ED | Symptoms | 0:15 | ENG

When people seek non-emergency 
care at emergency departments,   it can cause long wait times and delay 
care for true emergencies. So ask yourself,   what's the right place to receive the right 
care. Learn more at health.ri.gov/rightplace.

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Study: 1 in 3 COVID-19 survivors develop mental health problems within 6 months

IN SIGNIFICANT News. Show that COVID-19 THIRD OF PEOPLE WHO SURVIVE affects the mind and COVID DEVE very HEA significant ways IS . Researchers RDERS THEY found a third of people who survive COVID developed R HAD BEFORE. mental DOCTORS SAY health SUGGESTS T issues or brain disorders that they never had before. NUMBER OF PEOPLE WHO WILL NEED HELP… FOX13♪ )S BRIONA And doctors say the research suggests a bigger number EXPLAINS WHAT of people IDERS ARE DOING will be needing help in the future. FOX 13's Briona Arradondo explains what providers were doing to get ready for that wave. ((TAKE PKG)) SOME PEOPLE WHO RECOVER FROM COVID-19 MAY GET MORE THAN JUST A Some people NEW STUDY who recover LANCET PSY from L IN APRIL LOOK COVID-19 AND CO make RESEARCHERS it more than HEM DEVELOPE just antibodies DISORDERS WITHIN THE SIX MONTHS AFTER . A new study THAT published DEPRESSI in A STROKE. TH The Lancet DED TO DE psychiatry THE SIX journal EY STUDIED in April, looked at 236,000 COVID survivors, Researchers found a third of them developed mental health or brain disorders.

Within the six months after the infection that includes anxiety, depression or even a stroke. Psych burden tended to decline a little over the six months that they studied people. That's all they did. It was still there at the end, so it's not like it always goes away on its own. You might need help with Dr Glenn career heads up the psychiatry department at the University of South Florida. He tells us over video conference. This study shows how COVID-19 puts you at risk. There is more wife spread awareness of this in the medical kit. Yeah, it's up to us who work in specialty areas such as psychiatry, so organized care that's appropriate for folks. Florida Behavioral Health Association president Melanie Brown Wool after says mental health provider saw more people needing their help. In the last year. The industry and system of here is feeling the pressure. On, you know, creating access getting people in where they need to be seen and then being able to provide the appropriate treatment for them, so they're getting ready to meet even more demand.

We're lifeline. You know, we're here for anyone who's experiencing any kind of difficulty. Experts say the takeaway is how important it is to talk to your doctor. Don't minimize it. Don't be alarmist, but realized there's help to be had. And if people are struggling with any of this, they should seek out that help reporting in Tampa Briona Arradondo Fox13 News, Florida's manatees are in big trouble. They're dying across.

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What is depression? | Mind of the matter: Hear from the experts

Depression is, I think it's more than just feeling 
sad or down for a couple of days at a time. I think we all go through 
periods where we feel unhappy and we feel fed up at times, but I think 
depression is more so when those feelings and thoughts are sort of consistent and persistent 
and they affect your sort of everyday life. So we kind of think about it in maybe the 
milder sense of depression, so as I said, there's persistent feelings of sadness or 
feeling down all the time and whilst it may not be at the point where it's affecting your everyday 
life everything just feels a bit more difficult and then we kind of get to a point 
where depression is a bit more severe. These are the times where maybe it's more 
concerning because it can be life-threatening.

We know that people who are severely depressed 
can go on to experience suicidal thoughts and I think it's kind of being mindful and aware 
of that sort of persistent sadness and the impact that it can have in your everyday life.
I think it's important to to think about how depression is going to affect each individual 
person in particularly individual ways. So there are many sort of signs and symptoms. It can 
affect the way we think about ourselves and then sort of think about the world; so we might 
be sort of wracked with feelings of guilt or feeling quite worthless, or question our place 
in the world, or kind of have low self-esteem. It can impact our emotions, so feeling of 
uncontrollably sad, feeling quite upset, tearful. But it can also impact us physically and 
in terms of the way in which we behave. Feeling more tired for example and 
sometimes people experience a kind of loss of their sex drive, a loss of appetite.
And then in terms of how we interact or behave with the world we might become a bit more 
isolated or we might become a bit more withdrawn and all of those different symptoms, as I 
said, can sort of manifest in different ways for different people.

