Winter 2001 Issue
RHR Consortium Conference 2000: A Forum For Ideas And Action
Basic health and other services have been available to many refugees and internally displaced people around the world for several years, but the dedicated introduction of reproductive health services is relatively new. The Reproductive Health for Refugees (RHR) Consortium, whose members include the Heilbrunn Center, plays a central role in promoting comprehensive reproductive health services war-affected populations. To provide a forum for service providers, researchers, policy makers and donors to share program findings and ideas, Therese McGinn, Assistant Clinical Professor of Public Health, and Susan Purdin, Technical Advisor to the RHR Consortium, both at the Heilbrunn Center, helped to organize the RHR Consortium's Research Conference 2000: Findings on Reproductive Health of Refugees and Displaced Populations.
Conference 2000 was held on December 5th and 6th, 2000 in Washington DC. 250 people from 27 countries attended the event, learning about and discussing the fieldwork of participants from 40 refugee situations around the world. Conference 2000 provided an important opportunity for colleagues in diverse aspects of the field to collaborate, and it also gave several students of the Heilbrunn Center's Forced Migration program a chance to apply ideas learned in the classroom to practical examples of the challenges of working in the field. Tenley Mogk (MPH '00) commented that, Our coursework prepared us well to actively participate in the discussions following the presentations.
In addition to critical issues of ongoing concern (including the poor pregnancy outcomes of refugee women and refugees' expressed desire for reproductive health services), the particularly pressing, and largely unmet, needs of war-affected populations were targeted for future intervention: the reproductive health needs of adolescents, prevention of HIV transmission, and prevention and treatment of sexual and gender based violence.
The RHR Consortium recognizes that sharing ideas and information is just a first step. As Susan Purdin stated, It is imperative that the ideas and information presented at Conference 2000 be applied as participants and others plan programs, design studies, make funding decisions and provide services. Conference presenters emphasized that projects should be carefully planned, should draw on the experience of interventions that have been proven effective elsewhere, and should rely on empirical evidence to the greatest extent possible.
The interest in and success of Conference 2000 illustrate the necessity of continued research and dialogue to support improved reproductive health among war-affected populations around the world.
Heilbrunn Center Co-Sponsors Adolescent Sexuality Seminar
On February 12th and 13th , 2001, the Heilbrunn Center for Population and Family Health and the National Campaign to Prevent Teen Pregnancy co-sponsored a two-day Seminar entitled "Middle School-Age Youth: What Do We Know About Sexual Attitudes and Behaviors of the Under-15 Set?" The conference brought together a variety of perspectives in an effort to gain a deeper understanding of issues of adolescent sexuality and teen pregnancy, and to discuss approaches to program development that target young adolescents.
The seminar, moderated by Dr. James McCarthy, Director of the Heilbrunn Center, and Sally Sachar, Deputy Director of the National Campaign to Prevent Teen Pregnancy, was structured around panel discussions focusing on different issues that young teens face in sexual decision-making. These topic areas included young adolescents' family and community environments, media and market research, social and behavioral science and legal perspectives on teen sexual development, and the challenges and successes of programs serving young teens. The panelists represented a cross-section of academic, research, advocacy and direct-service expertise.
Several themes emerged throughout the course of the seminar. One of the central messages is that programs must be grounded in theory, evidence and systematic thinking in order to effectively address the sexual health needs of adolescents. The life circumstances and influences of teens are complex, as are the factors that lead to teen pregnancy; understanding and working within the contexts of adolescents' lives is essential to successful sexual health intervention. The moderators emphasized that formation of sexual identity is a life-long human process that begins at birth, and therefore adolescent exploration of sexual norms and behaviors is a normal and expected behavior. Although teen pregnancy rates are on the decline in the US, there remains a great deal of work to be done in preparing young teens to responsibly and safely handle sexual situations.
CONFERENCE PARTICIPANTS</>
- James McCarthy & Lorraine Tiezzi - Heilbrunn Center for Population and Family Health
- Sally Sachar & Marisa Nighingale - National Campaign to Prevent Teen Pregnancy
- James Garbarino - Family Life Development Center, Cornell University
- Ivan Juzang - Motivation Educational Entertainment
- Sharlene Breakey - Working Mother Magazine
- Julia Graber - Center for Young Children and Families, Columbia University
- Peter Bearman - Institute for Social and Economic Research and Policy
- Donna Lieberman - New York Civil Liberties Union
- Leslie Kantor - Planned Parenthood of New York Cit
y
- Pat Maloney - Inwood House
- Susan Philliber - Philliber Associates
The Heilbrunn Center Spreads Some Holiday Cheer
On December 14, 2000, the Heilbrunn Center for Population and Family Health celebrated the holidays with lunch at the Faculty Club. Center faculty, students and staff gathered and were joined by colleagues from all over the Health Sciences campus to enjoy the festive holiday mood, celebrate the end of the semester, and generously give gifts to many children in the Central Harlem Community. Partygoers donated toys which were given to all of the children in three of the Children's Hope In Learning and Development's Head Start Centers.
