1. SISTERS UNITED: A community based initiative to reduce infant mortality in the African American community Arkansas Department of Health Office of Minority Health & Health Disparities Family Health Branch 1

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3. MISSION  to provide leadership in improving health outcomes by advocating for health equity for at-risk populations as defined by race or ethnicity, age, education, disability, gender, geographical location, income, and sexual orientation. 3

4. OBJECTIVES  Describe the burden of infant mortality in Arkansas’ African American communities.  Describe a state health agency role in reducing infant mortality.  Describe key components of an initiative aimed at reducing infant mortality. 4

5. MINORITIES IN ARKANSAS  Consist of 670,689 (23%) of the population:  African-American (15.4%)  Latino (6.4%)  Asian (1.2%)  American Indian/Alaskan Native (0.8%)  Native Hawaiian/Pacific Islander (0.2%)*  Multiple Races (2.0%)  Other (3.4%) Source: www.2010.census.gov 5

6. Age-Adjusted Mortality Rates by Cause, Race and Ethnicity Arkansas 2008-2012 – Based on Level of Disparity 6 Cause of MortalityTotalAfrican AmericanWhite Disparity Ranking HIV 2.27.61.26.3 Homicide 7.521.14.84.4 Diabetes 26.257.622.92.5 Asthma 1.32.61.22.2 Cervical cancer 3.35.93.02.0 Infant mortality* 7.311.86.41.8 Colorectal cancer 18.524.918.01.4 Cerebrovascular disease 51.769.4750.091.4

7. Source: Linked Birth/Infant Death Files, Health Statistics Branch, Arkansas Department of Health 7

8. ARKANSAS RISK FACTORS Infants:  birth weights less than 3.3 pounds  born at gestational ages less than 32 weeks  birth defects  mothers had no prenatal care  mothers who smoked ≥ pack of cigarettes per day  mothers had at least one medical complication  African American 8

9. ADDRESSING THE PROBLEM  Our office was asked by the Branch Chief of the Family Health Branch to assist with addressing these disparities.  We suggested mobilizing graduate sorority chapters.  Met with key partners to determine the major focus areas of this new project. 9

10. POTENTIAL FOCUS AREAS  Low birth weight  Birth defects  Immunization rates  SIDS  Breastfeeding  Tobacco use 10

11. Low Birth Weight  Prematurity is the leading cause of African American death in the 1 st year of life  African Americans have 3X s the rate of 28 week babies as other races  Preterm deliveries account for the vast majority of racial disparity 11

12. Birth Defects  2 nd leading cause of death in the 1 st year of life  About 1 in every 33 babies is born with a birth defect.  Most occur in the first 3 months of pregnancy. 12

13. Flu Immunization During Pregnancy  Flu Shot can: decrease the chance of mother and baby dying from the flu by 50% decrease the chance of mother and baby getting the flu and premature delivery by 70%  Pregnant women that received a flu shot Latino------------69% White----------------66% African Americans ----40% 13

14. SIDS  Always putting a baby to sleep on their back decreases SIDS by 50%  Only 1 out of 3 Black Moms always put their babies to sleep on their backs  2 out of 3 White Moms always put their babies to sleep on their backs 14

15. Breastfeeding Rates in Arkansas 15

16. Tobacco Use  Smoking  African American Moms have low smoking rates AR pregnant smoking average--------------------24% AA AR Moms--------------12% 16

17. FOCUS AREAS 1 Folic Acid 2 Flu Shot 3 Breastfeeding Safe Sleep 17

18. Why Sororities? 18

19. History of Fraternities and Sororities  AA fraternities and sororities have roots in Masonry.  Inclusion was not welcoming to African Americans so a “black version” was created in the late 1700s.  The first white fraternity was established in 1776.  The first white was formed in 1867. 19

20. History of AA Sororities 20 1908 1922 1920 1913

21. Notable Members 21 AΦА Alpha Phi Alpha Fraternity Founded in 1906 at Cornell University Rev. Martin Luther King, Jr Civil Rights Activist AKА Alpha Kappa Alpha Sorority Founded in 1908 at Howard University Phylicia Rashad Actor KАΨ Kappa Alpha Psi Fraternity Founded in 1911 at Indiana University Johnnie Cochran Attorney ΩΨΦ Omega Psi Phi Fraternity Founded in 1911 at Howard University Ronald McNair Challenger Astronaut ΔΣΘ Delta Sigma Theta Sorority Founded in 1913 at Howard University Dr. Joycelyn Elders Former US Surgeon General ΦBΣ Phi Beta Sigma Fraternity Founded in 1914 at Howard University Rep. John Lewis US Congressman ZΦB Zeta Phi Beta Sorority Founded in 1920 at Howard University Zora Neal Hurston Author ΣΓΡ Sigma Gamma Rho Sorority Founded in 1922 at Butler University Victoria Rowell Actor

