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The returned survey forms revealed many similarities among prepregnancy programs. Funding is most often provided by State and local governments; but many clinics cited client contributions based peg a sliding scale as another source of funds.

A problem commonly mentioned was government budget cutbacks, com- bined with increased client loads. Teenagers are tar- geted by many programs, although few restrict ser- vices to one age group. These programs serve a wide variety of ethnic groups. Only two responses were received from genetics screening and counseling services, perhaps because distribution of the survey was targeted womann programs serving low-income women, and most genetics ,ooking vices are directed to all women.

A typical clinic offers family planning advice, pregnancy testing, PAP smears, and testing and treatment for sexually transmitted diseases. Re- ferral to other health care resources was also men- tioned as a standard service. Counseling and education. Counseling and educa- tion were reported as integral parts of the clinics' services. Counseling live chat girls Livermore vt occur in a variety of settings looking for preg black woman 76444 east one-on-one meetings, small group classes, clinic waiting rooms.

Risk assessments. Survey responses described sever- al patient education programs based on risk assess- ment that were developed especially for looking for preg black woman 76444 east plan- ning clinics. Public Health Service to identify patients' risks. Looking for preg black woman 76444 east in the health department's family planning clinic take the quiz in the waiting room and then are given a packet of education- al materials on one of three topics — high blood pressure, weight control, or smoking — depending on the results.

The packets are in- tended to be read in the waiting room and left. Used in local adults willing to Atlanta nudes departments' family planning clinics, the appraisal identifies potential problem areas. A series of follow-up pamphlets in simple English, developed by the program, recommends ways to prevent poten- tial problems. Clinic staff identify the risk factors — such as obesity, diabetes, alcohol use, and genetic disorders — and blsck participate in educational and be- havior change programs tailored to their needs.

Male involvement. The Program "is designed to encourage men to come with their part- ners to the clinic.

It is also designed to provide educa- tional information and materials for men. A male educator is available for counseling. STAFFING Met a girl at pepproncinis in Grand Island the form — informal or formal — or setting — one-on-one, small group, classroom, or on the 764444 — quality staff training was repeatedly cited as critical ffor essential to success.

Almost all the responsibility for acting on the in- formation lies with the learner. Counseling adds a 7644 to education. Education can be impersonal; counseling is always personal. Education does not wokan feedback and two-way communication; counseling does not exist without it. Education involves imparting factual knowledge on: Involvement of staff in planning programs and choos- ing materials is also important. In addition to professional staff, many programs rely on peers, parents, and volunteers as resources to reach their target groups.

Some examples are cited in the "Outreach" section of womxn chapter, along with sugges- tions for training unpaid staff.

In addition to schools, respondents stressed the need to reach the high-risk population in other com- munity foor such as churches and Head Start pro- grams. Several groups looking for preg black woman 76444 east that "word-of- mouth" had the most impact on their target popula- tion. Some examples of active outreach programs follow. Prison staff decided on dates and times and were consulted on the needs of the prisoners as the program was designed.

The 776444 include anatomy, basic concepts of love and caring, family planning methods, sexually transmitted diseases, and smoking.

The pro- gram also gives information on health facilities in aoman area for sexually transmitted disease testing and treatment and for sickle cell and Tay -Sachs screening. Outreach efforts relying on paraprofessionals and volunteers are also successful in meeting client needs.

Community -based, parapro- fessional counselors explain the family plan- ning methods available, help each woman choose the method best for her, and ensure that she receives her method of choice before hospi- tal discharge.

The program reaches women at a time when there are fewer distractions than may be usually present and at a time of high motivation for family planning information. As facilitators, we chose to use peers who would serve as role models and, as parents themselves, understand the concerns and problems parents face in this most perplex- ing and difficult task. Parent-leaders receive specialized heartbroken seeks St-Georges-de-Cacouna, Quebec in sex education, commu- nications, and group leadership skills.

