Originally posted in Every Woman Southeast blog, November 2017.
Women of childbearing age in local community based programs* are unapologetically sharing their stories with their peers and community influencers (i.e. doulas, care management team and volunteers). These women represent the Young Families Connect program and a collection of other programs housed at the YWCA Greensboro. For the last two years, I have been the Young Families Connect Media Outreach Coordinator, and one of the many components of my job was to collect stories from Young Families Connect (YFC) participants**. YFC served young families ages 13-24 years old in five rural North Carolina counties (Bladen; Onslow, 2013-2016; Robeson; Rockingham; and Wayne) from 2013-2017. Additionally, I had the privilege of sitting in on community conversations at the YWCA Greensboro Black Breastfeeding Week roundtable and conducting interviews with recent postpartum mothers at a local Durham, NC, based festival on behalf of the 4th Trimester Project. Here, I will refer to these persons as storytellers.
Case management programs reflect the recommendations outlined by the National Healthy Start Foundation white paper (2010). In fact, the soul of these case management programs rests in the multidisciplinary staff who carry out these services. Program staff and case managers are skilled professionals from their respective communities whose own experiences reflect a facet of the enrolled participants who are often experiencing pregnancy with much trepidation. Storytellers share that they initially heard of these family support programs when they were receiving services at their local social services, community health clinic (often at a community based organization or human service agency), or community college. Case managers had a relatively rapid response rate, following up with the storyteller’s inquiry (about the program) by scheduling an in-office or in-home visit to determine the storyteller’s eligibility. Storytellers then developed short-term goals based on their discussion with the case manager. These goals were the guideline for the case manager’s relationship with the client but most often included social needs like securing a home, childcare for other children in the home and job assistance. Storytellers enrolled in case management programs benefitted from the availability of a local resource expert like their case manager. Local resource experts (my term) are aware of programmatic services for persons across the lifespan. Local resource experts were innate community organizers as per their agreement addendum with their community based organization and the Division of Public Health. State funded case management programs are required to have community advisory councils made up of professionals representing community agencies serving enrolled participants. This means that local resource experts were in constant contact with area community agencies i.e., doula services, food pantries, community college programs, job readiness agencies, pre-school readiness, and parenting support groups. NC grant funded case management programs, such as YFC, have parent support and education built into the program.
In contrast, storytellers from community conversation settings (Greensboro and Durham respectively) were not all participating in case management programs and represented diverse socioeconomic statuses. These moms shared how they define support as recent postpartum mothers. Non-case management storytellers discussed a need for enhanced provider awareness for breastfeeding support, support groups for single moms and new moms in their local area. Whether an enrolled case management storyteller or not, all shared the importance of a positive patient-provider relationship. Case management-enrolled storytellers have transcended the clinical relationship. This is a desire shared by non-enrolled storytellers, for providers to get to know them outside of their clinical outcomes. Case management-enrolled storytellers show that this relationship deepens the storytellers’ accountability to their newly cultivated health narrative.
*These programs reflect the National Healthy Start Foundation recommendations for Home Visitors and Family Support.
** All participants have agreed to the terms outlined by institutional consent forms and have signed accordingly. You can find there stories here.