Santa Ana, California

Katie worked with MOMS: Maternal Outreach Management System, which is a non-profit organization located in Santa Ana, California. MOMS was created in 1992 in response to a prenatal and delivery crisis among California's uninsured Hispanic population. MOMS serves to connect their clients with prenatal care, health screenings and support services, while facilitating health education using a one-on-one case management system. MOMS staff provides a consistent level of support to clients through group classes, home visits and other contacts.

Since 1992, MOMS has served more than 30,000 women and their babies in Orange County. Countless fathers and other family members have benefited as well. MOMS clients are low-income women who are pregnant or have given birth within the last year. Most clients are the "working poor" who are uninsured or underinsured. Client services are offered at no cost to all those who qualify. MOMS serves more than 5,000 women and their families each year.

MOMS on-site health education classes include:

o Prenatal Classes
o Childbirth Preparation
o Taller para Papas (Workshop for Fathers)
o Building Blocks for Healthy Families
o Mommy and Me (Infant Development Workshop)
o Maternal Depression Support Group

MOMS received a grant from the Office of Women's Health to implement a postpartum program that addresses women's long-term health issues, instead of purely focusing on the pregnancy and baby. It was my good fortune to arrive during this period and I was given the task of developing such a program. In effect, I created a chronic disease prevention program deemed 'Pasos Pequeños' or small steps, which advocates small changes women can make in their daily lives to prevent chronic illnesses later in life.

Mission:

To help low-income and underinsured Hispanic mothers make positive choices in their current health behaviors to improve the likelihood of maintaining good health throughout their lifetime using a health promotion model.

Goal:

For each participating woman in 'Pasos Pequeños' to improve at least three current health behaviors, which can include any three of the following:

Increase consumption of fruits and vegetables, ideally five servings per day
Decrease the usage of lard while cooking
Increase amount of exercise per day, ideally 30 minutes per day
Reduce the incidence of diabetes within this population (immeasurable)
Reduce exposure to second hand smoke and/or eliminate smoking
Achieve one preventative health screening per year (immeasurable)
Introduce one new stress reducing behavior and/or lower current stress levels

Objectives:

- By the end of the program (6 sessions), low-income Hispanic mothers who receive the program will have a 20% increase in individual health knowledge.

- By the end of the program, participants who have received the program will report a 20% increase in self-efficacy.

- After receiving the program, participants will report a 10% increase in physical activity.

- By the end of the six-session program, participants will report a 20% increase in fruit and vegetable consumption.

Focusing on the Woman

Women often neglect their own health in favor of their family, due to maternal roles and responsibilities, however the mother's health is just as important if not more important than others. This program reinforces the importance of a mother's role in the family and how it impacts the family as a whole. In this sense, the empowerment of women is a vital component of 'Pasos Pequeños', encouraging and enabling women to take control over their lives and make positive health choices, for themselves and their families.

Background:

The leading causes of death in the U.S stem from chronic illnesses, which are preventable with dietary changes and exercise. Minority populations have been disproportionately impacted by the obesity epidemic, which leads to numerous health problems. Currently 71.9% of Mexican American women can be classified as overweight or obese, compared to 57.3% of non-Hispanic whites (niddk.nih.gov). Additionally, the NIH estimates the total costs associated with such conditions amounted to $117 billion in 2001 (niddk.nih.gov).

Methods:

'Pasos Pequeños' (Small Steps) advocates slight changes women can make to prevent chronic illnesses. Our target population included low-income, postpartum Hispanic women already enrolled in MOMS case-management program. The course consisted of six health education classes that met weekly, which provided the mothers with health information and a supplementary yoga session for stress reduction. Course topics included: Overweight/Obesity, Diabetes, Physical Activity, Heart Disease/Nutrition, Stress and Smoking.

Results:

The evaluation measures revealed that participants increased their health knowledge by 11% and improved 2 health behaviors. The self-reported surveys showed that 100% of the women stated they benefited from the classes, learned "a lot" and want more yoga. Stress levels improved drastically with 91% of participants reporting "normal stress", a 21% increase from the pre-test. Additionally, the women felt more satisfied with their physical condition after the course, a 15.8% increase from the pre-test.

Conclusions:

This project demonstrates that a holistic approach to disease prevention can be effective in empowering women, increasing self-perception and decreasing stress levels, all of which are advantageous for health and beneficial to society as a whole.

Overall, I feel that the 'Pasos Pequeños'course greatly benefited the program participants as well as the larger community. The most significant outcome from this program was the overall decrease in stress levels and increase in contentment with respect to physical condition. These findings demonstrate that women feel better about themselves as a result of this class. In support of this notion, almost all of the women reported that they felt 'excellent' during the class, proving that our weekly sessions provided them with a safe place where participants felt good about themselves and encouraged each other to adopt healthier practices.

The evaluation from this six-week program has demonstrated that with the introduction of health education, an open group discussion, yoga and stress reduction techniques the women feel much better about themselves as a whole. Instead of using a purely didactic teaching model, we hoped to supply these women with tools to facilitate long-term behavior change to promote a healthier standard of living.

Teaching them various yoga positions to foster better digestion, increase metabolism and alleviate back pain will undeniably provide them will better coping strategies for health problems and stress reduction in the future; especially for women who can't afford health clubs or gym memberships. In addition, showing these mothers how to tune into their breath and relax, slows down the central nervous system and heart rate and enables them to take a little time for themselves in this busy and demanding world in which we live.

By improving the women's levels of happiness, as well as their physical and psychological well-being, we are undoubtedly impacting the entire family unit. When the women are empowered and feel in control of their own lives, the whole family prospers. The mothers are making healthier choices for their children and husbands by promoting healthier behaviors, positive attitudes and utilizing their power in the kitchen to cook healthier meals.

In effect, we hope to decrease the prevalence of chronic illnesses among this low-income, predominantly Hispanic population, which is at a higher risk for such diseases. By empowering and enlightening the mothers, we aspire to influence the overall health of the family to create happier, healthier and better educated communities, which will undoubtedly benefit our overall society.

 

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