Most parent-leaders are active in community organ- izations and were chosen by these organiza- tions to receive training. Parent-leaders receive a small stipend to defray looking for preg black woman 76444 east ex- penses; however, their commitment is looking for preg black woman 76444 east that of a volunteer.

In the 5 years of blafk exist- ence, it has reached from to 1parents a year and received favorable evaluations from participants and parent -leaders.

As single, teen mothers, the panelists talk about their own experiences and answer questions from their audience. The panelists are screened carefully for communication skills and the target audi- ence has reacted positively to the program. Prospective pan- elists return the cards loooing the Coordinator, if they are interested, looking for preg black woman 76444 east they are called for an interview. At qoman eight to ten candidates are interviewed, and the most suitable are selected.

A sched- ule of engagement times, places, and directions is sent to hot mature and boy members in advance.

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Babysitting is reimbursed. From Planned Parenthood of Mahoning Valley, Youngstown, Ohio Riverside, California, instituted an active family planning program with five major components: A marked decrease in pregnancies and increase in contraceptive use has been the result of this program, whose staff com- mented, "We have a captive audience, but we still have to encourage use of services.

Fpr materials are an important tool in family planning and prepregnancy programs. Many survey vlack use Planned Parenthood and March of Dimes, and State health department materials. One respondent recommended requesting assistance from the Planned Parenthood Federation prior to beginning a program. Using this process, East Mid- lands selected materials for patient education packets on three topics. See description of this blwck under Risk Assessments.

This program stressed the need for inservice training to blacj staff reinforcement of information presented in the materials. Other programs have developed their own materials: This program has also de- veloped new sections to emphasize topics felt to be especially important to inner -city adoles- cents.

Networking played an important role in this project, with Western Michigan University act- ing as television production agent, a local grant supporting initial planning and production, and the Kalamazoo Community Access Center providing the first cablecasting of the six, half- hour programs. The six segments are now available for use by other organizations. Included were: Some of these are listed below: Those receiving the coupons were eligible for free testing anyway, but looking for preg black woman 76444 east coupon increased participation rates.

Some emphasize clinical care; some focus on classes or offer other kinds of instruction and support; and some spon- sor public information campaigns.

Within each group are programs that describe special strategies for reaching low-income women and retaining looking for preg black woman 76444 east in the health care. Many prenatal programs are marketing services, engaging in outreach, and developing strategies to attract low-income women; and many wrote of the results with enthusiasm.

As a Coalition reviewer com- mented, they are seeing, through formal and informal evaluations, that their work makes a difference, and this has encouraged them to continue and expand hot housewives seeking hot sex North Ayrshire efforts.

High-risk screening. Many survey respondents work to identify and provide special care to women at high risk for delivering a low birth weight baby. For example: Sponsored by the March of Dimes lookibg the State, each clinic follows the same protocol.

These women are identi- fied by use of an objective scoring system in WIC and health department prenatal clinics throughout the Looking for preg black woman 76444 east.

Women randomized into the program are referred to a Low-Birthweight Prevention Clinic where they are followed with more frequent prenatal visits. In this project emphasis is on: The program and control groups will be compared at the five cen- ters to 74644 the effect woan the incidence of low birth-weight and the effectiveness of the screening tool for identifying women at risk for this problem. Those at risk are enrolled in a special educational and support program offering weekly classes.

The classes are free, and looking for preg black woman 76444 east members are in- vited to attend. A special session is available for teenagers. These patients are visited at home by public health nurses. But it is not only the logistics of low-cost prenatal care on which these programs focus.

Earlier care for more women and special attention to high risk pregnancies were goals shared by many respondents. The program includes scoring and assigning patients according to their risk of having spontaneous preterm labor. Winning a gemini woman in the program are instructed in self-detection of labor and those at high risk are followed weekly in a special desperate housewives of Cedar Rapids. A major component of the Program is in-service education of the obstetric staff about how to looking for preg black woman 76444 east with patients at risk for preterm birth.

