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Part 4 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: May 14, 2014
PRESENTED BY:  Candace Kugel, FNP, CNM and Megan Danielson, CNM

View Recorded Webinar 

 Participant Evaluation  

 Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

Migrant women face significant disparities with an additional layer of complexity and require different intervention strategies. Among them are reproductive health, pregnancy and childbirth, sexual and intimate partner violence, and cancers that disproportionately affect women, including cervical and breast cancer. Women often face environmental and occupational health exposures both in the home and in the workplace that heighten health risks. This session will provide a follow-up to the July 2013 presentation “Women’s Health at the Intersection of Poverty and Migration” that was part of our Clinician Orientation to Migration Health webinar series.  During this presentation Candace Kugel, FNP, CNM, and Meagan Danielson, CNM will discuss quality improvement and health care services for migrant women. The HRSA clinical performance measures related to women’s health will be reviewed as well as resources and best practices for improving the health of migrant women.

Learning Objectives:

  1. Describe strategies to address clinical core measures that relate to women’s health .
  2. Discuss case studies that assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
  3. Participants will be able to access clinical resources for working with female migrant patients.

 

FURTHER READING

Low Birth Weight Resources

Cervical Cancer Resources

Other Resources

Part 6 of the 7 webinar series: Clinician Orientation to Migration Health

DATE: presented live on July 17th, 2013

PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.

 Women's Health at the Intersection of Poverty & Migration
View Recorded WebinarParticipant EvaluationPresentation Slides

  

Additional Resources:

MCN Women's Health page

MCN Health Network

Any prenatal patient who may move out of your area before giving birth is eligible to be enrolled in the Health Network. MCN will provide care coordination throughout the course of her pregnancy, until her postpartum visit is completed, to help ensure that there are no gaps in her health care.  512-327-2017 or 800-825-8205.

 

MCN Environmental Health/Pesticides Resources
MCN Family Violence Resources
MCN Streamline articles
Other Women’s Health Resources for Migrant/Immigrant Care
  • Text4Baby:  A free service that provides health education by text to pregnant women and new mothers in English and Spanish
  • The Perinatal/HIV Hotline: The National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) provides 24-hour advice from HIV experts on indications and interpretations of HIV testing in pregnancy as well as consultation on treating HIV-infected pregnant women and their infants. The Perinatal Hotline (888-448-8765) is available 24 hours, seven days per week.
  • Centering Pregnancy: A model of group prenatal care widely used in a variety of settings, including FQHCs and with immigrant populations.  Materials are available in Spanish.
  • Rural Women’s Health Project  Pregnancy fotonovelas in English and Spanish.
  • Auger Communications “Teach with Stories” Prenatal Care fotonovela series and “Pregnancy and Diabetes: Lucia’s Story”
  • Wake Forest University One-page pesticides and pregnancy handout in English and Spanish. 
  • Migrant Health Promotion Farmworker Doula Manual
  • National Women’s Health Information Center. This website and toll-free call center were created to provide free, reliable health information for women everywhere, including lots of materials in Spanish.
  • March of Dimes  An array of materials at various literacy levels and almost everything in Spanish. Pamphlets, videos, "Comenzando Bien" curriculum.
  • Centers for Disease Control The CDC's Spanish website for women's health includes handouts in Spanish that can be printed from the website
  • National Perinatal Association Published transcultural perinatal education curriculum.
  • California Diabetes and Pregnancy Program.  Catalog of patient education materials in English and Spanish for perinatal issues related to diabetes and gestational diabetes.
  • “Diabetes gestacional: Guía para la mujer embarazada”.  Spanish language guide on gestational diabetes from AHRQ.
  • Association of Farmworker Opportunity Programs: “The Fields: The Hidden Faces of Farmworker Women” Interviews and stories about the issues that matter most to farmworker women’s health and well-being
  • Human Rights Watch:  “Cultivating Fear: The Vulnerability of Immigrant Farmworkers in the US to Sexual Violence and Sexual Harassment”
  • Legal Momentum Immigrant Women Program legal rights for immigrant women
  • Trafficking information

 

 

Historically, the field of women's health consisted of issues surrounding reproduction and childbirth. However, increasingly, the health care community has come to see women as a distinct patient group that has unique health concerns over a lifetime. Migrant farmworker women experience unique risks during pregnancy and otherwise, due to the physical demands, environmental exposures and other circumstances of their lives.  The provision of healthcare services to migrant women presents distinctive challenges for both clinicians and organizations.  MCN’s Candace Kugel, CRNP, CNM, and Melissa Bailey, Executive Director of NC FIELD, Inc., both with many years of experience with this population will discuss the problems, solutions and rewards of working with migrant women, through case illustrations and review of resources.