Again it's keeping 
a track of those symptoms and thinking how severe are am I experiencing this? How 
persistent is this sort of sadness? How long has this gone on? and What sort of impact is it 
having on my day-to-day life? So, is it affecting my relationships, affecting my ability to work, 
is it affecting my ability to sort of concentrate? And I think for each person they'll be able to to 
maybe recognise that at different points and so I think the the best thing to do is 
think about if you recognise that, if you recognise a change that doesn't seem 
to be going away after sort of days and months to get the right support and seek help for it.
Often I think there are kind of different sources of information that people can sort 
of interact with but thinking about getting the right help and at the right time it is vital.
Speak to your to your GP if you have concerns but then also think about well-known sources.
So for example MIND as a charity thinking about accessing their resources to 
develop your understanding of what might be going on for you and what you might be experiencing 
and how best to go about managing that

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Climate Change Impacting Children’s Health

IMPACTS OF CLIMATE CHANGE IN CHILDREN FROM ASTHMA AND ALLERGIES TO PREMATURE BIRTH. HOW DOCTORS AROUND THE COUNTRY ARE DRIVING A CALL TO ACTION. Reporter: AS WILDFIRES BURNED NEAR SAN FRANCISCO LAST SUMMER, PEDIATRICIAN LISA PATEL SAID SHE SAW FIRSTHAND HOW CLIMATE CHANGE CAN AFFECT HEALTH. LATE SEPTEMBER, I REMEMBER SHIFT AFTER SHIFT I HAD SEVERAL DELIVERIES I WOULD GO TO AND EACH SHIFT THAT MOMS ARE COMING IN AND LABOR A MONTH OR TWO MONTHS EARLY. PREVIOUS STUDIES SHOW AIR POLLUTION AND EXCESS HEAT CAN CAUSE PREMATURE LABOR. AMERICAN ACADEMY OF PEDIATRICS CALLS CLIMATE CHANGE ONE OF THE TOP HEALTH THREATS TO CHILDREN. WHAT ARE THE EFFECTS OF CLIMATE CHANGE ON CHILDREN? EVERYTHING YOU CAN IMAGINE. THAT IS WHY ALL OF US ARE SO INVOLVED IN THIS.

NOW WE UNDERSTAND THAT CLIMATE CHANGE AFFECTS EVERY PART OF OUR BODIES AND HEALTH. IT INCLUDES POLLUTION TRIGGERED ASTHMA, SEVERE ALLERGIES, AND HEAT ILLNESSES WITH RISING TEMPERATURES. TO PROTECT FAMILIES, U.S. PEDIATRICIANS ACROSS THE COUNTRY ARE BANDING TOGETHER AND LOBBYING LAWMAKERS FOR CHANGE. CLIMATE CHANGE ADVOCATES WITH THE AMERICAN ACADEMY OF PEDIATRICS ARE PUSHING FOR NEW LAWS ON RENEWABLE ENERGY. PASSING CLIMATE RESOLUTIONS, AND EDUCATING OTHER PHYSICIANS. MONTANA PEDIATRICIAN LAURA BYRON FOUNDED THE PROGRAM. WHETHER IT IS DOING IT OUT OF YOUR HOME ARE USING YOUR ECONOMIC SECURITY SOMETIMES FOR FARMERS AND RANCHERS LIVING.

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Coronavirus Outbreak: CBS3 Goes 1-On-1 With Pennsylvania Secretary Of Health Dr. Rachel Levine

WILL ALSO BE TESTED. JESS, BACK TO YOU. DAN, THANK YOU FOR THAT. TESTING FOR CORONAVIRUS WILL QUICKLY BE RAMP UP AND AVAILABLE TO A LOT MORE PEOPLE IN PHILADELPHIA, AND MONTGOMERY COULDN'T, AND HEALTH OFFICIALS HAVE IDENTIFIED AT LEAST TWO CLUSTER INS MONTGOMERY COUNTY. HEALTH REPORTER STEPHANIE STAHL HAD A ONE ON ONE INTERVIEW TODAY WITH THE PENNSYLVANIA SECRETARY OF HEALTH. STEPHANIE? WELL, DOCTOR LEVIN TOLD ME THERE IS NOW A BIG FOCUS ON THREE THINGS MAINLY. WIDESPREAD TESTING FOR ANYONE WHO WANTS IT SHE SAID GETTING ADEQUATE SUPPLIES AND MAKING ARRANGEMENTS FOR SURGE CAPACITY OF PATIENTS FOR THAT THEY'RE WAVING REGULATIONS COVERING HOSPITAL BEDS. WE ARE DISCUSS WITHING THEM WHERE THEY MIGHT BE ABLE TO ADD BEDS, HOW TO ADD ICU BEDS, AND THEN IN PARTICULAR THE EQUIPMENT WE'VE BEEN DISCUSSING, ALL ARE HAPPENING AS WE SPEAK, AS WE PREPARE. DOCTOR RACHAEL LEVIN SECRETARY EVERY HEALTH IN PENNSYLVANIA TOLD ME IN A ONE ON ONE INTERVIEW, THAT HOSPITALS WILL BE ALLOWED TO EXPAND THEIR BED CAPACITY TO CARE FOR COVID-19 19 PATIENTS IN NECESSARY.