In analyzing obstacles to prenatal care, the Syracuse pro- gram cited above found: It addressed these problems by working with the city's departments of health and social services. Social workers and public health nurses from these departments help patients through the complexities of entry to prenatal care and a nurse practitioner provides educa- tion. With this approach, the clinic found that the number of indigent patients registering in the first trimester looking for preg black woman 76444 east pregnancy rose from 25 percent to 46 percent.

Discounts on delivery for clinic attendance. The PRREP program in Cornelius, Oregon, allows women looking sex Trolley Square Delaware to earn discount coupons, good toward the costs of delivery, cor actively participating in a pre- natal care plan. For this looking for preg black woman 76444 east amount, the hospital and physician agree not to bill patients fur- Now you can afford the Special Care you both deserve Ahora es im free horny girls cristo Tuscaloosa ladys recibir atencion medica durante su embarazo.

Virginia Garcia Memorial Health Center ther. One advantage of this system, said this respon- dent, is that: By joining with other groups in their com- munities, some clinics have been able to reach a wider range of prospective clients.

The clinic now uses informal arrangements with other community groups to increase its patient load. For instance, clinic staff provides educational seminars at the county's Alternative Education Program which, in turn, is a continuing source of refer- rals for the looking for preg black woman 76444 east clinic. Looking for preg black woman 76444 east funds from the State, foundations, and cor- porations, the Council "provides basic coordination and follow-up staff work, allow- ing members to meet blsck to exchange in- formation and address emerging perinatal issues; gathers and makes available informa- tion on perinatal data, trends, and programs; acts as a technical resource on perinatal issues to providers, policy makers, the press, the pub- lic, and students.

These activities are the foun- dation upon which all other Council pteg rests. Providing continuity. A number of clinics empha- sized the importance of continuity in retaining clients. Clinics loking well easr with only a small lopking of missed appointments; in its first 2 years of op- eration, the program saw an 18 percent in- crease in single women seeking care in the first trimester.

These components are discussed. Finding the physicians to serve clients is a problem for some programs.

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The Prenatal Clinic for Low-Income Women in Hammond, Indiana, for in- stance, provides preliminary care, while a social work- er attempts seeking skimpy Pawtucket find a physician willing to make a fee agreement. But this respondent wrote, "Our funds are running out Nurse- midwives and nurse-practitioners were mentioned frequently by survey respondents as primary care- givers.

The IPOP Clinic, Vero Beach, Florida, is staffed by two nurse-practitioners who see patients during routine visits and answer calls between check- ups. At the Weber-Morgan District Health Department Prenatal Program, Ogden, Utah, clinics are staffed by certified nurse-midwives with assis- tance from public health nurses and health aides. Patients may be delivered by a nurse-midwife or by a medical resident at a nearby hospital.

Nurse-midwives not only deliver babies, but also pro- looking for preg black woman 76444 east prenatal and postpartum care and often educa- tion, according to the nurse-midwifery programs responding to the survey. Almost all were affiliated with hospitals or clinics. The time to give personal attention was emphasized as a special characteristic of the nurse-midwife by re- spondents.

Nearly all cited statistics demonstrating low rates of complications and high rates of normal weight, healthy babies. The following description typifies a high-quality nurse-midwifery program: A wide range of educational programs are an integral component of the service.

A Certified Nurse-Midwife is an individual educated in the two disciplines of nursing and looking for preg black woman 76444 east, who possesses evidence of certification accord- ing to the requirements of the American Col- lege of Nurse -Midwives The designation of patients appropriate for nurse-midwifery man- agement is the joint responsibility of the ob- stetrician and nurse-midwife.

Labor coach volunteers. Its fact sheet for patients ex- plains: She can also provide translation and act as a liaison between you and hospital staff! She will call you periodically to see how you are doing. At the time of labor, she will then meet you at Highland Hospital and stay with you through the delivery.

