Priorities 1 & 2: Nebraskans will have reduced heart disease, stroke and cancer mortality, morbidity and associated risk factors.

Heart disease, stroke and cancer are among the top five leading causes of death in Nebraska. They are some of the most widespread and costly health problems facing our nation and are among the most preventable. The morbidity and mortality of heart disease, stroke and cancer are caused by many factors including high risk behaviors, poor access to care, and lack of understanding of screenings. Strategies that successfully impact these three major health problems are similar, therefore SHIP Priorities 1 and 2 were combined to create a comprehensive approach capitalizing on the efforts of collaborative partnerships.

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Nebraska SHIP Priorities 1 & 2: Nebraskans will have reduced heart disease, stroke and cancer mortality, morbidity and associated risk factors.

For this SHIP goal, several activities were planned for implementation:

  • Develop and evaluate community health hubs.
  • Develop standard guidance templates for community health hubs.
  • Disseminate best practices for community health hubs.
  • Implement a statewide education campaign to promote health screenings at community health hubs.
Strategy

A map of the Federally Qualified Health Centers (FQHCs) and Community Health Hubs among local health department districts.

How We Impact

In 2012 the DHHS Division of Public Health, Office of Women's and Men's Health initiated a Community Health Hub pilot project in six regions across the state. This SHIP objective provides for the support the the Health Hub framework designed to provide coordinated health services and screenings.

Why Is This Important?

The Community Health Hub is a framework where public health resources are passed down to the community throughout collaborative teams and activities in a structured manner that improves access to high-quality preventive screening services, enhances community linkages, and strengthens data collection and utilization.

Definition

This scorecard is created to track performance, therefore the demonstration of data (numerical and narrative) describes what we define as success. In some instances, a trend may be moving in the wrong direction, but still may be within our 'Target for Success' area. The use of Color Arrows (and sometimes also Color Bands) help to define the Target for Success and Current Progress.

Green, Black and Red color arrows are used to reflect our 'Current Progress' status.

  • GREEN Arrow = We're getting better!
  • BLACK Arrow = We're maintaining our position.
  • RED Arrow = We're going in the wrong direction.

Green, Yellow or Red color bands are used to reflect our 'Target for Success' zones.

  • GREEN Color Band = We've reached our Target for Success!
  • YELLOW Color Band = We're making progress, but not quite there yet.
  • RED Color Band = We're below our Target for Success.

Data is described with the Time Period, Actual Value, Target Value, Current Trend and Baseline Change %. These mean:

  • Time Period - The most current time period for which the data were available.
  • Actual Value - The actual level of achievement, the most current data point for the indicator, also shown in a Color Band to reflect if that value is or is not within our Target for Success zone.
  • Target Value - The desired level of achievement for the data indicator.
  • Current Trend - The direction of progress is shown by a Color Arrow to reflect our Current Progress status, and also noting for how many data points the direction been occurring.
  • Baseline Change % - The percentage of change between the baseline data point and the current data point (actual value); also shown with a Color Arrow to describe Current Progress status.
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As of July 2015, all 16 Community Health Hubs have completed their Environmental Scans, Resource Scans and have created their own Resource Directories. 13 out of 16 have completed their Evidence-based Strategy Documents and have begun to implement evidence-based strategies within their communities and clinics. To date, the biggest challenge has revolved around sufficient manpower of key staff persons within the Division of Public Health and at Community Health Hubs.

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Nebraska SHIP Priorities 1 & 2: Nebraskans will have reduced heart disease, stroke and cancer mortality, morbidity and associated risk factors.

For this SHIP goal, several activities were planned for implementation:

  • Provide training opportunities for lactation professionals that are designed to support IBCLC certification.
  • Develop a preceptor model and preceptor sites for lactation professionals.
  • Provide trainings for community health workers about lactation support services.
What We Do

The Nebraska Breastfeeding Coalition has developed The Community Breastfeeding Initiative (CBI), which aims to bring breastfeeding support and resources to local communities across Nebraska willing to engage community stakeholders impacting breastfeeding support.Built off the success of the Lincoln Community Breastfeeding Initiative and pilot tested in Norfolk, the Nebraska Breastfeeding Coalition offers mini-grants and trainings to communities in need of resources, education and support to advance their community breastfeeding efforts with the goal of strengthening community breastfeeding support networks by engaging stakeholders, providing trainings and connecting local and state breastfeeding advocates.

Who We Serve

This map illustrates the gap of IBCLC support across Nebraska’s 62 birthing hospitals.