Finding Common Ground Launches New Component Of Multifaceted Study
The overall objective of the Finding Common Ground Project, headed by Dr. Wendy Chavkin, is to assess the association between state welfare reform policies and women's and children's health services utilization and health outcomes. The project, in existence for four years at the Heilbrunn Center, has received several grants to study various aspects of this issue, such as the impact of welfare reform on reproductive and maternal behaviors, health insurance, and more recently, health effects of welfare reform on Hispanic populations. The goal is to provide data on the health of women and children to policymakers and advocates when they deliberate reauthorization of welfare legislation in 2002.
The newest component of the Finding Common Ground project, entitled The Impact of Welfare Reform on the Health of Chronically Ill Children and their Mothers, is a study which explores the experiences of families receiving TANF (Temporary Assistance to Needy Families) with children who have chronic illnesses. In addition to assessing the association between TANF status, health status, and health care utilization, the study is also interested in identifying potential barriers to the use of preventive medications and adherence to outpatient management plans.
The project is a longitudinal cohort study with two rounds of data collection - in-person baseline surveys and follow-up telephone surveys at six months. Trained interviewers will approach mothers or primary caretakers of children at one of four clinical sites or TANF offices. Eligible participants will be mothers or primary caretakers who are able to complete the interview in English or Spanish, with children ranging from two to twelve years of age who have been diagnosed with asthma, sickle cell anemia, diabetes, hemophilia, cystic fibrosis, seizure disorder or serious neurologic impairment. Those who complete the interview will be given a $10 gift certificate for groceries, as well as social and health services referral information.
The ultimate goal of this study is to identify needs of poor families with chronically ill children. The information gathered will be provided to both health care providers and TANF agencies so they can better serve their clients. The project, which began in early February, is scheduled for completion at the end of this year. For more information on the work of Finding Common Ground, please visit the project's website: www.findingcommonground.hs.columbia.edu
What's New At The Center?
New Staff And Promotions
- Patricia Bailey Senior Lecturer, AMDD
- Kavita Bali (CPFH '01) Program Coordinator, AMDD
- Judith Fortney Senior Lecturer, AMDD
- Dileep Mavalankar Associate Research Scientist, AMDD
- Jason Smith Senior Lecturer, AMDD
- Marie Thoma Administrative Coordinator, Rakai Project
- Kim Van Atta Assistant Director for Finance, Head Start
- Cathy Hwang (CPFH '01) Program Coordinator, WOW
New Grants
- A Program on Forced Migration and Health
Donor: The Andrew W. Mellon Foundation
PI: Ron Waldman
Amount: $900,000
Period: 1/1/1-12/31/03
Description: This three-year grant provides continued support for the Program on Forced Migration and Health.
- The Impact of Welfare Reform on Ethnic Minorities Donor: Institute for Social and Economic Research and Policy, Columbia University PI: Wendy Chavkin, Diana Romero Amount: $7,000 Period: 1/1/01-6/1/01 Description: This seed grant supports a study to identify barriers that Hispanic women face in this new welfare system and to explore whether this experience has had consequences for women's and children's health.
- Finding Common Ground in the Era of Welfare Reform
Donor: The Open Society Institute
PI: Wendy Chavkin
Amount: $70,000
Period: 11/1/00-10/31/01
Description: This project will examine the impact of state welfare policies on health utilization and maternal and child health outcomes, and will strategically disseminate the findings to relevant parties as reauthorization of the law is considered by Congress in 2002.
- Finding Common Ground - Welfare Reform and Women's and Children's Health: National and State Health Indicators
Donor: The Association of Schools of Public Health
PI: Wendy Chavkin
Amount: $249,729
Period: 10/1/00-9/30/01
Description: This grant will fund a three-year study to assess the impact of welfare reform on health care access, utilization and health outcomes in women and children.
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Presentations & Publications
Chavkin W, Romero D, Wise PH. State Welfare Reform Policies and Declines in Health Insurance. American Journal of Public Health. 2000; 90:900-908.
Chavkin W, Draut T, Romero D, Wise PH. Sex, Reproduction and Welfare Reform. Georgetown Journal on Poverty and Law. 2000; 7(2): 1- 11.
Romero D, Chavkin W, Wise PH. State Welfare Reform Policies on Child Protective Services: A National Study. Journal of Social Issues. 2000; 56(4): 799-810.
