Download Reproductive Life Planning

yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts
no text concepts found
Every Woman Southeast (EWSE) is a coalition of leaders working together to build a multi-state,
multi-layered partnership to improve the health of women and infants in the south. As part of this
effort, EWSE invites you to participate in our Reproductive Life Planning Community Grants
program. The goal of this program is to identify and fund innovative community-based initiatives that
seek to work with traditional and non-traditional partners to improve women and men’s capacity to
plan childbearing and improve preconception and interconception health using a life course approach.
EWSE will fund up to 8 projects that seek to address reproductive life planning from a life course
approach in communities in the southeastern states of Alabama, Georgia, Florida, Kentucky,
Mississippi, North Carolina, South Carolina, and Tennessee. The projects must include an
interdisciplinary team that works across traditional silos and includes representatives from at least one
“non-health” sector or entity. Projects must be willing to work closely with EWSE as a project and
with the larger group of RLP Community Grantees as collaborative learners. Grantees will also
participate in monthly conference calls, a site visit, reporting, and possibly an in-person meeting.
By the end of the 15-month grant period, projects will have made strides to increase awareness in their
communities about the life course approach and reproductive life planning. They will also have
developed new partnerships and systems to increase the number of young women and men in their
community who receive reproductive life planning information and support. We expect that projects
will target populations in their community who have the highest risk for unintended pregnancy. We
anticipate that some proposed projects may be extensions of existing programs. This is acceptable as
long as you demonstrate expanded partnerships and an innovative approach.
Grantee Support from Every Woman Southeast
Grantees can expect full support from the EWSE staff throughout the grant period. That support will
include assistance with planning and evaluation and ongoing access to content experts and technical
assistance to address challenges that arise. Grantees will also have the opportunity to network with
other communities facing similar challenges, as well as to share their successes and lessons learned.
Application Due:
Friday, August 31, 2012, by 11:59pm EST. Please email applications to
[email protected]
Awards Announced: Friday, September 14, 2012
Project Start Date: October 1, 2012
Project End Date:
December 31, 2013
Number of Awards: Up to 8 awards to organizations in AL, GA, FL, KY, MS, NC, SC, & TN
Amount Available per Award: Up to $43,500 over the 15 month grant period
Women and girls in the southeastern region of the United States face many reproductive health and
chronic disease challenges. Rates of tobacco use, hypertension, diabetes, sexually transmitted
infections, and unintended pregnancy are high. Contraceptive use among those not planning to become
pregnant remains suboptimal, and as such the southeast continues to have high rates of unintended
pregnancy. As reported by the Region IV Network for Data Management and Utilization, 75% of live
births to mothers age 19 and younger across the region in 2010 were the result of unintended
pregnancies; additionally, 50% of babies born to 20-29 year old mothers, and 32% of babies born to
mothers age 30 and above were the result of unintended pregnancies.1 While these pregnancies may
have not been unwanted, even mistimed pregnancies have risks for poor maternal and fetal health,
including no opportunity for preconception health care, delayed entry into prenatal care, and increased
risk of preterm birth and low birthweight.2,3 In addition to high rates of unintended pregnancy, 12 %
of women in our region reported an interval of less than six months between pregnancies.1 Compared
to women with 18-23 months between pregnancies, inter-pregnancy intervals of 6 months or less can
lead to dramatically increased rates of preterm birth, low birthweight, and an increased risk of the fetus
being small for gestational age.4 Unintended pregnancies can also affect a woman/couple’s
educational or career goals and financial stability.
Preconception health interventions, such as counseling around folic acid consumption, tobacco
cessation, and management of chronic diseases, improve outcomes for mothers and their babies. Yet,
too many women in the southeast do not have adequate access to care, particularly low-income and
minority women, resulting in inequities in maternal and infant outcomes, including infant mortality.
 Folic Acid: Fifty to seventy percent of birth defects could be prevented by the adequate
consumption of folate in the earliest weeks of pregnancy.5 For greatest benefit, though, folic
acid must be consumed regularly for at least three months before conception.5 Additionally,
women who consume folate for at least a year prior to pregnancy may reduce their risk of
preterm birth.
