Celebrating, Learning and Leaping
More specifically, we helped more than 32,000 families enroll in health insurance, and nearly 18,000 access in the WIC nutrition program. In addition, we provided 232,000 families with information on immunizations, informed 174,000 families about local breastfeeding resources, and provided 227,000 families with information on free summer meals programs in their neighborhoods. Beyond the numbers, we helped set the stage for a coordinated statewide Help Me Grow network, became recognized as national experts in addressing vaccine hesitancy, and our Healthy Connections Model is widely known to be an effective and efficient model for addressing the social determinants of health.
Now we are looking ahead and exploring, as Seth Godin says, “the space between where we are now, and where we want to be, ought to be, are capable of being.” He describes this as a gap between our reality and our possibility, and notes that if we imagine the gap as a huge gulf or crevasse we will surely be paralyzed.
Rather he suggests that “the magic of forward movement is seeing the space as leap-sized, as something that persistent, consistent effort can get you through.” Herein is the grace—our work is to hold tight to a strong vision, while taking one step at a time toward a new reality.
Over the next several months our Board and Staff will work together to define a new 3-year strategic direction for our work. We know we want our new direction to be nimble and bold, in every way rooted in our strong history of service, capacity-building and advocacy, and inspired by our unending belief that every family deserves to be healthy and safe.
We look forward to having you join us on the journey ahead, in leap-sized strides, making sure that every family can be healthy and safe!
Building a Breastfeeding Friendly King County
HPV Prevention in High School: A Guest Blog
Paul and Claire are juniors at Nathan Hale. Paul initially got involved when his mom asked him if he would support her in a public health panel sponsored by the Group Health Foundation, which focused on HPV awareness. Paul recruited Claire for the effort too, and their remarks were so well-received that after the panel discussion they were approached by public health nurse Lauren Greenfield from Public Health–Seattle & King County about an HPV campaign to be launched at six Seattle public schools, including Nathan Hale. Their history with this brilliant project is detailed below. Enjoy! -Todd
When we both agreed to be a part of this campaign (to spread awareness about the importance of HPV vaccine at Nathan Hale and get students immunized at the teen health center), we had no idea what to expect. But despite that, we both said yes for the same reason: we realized that this campaign was a way for us to help and have a positive impact on our community. Human Papillomavirus (HPV) cancers and disease have affected the lives of many people and will continue to if nothing is done, and if immunization rates in our state remain low. People have been looking for a cure for cancer for a long time, and the thought of finding one seems impossible. But what people don’t realize is we have something even better than that. We have a way to PREVENT cancer. And it’s right at our fingertips. The HPV vaccine is of great importance because it has the ability to save thousands of lives from future cancers. And our job is to make sure that people, especially our peers, understand this.
When we started the campaign, there was no plan to work off of, no template or outline of what we were supposed to do. We were basically winging it. At our first meeting with our advisor, she asked us, “What are your ideas? What do you guys want to do?” This was one of the best features of the opportunity; it was up to us to come up with ideas on how to run a successful campaign, and it was our ideas that mattered the most. This campaign taught us many important skills, including leadership organizational skills. Running into many obstacles, we’ve learned to be persistent in our goals. The biggest challenge, though, was always juggling this on top of schoolwork, sports, and other activities we do outside of school—especially since it was just the two of us.
As for the future of the campaign, we have high hopes and many plans. We plan to continue running the campaign at Nathan Hale, and this year hope to create an HPV Awareness Club at our school. The club will not only educate people on the topic, but also the group can help with certain projects throughout the year that are part of the campaign. We also hope to get speaking time at an assembly this year, and maybe do a schoolwide HPV awareness week. And of course, our goal every year is that more and more people at our school get vaccinated. Finally, as a more widespread goal, we hope students at other schools around the state take on the challenge that we have and raise awareness about HPV, and the vaccine that prevents certain HPV cancers and disease, at their schools.
It’s wonderful to see young people getting involved and speaking up for the health of their peers. Many thanks to Paul and Claire for their great work!
Partnering to prevent HPV
Using the extensive immunization network of WithinReach, our cutting-edge work surrounding HPV promotion, and our depth of knowledge in vaccine hesitancy issues, WithinReach staff review all funded proposals with an eye towards:
- Connecting grantees to existing resources that will further their projects
- Eliminating duplication of efforts
- Creating partnerships between organizations with aligned goals
- Encouraging organizations to attend our HPV Task Force or other immunization committees in the state
When WithinReach launched the HPV Task Force in 2015, we learned that many organizations were developing HPV initiatives, but there had been little communication between organizations, largely because there was no venue to do so and because HPV vaccination brings together organizations from seemingly disparate fields: immunization, cancer prevention, sexual health, and adolescent medicine to name a few. Having the HPV Task Force–and now the assurance that these organizations are collaborating–will make Washington a leader in HPV vaccination.
