Reducing Infant Mortality-UPDATE!
Lay Health Advisors (LHA) have been working tirelessly to spread the word about the
high rates of infant mortality in our Memphis community. In the 2009 calendar year
Community Voice trained 447 new LHAs. Of those trained, 26% lived in the targeted zip codes with
the highest rates of infant mortality. During the 2009 calendar year LHAs educated
a total of 2,865 people in the Memphis community. Since the beginning of the program
5,329 contact reporting forms (forms our LHAs fill out to document their contact with
the community) have been returned, and a total of 15,000 people (including individual contacts and group presentations) have been educated about
Thank you Lay Health Advisors!
Reducing Infant Mortality through Community Voice
In 2008 the Center for Research on Women began work on a comprehensive, four-year
evaluation of Community Voice (CV), a grassroots educational program designed to reduce and prevent infant mortality. CV
is administered locally by the Tennessee March of Dimes. The educational program
and its evaluation are part of Governor Phil Bredesen's statewide Infant Mortality
Initiative. The initiative in Memphis is coordinated by the Shelby County Office
of Children and Youth.
CROW is working in partnership with the UofM Center for Community Building and Neighborhood
Action (CBANA) to evaluate the program's effectiveness in Shelby County.
Based on a curriculum and trainer’s guide developed by the Community Voice Program
of the South Central Perinatal Council of Virginia, lay health advisors are recruited
and trained to take the information they receive throughout the community.
Premised on the understanding that local, indigenous, and tacit knowledge about pregnancy
and parenting motivates behavior, Community Voice is intended to diffuse new knowledge
working through indigenous and credible social networks and pivotal persons in those
The vision for Community Voice is that it will lead to better birth outcomes in communities where new knowledge
is diffused and healthier behaviors adopted. Better birth and maternal outcomes (lower incidence of prematurity and low birth weight, diminished infant mortality, and other indicators that may be identified) are expected
to be a moderate to longer term effect, so that while these outcomes will be baselined
and tracked during the three year period, we expect to more fully document process
and interim outputs.
In just one year, over 200 lay health advisors (LHAs) have been certified through
the Community Voice program and those LHA's have reported sharing their new knowledge with over 2,000
people in the Memphis community.
The Evaluation Process
In this project, CROW and CBANA are using an empowerment evaluation protocol where contextual knowledge that evaluators might bring to bear as the program
is being implemented is shared with program staff and volunteers, and where community-based
participants share in the interpretation and fine-tuning of the evaluation process.
Evaluation components include:
Process evaluation: Participant observation and standard field methods documenting design, implementation,
and acceptance of the training and other aspects of Community Voice.
Standardized pre and post-testing for training participants (knowledge, beliefs and attitudes, and intended behaviors), along with activity logs
designed to document actual changes in behavior and fidelity to the diffusion concept.
Asset mapping and other contextual analysis to grasp neighborhood inputs (strengths, weaknesses, opportunities and threats) that
may impinge on the successful implementation of Community Voice among particular social
networks or in particular neighborhoods (risk and protective factors for successful
implementation or diffusion.)
Measures of diffusion and penetration, including the activity log and perhaps other measures such as a systematic survey
of network members/neighborhood residents.
Tracking birth and maternal outcomes from 2007 baseline through 2010 (with final report in 2011.)