 Chronic Conditions: Women with uncontrolled hypertension have an increased risk of fetal
complications, including preterm birth, placental abruption, intrauterine growth restriction, and
fetal death, as well as a two-fold increased risk for gestational diabetes and an increased risk of
maternal death.6 Women with Type 1 and Type 2 diabetes face a three-fold increased risk of
birth defects.7 Obesity increases the likelihood of having hypertension and diabetes and
increases the risk of reproductive complications, including neural tube defects, preterm birth,
gestational hypertension and diabetes, and cesarean section. Proactive management of these
conditions before conception and during gestation can greatly reduce the risk of poor
 Sexually Transmitted Infections: Women in the southeast are facing rates of sexually
transmitted infections (STIs), particularly chlamydia and gonorrhea, that are uniformly higher
than most of the United States.8 Chlamydia, gonorrhea, and other STIs contribute to adverse
perinatal outcomes, including infertility, miscarriage, ectopic pregnancy, stillbirth, preterm
delivery, and infant morbidity and mortality. Screening, particularly of women under 25 years
of age, and early treatment can mitigate the risk of these poor outcomes.
 Tobacco: Tobacco use among reproductive-age women in the southeast remains high,
particularly in states such as Kentucky and North Carolina that historically grow and process
tobacco.9 Tobacco use during pregnancy and postpartum results in many poor outcomes for
mothers and their babies, including increased risks of preterm birth, low birth weight,
miscarriage, fetal death, and SIDS. Cessation counseling by providers and community
EWSE Reproductive Life Planning Community Grants RFA
supports, such as excise taxes and smoke-free laws and policies, make a difference in the
health of mothers and infants.
Life Course Approach
The Life Course Approach recognizes that unintended pregnancy and poor birth outcomes for women
in our region do not happen in a vacuum. Instead, this approach, built on the socioecological model,
posits that health outcomes are multifactorial, involving the individual and social, policy, and physical
environments. There is a complex interplay of protective and risk factors that cumulatively contribute
to an individual’s health across the lifespan.10 The Life Course model suggests that there are many
points at which protective factors can be enhanced and the impact of negative factors mitigated,
helping to improve an individual’s health across their life and into the next generation.10 Finally, this
approach enhances our understanding of health inequities. There are four key elements in the life
course approach: Timing, timeline, equity and environment. They are described below.
 Timing: Health trajectories are particularly affected during critical or sensitive periods.
Strategic planning should focus on providing services and supports during critical or sensitive
periods throughout the life span. There is a need for substantial attention on the earliest periods
of development as they lay the foundation for health over the life course and for that of future
 Timeline: Today’s exposures / behaviors influence tomorrow’s health. Strategic planning
should link or integrate health services and systems across the life span and generations. They
should pay special attention to the relationship between the health of parents and children. It is
important to develop systems that provide early identification and intervention of health risks.
 Equity: While genetic make-up offers both protective and risk factors for disease conditions,
inequality in health reflects more than genetics and personal choice. Programs need to move
beyond tracking disparities to identify the root causes. They should use an “equity” lens to
assess the potential for differential impact of public health interventions. Interventions focused
on individual behavior changes need to take into account the broader social and environmental
 Environment: Planning strategies should link women, children and families to other service
systems such as employment, housing, family support, etc. Strategies should focus on
promoting integrated, multi-sector service systems and making sure those systems are
accessible. They should also incorporate a whole person, family and community approach.
Finally, programs should partner with community residents to enable communities to effect
Reproductive Life Planning
Reproductive life planning is the process of developing personal goals about whether or not and/or
when to have children or additional children. Each person will have a different plan, influenced by
personal and cultural beliefs and values. No plan is “wrong,” and a plan may change over time.
However, having a plan is essential. Common components of reproductive life planning include:
Personal beliefs about readiness to parent; relationship stability and social support; financial stability;
educational goals; health behaviors and current health status; and genetic and environmental risks.11
The reproductive life planning process can provide the opportunity to address health concerns before
conception and to better match a contraceptive method to an individual’s short and long term goals,
potentially supporting pregnancy intendedness.12
EWSE Reproductive Life Planning Community Grants RFA
While reproductive life planning does have clinical components, in truth many different types of
partners and groups can start this conversation with their clients. Children affect every aspect of a
family’s life, and the conversation and information about planning for children can be started by many
different people. For example, information on topics such as financial literacy, career planning, and
communication with one’s partner all have relevance to reproductive life planning.
 For more information about the Every Woman Southeast Coalition please go to
For more information about the Life Course Approach, go to
then click on Resources and then Life Course. This section includes a power point presentation
and other helpful information.
For more information on preconception health and reproductive life planning, go to
Every Woman Southeast is funded by the W.K. Kellogg Foundation.