AND THE CONSIDERATIONS ARE BEING MADE FOR TEMPORARY MEDICAL TREATMENT FACILITIES. SHE SAID MEDICAL SUPPLIES, PERSONAL PROTECTIVE EQUIPMENT FOR HOSPITAL STAFF, IS RUNNING THIN, EVERYWHERE. BUT PLANS ARE UNDERWAY TO GET MORE. AND SHE REVEALED THAT CLUSTERS HAVE BEEN IDENTIFIED IN MONTGOMERY COUNTY. I ASKED SPECIFICALLY ABOUT THE CARDIOLOGIST WHO HAD CONTACT WITH FAMILIES AT THE PULSE FACILITY AND THE POLICE OFFERS NERVE LOWER PROVIDENCE, WHO PRESUMABLY HAD CONTACTS IN THE COMMUNITY. FOR PATIENT CONFIDENTIALITY. BUT I THINK THAT YOU UNDERSTANDS THE SITUATION QUITE WELL. NOW BOTH THE DOCTOR, THE POLICE OFFICER DID NOT HAVE SYMPTOMS, WHEN THEY WERE WORKING AND INTERACTING WITH PEOPLE. ALL OF THE PEOPLE WHO HAD CONTACT WITH THEM HAVE BEEN CONTACTED BY HEALTH OFFICIALS, TAN APPEARS, SEVERAL OF THEM TESTED POSITIVE. NOW, CLUSTERS OF THE VIRUS ARE MAINLY ASSOCIATED WITH PEOPLE WHO HAVE BEEN IN CLOSE CONTACT, LIKE IN FAMILIES OR THE WORKPLACE, BUT WE NOW KNOW

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Watson Assistant for Marketing: This is not a demo.

– All of your data will
produce better results. This is not a demo. If you're expecting the
usual, this isn't for you. It can't be a demo because
this is Watson Assistant for Marketing the AI-powered advisor in a lot of Watson Marketing products. It gets you data and insights faster giving you more time to deliver mind-blowing customer experiences. This is a powerhouse. It helps you pull campaign
reports, evaluate metrics, get support to make smarter
marketing decisions, (cheering) and it makes you look like a superstar. This is fast. Blink-or-you-might-miss-it fast. Did you blink? Because Watson just compared this quarter's campaign to
last quarter's, in seconds. This is smart. It's not a chatbot, it's a conversation.

– What's up? – Hi, Michael, here's your dashboard. That happens wherever you are. This is more than a dashboard, it's a command center that learns with every question you ask. Automatically serving up the info you're usually looking for. Like comparing your
performance to industry data, identifying relationships within the data, and even predicting performance. – Show me industry benchmarks. – I have found the following benchmarks. Boom, you just accessed benchmarks for 20 industries and nine geos. And it pumps out metrics faster than Bobby the Science Fair King. The click-to-open rate of mailing
Ski Season Opening is 47.6. This is a navigator. – How do I create a mailing template? – Check out these results. That guide you through the
application you're working in. See, this is not a demo because this is not your
regular marketing tool. It's the one that changes
the way you do marketing. (drumming)
This is Watson Assistant for Marketing..

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2 Your Well-Being: Cone Health breaks down mask recommendations

To get updates, we're now seeing people not wearing masks anywhere. Others are still choosing to wear masks in certain places to help us understand the recommendations, make the best decision for our own health. We have Doctor Cynthia Snyder from Cone Health here today. 4/2 your well being she is there. Infection Prevention medical director. So let's first start off with what are the new mask recommendations based on? So the CDC recently gave new guidance to incorporate not only how much COVID is in the community, but also takes into consideration like hospital capacities and so. What's really neat is that the CDC has created a map that you can look up your county to see what category you fit in, and so it's similar to like I would say, like a speedy like a light where it's air traffic light where it's either. Green, yellow or red. And.