After taking this webinar:

  • Participants will be able to identify at least 2 health risks unique to women farmworkers and the impact of those challenges on work, nutrition and health.
  • Participants will be able to describe environmental and occupational health exposures relevant to farmworker women of reproductive age.
  • Case studies will assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
  • Participants will be able to access clinical resources for working with female migrant patients.

PRESENTER BIOS:

Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health, Migrant Clinicians Network

ckugel@migrantclinician.org

Candace Kugel is a Family Nurse Practitioner and Certified Nurse-Midwife with over twenty years of experience in health care for the underserved. She has worked in various clinical settings, including family planning, migrant health, community health center, and private practice. She has worked almost exclusively in rural settings.

Candace has also been active in aspects of health care other than direct patient services. She has served as a clinical instructor for nurse practitioner, nurse-midwife, nursing, and medical students, and currently has faculty appointments with the University of Cincinnati and Penn State University’s Schools of Nursing. She has worked in program development in various arenas, including co-founding a “Stork’s Store” prenatal incentive program, initiating a natural family planning education program, and teaching childbirth education classes.

Melissa Bailey, Executive Director of North Carolina Field, Inc.

 mbailey@lenoir.k12.nc.us

Melissa Bailey is a native of southern West Virginia. She has worked in North Carolina migrant education programs since 2001. In 2010 AFOP’s Children in the Fields Campaign assisted community workers with forming the nonprofit NC FIELD. This effort aimed to establish an organizational empowerment and advocacy model to build capacity in farmworker communities, particularly among child laborers in agriculture. In 2012 Melissa became the Executive Director of NC FIELD. 

She has presented to local, state, and national stakeholders; assisted media; has worked as a research assistant on farmworker studies; assisted with organizational development and the leadership training of child farmworkers, and is a successful field organizer, consultant, and project manager. Melissa holds a certificate in Nonprofit Management from Duke University, among other certifications related to the delivery of supplemental education services and data.

In her spare time Melissa enjoys reading, writing, gardening, and spending time with loved ones.

Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals.  The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Ostetricicans and Gynecologists and the American Society for Reproductive Medicine join leading scientists and other clinical practitioners in calling for timely action to identify and reduce exposure to toxic envrionmental agents while addressing the consequences of such exposure.

This webinar is the sixth in a series of seven in our Clinician Orienatation to Migration Health.

DATE RECORDED: Wednesday, July 17, 2013
PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.

To view the recorded version of this webinar, click here.

 

Geoffrey M. Calvert, Walter A. Alarcon, Ann Chelminski,
Mark S. Crowley, Rosanna Barrett, Adolfo Correa, Sheila
Higgins, Hugo L. Leon, Jane Correia, Alan Becker,
Ruth H. Allen and Elizabeth Evans
doi:10.1289/ehp.9647 (available at http://dx.doi.org/)
Online 21 February 2007

Geoffrey M. Calvert, Walter A. Alarcon, Ann Chelminski,Mark S. Crowley, Rosanna Barrett, Adolfo Correa, SheilaHiggins, Hugo L. Leon, Jane Correia, Alan Becker,Ruth H. Allen and Elizabeth Evans

doi:10.1289/ehp.9647 (available at http://dx.doi.org/) Online 21 February 2007

Introduction

In August of 2005, the North Carolina Division of Public Health, Occupational and Environmental Epidemiology Branch (OEEB) was notified that three women who had worked on farms in North Carolina owned by Ag-Mart had delivered infants with birth defects.  All three births took place in Florida where the women also worked on Ag-Mart farms and lived near each other.  This report summarizes the OEEB’s investigation and assessment of the pesticide exposures likely experienced by these women while in North Carolina. 

