Howard University

Problem:

The nation is struggling with persistent racial and ethnic health disparities in all Healthy People 2010 focus areas including maternal and child health (MCH). African Americans have the highest rates of maternal and infant mortality in the nation. So often African Americans, Hispanics/Latinos and American Indians have limited access to resources due to high rates of poverty and unemployment making them less likely than Caucasians to receive high quality health care. Research has shown that minority health professionals are more likely to serve minority and medically underserved populations. Yet, despite this fact, there is a severe under¬representation of minorities in the health professions. The Healthy People 2010 Primary Care Objective 1-8. "In the health professions, allied and associated health profession fields, and the nursing field, increase the proportion of all degrees awarded to members of underrepresented racial and ethnic groups" sets forth the national goal of increasing minority representation in the health professions. Diversifying the healthcare workforce is seen as a key strategy to addressing the severe health disparities that exist among minority populations. To that end, several initiatives both nationally and regionally have been established. Many of these programs are graduate level and current MCH professional focused. Few focus on the beginning of the pathway/pipeline, the undergraduate student. The undergraduate level is an excellent time to nurture future interest in pursuing a career in the MCH professions. Howard University's Pathways to Maternal and Child Health Professions will address this critical gap by implementing a program that increases students' interest in MCH public health professions (i.e., health education, pediatrics, public health nursing, social worker, speech language pathology, etc). The program, located at one of the nation's premier historically black colleges and universities (HBCU), will target financially disadvantaged underrepresented undergraduate students and provide training and mentoring that seeks to promote the development of a culturally diverse and representative health care workforce.

Goals and Objectives:

Howard University's Pathways to Maternal and Child Health Professions has two goals: (1) Promote the development of a culturally diverse and representative health care workforce by recruiting, training, and retaining students from underrepresented minorities into Maternal and Child Health (MCH) public health professions; and (2) Develop institutionalized broad-based support within Howard University for MCH training. Below are the goals and corresponding objectives that will be achieved during the program: Goal 1: Promote the development of a culturally diverse and representative health care workforce by recruiting, training, and retaining students from underrepresented minorities into Maternal and Child Health (MCH) public health professions. Objective 1.1: Develop and integrate a MCH focused topic in the current undergraduate health education curricula to increase students' interest in MCH public health professions. Objective 1.2: Develop and implement an undergraduate, The Health of Women, Children and Families, course. Objective 1.3: Develop and implement an undergraduate MCH summer institute course. Objective 1.4: Recruit and retain 15 financially disadvantaged underrepresented undergraduate students for the summer course. Goal 2: Develop institutionalized broad-based support within Howard University for MCH training. Objective 2.1: Incorporate undergraduate The Health of Women, Children and Families" course as a required course for Health Education majors. Objective 2.2: Incorporate undergraduate The Health of Women, Children and Families course as one of the major elective courses for sociology, nutrition sciences, nursing, and other health and social science related undergraduate majors. Objective 2.3: Foster MCH as a concentration for the MPH program and as a PhD level Health Education concentration. While this objective focuses on graduate level training, it is anticipated that the ground swell of interest generated from the graduating undergraduate students as well as the lobbying of the Advisory Board will logically move the University to achieving this objective and therefore warrants mentioning.

Methodology:

The objectives described above will implemented in a variety of ways including: the delivery of an undergraduate semester and summer MCH institute, provision of field practicum experiences for undergraduate students which will expose students to the various MCH career professions, and linking students with appropriate MCH profession leaders for mentoring and leadership skills development. These activities will be guided by an Advisory Board whose membership will consist of faculty and staff of Howard University's College of Arts and Sciences, Medical School, and Allied Health Sciences and Nursing Division. In addition, Project Directors from two existing MCHB long-term MCH programs will serve as Advisory Board members as well as guest lecturers for both the semester and summer course. The State Title V Agency Director and the Association of Maternal and Child Health Programs (AMCHP) will also serve as Board members. Specific strategies for recruitment and retention include adding the course as a required elective to the undergraduate curriculum of Health Education, Sociology and Anthropology, Allied Health Sciences and Nursing, and the School of Communication, meeting with campus student organizations during their monthly meetings to inform their membership of the new course and MCH focus, sending blast email, via the University's student email system, to all undergraduate students informing them of the course and summer institute, and placing an ad in the Hilltop, the University's student newspaper. Students will also be recruited from the thirteen schools in the Consortium including the Historically Black Colleges and Universities (HBCUs), specifically, the University of the District of Columbia, Bowie State University, and Morgan State University. To assist with student recruitment and retention efforts for the summer institute, the program will provide support in the form of tuition and fees as well as a stipend for 15 economically disadvantaged students to attend the summer training course.

Coordination:

The Department of Health, Human Performance and Leisure Studies has established direct connections with the State Title V agency, the Association of Maternal and Child Health Programs (AMCHP), the Departments of Sociology and Anthropology within the College of Arts and Sciences, the Division of Allied Health Sciences and Nursing, Howard University Medical School, Howard University Child Development Center, and Howard University Hospital. A major partnership has been established with two MCHB long term MCH training programs: the Howard University/NIDCD Center for Leadership in Communications Disorders and the Maternal and Child Health Program at the University of Illinois.

Evaluation:

The evaluation of the program will encompass both formative and summative activities. Specific process evaluation activities will include surveying students and field preceptors to determine achievement of targeted MCH competencies, tracking progress in meeting program implementation milestones, assessing outreach and recruitment activities, and obtaining feedback from students on the course. A unique component of the process evaluation and integral part in the continuous quality improvement process will be the formation of a Student Course Evaluation Committee. The purpose of the Course Evaluation Committee is to ensure that the students' academic and intellectual needs are being met as part of their participation in the course. Summative activities will include surveying students taking the semester course and/or summer institute to determine whether or not the course had an influence on their desire to pursue a MCH related health profession, conducting a follow-up survey with students after they graduate to determine if they pursued MCH professions and to what extent the program influenced their decision. A robust student database will be developed to collect the information needed to conduct the evaluation.