Here’s an example of an early success: Planned Parenthood wanted to pioneer an electronic signature process to easily obtain permission from parents to give their children the HPV vaccine. WithinReach has long known that Public Health – Seattle & King County successfully uses a service called DocuSign for this very purpose. By putting the two organizations in contact, Planned Parenthood was able to mobilize quickly and follow an existing blueprint to make this service available. Another success? All GHF grant-funded organizations are routinely meeting as a group outside of the HPV Task Force because they have found informal conversations about sharing resources and ideas helpful and productive.
And if you need a reminder of why the HPV vaccine is important, here are the pertinent details: All cases of cervical cancer, and a large percentage of other genital and anal cancers/warts and oropharyngeal (mouth and throat) cancers are caused by the HPV. The latest HPV vaccine protects girls from 90% of the strains that cause cervical cancer. Cervical cancer takes the lives of over 4,000 American women annually, and inflicts untold sickness and suffering on many more. The vaccine can virtually eliminate morbidity and mortality from cervical cancer.
WithinReach has been working with community partners for over 25 years to not just address health issues facing our community, but to actually create lasting change. Partnerships like this one with the Group Health Foundation are essential to that goal.
It’s time to give the flu vaccine the respect it deserves
Recently, I was talking with my pro-vaccine friends who became parents not too long ago. They have an eight-month old baby and are following the CDC’s recommended childhood vaccination schedule. They consider themselves to be strong vaccine supporters and trust in the science of vaccination and the protection vaccines provide. You can find Facebook posts of their baby immediately following her vaccine doses. In the pictures she’s smiling with captions like: “I got fully vaccinated and this is how happy I am about it only 3 minutes later.” However, when I brought up the flu shot they were quick to dismiss it.
Why is the flu vaccine viewed differently from other vaccines?
If I’m perfectly honest, there was a time when I too thought of the flu vaccine as somehow inferior and less important than the other vaccines. Data shows that I am not alone. Even though the flu vaccine is nearly universally recommended for individuals over 6 months old, it has one of the lowest coverage rates when compared to other vaccines. Last year, less than half of those eligible received the vaccine. People often opt out of the flu vaccine due to some key misunderstandings, but below are the compelling facts for consideration.
Here are the facts about flu strains.
Unlike other viruses, the flu is constantly changing. Each year influenza experts predict which strains of the virus will be most common and develop a vaccine to protect against those strains. Some years these predictions are better than others. The good news is that even when the vaccine does not match with the circulating viruses as perfectly as we hope, some protection is still better than no protection. And more good news: early tests indicate that this year’s vaccine is a better match than last, which will make it more effective against preventing the flu.
The flu vaccine cannot cause the flu.
The vaccine is comprised of either dead or weakened virus strains (depending on which vaccine you receive) making your likelihood of contracting the flu from the vaccine impossible. The flu vaccine takes up to 2 weeks to provide protection, so get your shot early to maximize its benefit.
The flu can be miserable and dangerous even for healthy people.
I used to think I was tougher than the flu. My immune system is strong – I can handle the flu. Let’s assume I’m right and that I survive two weeks of muscle aches, chills, sweats, fevers and vomiting caused by the flu. Many aren’t so lucky and by hosting the flu virus, I could pass it to others when I’m infected but have no symptoms. The flu is most dangerous for those 65 and over and infants under two, as well as people with common health conditions such as asthma, diabetes, and even pregnant women. Each year, thousands of hospitalizations and deaths are a result of the flu. By getting the vaccine, I not only protect myself from the dreadful symptoms but I also protect those around me who may be at a higher risk of suffering serious complications.
So get out there and get your flu shot! I may not have been able to persuade my friends but I’ll keep presenting them with the facts. The flu vaccine is available at pharmacies and doctor’s offices. I got mine and feel happy about not only protecting myself but relieved to be protecting vulnerable individuals in my community.
Promoting a healthy Washington: the Pink Book Course
Back to school…every day!
Leadership legacy is a gift. I started my new role with the recognition that I was stepping into it on the heels of amazing leaders – the women who envisioned, started, and grew WithinReach. Over the last year, I have channeled them often, AND I have learned from each and every member of our Board, all of whom have become teachers and guides for me. For 27 years, WithinReach has been blessed with the strength of smart, committed leaders. This history of strong leadership provides the vision, strategy, and stability we need to serve more families each year.