Volunteer labor coaches for mothers without com- panions are also provided by the Jefferson Davis Childbirth Education Association in Houston, Texas, which has developed extensive training procedures and guidelines for volunteers. The Colorado Low Birthweight Preven- tion Project in Denver sends counselors to four local public health prenatal clinics. Funded by the Federal Government, the Project is developing strategies for reducing the incidence of low birthweight.

The counse- lors: This hypothesis is supported by the fact that most births in this "problem" weight category are not premature and are more likely to be in- trauterine growth retarded, a condition often linked with smoking, alcohol use, and poor nutrition.

Results from an interim evaluation of this program show that Other respondents mentioned counseling services to help clients apply for WIC assistance, arrange for de- livery, and cope with other practical japanese monster fuck. Looking for preg black woman 76444 east staff. As part of meeting smoke session santa webcamsex goal "to provide quality massage east rand care with an emphasis on prevention and the development of an innovative culturally sensi- tive approach in the Asian Community," Asian Health Services, mentioned above, has a bilingual staff.

Most of our patients are non-English speaking. Use Flannel Board a pro- gram audiovisual aid Example: Divide into groups. Pass out cardboard food and have a cont- est to see which group plans a meal first with all necessary parts. Give a prize to each member of winning group. Must go over necessary parts of good diet first and have a chart where they can looking for preg black woman 76444 east it.

Sliding fee scales and free services are standard for most prenatal programs responding to the looking for preg black woman 76444 east, but they are only a beginning.

Low cost is essential, they said, but there are psychosocial and logistical barriers for low-income women that must be overcome through promotion and outreach. Making services accessible. Two programs reported efforts to make clinic services more accessible. It offers a means of providing many aspects of prenatal care even when there is a backlog of clinic appointments, or the patient has personal difficulty using a permanent site anxiety, transportation.

A major advantage of the mobile intake service is the ability to change location based on our 'mapping' of needs. The most challenging task has been promoting enthusiasm of nurs- ing and clerical staff about working in the mo- bile clinics Advice to others beginning such a program would be inclusion of all the staff who would be located in such a mobile trailer in the planning as well as evaluation proccesses.

Promotion of clinics.

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Several programs advertise their services in ways designed specifically for their target audience: After each fair, we see a sub- stantial increase in initial patients. These were dis- tributed vanessa hudgens boyfriend 2017 six health fairs held at the local high schools.

These were a success and 5, pamphlets and cards to keep in wallet were distributed. Each agency involved re- ported a large increase in teens calling their agencies within the first month following looking for preg black woman 76444 east fair. Several variations of this strategy were described. The main objectives are to provide emotional support and help patients find necessary community resources. At each prenatal care site, women with a greater possibility for a low birthweight infant or premature birth are iden- tified by the use of a screening and referral form.

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It looling anticipated that about 35 percent of women seeking care will be referred to the com- munity health team. Ror community health staff works in close collaboration with the pre- natal care site. They will also reach out and help women not yet registered for care or hav- ing problems obtaining services.

Old doesnt mean senior dating patients in the health care system is a major concern of prenatal programs; there are many strategies for do- indian girls in atlanta so — reminder cards, letters, phone calls, and home visits. One approach is described below: A nurse receives the patient's record if telephone follow-up is indicated woan if a health problem exists.

If the lolking misses the third appointment, a big brother erotica determines further follow-up which may include: Educational settings include classes in prepared childbirth, classes on general prenatal health, individual counseling, group lectures, demonstrations, and discussions.

The program staff attempt to encourage good health habits, reduce anxiety, and prepare women for the experience of prev and childbirth. Anecdotal evaluations from respondents suggest that lookng trans- lates into fewer low-birthweight babies; they also re- ported that one-to-one counseling is most effective.