Romero D, Chavkin W, Wise PH. "State of Welfare Reform Policies, Medicaid Declines, and Increased Uninsurance." Presentation at the Maternal, Infant, and Child Health Epidemiology (MICHEP) Workshop, Atlanta, GA, December 13, 2000.
Romero D, Chavkin W, Wise PH. "Welfare Reform and Women's and Children's Health: State Case Studies." Presentation at the Maternal, Infant, and Child Health Epidemiology (MICHEP) Workshop, Atlanta, GA, December 13, 2000.
Romero D, Chavkin W, Wise PH. "Welfare Reform Policies and Maternal and Child Health Services: Findings from a National Study." Presentation at the American Public Health Association annual meeting, Boston, MA, November 13, 2000.
Romero D, Chavkin W, Wise PH. "Women's Reproductive Health in a 'Reformed' Welfare System." Presentation at the American Public Health Association annual meeting, Boston, MA, November 14, 2000.
Krause S, Jones R, Purdin S. Programmatic Responses to Refugees' Reproductive Health Needs. International Family Planning Perspectives. 2000; 26(4): 181-7.
Lamb-Parker F, Piotrkowski S, Baker AJL, Kessler-Sklar S, Clark B & Peay L. Understanding Barriers to Parent Involvement in Head Start: A Research-Community Partnership. Early Childhood Research Quarterly, Forthcoming in 2001.
McGinn T. Reproductive Health of War-Affected Populations: What Do We Know? International Family Planning Perspectives. 2000; 26(4): 174-179.
Matilde M, Irigoyen MD, Findley S, Earle B, Stambaugh K, Vaughan R. Impact of Appointment Reminders on Vaccination Coverage at an Urban Clinic. Pediatrics. 2000; 106(4): 919-23.
Resnicow K, Braithwaite R, Dilorio C, Vaughan R, Cohen M, Uhl G. Preventing Substance Abuse in High Risk Youth: Evaluation Challenges and Solutions. Journal of Primary Prevention. 2000; 21(3): 399-415.
Resnicow K, Odom E, Wang T, Dudley W, Mitchell D, Vaughan R, Jackson A, Baranowski T. Validation of Three Food Frequency Questionnaires and 24-Hour Recalls with Serum Carotenoid Levels in a Sample of African-American Adults. American Journal of Epidemiology. 2000; 152(11): 1072-1080.
Smith L, Wise PH, Chavkin W, Romero D, Zuckerman B. Implications of Welfare Reform for Child Health: Emerging Challenges for Clinical Practice and Policy. Pediatrics. 2000; 106(5): 1117-1125.
Wawer MJ, Eng SM, Serwadda D, Sewankambo MK, Kiwanuka N, Li C, Gray RH. Prevalence of Kaposi Sarcoma-Associated Herpes Virus Compared with Selected Sexually Transmitted Diseases in Adolescents and Young Adults in Rural Rakai District, Uganda. Sex Trans Dis. 2001; 28: 77-81.
Wabwire-Mangen F, Gray RH, Wawer MJ, Sewankambo N, Serwada D. HIV-1 Infection and Malaria Parasitaemia (let). Lancet. 2001; 357:233.
Sewankambo NK, Gray RH, Ahmad S, Serwadda D, Wabwire-Mangen F, Nalugoda F, Kiwanuka N, Lutalo T, Kigozi G, Li C, Meehan MP, Brahmbatt G, Wawer MJ. Mortality Associated with HIV Infection in Rural Rakai District, Uganda. AIDS. 2000; 14: 2391-400.
Gray RH, Kiwanuka N, Quinn TC, Sewankambo NK, Serwadda D, Mangen FW, Lutalo T, Nalugoda, F, Kelly R, Meehan M, Chen MZ, Li C, Wawer MJ. Male Circumcision and HIV Acquisition and Transmission: Cohort Studies in Rakai, Uganda. AIDS. 2000; 14: 2371- 81.
Lutalo T, Kiddugavu M, Wawer MJ, Serwadda D, Zabin LS, Gray RH. Trends and Determinants of Contraceptive Use in Rakai District, Uganda, 1995-1998. Stud in Family Planning. 2000; 31: 217-27.
Emonyi IW, Gray RH, Zenilman J, Schmidt K, Wawer MJ, Sewankambo NK, Serwadda D, Kiwanuka N, Nalugoda F. Sero-prevalence of Herpes Simplex Virus Type 2 (HSV-2) in Rakai District, Uganda. East African Medical Journal. 2000; Aug: 428-430.
Yamin, A. Protecting and Promoting the Right to Health in Latin America: Selected Experiences from the Field. Health and Human Rights: An International Journal. Boston: Francois-Xavier Bagnoud Center for Health and Human Rights. 2001; 5(1): 116-148.