECEIPT OF CARE COORDINATION/CASE MANAGEMENT TO FACILITATE ACCESS TO MEDICAL CARE AND COMMUNITY-BASED RESOURCES BY PROVIDING INDIVIDUAL CARE COORDINATION/CASE MANAGEMENT, DOULA SUPPORT, SUPPLEMENTAL EDUCATION, AND SUPPORT IN NAVIGATING SOCIAL DETERMINANTS OF HEALTH (SDOH) TO 250 PREGNANT WOMEN, 25 PARTNERS, 100 HUNDRED POSTPARTUM WOMEN AND FAMILIES, AND 75 PRECONCEPTION/INTERCONCEPTION WOMEN (TOTAL OF 450). WE WILL CONDUCT A PUBLIC HEALTH CAMPAIGN USING TRADITIONAL AND NON-TRADITIONAL MODES OF COMMUNICATION TO REACH AT LEAST 10,000 PEOPLE, AND WE WILL CONDUCT COMMUNITY OUTREACH AND HEALTH EDUCATION SESSIONS THROUGH COMMUNITY-BASED AND FAITH-BASED ORGANIZATIONS TO REACH AT LEAST 500 PEOPLE EACH YEAR. OUR COMMUNITY CONSORTIUM WILL FINALIZE AND IMPLEMENT A PLAN TO ADDRESS “UPSTREAM FACTORS” AND SOCIAL DETERMINANTS OF HEALTH CONTRIBUTING TO DISPARITIES IN PERINATAL OUTCOMES IN THE PROJECT AREA AND DISSEMINATE NEEDS, UPDATES, AND OUTCOMES TO BROAD AUDIENCES.

REACHING EVERY ARKANSAN BY CONNECTING HEALTH (REACH) RESOURCES TO REDUCE DIABETES DISPARITIES. REACH WILL FOCUS ON REDUCING DIABETES HEALTH DISPARITIES AND ACHIEVING HEALTH EQUITY WITH A FOCUS ON 61 HIGH-NEED COUNTIES IN ARKANSAS.

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM - FUNDING TRACK: SPECIAL TRACK FOCUS AREA: MATERNAL HEALTH FUNDING PREFERENCE. OUR PROJECT QUALIFIES FOR ALL THREE FUNDING PRIORITIES: IT SERVES HPSAS, MUCS/MUPS, AND FOCUSES ON PRIMARY CARE WITH WELLNESS AND PREVENTION STRATEGIES. PROPOSED RURAL SERVICE AREA: ASHLEY, OUACHITA, AND UNION COUNTIES, ARKANSAS. ALL DESIGNATED AS RURAL AND AS MEDICALLY UNDERSERVED AREAS. ZIP CODES: 71635, 71642, 71646, 71658, 71661, 71663, 71676, 71701, 71711, 71720, 71726, 71751, 71764, 71724, 71730, 71731, 71747, 71749, 71750, 71758, 71759, 71762, 71765, AND 71768. TARGET POPULATION: THE AR BIRTH PROGRAM WILL SERVE ALL MATERNAL/PERINATAL WOMEN IN THE THREE COUNTIES WITH A FOCUS ON AFRICAN AMERICAN (AA)/BLACK, AND HISPANIC/LATINO/LATINA (HISPANIC) MATERNAL/PERINATAL PATIENTS, ENSURING WE REACH RACIALLY/ETHNICALLY MINORITIZED COMMUNITIES. IN THE REGION, THE MOST MINORITIZED POPULATIONS ARE AA/BLACK AND HISPANIC. 100% OF THE POPULATION IS RURAL, 34% IS AA/BLACK, 5%, IS HISPANIC, 66% IS WHITE, AND 2.5% ARE PART OF OTHER RACIAL AND ETHNIC GROUPS. PROJECT GOALS AND OBJECTIVES: THE GOAL OF THE AR BIRTH OUTREACH PROGRAM IS TO IMPROVE MATERNAL/PERINATAL BEHAVIORAL HEALTH OUTCOMES USING EVIDENCE-BASED MODELS. OUR OBJECTIVES ARE: 1) WORK WITH OUR COMMUNITY CONSORTIUM TO DEVELOP A COORDINATED AND CULTURALLY SENSITIVE