Trust is key. Over the last year, I have learned that the key to our success is trust. Do the families we serve every day trust that we will make the connections they need to live healthy lives? Do our donors trust that we will help them fulfill their vision for a healthier Washington? Do staff trust that their supervisors will help them do their best and more? Does the Board trust me to build on the successes of the past? I believe the answer is yes, because we are an organization that values integrity, quality, and compassion – all important pieces to building trust.
Plans are only as a good as they are nimble. As we continue to work our 3-year strategic plan, it is clear that our plans must bend and sway to match our ever-changing world. Our vision is a constant: everything we do is aimed at ensuring that all families have quality health care and adequate nutritious food to eat. And yet, when a measles outbreak hits like it did this year, we must be ready to respond – to redouble our efforts to ensure that every child in Washington is protected from vaccine-preventable diseases. It is our nimble, innovative, dynamic nature that makes us a true agent for change.
The CEO role is exciting and exhausting. It goes without saying that the CEO role is a big one, and my days are busier than ever before. They are busy because the opportunities to improve the health of all families in our state are beyond measure, and because the staff at WithinReach stand ready to examine, develop and implement each opportunity. Our smart, caring, and committed staff push themselves harder every day to make the connections WA families need to be healthy. I can only follow their lead.
One thing I know for sure… if my second year as CEO is anything like my first, I will learn new things each day. So, here’s to going back to school…every day!
Fighting health inequities, one shot at a time
Did you know that Latina women in the US are over 1.5 times more likely to be diagnosed with cervical cancer than non-Latinas and, once diagnosed, 1.5 times more likely to die from cervical cancer? To us at WithinReach, inequities like this are unacceptable.
Some of the factors that contribute to this inequity include lack of access to quality care, making Latinas less likely to get regular Pap smears, more likely to have more advanced cervical disease when they are screened, and less likely to receive follow-up care after diagnosis. Without a doubt, Latinas need better access to care and better quality of care when they do have access. But to get to one root of the problem, we need to prevent cervical cancer in the first place. Fortunately, we have a very effective way to do so: the HPV vaccine.
That’s why it’s disturbing to us that Latino parents are less likely to report that their provider recommended the HPV vaccine for their child(ren). Among a group of Latino parents in Yakima, 87% said that they would get their daughter vaccinated if their doctor recommended it, but only 46% had actually ever been offered the HPV vaccine!
We’re working to change that through a project offering targeted training to providers and staff in clinics that serve Latino families in western Washington. We talk about why the HPV vaccine is so important, how to make an effective recommendation, and how to have respectful and helpful conversations with parents about it. Luckily, we found a great partner for this work in the Seattle Cancer Care Alliance.
Inspired by its Community Health Needs Assessment (CHNA), Seattle Cancer Care Alliance (SCCA) launched a Community Health Improvement Grant program to addresses specific cancer screening, early detection, and prevention needs for at risk populations in King, Snohomish, and Pierce counties. Designed to build sustainable collaborations with Washington communities, SCCA selected seven local nonprofit organizations to receive funds in 2015, including WithinReach.
Finally, I can’t end this post without mentioning that the HPV vaccine prevents many different cancers that are caused by the human papillomavirus in both men and women, including cancers of the anus, oropharynx (throat area), and genitals. No one wants those diseases for their children. That’s why it’s important for both boys and girls to be immunized! And for providers out there interested in the latest on HPV immunization recommendations and how to navigate conversations with families, check out our free online CEU course.
Protecting newborns from whooping cough: a new protocol at WithinReach
A few weeks ago, WithinReach’s Immunization and Healthy Connections Teams collaborated to roll out a new conversation pathway with callers to the Family Health Hotline, where our friendly and informed staff helps callers understand and apply for a variety of food, health, and child development resources in Washington State. We are proud of the fact that all pregnant callers, or all callers who are in a household with a pregnant person, are now being advised of the recommendation that all pregnant women get a booster of the Tdap vaccine in every pregnancy. The Tdap booster ensures continued immunity from three diseases: tetanus diphtheria, and pertussis. We are particularly concerned about pertussis, commonly known as whooping cough, in Washington for several reasons:
- We are seeing a surge in new cases right now.
- Whooping cough makes babies very, very sick, and some die.
- Most babies who get whooping cough get it from a person in their household, particularly a parent.