Luckily, Guilford County just recently, as now in that green category, which really means that it is. The rates are low, the hospitals are doing OK, so anybody that needs to come in to be evaluated for anything, please come on in. And it also mentions that if you have symptoms, definitely still get tested. If you're not up to date on your vaccine, this is a perfect time. The times where we would want you to wear a mask is for those who are immune compromised.

You know, and that that the folks who are who we know that probably don't respond to the vaccine very well should still be wearing a mask in public, especially in indoor areas. Areas where it has not changed. Masking is still required in the hospital and is still required on public transit's alright. So how can people find the transmission rate for their area no matter where they are? So the CDC has like a COVID map and but you can also go to conehealth.com back slash COVID and the link is there and then that way you'll get to see where you are living, whether you're in the red or the other colors, the yellow or the red or green. Yeah, OK, so walk us through the risk levels there and how it applies to those mask wearing with the green, the yellow and the red levels. Sure, so the the lowest category would be considered the Green Zone, which were in, and that's really when the rates are the lowest. When the hospitals are not filled to the Max and the risk of transmission is very low, we know that the IT is safe in schools you know kids have have now.

It's optional to wear masks and also for folks who still feel. Like you know they're not quite ready to stop wearing a mask. It is obviously fine to still, you know to still use it and the the key thing is that it's really based on the transmission rate and the rates in the community. If if the rates start getting higher and we're also seeing more hospitalizations associated with that, you move into the yellow zone, and that's really again where we still want people vaccinated. Get tested with symptoms. If you have symptoms or also, this is also a good time to. Wear mask if you have been exposed to somebody right. There's that pre that period like right before you start having symptoms that you can still be shedding infectious virus and and those those precautions I think are really good to prevent spreading cases around and then again if those rates really shoot up again with our next surge, that's when that the rating will go back up to the red zone where everybody should be wearing a mask indoors.

And this opportunity now for it kind of, does give us a breath of fresh air. You know, when the rates are low, I think people are less anxious seeing a bit, you know, but still, I think it's really important, especially if you're not vaccinated or under vaccinated. You're realizing that your risks are greater for contracting kovid, especially when you're in the yellow and red red red zones.

So I picked up on one. Other factor that people should consider when making their mass decision, and that is if you've been exposed to someone that had COVID, you should probably mask up. Is there anything else? Any other factors people should consider making mask decisions? Yes, it's still the key thing though is that you know when somebody is obviously having symptoms. You should obviously wear masks and get tested, and if people are positive and are in, you know they're not staying home that whole 10 day period. They should be wearing a mask during that. That process. Now, do you need to wear a mask? If you've recovered from COVID-19? As long as you finish that isolation period of 10 days, then and and and have improved and no longer having symptoms, you know then you cannot wear a mask, right? And I think we covered wear masks are required, so definitely in the hospital, so don't be surprised when you go to the doctor or anything like that that you're being asked to wear a mask. Correct and it including visitors right? So as you are going to visit some loved ones or friends, you'll still be asked to be wearing a mask the whole time and then also for public transits.

You know. Obviously our local buses and trains and flights. You'll still need to be wearing a mask at this time and then I believe also. And skilled nursing facilities there. Although they require visitors to wear masks and then also possibly at like local jails and and areas like that. OK now are there any other COVID updates that people need to know? I think the main thing is that we're heading into a bit of a sweet spot. You know, I would say this reminds me a little bit of part of the summer. Or come, you know, I think at the end of October, beginning of November, where our rates were low, you know we were able to do. A lot of activities outdoors, without masks and and and also being indoors without masks, but the key thing is making sure that you know if anyone is exposed or has symptoms.

That's the important part of wearing masks, then doors so that you're not exposing others. OK, alright, so now you have your chance to ask Doctor Schneider. Your questions for the rest of the show. She's helping you navigate the pandemic and hopefully towards the endemic, answering your questions directly. And here's how you get your. Question to her. You text us that question. It's 336-379-5775. We're going to take a quick break and we'll be back..

