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MINUTES - Draft ORANGE COUNTY BOARD OF HEALTH February 26, 2020 Dr. Kristin Tully, Center for Maternal and Infant Health at the UNC School of Medicine, along with assistance from Board of Health member, Dr. Alison Stuebe, provided an overview of their findings from a human-centered design project involving social determinants of health (SDoH) in maternity care. A tip sheet for health care providers was also included in the Board's agenda packet. Below are some highlights. • The project included workshops where mothers and health care professionals met and whose purpose was to build relationships, develop clinical workflows and make improvements. There were also two activities, journey maps and cards that aided in addressing feelings and the emotional needs around SDoH. Journey maps were used to show where they resonated with situations presented. It was found to be more effective that just asking them to talk about their lived experiences. The cards were used in a similar fashion; although, explanations were written on them to further express their thoughts and experiences. • The mothers were given gift cards for their time and participation. Mothers were also encouraged to bring their infants. Transportation and food were offered. • Some additional points presented: ➢ Patients need to feel listened to. They need to be set up to thrive. Assist in establishing humanity in health care. ➢ We live in either privilege or oppression. More people of color are living in poverty. ➢ Screening and mitigating for SDoH hasn't been fully implemented. It can be a difficult topic to approach, especially when time is limited during a medical visit. Four out of five health care professionals don't feel comfortable asking SDoH questions. Engagement needs to be authentic as patients will feel more open. The mothers in the project preferred that SDoH questions are embedded into other questions as some of them felt ashamed when asked separately. ➢ When engaging with the mother, health care providers can't make it about surveillance as people don't like being tracked. The mothers had also stated that they need to leave with resources vs finding out about resources after they're needed. Health care providers need to be informed of resources and that they patient is eligible to receive them. ➢ Clinician turnover can make staying up to date impossible which in turn could possibly affect being attentive to some patient barriers which cause them to miss multiple appointments and not refill medications. Patient barriers to care include finances, transportation, communication breakdowns and time. Paying for parking and transportation need to be considered. If Medicaid has paid for their transportation, a patient could possibly miss their ride if the appointment runs over. ➢ There should be trainings around communication and biases for patients and clinicians. The BOH members had questions that were addressed by Ms. Tully and Alison Stuebe. B. Campus & Community Coalition Update Elinor Landess, Director of the Campus & Community Coalition to Reduce the Negative Impacts of High Risk Drinking (the CCC), presented an update on the status of the Coalition's activities. Below are some highlights: • The CCC was formed in 2014 as a collaborative effort with the Town of Chapel Hill, UNC Chapel Hill, the Orange County Health Department and the Orange County ABC Board S:\Managers Working Files\BOH\Agenda &Abstracts\2020 Agenda &Abstracts/ February Page 2