SCREENING, TRIAGE, AND REFERRAL PROCESS FOR MATERNAL/PERINATAL BEHAVIORAL HEALTH CONDITIONS (DEPRESSION, ANXIETY, SUBSTANCE USE DISORDER) AND SOCIAL DETERMINANTS OF HEALTH (SDOH); 2) IMPLEMENT THE NEW MATERNAL/PERINATAL SCREENING, TRIAGE, AND REFERRAL PROCESS WITHIN THE TARGET GEOGRAPHIC REGION TO SERVE RURAL RESIDENTS; 3) TRAIN AND DEPLOY CULTURALLY CONGRUENT CHWS WHO WILL HELP ENSURE A CONNECTION WITH BEHAVIORAL HEALTH AND/OR HOME VISITING SERVICES (BASED ON SCREENING NEEDS) AND HELP CONNECT PATIENTS WITH RESOURCES TO ADDRESS SDOH; 4) CREATE A SUSTAINABILITY PLAN THAT INCLUDES WORKING WITH MEDICAID AND OTHER INSURERS/PAYERS TO ALIGN QUALITY MEASURES, INCENTIVES, AND REIMBURSEMENT. EVIDENCE-BASED OR EVIDENCE-INFORMED MODEL(S) PROJECT WILL USE: AR BIRTH IS GROUNDED IN A STRONG EVIDENCE BASE, UTILIZING SYSTEMATIC REVIEWS AND AUTHORITATIVE REPORTS FROM HRSA, CDC, AND AHRQ. THE PROGRAM INTEGRATES VALIDATED SCREENING TOOLS FOR DEPRESSION, ANXIETY, AND SUICIDE RISK, AS OUTLINED IN REPORTS SUCH AS THE U.S. PREVENTIVE SERVICES TASK FORCE'S REVIEW ON PERINATAL DEPRESSION AND POSTPARTUM CARE. SCREENING FOR SUBSTANCE USE FOLLOWS ACOG GUIDELINES AND REVIEWS ON OPIOID USE DURING PREGNANCY. AR BIRTH ALSO EMPLOYS EVIDENCE-BASED METHODS FOR SDOH SCREENING, INFORMED BY STUDIES ON RESPECTFUL MATERNITY CARE AND STRUCTURAL DETERMINANTS. A TRIAGE AND REFERRAL SYSTEM ENSURES THAT BEHAVIORAL HEALTH AND SDOH NEEDS ARE ADDRESSED, GUIDED BY REVIEWS ON POSTPARTUM CARE AND PERINATAL DEPRESSION TREATMENT. THE PROGRAM INCLUDES TRAINED COMMUNITY HEALTH WORKERS (CHWS) TO NAVIGATE SDOH BARRIERS, WITH EVIDENCE LINKING CHWS TO IMPROVED EQUITABLE MATERNAL CARE. ADDITIONALLY, AR BIRTH INCORPORATES HOME VISITING SERVICES, A PROVEN STRATEGY FOR PREVENTING PERINATAL DEPRESSION AND IMPROVING MATERNAL AND INFANT OUTCOMES, AS HIGHLIGHTED IN HRSA’S 2024 MATERNAL HEALTH WORKFORCE REPORT. EXPECTED OUTCOME(S) OF THE PROPOSED PROJECT: 1) INCREASED HEALTH CARE PROVIDERS USE OF EVIDENCE-BASED PRACTICES RELATED TO MATERNAL/PERINATAL BEHAVIORAL HEALTH AND SDOH; 2) IMPROVED HEALTH OUTCOMES FOR MATERNAL/PERINATAL WOMEN IN THE TARGET COUNTIES. CAPACITY TO SERVE RURAL UNDERSERVED POPULATIONS: AR BIRTH IS SUPPORTED BY A STRONG COMMUNITY CONSORTIUM WITH THREE LEVELS OF MEMBERSHIP: RURAL PRIMARY PARTNERS, STATEWIDE GUIDANCE CONTRIBUTORS, AND A COMMUNITY ADVISORY BOARD THAT INCORPORATES THE PERSPECTIVES OF COMMUNITY MEMBERS WITH LIVED EXPERIENCE. THE PROGRAM ALSO LEVERAGES EXISTING ASSETS SUCH AS ARCONNECT, CHW TRAINING, AND PARTNERSHIPS WITH LOCAL HEALTH CARE PROVIDERS TO ENSURE PROJECT SUCCESS.