||Dr. Debra Litzelman
||Dr. Betsy Rono
||WeCare Plus 2.0: An Innovative, Community-Based Collaboration to Decrease Infant Mortality
||Infant and maternal health
||WeCare Plus 2.0 is a partnership of healthcare, public, and community organizations, will reduce infant mortality in Indiana’s Central Region through outreach, health coaching, community engagement, and mobile health (mHealth) messaging technology. WeCare Plus 2.0 will continue to reduce infant mortality in Indiana’s Central Region by 2019 by expanding and enhancing WeCare Plus 1.0, an existing collaborative network of health care and community health services providers targeting infant mortality in 15 existing federally qualified health centers in Marion County. Specifically, WeCare Plus 2.0 will expand WeCare 1.0 services in highest IMR risk zip codes in Marion County especially fortifying services where black IMR’s are the highest (Table 2. above), target and include fathers, reinforce and enhance training and psychological support for CHW to prevent burnout, and create innovative partnerships with public health first responders (e.g., police, fire and emergency medical services) who provide outreach to women and fathers across the reproductive life span. Infant Mortality Rates (IMR) remain extremely high in many States in the US with persistently high Black IMR that are 2-3 times higher than White IMR. The WeCare Model provides evidence for the effectiveness of a CHW model in improving risk factors for IM and in reducing low birth weight infants with promising early indicators that IMR are being lowered in highest risk IMR zip codes in Central IN including for Black Infant. The program is ripe for dissemination and implementation across other high risk zip codes in Indiana and other States using Implementation Science research methodologies.
||Facilitators to the WeCare 2.0 expansion include community health workers, federally qualified health centers, as well as additional partners including Volunteers of America and other treatment centers; primary care sites providing medication assisted treatment (MAT) and pregnancy centering classes for women with substance use disorder (SUD)] and “public health first responders” (police, fire, and emergency medical services
||We will focus on the highest risk and most population-dense zip codes in the Central Region where we will have the highest impact. The demographic makeup of our target population is mostly black and non-Hispanic white (in Marion County); most mothers are on Medicaid with about 20% living below the federal poverty level. Because risk factors for infant mortality span preconception, prenatal, and postpartum periods, we will target women and fathers across all perinatal periods of risk to better understand and mitigate factors contributing to infant mortality across the reproductive life span.
|Process to Implementation
||We will continue to focus on the highest risk and most population-dense zip codes in the Central Region where we will have the highest impact on black and white IMR. Currently we have CHW working out of clinics in 5 of the 6 highest risk zip codes. We will hire and place additional CHW in these clinics based on the population of women of childbearing age served at each site. We will also expand WeCare Plus 2.0 services to clinics in the 46229 zip code area where we currently do not have a CHW and we will reach out through enhanced relationships with first responders, community centers, organizations and childcare centers within this zip code to further serve women and men in this high risk area.
||Stakeholders include medical clinics, FQHCs, community organizations, health-relevant non-traditional partners, such as Volunteers of America and other treatment centers; primary care sites providing medication assisted treatment (MAT) and pregnancy centering classes for women with substance use disorder (SUD) and public health first responders (police, fire, and emergency medical services)
|Scaled or Transferred?
||This program was expanded throughout Indiana after a successful pilot run.
|Type of Research
||The implementation science utilized to expand WeCare Plus 2.0 includes the following objectives and strategies: Objective 1) Expand WeCare Plus 1.0 Recruitment and Enrollment in Indiana’s Central Region; Objective 2) Provide Tailored Coaching by Trained CHW through Home Visitation supported by mHealth; Objective 3) Partner with Public Safety First Responders within the Highest Risk Zip codes in our Targeted Region;
||WeCare and CARE programs make significant contributions to lowering infant mortality in Indiana
Young mothers find support in community health workers
Supporting community health, and health workers, under pandemic restrictions
IU Health Grand Challenge 2015-2019; ISDH 2017-2023; IU Addiction Grand Challenge 2018-2021; Richard M Fairbanks Foundation 2018-2021