- If the booster is given to the mother in the third trimester, some immunity will be conferred to the baby, offering some protection if the baby is exposed to an infected person.
- Babies cannot begin the vaccination series until they are 8 weeks old.
The above-listed reasons, combined with the fact that our Healthy Connections Team interfaces with more than 250,000 families per year, makes this the ideal venue to protect families from this disease. This recommendation is new, so many people may not have heard about it. To learn about the recommendations for pregnant women, read more from the Centers for Disease Control and Prevention.
Lastly, antibodies for pertussis wane over time, so it’s critical that everyone (regardless of if you are in contact with a pregnant woman) consult their doctor about a booster. In particular, adolescents are scheduled to get their booster dose of Tdap in the 11-12 age range. But outside of these groups, please make sure you’re up-to-date with your Tdap vaccine, especially if you did not get a booster as a teen or pre-teen. With waning immunity, risk increases, and the best thing you can do to protect a newborn is to ensure that you’re providing a disease-free cocoon around that child.
Do You Believe in Magic?
Dr. Paul A. Offit’s book Do you Believe in Magic? The Sense and Nonsense of Alternative Medicine examines the $34-billion-a-year business known as alternative medicine. Dr. Offit is chief of the Division of Infectious Diseases and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, and a vocal advocate for immunizations.
Dr. Offit understands the allure of alternative medicine and begins with the story of his own disappointing experiences utilizing the modern healthcare system. He gets multiple incorrect diagnoses, including one which led him to believe he was dying from a fatal illness for two years. In another incident, he awoke from what he had been assured would be minor knee surgery to learn that it had been a major surgery which would take a year to recover from. Offit says, “the miscalculation didn’t seem to surprise or upset the orthopedist. But it upset me.” Through misadventures and mixed advice, Offit looks into the chasm between modern and alternative medicine.
Offit argues that the popularity of media celebrities who promote alternative therapies, such as Dr. Mehmet Oz, comes from their offer of “an instruction book for something that doesn’t come with instructions: life.” These superstars, as he calls them, claim that following their advice will enable you to live longer, love better, and raise happier children. Who doesn’t want the playbook for how to live life? Unfortunately, this playbook is often full of medicine that doesn’t work.
One chapter is dedicated to the myth that vaccines cause autism, a belief propagated by celebrities like Jenny McCarthy. Offit doesn’t fault parents for searching for a cause for their child’s autism. He understands how easy it is for parents to believe in untested theories and describes how the unfounded fear of vaccines has allowed a resurgence of vaccine-preventable diseases in the United States and incited parents to fear vaccines more than the diseases they prevent.
Part of the appeal of alternative medicine is that it is personalized. Offit acknowledges that modern medicine often leaves a patient feeling more like a number than an individual. He recognizes how the fluidity of modern medicine can be unsettling, highlighting that many alternative medicines have remained unchanged for hundreds even thousands of years, which begs the question: Haven’t we increased our knowledge of human anatomy and disease over these years?
The continual evolution of modern medicine should be comforting. We are constantly learning and applying that knowledge to medicine, which in turn adapts – resulting in new and changing treatments and recommendations.
Paul Offit is a supporter of medicine that works – he does not discriminate against type of medicine, whether alternative or conventional, he only distinguishes between medicine that can be proven to work and medicine that only pretends. Offit argues that proper evaluation of all medicine is paramount. With over 40 pages of notes and selected bibliography, Offit uses the platinum standard in scientific reasoning—a case-control study—to make his point. If the treatment proves to make a difference in comparison to its control than he simply calls it medicine that works. Summing up the timely takeaway message of the book, he writes:
“Although conventional therapies can be disappointing, alternative therapies shouldn’t be given a free pass. I learned that all therapies should be held to the same high standard of proof; otherwise we’ll continue to be hoodwinked by healers who ask us to believe in them rather than in the science that fails to support their claims. And it’ll happen when we’re most vulnerable, most willing to spend whatever it takes for the promise of a cure.”
Goodbye and good luck to our AmeriCorps team!
Our amazing AmeriCorps team will be finishing their service at WithinReach next week. Their work as Outreach and Enrollment Specialists over the past 10 months helped families and individuals all over Washington access necessary nutrition and health resources. We are going to miss this team, but they are off do to more meaningful work in Washington and beyond! Check out where they’re headed, and what their time at WithinReach meant to them:
Jessica Vu: I’ll be doing another year of service as a VISTA member with Harvest Against Hunger and the South King County Food Coalition. We will be working to develop a farm that will grow produce for 12 food banks in South King County. In my year at WithinReach, I learned the value of engaging your community!