As found on YouTube

Basic Food Safety: Chapter 2 “Health and Hygiene” (English)

Welcome to "Part Two: Health and Hygeine What is biological contamination? How does food worker health affect safety? What should you do when you are sick? What does good personal hygiene mean? Find the answers to these and other important Food Safety questions including: Proper handwashing and when it's important How to avoid barehand contact with ready to eat foods Glove Use and how personal habits can affect food safety. Of all the types hazards that can arise from unsafe food handling practices, Biological Contamination is the most common. Our world is filled with germs, and some can make us sick. It’s those harmful pathogens that cause foodborne illness. Food worker health is one of the most important factors to preventing foodborne illness.

It’s simple, when you are sick, do not work with food. Germs can easily be spread if you are experiencing flu-like symptoms, jaundice, or other illness. If you are sick stay home. Remember the 24 hour rule- Vomiting, Diarrhea, Fever with Sore Throat, or jaundice. Stay home for 24 hours after the last symptom. If my employees are sick I tell them to go home and comeback when they are feeling better – it’s not worth the risk Besides being aware of your own health and knowing that when you are sick, that you pose a risk to the public – being aware of your personal hygiene is another aspect of avoiding contaminants in the food you serve.

In fact, food workers with good personal hygiene save lives. Following proper hand washing protocol, by washing your hands the right way and at the right times, keeping fingernails trimmed for easier cleaning, wearing hair restraints and proper work clothing and covering cuts and burns with bandages and gloves – in addition to not working while sick – are all ways that hygiene prevents the spread of germs in the kitchen. Handwashing is something that we all learned at a very young age- but if you want to work as a food handler it is important to re-learn this task in the proper way that complies with the health department guidelines. But first lets review the times that it is necessary to wash up. Wash your hands throughout the day, even when hands look clean, to keep germs out of your body and the food you prepare.

Always wash before you begin food preparation and when you have been contaminated by exposure to potential germs. Contamination can be caused by using the bathroom- touching ones face or nose – handling raw meat, fish or poultry- sneezing, coughing or blowing ones nose – handling garbage or dirty dishes – handling animals or using chemicals – or after taking a break, eating or smoking. If you aren’t sure if a wash is necessary, wash anyway just to be safe. Proper handwashing is a six step process that requires a handwashing sink with hot and cold running water, soap, and paper towels or other single-use drying method.

Step 1: Get hands wet to help the soap work Step 2: Apply soap and scrub, Remember to pay attention to your entire hand when washing. Step 3: Rub your hands for a full 20 seconds. This is how long it takes for soap to kill germs. Step 4: Scrub the backs of your hands and between your fingers, a common breeding ground for bacteria. Scrub your forearms. They frequently touch food, food prep surfaces, and utensils. Step 5: Rinse hands to send the soap suds and germs down the drain. Rinse for about 5 seconds to fully remove the soap. Step 6: After rinsing, dry hands and forearms with disposable paper towels or an air blower. Don’t use cloth towels or dishrags, which can stay damp and recontaminate your hands. It’s important to know that hand sanitizers may be helpful on clean hands, but are NOT substitutes for handwashing.

In fact, in some cases double hand washing may be required. Always remember that hand washing is the most important food safety tool to get rid of the germs that make people ill. When in doubt, wash. But germs can remain on your hands even after washing, that’s why it is important to prevent bare hand contact with ready-to-eat food by using utensils such as tongs, scoops, deli papers, or single-use gloves. Focus on minimizing bare-hand-contact. Utensils, Tongs, Tissue paper – these are all acceptable when handling ready-to-eat foods- so you don’t need to glove up as often as you would think. Remember when you do use gloves, it is required to wash before and sometimes after glove use. Ready-to-eat foods are those served without additional washing or cooking to remove germs – and they include washed produce that is eaten raw such as sliced fruit, salads, and garnishes – foods that will not be cooked such as sandwiches, sushi, and deli salads – bakery or bread items such as breads, cakes, pies, and tortilla chips – ice that may be used in drinks or foods that have already been cooked.

Gloves can be tricky because if a food handler thinks they are using gloves correctly- and they aren’t- they can put the public at an increased risk by contamination. Gloves are there to protect food from germs, not your hands from the food – so remember to change them often and never wash or reuse them, especially if between working with raw and ready-to-eat food When you’re done with them be sure they go in the trash and wash your hands afterwards. When it comes to health and hygiene as a defense against food borne illness, it’s important to realize that personal habits affect food safety. You may not eat, drink, or use any type of tobacco in food prep areas. This is to prevent spills and reduce contamination Use hair restraints that are intended to keep hands out of hair and hair out of food. Hair must always be restrained when working around food or in food prep areas. Hair restraints include hairnets, barrettes, ponytail holders, and tight braids. Long beards must also be restrained. Fingernails must be trimmed for easier cleaning. If nail polish or artificial nails are worn you must wear gloves when preparing all foods, not just ready-to-eat foods.