Latinas are experiencing high rates of sexually transmitted diseases (STDs), teen childbearing, and unintended pregnancy. This report presents nine recommendations for sexual and reproductive health clinics and providers to increase young Latina women’s access to reproductive health services. The recommendations are based on findings derived from 14 focus groups conducted by Child Trends in three cities in the United States with young adult Latina women (18-24 years-old) and with reproductive health care and social service providers serving large Latina populations.

Urinary Tract Infection treatment protocol decision tree.
Sample protocol for the assessement and care of prenatal patients.

Presentations by Pacific Northwest Agricultural Safety and Health Center (PNASH): 

 

1. Age Considerations: Impacts on Pesticide Exposure and Health Outcomes

2. How to Identify the Products Your Patients are Exposed to

3. Reporting, Surveillance, Legal Aspects of Pesticide Related Illnesses

4. The Work to Home Pesticide Exposure Pathway: How to Protect Pregnant Women and Children (English and Spanish)

5. Chronic Health Effects of Pesticide Exposure

An MCN/CDN webcast facilitated by Candace Kugel, FNP, CNM

Program information for counties of Wicomico, Somerset, or Worcester residents. Supported by a Grant from the Maryland Affiliate of Susan G. Koman for the Cure this presentation outlines eligibility for the Koman Program, what the Koman Program provides, documentation, and who to refer clients to.

This hour long webcast features Jennie McLaurin, MD, MPH – a former medical director of a migrant and community health center and a pediatrician with over 20 years of practice serving farmworker and immigrant populations.

 

There is convincing evidence that breastfeeding provides substantial health benefits for children and adequate evidence that breastfeeding provides moderate health benefits for women. This link provides a summary of the 2008 recommendation of the U.S. Preventive Services Task Force (USPSTF) on counseling to promote breastfeeding.

To help ease the burden of displacement in the face of disaster/emergency, new information for pregnant women and mothers of young children has been uploaded to the Centers for Disease Control and Prevention’s (CDC) web site. Because you are recognized as an important champion in the community and can provide a channel for vital emergency information.

Palm Beach Post’s page Farmworkers and Pesticides. Excellent artilces on Florida's farmworkers, with special attention to pregnant farmworkers and birth defects.

They offer free birth control and screening services for young or low-income women and girls. They also have support groups and counselors to work with teens who are pregnant. Phone: 1 (800) 230-PLAN [7526]

Between Women: provides support services, promote awareness and advocates throughout the community. This organization is the only one in California's Imperial Valley devoted exclusively to breast health.

The fourth edition of the data book, developed by the Health Resources and Services Administration's Office of Women's Health, presents a profile of women's health. It highlights racial and ethnic disparities in women's health and is intended to be a concise reference for policymakers and program managers.

This web site and toll-free call center were created to provide FREE, reliable health information for women everywhere.

The RWHP, founded in 1992, develops community-based educational materials. independently as well as in collaboration with other grass-roots organizations. Their projects focus on the health issues of rural women and their families, with a special emphasis on the challenges faced by Spanish-speaking farmworking families.

The CDC's Spanish website for women's health. Includes handouts in Spanish that can be printed from the web.

A wide array of materials at various literacy levels and almost everything in Spanish. Pamphlets, videos, "Comenzando Bien" curriculum.

This website includes free handouts in Spanish that can be downloaded directly from the site.

HRSA/HAB has developed a new 24-hour clinical consultation service, the National Perinatal HIV Consultation and Referral Service (Perinatal Hotline). This service provides 24-hour advice from HIV experts on indications and interpretations of HIV testing in pregnancy as well as consultation on treating HIV-infected pregnant women and their infants. The Perinatal Hotline (888-448-8765) and the PEPline (888-448-4911) are both available 24 hours, seven days per week. The Warmline (800-933-3413) is available 8 a.m. to 8 p.m. (EST) Monday through Friday.

Catalog of patient education materials in English and Spanish for perinatal issues related to diabetes and gestational diabetes.

Buttons available in English and Spanish.

The goal of Women's Way is to reduce morbidity and mortality by increasing breast and cervical cancer screening. This program promotes participation of women ages 18 through 64 who are income eligible, uninsured or underinsured. No-cost screening is available to eligible women. For more information call 701.222.6527 or 1.800.449.6636 or visit the website.

This site offers a list of contractors providing services and a map. For information, including sites anywhere in PA offering free or discounted screening, contact Cancer Information Services at 1-800-4-CANCER or 1-800-422-6237.