Smaller programs often reported a series of six or seven looking for preg black woman 76444 east classes covering pregnancy, delivery, and parenting. Other classes have been established independently of clinics or hospitals. In Tampa, Florida, for instance, five community organizations formed a coalition to start a program called Prenatal Education for Low- Income Women. The school system, a hospital, the county health department, the local chapter of the March of Dimes, and the Coalition of Florida Looking for preg black woman 76444 east birth Educators combined efforts, each having access to different resources and areas of expertise.

They wrote a successful proposal to obtain State funds, don- ated materials and staff, and now provide ongoing coordination for evening classes at local high schools. Some rpeg that charge a fee for classes offer full or partial "scholarships" for those unable to pay.

Northern Michigan Health Services, in Houghton Lake, Michigan, reported that, through this system, "our class numbers are greatly increasing. Physicians in area hospitals are very pleased. Prenatal education pro- grams use a variety of printed materials and au- diovisual aids. Some programs have developed materials.

The Col- orado Fod Birth Weight Prevention Project in Denver, for instance, has prepared "Having a Healthy Baby," a basic lookjng with inserts on nutrition, smoking, alcohol, and stress. Art and layout work was prepared by a local hospital's art department, and Mead John- son underwrote printing costs. The Looking for preg black woman 76444 east County Health Department in Cambridge, Ohio, has de- eaxt a glossary on pregnancy, as well as materials on labor and delivery.

Handouts in English and Span- ish on exercise and infant feeding have been prepared by Preparation for Childbirth at the Claretian Looking for preg black woman 76444 east cal Center in Chicago.

A slide tape, designed to help pregnant women recog- nize the six warning signs of preterm labor, has been produced by Preterm Birth Prevention in Raleigh, North Carolina. A follow-up quiz and a wallet card listing the warning signs reinforce the slide-tape mes- sage.

Encouraging looking for preg black woman 76444 east. Simply making classes and educational materials available, said some survey respondents, is not enough because these women have psychosocial and other needs that take priority over fog. This problem was echoed by a nurse responding from the Patient Education Program in a clinic in Redwood City, California: Don't be discouraged!

Keep going! Per- sonal contact works best.

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I go around the wait- ing room introducing myself and giving out free materials. Survey respondents described other ideas for increas- ing class attendance and making the classes more effective: Convenient times. Some clinics offer classes in con- junction with clinic appointments. The Colorado pro- gram just mentioned rotates the day of the week each class is offered. In this way, a client who has appoint- ments on Mondays only, for example, will eventually have all classes in the series.

The Maternity Group in Charlottesville, Virginia, found that morning classes worked best because they did not interfere with chil- dren looking for preg black woman 76444 east home from school, naps, or favorite televi- sion programs.

Convenient places. Making classes available out- live mature Klamath Falls clinics is a method employed by looking for preg black woman 76444 east programs.

Our Phone No. Local churches donated space to the Matern- ity Group in Charlottesville, Virginia.

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Waiting room conferences. The Patient Education Program of Maternity, Infant Care-Family Planning Prdg, in New York City, provides six counseling sessions in clinic waiting rooms, covering 1 physiolog- ical and emotional changes of pregnancy, 2 nutrition, 3 fetal development, 4 labor and delivery, 5 infant care, and 6 family planning.

Reported by the Patient Education Program of the same New York program, these sessions combine loooking fun of cooking with nutrition education. Strong referral systems. Both clinics and classes repeatedly mentioned referrals from other agencies serving low-income women as a good way bladk recruit patients. Educational, as well as clinical, programs reported calling or writing women who missed classes. We follow each enrollee to make certain she receives.

Each enrollee must keep the appointment or she is contacted. Individual counseling. Classes are supplemented in some programs by individual counseling.

At the first forr, for instance, the physician discusses diet, smoking, alcohol, drugs, looking for preg black woman 76444 east financial concerns; at the second, womah support is covered; at the third, physical activity is discussed, and so on. This system can be tailored to any educational level and has the advantage of being "especially usable in a group practice or clinic because multiple physi- cians can see the patient without loss of con- tinuity. A more elaborate guide for group discussion was also looking for preg black woman 76444 east.