Jewelry including rings, watches, bracelets, and all other jewelry on arms or hands must be removed during food preparation. Wedding rings may be worn if they are covered with a glove when the food worker is preparing food. Personal items like medicine, coats, and purses must be stored away from food, dishes, and linens. Let's review "Part Two: Health and Hygeine We learned that biological contamination is caused by germs on our bodies and in our environment, and that if you are sick – Don't come to work, Follow the 24 hour rule, and check in with your Person-in-charge about your symptoms.

Follow proper handwashing steps at the correct times to avoid biological contamination. Avoid barehand contact with ready-to-eat-foods. Use gloves to protect food, not your hands – and wash before and after glove use. Be aware of your own personal habits and hygiene as a defense against Food Borne Illness..

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Rapides Regional Health Talk – Colors of Courage 5K

– [Narrator] Health Talk, brought to you by Rapides Regional Medical Center. (upbeat music) Just about everyone is impacted by cancer. It may be you, or a
loved one, or a friend. That's why Rapides Cancer Center is holding its first
Colors of Courage 5K Run to raise money for the
American Cancer Society. – The Colors of Courage is a 5K run walk that we will hold at Rapides
Regional Medical Center on Friday April 8th at 6:00 p.m.. The course will start and end on the Rapides Regional
Medical Center campus, and we thought Colors of
Courage Run to represent all the different colors of cancer. There's a color for every
different type of cancer, so what better to associate
that with than a color run? – [Narrator] And there will
also be three coloring stations at each of the mile markers.

There, volunteers will
shower willing participants with a colored powder made
of food-grade corn starch. – It's a fun run that you
can do with your family, your friends, your co-workers. It's a high-energy run. You can get really really
messy if you want to. You can avoid the color
stations if you want. Form groups, dress up, come in costume. It's just high-energy and
fun and it's a great way to earn money and raise
money for a great cause. – [Narrator] Registration
is currently underway online at www.IMAthlete.com, and search for Colors of Courage. The cost is $30 and if you're
registered by March 31st, you are guaranteed a race t-shirt. (upbeat music) For more information or to
download a registration form, visit www.rapidesregional.com..

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Rural Postpartum Mental Health Care Challenge Webinar 2

Priscilla Novak: I'm Priscilla Novak from Agency for Healthcare Research and Quality and I want to thank you for joining us today for our second webinar to provide an overview of our current challenge which is called the cross sectional innovation to Improve Rural postpartum mental health challenge. Priscilla Novak: Very pleased to be here with you today and just want to remind you that the webinar will be recorded and Priscilla Novak: I will give you the overview of the agenda.

Next slide please. Priscilla Novak: So the first thing that we're going to talk about is the purpose of the challenge and the theme and then we will have Priscilla Novak: Dr. Beth Collins Sharp from the Office on Women's Health providing substantive overview on the problem of postpartum depression and postpartum mental health. And then secondly, Priscilla Novak: We will have the timeline price structure and submission requirements will also have the evaluation criteria centered and go over the submission process. Priscilla Novak: Finally, at the end of our webinar we will have a time for questions and answers. If you experienced technical difficulties during this webinar, please Priscilla Novak: Send in any questions or requests via the chat feature, everyone is in listen only mode. At this time, so if you have a question, you can send it into the Q and A box Priscilla Novak: Next slide please.

Priscilla Novak: The purpose of this challenge is to elicit narratives and proposals regarding solutions to address postpartum mental health diagnosis and treatment in rural communities. Priscilla Novak: And AHRQ will share these narratives with healthcare systems healthcare professionals local and state policymakers federal partners and the public. Priscilla Novak: AHRQ is interested in both success stories to highlight community achievements and program proposals to demonstrate innovative planning for Community action to improve post part of mental health. Priscilla Novak: We'll talk a little bit more in depth later on in this webinar about the two categories that people can submit to which are success stories or program proposal. Priscilla Novak: And it's challenged solutions or submissions that are sent to AHRQ should highlight successful or promising programmatic interventions. Priscilla Novak: To improve world postpartum mental health and the people who can submit solutions or submissions through this challenge include health care providers community based organizations and clubs faith based groups Cooperative Extension services.