22. Honorary Members 22 Former US President Bill Clinton Phi Beta Sigma Fraternity Former First Lady Eleanor Roosevelt Alpha Kappa Alpha Sorority

23. Arkansas African American Sorority Graduate Chapters (2012) Data source: State Coordinators of African American Sorority Graduate Chapters AKA CHAPTER’S Beta Phi OmegaTjuana ByrdSherwood Chi Eta OmegaPhilis L. Nichols-AndersonLR, Faulkner Chi Nu OmegaLaura M. HunterMalvern Delta Omega OmegaCynthia L. BennettPine Bluff Eta Sigma OmegaJacqueline E.H. YoungMarianna Kappa Nu OmegaGenee' L. GainesJonesboro Lambda Sigma OmegaBobbie Trible-DiamondBlytheville Mu Chi OmegaDonna Faye RossHelena Phi Alpha OmegaElla Donnell LambeyBentonville Phi Zeta OmegaPatricia Doss GloverMagnolia Pi Chi OmegaAngela Marie DavisWest Memphis Sigma Beta OmegaSheryl HamiltonCamden DELTA CHAPTER’S Central Arkansas AlumnaeClaudette BarbeeLittle Rock Northwest Area AlumnaeKimberly McGeeFayetteville Blytheville AlumnaeFloyd Jean MooreBlytheville Forrest City AlumnaeKristen HaynesForrest City Fort Smith AlumnaeTiffinee C. BakerFort Smith Helena AlumnaeTanya GreenberryWest Helena Hot Springs AlumnaeAmanda SnowdanArkadelphia Jonesboro AlumnaeKim McCrayState University Little Rock AlumnaeAngela DoyneLittle Rock Magnolia AlumnaeCheryl StuartMagnolia Marianna AlumnaeJanis WaddyMarianna Pine Bluff AlumnaeCharlene KelleyPine Bluff Southeast Arkansas AlumnaeRhonda RigellMonticello West Memphis Area AlumnaeSheri LoweWest Memphis Texarkana AlumnaePatricia AnthonyTexarkana ZETA CHAPTER’S Alpha Mu Zeta ChapterBeverly CookLittle Rock Eta Sigma ZetaKathy TatumNo. Little Rock Epsilon Zeta ZetaJuanita CookPine Bluff Nu Omega ZetaSabreana HytcheArkadelphia Sigma Gamma ZetaAja OslerJonesboro Upsilon Pi ZetaTreva SandersWest Memphis Xi Sigma ZetaSandra TaylorForrest City Psi Iota ZetaCarolyn SaterfieldCamden Pi Psi ZetaShonta WilliamsStamps Pi Chi ZetaNashanda BrownLowell Theta Gamma ZetaU. Jean WilliamsWest Helena Iota Beta ZetaMarva WashingtonOsceola SIGMA GAMMA RHO CHAPTER’S Little Rock -Theta SigmaCarroll BrownLittle Rock Conway -Kappa Xi SigmaMonika MillerMaumelle Pine Bluff- Kappa Psi SigmaDorothy PenixPine Bluff

24. Arkansas African American Sorority Graduate Chapters Data source: State Coordinators of African American Sorority Graduate Chapters

25. Alpha Kappa Alpha (1908)  12 chapters  Oldest Chartered Chapter: Beta Pi Omega (1937)  699 combined members  6 websites  4 Facebook accounts  Over 800 combined Facebook contacts  1 Chapter has past experience in infant mortality “Service to All Mankind”

26. Delta Sigma Theta (1913)  15 chapters  Oldest Chartered Chapter: Pine Bluff Alumnae (1944)  860 combined members  6 websites  2 Facebook accounts  203 combined FB contacts  1 chapter has past experience in infant mortality “Intelligence is the torch of wisdom”

27. Zeta Phi Beta (1920)  12 Chapters (9 responses)  Oldest Chartered Chapter: Alpha Mu Zeta (1940)  203 combined members  2 websites  1 Facebook account  128 combined FB contacts  5 chapters have past experience in infant mortality “A community conscious, action-oriented organization”

