Health of the Public Funding Helps University of Pennsylvania Focus on Population-Based Medicine, Maternal Health

From 1993 to 1996, staff at the University of Pennsylvania, Philadelphia, established a collaborative educational program with an infant mortality program—the Healthy Start Program for Teen Mothers—and introduced medical and nursing students to population-based medicine through a focus on maternal and infant health.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national program Health of the Public: An Academic Challenge. The University of Pennsylvania joined the program in 1990.

The federally funded Healthy Start program, run by the Children's Hospital of Philadelphia at a satellite practice in West Philadelphia, provided quality, continuous primary care, including preventive health education, injury prevention, nutrition, family planning, and social supports for the mother-baby unit.

Key Results

  • Penn developed three new pre-clinical electives:
    • "Introduction to West Philadelphia." Members of the Healthy Start Consortium served as instructors for this summer course on community health in West Philadelphia.

      Sessions focused on the relationship between particular social issues and women's and infant's health.
    • "Tools for Working in Community-Based Projects." This spring seminar allowed students to set up summer projects under Bridging the Gaps: Philadelphia Community Health Internship Program, which provided health-related services in the West Philadelphia community.

      The Bridging the Gaps Consortium, which also collaborated with the Health of the Public project at Thomas Jefferson University, is a local initiative that places medical students from all of the city's medical schools in community health-related projects.
    • "Women's Health Seminar." This seminar focused on reproductive health and the health of inner-city women from West Philadelphia, with presentations by community leaders and academic health center faculty.
  • Students in the Women's Health Seminar organized a new course focusing exclusively on reproductive health issues for women. During the course, students spend eight sessions at family planning and abortion clinics learning to counsel women and observing procedures.
  • A new interest group on maternal and infant health was organized as part of the required Clinical Epidemiology course for all first year medical students. The students critically review literature on maternal child health issues and produce an in-depth report.
  • The Health of the Public project offered three clinical components:
    • Healthy Start Program for Teen Mothers. Students generally participate in this practice during the first, second, or fourth year of nursing school and during the first or second year of medical school. Student tasks include health education, weighing and measuring infants, counseling mothers, and performing histories and physicals.
    • Adolescent Clinic at Children's Hospital of Philadelphia. This clinic provides well person care and family-planning services to adolescents ages 12 through 19. Teaching is performed across disciplines, with nurse practitioners teaching medical personnel and medical personnel sponsoring and teaching nursing students.
    • Ob/Gyn Clinical Clerkship/Nursing Health Care of the Childbearing Family Course. This course provides students with the tools to become clinical advocates for the women they treat in the delivery room, the clinic, or the community. Debriefing sessions at the end of the course have provided information both for improving access to the community-based organizations of Healthy Start, as well as for improving the inpatient systems of care.
  • The Health of the Public project pilot tested domestic violence training for pediatric residents and pediatric nurse practitioner students. Presenters for the training, which was developed by Physicians for Social Responsibility, included social workers, police, physicians, and nurses.