The uneven blue areas indicate the location by zip code of the IBCLC. The light blue areas indicate there is 1 IBCLC in that zip code and the darkest blue areas indicate there are 4 IBCLCs in that zip code. For some counties, Lancaster for example, you need to add the IBCLCs up for all the zip codes. There are 7 IBCLCs in Lancaster County to serve approximately 5000 births.Hall County (Grand Island) has 1 IBCLC for over 1000 births – same as Scottsbluff County. And then there is dozens of smaller hospitals with 50 – a few hundred births annually and they have no IBCLC in their counties.

The red dots are the sites of our birthing hospitals.The larger the dot, the more births occurring at that site.

Even though nearly half (48%) of the 26,000 births occur in Lancaster and Douglas Counties, there is a clear need for increased Lactation Support Providers – IBCLCs - in rural, central, north eastern and western Nebraska.

How We Impact

Additionally, with support from the State Health Improvement Plan, a three part webinar series was presented with speakers from the International Board of Lactation Consultation Examiners, the United States Lactation Consultant Association, The Nebraska Perinatal Quality Improvement Collaborative, local pediatricians, IBCLC’s, and nurses.These webinars aimed to increase lactation support throughout the state and to inform potential IBCLC candidates of the different pathways available to them in pursing their certification. Research shows that adoption of the practices to encourage and support breastfeeding could result in a $51,000,000 annual reduction of healthcare costs in Nebraska if 60% of babies were fed exclusively breast milk for the first 6 months (based on Bartik & Reinhold, 2010). Savings include costs associated with NEC, otitis, gastroenteritis, hospitalization for lower respiratory infection during infancy, atopic dermatitis, SIDS, childhood leukemia, asthma, type1 diabetes and obesity.

Why Is This Important?

One of the recommendations made in the Surgeon General's Call to Action to Support Breastfeeding is to ensure access for breastfeeding mothers to services provided by International Board Certified Lactation Consultants (IBCLCs). IBCLCs are healthcare professionals who specialize in the clinical management of breastfeeding; they are the only healthcare professionals with this type of certification and so far the only ones potentially reimbursable by insurers. They work with mothers to solve breastfeeding problems and educate families and healthcare professionals about the benefits of breastfeeding. One of the main barriers to increasing lactation support in this manner is the lack of reimbursement by private and public insurers. Rates of exclusive breastfeeding and of any breastfeeding are higher among women who have had babies in hospitals with IBCLCs on staff.

A statewide Breastfeeding Coalition was established in 2008 and is supported by a part-time director and leadership team, who have provided education, leadership and support for breastfeeding initiatives statewide.

Currently, there are 4.13 IBCLCs per 1000 live births in Nebraska, with a disproportionate number of these lactation professionals located in the Eastern part of the state. Increasing access to IBCLCs is a key recommendation found in the Surgeon General’s Call to Action to Support Breastfeeding and the Centers for Disease Control & Prevention Guide to Evidence-Based Interventions.

Definition

This scorecard is created to track performance, therefore the demonstration of data (numerical and narrative) describes what we define as success. In some instances, a trend may be moving in the wrong direction, but still may be within our 'Target for Success' area. The use of Color Arrows (and sometimes also Color Bands) help to define the Target for Success and Current Progress.

Green, Black and Red color arrows are used to reflect our 'Current Progress' status.

  • GREEN Arrow = We're getting better!
  • BLACK Arrow = We're maintaining our position.
  • RED Arrow = We're going in the wrong direction.

Green, Yellow or Red color bands are used to reflect our 'Target for Success' zones.

  • GREEN Color Band = We've reached our Target for Success!
  • YELLOW Color Band = We're making progress, but not quite there yet.
  • RED Color Band = We're below our Target for Success.

Data is described with the Time Period, Actual Value, Target Value, Current Trend and Baseline Change %. These mean:

  • Time Period - The most current time period for which the data were available.
  • Actual Value - The actual level of achievement, the most current data point for the indicator; also shown in a Color Band to reflect if that value is or is not within our Target for Success zone.
  • Target Value - The desired level of achievement for the data indicator.
  • Current Trend - The direction of progress is shown by a Color Arrow to reflect our Current Progress status, and also noting for how many data points the direction been occurring.
  • Baseline Change % - The percentage of change between the baseline data point and the current data point (actual value); also shown with a Color Arrow to describe Current Progress status.
Partnerships

The Really?Really. campaign:

The Really? Really. campaign was developed through a partnership between Live Well Omaha Kids and the Nebraska Breastfeeding Coalition to increase knowledge around the importance of breastfeeding for physicians and other healthcare providers, and moms and their support network. The easy-to-understand and eye-catching materials are available for anyone to download and to date, they have been downloaded in 47 states, 9 countries and 4 tribal communities. This link contains additional information on how to obtain the material for distribution: http://www.reallyreally.org/

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