28. Sigma Gamma Rho (1922)  3 Chapters  Oldest Chartered Chapter: Theta Sigma (1932)  29 combined membership  0 Facebook account  0 Combined FB contacts  0 websites  1 Chapter has past experience in infant mortality “Greater Service, Greater Progress”

29. SISTERS UNITED POTENTIAL IMPACT  42 Chapters  1,762 combined members  7 Chapters have past experience in Infant Mortality  23 counties  315,986 AA’s in counties  Over 1,100 combined FB contacts  14 websites / 7 Facebook accounts

30. SISTERS UNITED Invited presidents of African American Sorority graduate chapters to attend leadership meeting. Asked for their help by joining SISTERS UNITED. 31 out of 42 chapters joined and committed to send representatives to attend an 8 hour training. 30

31. WORK GROUP MEMBERS 31 3 members from each chapter Prefer MDs, PhDs, Nurses, Public Health professionals Able to attend meetings during work hours At least one member > 50 (grandmother)

32. SISTERS UNITED GOAL  To increase awareness among African Americans about infant mortality and share prevention methods to disseminate throughout the community. 32

33. SOCIAL MEDIA 33

34. FACEBOOK 34

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37. EVALUATION 37  2 - flu shot  1- folic acid  1- breastfeeding  2 - safe sleep

38. TRAINING 58 sorority members from the 31 chapters attended a train-the-trainer conference The attendees received name badges with the title SISTERS UNITED TRAINER Session included mock inter­views to learn how to deliver effective media messages. Participants received a binder with handouts, flash drive, evaluation forms, talking points when scheduling media interviews and youtube videos. 38

39. BRANDING 39

40.  NICHD released RFA to conduct community outreach and education aimed at reducing the risk of SIDS within the African- American community.  Our office encouraged each SU chapter to apply for these funds.  A total of 29 organizations awarded grants and 21 of those were SISTERS UNITED chapters. MINI-GRANTS

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47. 47 PORTRAIT UNVEILING “The artwork entitled, Sisters United, is a representation of African-American Greek sororities united on a campaign to address the community on information to help reduce the infant mortality rate in the state of Arkansas. The globe in the artwork represents the future of our world as these sororities come together to ensure the safety and future potential that our children have in making this world a better place. By reducing the infant mortality rate, our children will thrive to become educated individuals destined to change this world.”

48. 2013 Community Survey Total = 970 48

49. RESPONSE SUMMARY PRE TESTPOST TEST 1. The illness caused by the flu virus is worse in a pregnant woman 79%76% 2. The flu can cause a very mild illness in a pregnant woman 32%30% 3. It is harmful for the baby if the mother receives a flu shot during pregnancy *24%9% 4. A flu shot taken during pregnancy can be harmful for the baby *27%7% 5. A flu shot during pregnancy can protect an unborn baby *63%88% 6. A flu shot during pregnancy can protect the baby after birth *39%57% 7. A flu shot can protect a pregnant woman's life *50%63% 8. A flu shot can put a pregnant woman's life in danger *12%4% 9. Folic acid intake is harmful for a pregnant *12%3% 10. Folic acid intake helps prevent some birth defects in the baby only if mom takes it for at least 3 months before getting pregnant * 56%73% 11. Folic acid should be taken by a pregnant woman before/during pregnancy 74%76% * Statistically significant; Two Sample z-test 49

50. RESPONSE SUMMARY PRE TESTPOST TEST 12. Breastfeeding increases the risk of chronic disease in the baby 7.4%8.5% 13. Breastfeeding is harmful to the mother's health 14.1%13.0% 14. Breastfeeding is the beginning of healthy eating for the baby 88.2%86.7% 15. Breastfeeding builds a loving relationship between mom and the baby 69.4%71.3% 16. Breastfeeding is important for moms who cannot afford formula *44.1%53.8% 17. Breastfeeding reduces the chance of SIDS by 50% *49.1%68.0% 18. A baby should be laid down on his/her side to sleep *17.2%3.2% 19. A baby should be laid down on his/her stomach to sleep *14.4%4.4% 20. A baby should be laid down on his/her back to sleep *77.0%94.1% 21. It is safer for a baby to sleep in the same bed as the parents 2.7%2.3% 22. It is safer for a baby to be wrapped in several blankets for sleep 4.1%2.1% 23. It is safer for a baby to sleep in their own crib # 97.1%97.9% 2013 Community Survey Results * Statistically Significant; Two Sample z-test 50

