System-change achievements advocates are making for central Iowa’s kids

Through strategic thinking, relationship building, courage, and persistence, central Iowa advocates are making incredible progress in shifting how our systems interact with and support children and families. The work is hard and long term but pausing to celebrate along the way helps acknowledge the progress that is being made. That’s why we are taking this moment to highlight just a few examples of the HealthConnect Fellows’ amazing work and to showcase what system change can look like. Check out how these efforts are improving the well-being of our kids.

System change is changing the narrative

At a conference last year, Mx. Olivia Samples, a Holistic Doula under Kismet Doula Services and staff member at the Iowa Coalition for Collective Change, became frustrated and upset after hearing many statistics about disparities for Black birthing people in Iowa. They had this thought: “Is it not also racist to only perpetuate disparities? I wish we could have a Black Maternal Health Conference that centered around not only Black birthing people, but the joy in Black parenthood, in birthing Black children, and in Black communities. There are so many people and projects making a huge impact on these disparities in our own community. Why do we most often uplift the violence? What you pay attention to grows.”

Responding to the negative narrative and how it often involves blaming Black people for the disparities, Samples is creating a new conference to give Black people a place to share their experiences, including the joys in birth and parenting and their needs, and to dream about what a new system of support could look like.

“How often are we asked what we need or want in our health care?” Samples asks in this blog. The Celebration of Black Kin conference will take place April 11-17 as a part of Black Maternal Health Week and is currently seeking speakers and sponsors. Samples’ work has already generated strong attention from Iowa media. Anyone is invited to attend and listen.

System change is creating common understanding for cross-system collaboration.

After hearing mental health advocates, pediatricians, parents, and service providers each push for specific changes related to children’s mental health, Ms. Chaney Yeast, Director of Government Relations at Blank Children’s Hospital, worked with advocates to create a broad message about the entire children’s mental health system that everyone could get behind while still being able to talk about their individual issues or needs. The concept of using the public health pyramid to illustrate the recommended children’s service array  created a tool for advocates to explain how all of the services to meet the unique developmental needs of children fit into one system that includes prevention, targeted interventions, and treatment options.

While this message helped inspire a new law in 2019 to create a children’s mental health system, work continues to align all services Iowa provides and to advocate for funding to create a more comprehensive system. Most recently, the pyramid has become a tool to help explain how services and funding align within state child welfare and juvenile justice systems. Stakeholders at the Iowa Dept. of Human Services, in juvenile justice, and in child welfare have been using the pyramid graphic to build cross-sector communication around what mental health services and funding mechanisms are in place for children and families in the systems currently and what needs to be in place to meet the requirements of the Family First Prevention Services Act.

System change is getting top-level buy-in for action.

With a goal of ensuring kids are prepared to learn in school and succeed lifelong, Ms. Malai Amfahr has focused her efforts on addressing inequities in the early care and education systems. In her role as Story County Reads Director, she has led a coalition that is working to get buy-in from schools to integrate their data into one third-party system that will then allow leaders to look at trends across the region so that schools, nonprofits, and other partners can respond to challenges and determine which interventions are most effective. In her role as co-chair of the Early Childhood Iowa Equity Committee, she has been encouraging the statewide network to adopt equity guiding principles and to infuse these principles into all of their work.

Moving both efforts forward has required building buy-in at the leadership levels. For the data sharing project, Amfahr has had to work with Iowa State University to meet the school superintendents’ needs for the data to be secure and analyzed at the highest standards. The superintendents are now the advisory council that decides how the data exchange will operate. With these systems in place, many districts are now signing on in agreement to share their data. With Early Childhood Iowa, Amfahr and the equity committee worked with the state board to adopt the equity guiding principles for the entire network. Once this happened, Amfahr began receiving many requests for presentations and support in implementing the principles, and the work is becoming a more natural part of all of the committees’ efforts.

System change is proving effectiveness of an intervention and scaling.

Developed to prevent preventable stillbirths, the evidence-based Count the Kicks app helps pregnant moms in the third trimester track their baby’s movements to determine their baby's normal movement pattern. The app acts as a red flag when baby's normal movement changes - a sign that something might be wrong and mom should speak up to her provider. Now several years into offering the free app, Healthy Birth Day, Inc. teamed up with researchers at Des Moines University and The Harkin Institute for Public Policy & Citizen Engagement to better understand the impact of the app. Researchers asked 1,200 women who used the app from 2015 to 2019 about their experiences and differences between pregnancies in which they did not use the app compared with their most recent pregnancy using the app.

The research found that app users were more likely to contact their health care provider with concerns during the third trimester, and preliminary results show a reduced rate in stillbirth for the pregnancy in which they used the app compared to earlier pregnancies. This is the first study that researchers know of to examine the relationship between a mobile health app that tracks fetal movement and birth outcomes. The research is now helping Executive Director Ms. Emily Price and her team at Healthy Birth Day analyze its Count the Kicks® stillbirth prevention campaign to better serve expecting parents and to gain buy-in to expand the program broadly across the U.S.

Thank you, Fellows!

These are just a handful of examples of the work fellows have been leading so that Iowa’s children and families have opportunities to thrive in our communities. Their efforts show a sustained commitment to the goal of improving children’s well-being, as well as the various tactics that can be used to get to that goal. We thank the fellows for their tireless dedication to this hard, but meaningful, work.

‍