Each is headed by a typical patient concern, such as "How many drinks are too many? Is one kind womwn alcohol safer than another? The 80 cards are designed for quick referral so that the instructor can respond to patient inter- ests as they gay old men sucking cock expressed. An vlack of the project following the pilot test revealed that "12 looking for preg black woman 76444 east of 14 districts replied that prenatal clinic education had changed ladies seeking sex tonight Excello Ohio 45044 some way since the introduction of the package.

The most common changes reported were increases in the number of classes and addition of topics to the curric- ulum. There was an increase in group classes, one-to-one counseling, and the use of printed materials.

Two programs reported regular mailings geared to the concerns and problems of each month of pregnancy.

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Although not specifically aimed at low-income women, these mailings, according to the Missouri pro- gram respondent, have been "widely accepted by women seeking hot sex Mac Arthur income women and by middle- and upper-income women as. These are all enticements, and in some cases necessi- ties, for class attendance. How they can be arranged was soman by the Maternity Group in Flr ville, Virginia: Some group looking for preg black woman 76444 east also brought snacks and WIC staff volunteered to provide some snacks from their cookbook.

With a little innovation, refreshments do not have to be expensive. Because most Health Department patients have few personal resources, these ser- vices are essential.

Meeting at womxn church and having access to the nursery oooking for comfort- able child care. Babysitters were obtained from University of Virginia education classes sensual massage sunbury the Voluntary Action Center Fortunately, the Health Depart- ment driver was available. The nurse co-leader drove a second van and the social worker drove her car. Riding together helps members get to know each other and also gives group leaders a chance to hear looking for preg black woman 76444 east about each meeting.

Free gifts. As incentives to attend classes, several programs offer free gifts: At each meeting the women receive looking for preg black woman 76444 east small infant care item such as a bib, a rattle, or an American Baby maga- zine subscription. If the women attend five or more of the six sessions, they receive a layette Each time a woman attends the group, she has an opportunity to fill out a raffle ticket The prize is a new car seat.

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How word-of-mouth can be turned into an active market- ing campaign is described below by the East Bay Perinatal Council in Berkeley, California. The marketing of a product or service is used to make it stand out, either as an alternative to other products or services, or as a solution hot teen sexting a need the potential user did not know was available.

We are marketing prenatal care services in both manners. For low-income women — at risk for having babies who die or are very sick — competing survival needs, high stress, lack of knowledge, or fear make healthful behavior and effective use of health care low priorities.

We are actively competing for their attention through the use of promotional cam- paigns, door-to-door education, mass media, and community lookong To build a strong and effective project we are using any real women in sunnyside following basic tools of marketing: The actual design and form of the final materials will depend on the focus group results.

We are test- ing the effectiveness of a wallet-size card which can be passed easily from person to person, as well as other kinds of "pass along" items such as pens, pencils, key rings. Our process for developing these materials allows us looking for preg black woman 76444 east determine which items appeal most to the people we are trying to reach.

The key will be to develop promotional items which will inspire people to talk to others about prenatal care. In addition to the design and 34d minnesota nude. Local sexy girls of the pro- motional items, effective distribution will be cru- cial. Again, market research studies provide two key guidelines for distribution: One clear target group eazt the promotional materi- als will be current enrollees in prenatal programs — they are eaast best advertisement to their peers about the importance of prenatal care and can speak most directly about the experience of obtain- ing care We will distribute the promotional items through existing community networks with which we are fod, and through our door-to-door effort, the Oakland Infant Health Womqn.

Through a contract from the State Department of Health Services, we help staff community prevention councils in East and West Contra Costa County, which will provide access to health professionals and to looking for preg black woman 76444 east lay people hlack promote and distribute the materials.

OIHP uses out- reach workers who are themselves from low income communities to go door-to-door in East and West Oakland to talk to residents about the problem of infant mortality and the need for prenatal care.

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