Policy Resource

Blogging NTI: Notes from Sessions

Dec 24, 2011

Laughter, tears, sharing, listening, and song, in addition to a wealth of information, all were experienced in the rich array of sessions open to NTI attendees on Friday.

The Baby Policy Blog could not be everywhere at once, so enlisted the aid of many correspondents to report back on what they learned—and what moved them—in these gatherings. We promised you the NTI experience, so here are highlights our reporters brought back about a variety of sessions. Common themes: meaty presentations, packed rooms, participants begging for extended sessions–and genuine human connections.

Healing a Painful Past

Some in the audience were moved to tears, some were moved to sing. The room was definitely ALIVE! And there is no doubt that all participants in this symposium, Healing a Painful Past, were moved in some way. Marva Lewis and Eduardo Duran painted a powerful portrait of the legacy of historical trauma inherited by various cultural groups worldwide, and its effects today (including ongoing racial disparities across numerous public health issues). Lewis and Duran provided special emphasis on African American slave descendants and Native American tribal descendants. The focus was on identifying the needs of children born into families where historical trauma is part of their “story”. Most importantly, the presenters poignantly revealed the healing that is possible and the critical need to honor the memories, the traditions, the values, etc., that are unique to the origins of the particular cultural group. Participants were challenged to consider that behavioral interventions and evidence-based practices may not be successful in and of themselves, in the absence of strategies that address the “Soul Wound”, as described by Duran, allowing families to transcend the trauma and heal the “injury to the spirit”.

The conversations that emerged in the packed room of Healing a Painful Past prompts the need for practitioners and policymakers to ensure that evidence-based practices are culturally sensitive - uniquely designed and tailored to address the spiritual wound, such that we do not inadvertently, as Duran metaphorically mentioned, “try to get a toothache remedy from a transmission specialist”, because if the intervention does not make sense within the context of the culture of the recipient(s), the community will struggle for yet another generation.

Fathers for Change

A full house of participants were thoroughly engaged in listening to Dr. Carla Stover of Yale University School of Medicine present a new model for intervening with fathers when there have been incidents of domestic violence. This approach includes three components: individual, co-parenting and father-child modeling. After reviewing the sparse research on domestic violence interventions with fathers and the room for improving positive outcomes for children, Dr. Stover noted that court and child welfare systems are still reluctant to change the traditional approaches.

An initial complete assessment process of the men referred for the “Fathers for Change” program is essential; the two hour interview includes a review of the man’s past experiences, psychological symptoms, addiction, conflict coping, knowledge of child development, and police and social service records. A session of the father playing with the child is videotaped and used later for the father’s reflection. Dr. Carla provided real-life examples of men who are suitable for the program and those who were not accepted. She stresses there is no formula number of sessions for the three component stages as each father and family has different histories and emotional resources for healing. The father’s ability to self-regulate emotions and to build functional attachments with his co-parent are key factors in long term improvements.

The audience expressed much disappointment that the session was so short–wishing it had been two or two and a half hours–and many remained afterwards to discuss case situations and implementation of the program into their own community system.

Personal Encounters: An Innovative Home Visitation Model for High-Risk Families

It seems counterintuitive that a universal, strengths-based approach could be better at reaching high-risk families than a more targeted approach. Yet, that is exactly what the research on the Baby TALK home visitation model has found. Presenters Aimee Hilado and Claudia Quigg described the Baby TALK model, which started in Illinois 25 years ago and is now operating in 36 sates and Canada. Baby TALK builds a trustworthy system in which families are identified and appropriate services are delivered through both personal and group experiences and collaborative referrals. Twelve words describe their approach: Build a system; screen every family; identify the need; deliver appropriate servicees.

Trained staff are strategically placed at community locations where families are—hospitals, WIC offices, and health clinics. Through a “soft” approach—having quality interpersonal experiences with families—staff determine their needs and provide extensive support through personal encounters in homes or community locations. An important aspect of the work is developing strong connections between agencies and setting collaborative goals, which ensure a wide variety of services are available to benefit families. With today’s increased emphasis on accountability, it is heartening that a positive, supportive approach to all families with young children can result in engaging the most at-risk families and supporting them to become better parents.

Improving Parental Health Literacy Through Home Visiting

Dr. Susan Smith, developer of the Better Beginnings educational guides, and Linda Walleson, developer of the Life Skill Progression assessment tool, have worked together to highlight the importance of health literacy for child health outcomes. Using a worksheet that participants completed during the session, the leaders presented the theory behind their work with health literacy. Three-sides of the triangle included Thinking, Linking and Responding. While much of their work on health literacy focuses on the skill of reading, they stated that this is not sufficient for health literacy. Empowering parents–especially mothers—to think about the situation, to gather information (link), and then to develop solutions are the critical features of their approach. Attendees discussed together their experiences of working to increase health literacy, especially how this has affected childhood immunization rates, dental care, and maternal health care.

The presenters see home visiting programs as ideal mechanisms for increasing parental health literacy. Everyone’s ears perked up when Susan mentioned that there are avenues of funding in health care reform! Some managed care organizations are also aware of the possible cost savings that might result with improved literacy. Susan has research reported on the www.ahrq.gov website under the “Innovations Exchange”, “Home visitor Empowers Mother to Better Manage her Child’s Health Care" –so be sure to check it out!

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