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53. WORK PLANS (Level 1) 53 Goal: Increase awareness among the African American community about infant mortality and share prevention methods they can use to disseminate throughout their respective communities. Objective: Increase Education and Expand Outreach. To reach 30 African Americans and provide education about the importance of folic acid, getting an annual flu shot during pregnancy, breastfeeding, and safe sleep methods. Key Action Steps:Target Outcome MeasureTime Frame Promote National Birth Defects Prevention Month Post message on chapter FB page about the benefits of folic acid and share YouTube video January 7, 2014 Promote National Breastfeeding Month Post message on chapter FB page about the benefits of breastfeeding August 1, 2014 Promote Infant Mortality Awareness Month Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours. September 1, 2014 Promote SIDS Awareness Month Post message on chapter FB page about SIDS Prevention October 1, 2014

54. WORK PLANS (Level 2) 54 Promote National Birth Defects Prevention Month Post message on chapter FB page about the benefits of folic acid and share YouTube video January 13, 2014 Conduct Folic Acid Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 February 2014 Promote National Breastfeeding Month Post message on chapter FB page about the benefits of breastfeeding August 1, 2014 Conduct Breastfeeding Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 August 2014 Promote Infant Mortality Awareness Month Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours. Sept 1, 2014 Promote SIDS Awareness MonthPost message on chapter FB page about SIDS Prevention October 1, 2014 Conduct Safe Sleep Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 October 2014 Conduct Flu Shot Presentation at Chapter meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 Nov 2014

55. WORK PLANS (Level 3) 55 Promote National Birth Defects Prevention Month Post message on chapter FB page about the benefits of folic acid and share YouTube video January 13, 2014 Conduct Folic Acid Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 Feb 2014 SIDS Walk Run50 SIDS Grant Pre/Post Surveys on Safe Sleep. Submit forms to NICHD according to guidelines. May 2014 Promote National Breastfeeding Month Post message on chapter FB page about the benefits of breastfeeding Aug 1, 2014 Conduct Breastfeeding Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 August 2014 Promote Infant Mortality Awareness Month Post message on chapter FB page and encourage all members to change FB profile pic to SU logo for 24 hours. Sept 1, 2014 Promote SIDS Awareness Month Post message on chapter FB page about SIDS Prevention Oct 1, 2014 Conduct Safe Sleep Presentation at Chapter Meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 October 2014 Conduct Flu Shot Presentation at Chapter meeting 10 SU Pre/Post Surveys on Folic Acid, Fax forms to Cicely at 501.661.2414 Nov 2014

57. Source: State Coordinators of African American Sorority Graduate Chapters 42 African American Sorority Graduate Chapters, 2014 SISTERS UNITED 42 African American Sorority Graduate Chapters, 2014 SISTERS UNITED

58. SUCCESSES 58

59. STATE REPLICATION  List of chapters in your state  Contact chapter presidents  Convene leadership meeting  Form SU action group  Provide training  Develop work plans  Follow-up with chapters  Utilize social media  Evaluation tool  Consider chapter sustainability 59

60. RESOURCES https://www.facebook.com/arsistersunited http://www.youtube.com/watch?v=c4IlmpQ54Y4http://www.youtube.com/watch?v=c4IlmpQ54Y4 (Intro) https://www.youtube.com/watch?v=f0Nxhsx9Iokhttps://www.youtube.com/watch?v=f0Nxhsx9Iok (Folic Acid) http://www.youtube.com/watch?v=MAiLaNgarb4http://www.youtube.com/watch?v=MAiLaNgarb4 (Flu Shot) http://www.youtube.com/watch?v=PIAycz8DYJk&feature=plcp (Breastfeeding) http://www.youtube.com/watch?v=wfudqfhjVgshttp://www.youtube.com/watch?v=wfudqfhjVgs (Safe Sleep) http://vimeo.com/22659669http://vimeo.com/22659669 (Crisis in the Crib) www.aka1908.com http://www.deltasigmatheta.org/ http://www.zphib1920.org/ http://www.sgrho1922.org/home http://www.youtube.com/watch?v=kvtfJjw4_g4http://www.youtube.com/watch?v=kvtfJjw4_g4 (Impact Video) 60