Priscilla Novak: hospitals, schools, local health departments and state territorial and tribal organizations more on the eligibility criteria will be shared later in the webinar. Next slide please. Priscilla Novak: So it's my pleasure to introduce today, Dr. Beth Collins Sharp. She is the Director of the Division of Program innovation at the Office on Women's Health Priscilla Novak: within the Department of Health and Human Services. She has a long list of outstanding achievements and she has served as a member of a university Institutional Review Board, she's Priscilla Novak: Outstanding nurse with many honors. She served as the chair of the university's general Clinical Research Center scientific research committee.

Priscilla Novak: And as the President of a southern Nursing Research Society. So what we're going to do is turn over the controls to Beth Collins Sharp and she will take you take us through Priscilla Novak: Her content outlining the different office on women's health and HHS initiative to address the problem with postpartum depression. Priscilla Novak: Go ahead. Priscilla Novak: I'm not hearing you. Priscilla Novak: Here we are. Priscilla Novak: Yeah, thank you. Beth Collins-Sharp: We'll try again. Good afternoon, everyone. Beth Collins-Sharp: Pleasure to be here with you and to talk about this really important Topic. Beth Collins-Sharp: I live in the Office of the Assistant Secretary for Health, which is in the Office of the Secretary Beth Collins-Sharp: Where there are among other things 10 regional offices, the Office of the Surgeon General Office of Minority Health, the Public Health Service Commission. Beth Collins-Sharp: And of course the Office on Women's Health today our agenda is fairly straightforward. We're going to start by talking about some basic hormone physiology to find postpartum depression. Beth Collins-Sharp: Then the meat and the interesting part of the study is to discuss some current research findings and then some HHS activities and resources that may inform your challenge submission Beth Collins-Sharp: Or so I'd like to make a distinction distinction between prenatal and postpartum versus perinatal terminology Beth Collins-Sharp: You'll see perinatal used more and more in the literature and will be used in research that will be discussing today perinatal is defined Beth Collins-Sharp: Simply as the last trimester of pregnancy through about the first month postpartum this definition may vary somewhat depending on the practitioner, but in general sense peri means around natal means birth.

So, in a general sense, it refers to Beth Collins-Sharp: That that time period postpartum, of course, is after birth, as we all know, and prenatal and during the pregnancy. Beth Collins-Sharp: So with that out of the way, let's talk about some of this basic hormone physiology, as we many of us know the hormones during an average menstrual cycle is pretty much controlled chaos. Beth Collins-Sharp: Please notice that I have used the word average on purpose because that is what this is normal is defined by each individual woman. So whether her period starts on day 32 or 27 that is still normal. So we'll refer to this as an average menstrual cycle there is Beth Collins-Sharp: A rhythm to these Beth Collins-Sharp: To these hormone changes, even though they seem quite drastic in US graph like this.

Beth Collins-Sharp: On the other hand, during pregnancy, other than a little jumpstart at the beginning of the pregnancy to get it started. It's really just a gradual increase in the hormones over the course of the pregnancy quite high up to 10 times as much as would be Beth Collins-Sharp: Normal for a hormone change and certainly the largest change in hormones in an individual's life. Beth Collins-Sharp: Then the question becomes what happens there that 40 weeks of pregnancy. Does it just immediately drop off back to zero, or how does it get to that back to this. Beth Collins-Sharp: Quote unquote normal or average set of hormones and I bring this up because it's not possible to line up these two graphs, but you can still see that there's going to be quite a dip in the hormones. Beth Collins-Sharp: To get to Beth Collins-Sharp: To get to Beth Collins-Sharp: Your normal and this happens much for seven to three to seven days where these are dropping off, but it still may take two to three months to get back Beth Collins-Sharp: Controlled chaos.

Beth Collins-Sharp: During the postpartum time period. This is a much better picture, but we've also overlaid on top of this a picture of what happens to the hormones. Beth Collins-Sharp: During lactation. So there are then these roller coaster ups and downs with certain hormones, if the woman is in fact breastfeeding. So you can see that the drop is quite precipitous and that causes any number of physiologic changes which will play a part in postpartum depression. Beth Collins-Sharp: So let's define postpartum depression here just ever so quickly. There are three quote unquote types of postpartum depression and folks will often Beth Collins-Sharp: Combine them in one way or another.