Kasey Johnson: I am applying to medical programs to become a family physician that serves a rural community here in Washington state. I am also planning to continue working with one of our community partners, the Edmonds Mobile Clinic. My year at WithinReach taught me so much; it’s been very exciting to be a part of broad change regarding health insurance and to see how public benefits are distributed and accessed by our community members experiencing poverty. This knowledge will be carried with me as I continue to serve my community and work toward change for its most vulnerable members: the poor and uninsured.
Chris Garrido-Philp: It has been a pleasure to get to know communities in King and Snohomish County through WithinReach. I have learned that the diverse people who access assistance through our state’s programs come from all walks of life. I plan to continue my learning of direct service work and overcoming barriers in the healthcare system through the University of Washington Master of Social Work program this fall.
Amber Bellazaire: In September, I will begin a Master in Public Health program at the University of Michigan. I look forward to implementing the knowledge gained through our community-based fieldwork as service members at WithinReach in my future studies.
Jodie Pelusi: I hope to use the communication skills/methods I learned in this position to better serve communities in the future while working in the PeaceCorps. I will be in Cameroon starting in the fall for 2 years as a Maternal and Child Health Specialist. I am interested in further developing resourceful methods to work with community members in creating their own solutions to the health disparities they face. This year has given me the courage to take initiative in my future goals.
Emma Lieuwen: I will be staying on at WithinReach and will continue to do outreach over the summer. I have learned there is a great need in Washington for food and health resources and there is plenty of work left to be done.
We are proud to be part of the journey for these future leaders! If you’re inspired to serve, check out the application to be part of the next wave of AmeriCorps members at WithinReach.
Vaccine Education Across Language and Culture
By Judith Pierce, WithinReach Immunizations Graduate Intern.
From April 18-25, we’re celebrating National Infant Immunization Week. Did you know that routine childhood immunization in one birth cohort prevents about 20 million cases of disease and about 42,000 deaths? It’s pretty awesome. That’s why we work to ensure that all children in Washington have access to immunizations, and their parents have the information they need to make a good decision. Unfortunately, not everyone has the same access to health information. Below, our graduate intern, Judith Pierce, describes her work with us to help address one of these gaps.
In summer of 2014 I had just completed my first year of public health school, and was in search of a year- long project for my capstone requirement. I knew I wanted to practice skills in evaluation and data analysis, but I also wanted a project with content that would be able to hold my interest for a year. When I initially approached WithinReach’s Immunization program, I was really interested in their work with provider training and the Immunity Community, and assumed I would work on those projects. Instead, they gave me the opportunity to develop a community forum for Russian speakers. Through speaking with the Immunization team I learned that Russian speakers have the lowest childhood immunization rates of any population in Washington, and have had the lowest rates since 2008. This was incredibly interesting and I grew curious to learn more.”
Over ten months I researched the literature and spoke with key informants to better understand the historical context and social connections in Russian speaking populations that contribute to low immunizations rates. Much of the vaccine hesitancy we find in Russian speakers stems from confusion and frustration with the US immunization schedule, concerns of adverse reactions to the vaccines and an inability to find a Russian speaking provider to answer their questions. The Washington State Department of Health conducted a series of Russian speaking focus groups to identify major themes, and all four groups requested an event with a Russian speaking provider to address immunization concerns in a community forum. With help from Spokane-based health service providers, we were able to develop the community forum parents asked for. At the forum, parents expressed their frustration and fears about childhood immunizations to a Russian speaking pharmacist who was able to answer their questions and explain why the US immunization schedule is different from their home countries. At the end of the meeting, the majority of surveyed participants said they enjoyed the forum and were able to have their questions answered by someone they trusted. 40% said the forum changed their minds about immunizations.
With the measles outbreak at Disneyland and whooping cough on the rise in Washington, media pundits and bloggers often lay the blame squarely on a mythical homogenous anti-vaccination group. The reality is people have a variety of concerns, and those of us doing immunization work should not assume why a particular group has fears about vaccines. This project allowed me to not only develop skills and learn new content, but also develop an appreciation for programs, such as Washington State Department of Health’s focus groups, that actively seek to understand health disparities and find culturally appropriate ways to address concerns within a community.
For additional information on how to develop a community forum addressing vaccine concerns for Russian speakers, contact Sara Jaye Sanford, WithinReach’s Immunization Action Coalition of Washington Program Coordinator at: (206) 830-5175 or firstname.lastname@example.org.