Region IV Network for Data Management and Utilization (RNDMU) Databook, 2010,
2. Brown SS, Eisenberg L, ed. (1995). The Best Intentions: Unintended Pregnancy and the Well-Being of Children
and Families. Washington, DC: National Academy Press.
3. Mohllajee AP, Curtis KM, Morrow B, Marchbanks P (2007). Pregnancy intention and its relationship to birth and
marital outcomes. Obstetrics and Gynecology; 109(3):678-686.
4. Conde-Agudelo A, et al. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006 Apr
19; 295(15):1809-23.
5. March of Dimes Folic Acid Survey, 2008.
6. Hypertension and Pregnancy, Gibson,
7. CDC Preconception Health,
8. US DHHS CDC Div. of STD Prevention. Sexually Transmitted Disease Surveillance 2010. Available from:
9. March of Dimes, Peristats, 2010. Available from:
10. Fine A, Kotelchuck M, Rethinking MCH: The Life Course Model as an Organizing FrameworkUS DHHS, HRSA,
MCH Bureau, 2010.
11. Centers for Disease Control and Prevention,
12. MK Moos, "Family Planning: Foundation for Preconception Health", RNDMU, 2010.
EWSE Reproductive Life Planning Community Grants RFA
 Please submit all required application materials via email by 11:59pm EST on August 31,
2012 to Erin McClain at [email protected]
Applications must address all of the sections listed below.
Page Limit: There is a 5 single-spaced page limit, with no smaller than 11-point font and 1
inch page margins. The cover-page, letters of commitment, and the budget/budget justification
are not included in the 5 page limit.
Applications received after the deadline will not be considered. You will receive email
notification of receipt of your application.
Questions? Contact Erin McClain at [email protected] or 919-808-0989
COVER PAGE: Please include the name of your organization, name of a contact person,
complete address, telephone number, email address, website (if applicable), a paragraph
summary of your proposal, and the applicant’s signature.
Brief description of your community: This section should provide a succinct summary of
your community as it relates to basic demographics, urban/rural area, issues specifically related
to preconception/interconception health, unintended pregnancy, and health and socioeconomic
Statement of Need: This section should articulate the need your team plans to address with
this opportunity. Make sure to identify the characteristics of the reproductive-age population
your project will target.
Project Aims and Strategy: This section should include your team’s thoughts on goals for
your project and how your team might meet these goals. Please link your aims to the data from
Section II.
Discuss how you will address the following components:
a) Build engagement and buy-in from diverse partners by incorporating the life course
approach and preconception health information into trainings and community education
b) Review programs with an eye toward better incorporating the key life course concepts
by examining current programming gaps, duplications, or inefficiencies across the
lifespan and considering a portfolio of programmatic strategies instead of stand-alone
c) Link with non-health sector programs.
d) Encourage more interpersonal and community support programs.
Evaluation: Please describe how you will evaluate the proposed activities, including process
and outcome measures that you will be able to collect and report.
EWSE Reproductive Life Planning Community Grants RFA
 Current Efforts: This section should include a description of current local activities related to
family planning, preconception health, and reproductive life planning, including (if applicable)
existing programs upon which you will be basing your proposed work. Consider the question
of how your identified rationale and proposed goal and strategies relate to these efforts. This
section should also describe the current situation in your community that can facilitate your
efforts, e.g., resources, pending policy changes, programmatic work, relationships, etc.
 Collaboration: This section should identify existing or potential partnerships and community
allies that you believe will be key to your planning and implementation efforts. Consider the
question of the benefits of collaboration on these issues.
 Current Capacity: This section should explain the specific assets/capacity of your team
members to address your proposed strategy.
 Barriers: This section should state some challenges (specific to your community) you think
your team might experience and how you plan to address them. Please be specific, e.g., if time
or money are barriers, discuss specifics about how they are barriers to this work.
 Please provide information on how your team believes they will be able to sustain this work
past the grant period. This section should identify resources needed (including partnerships,
issue champions, financial resources, training, and dissemination), and resources which might
be available to sustain your team’s long-term efforts.
 Please provide information about each team member and their expertise as it relates to this
project. This is in addition to the 5 page limit.
 Please provide letters of commitment that clearly indicate support for the project, including
staff time, throughout the duration of the grant period. This is in addition to the 5 page limit.
 Please see sample budget spreadsheet in Appendix A. Please provide detailed information
about your requested budget items in a separate document. This is in addition to the 5 page
EWSE Reproductive Life Planning Community Grants RFA