There's a nice diagram in the references slipped is listed here on the bottom but baby blues is during the first few days when that hormone precipitously levels precipitously drop off and Beth Collins-Sharp: It causes crying anxiety. Beth Collins-Sharp: Feeling overwhelmed. I think we're pretty familiar with these symptoms. The good news is it's pretty much over by two weeks. The bad news is it takes two weeks. So it can be feel like quite a long time to the woman who is going through this Beth Collins-Sharp: So then to postpartum depression.

This is obviously a more serious. Beth Collins-Sharp: Depression set of feelings and it's not just related to the drop in hormones. It is a clinical depression. Beth Collins-Sharp: Like other types of depression. There's loss of interest in the usual things that she likes to do persistent sadness, not feeling up to doing everyday tasks. Beth Collins-Sharp: It typically starts around two weeks postpartum but don't let that fool you. It may be masquerading itself during the baby blues period. Beth Collins-Sharp: And then finally postpartum psychosis, which is a true psychosis. It's very rare one to two per thousand women. Beth Collins-Sharp: And includes hallucination. She both sees and or hears things paranoia. There's talk of harming herself for the baby. There's persistent thoughts that she just can't get out of her head. Beth Collins-Sharp: There's lack of interest in the baby. This is a true medical emergency. So if in your activities around postpartum depression. You think that someone has postpartum psychosis, getting them. Beth Collins-Sharp: Right away is an important thing to do. And finally there's talk a lot in the more recent literature about postpartum anxiety.

Beth Collins-Sharp: It's being referenced more and more for the purposes here we're going to Beth Collins-Sharp: Sort of fold that into depression. A lot of women with postpartum depression have anxiety postpartum anxiety is when that's the pretty much the only symptom that Beth Collins-Sharp: A woman has so this challenge really does focus on postpartum depression. So let's get back to that. Beth Collins-Sharp: Focus postpartum depression and perinatal mental health conditions are one of the most common complications of the perinatal period, it affects as many as one in seven with women. And it's about Beth Collins-Sharp: It's the underlying cause for about 9% of pregnancy related deaths.

So if you didn't think that Postpartum Depression was a serious thing before contemplate these two first two bullets and hopefully you realize what a serious Beth Collins-Sharp: Condition. This is postpartum depression is associated with lower rates of breastfeeding startups poor bonding increased likelihood of the infant showing developmental delays and infant sleep and eating problems as well. Beth Collins-Sharp: There are some professional recommendations and policy recommendations for related to parse part of postpartum depression and Beth Collins-Sharp: I'll give you an example of three evidence based ones. The, the one that Beth Collins-Sharp: Is one of the most recent which was promulgated in 2019 comes from the US Preventive Services Task Force, which recommends that all adults be screened for depression, including pregnant and part postpartum women and Beth Collins-Sharp: Clinicians should provide or refer pregnant and postpartum women who were at increased risk for perinatal depression for counseling interventions. Beth Collins-Sharp: So screening is not enough, the referral needs to happen as well. And the there are all sorts of things to think about with referral, it is no longer that you hand a sheet of paper with a phone number on it to the woman and hope that she goes for that follow up work.

Beth Collins-Sharp: The clinical recommendations come from a number of sources. And I've just for time sake chosen to that happened to be physician, a large physician groups. The American College of Obstetricians and Gynecologists Beth Collins-Sharp: Recommend that obstetric care providers ob gyn screen patients for depression, anxiety symptoms at least once during the parent perinatal period and also conduct a full assessment of mood and emotional well being at the comprehensive postpartum visits. Beth Collins-Sharp: Similarly, the American Academy of Pediatrics have a wonderful recommendation that routine screening for maternal postpartum depression could be in fact integrated into well childhood well child visits during the postpartum period. Beth Collins-Sharp: So that is depressed postpartum depression, in a nutshell, I want to jump to the research findings, so that we have all of our Beth Collins-Sharp: Thoughts and resources are research based and evidence based Beth Collins-Sharp: And the most recent Beth Collins-Sharp: Set of data about Postpartum Depression comes from the CDC, about a week and a half ago and it was part of their MMWR — their morbidity, mortality weekly report, and it was called vital signs postpartum depressive symptoms and provider provider discussions about perinatal depression.

Beth Collins-Sharp: I've underlined postpartum depressive symptoms here because all of the data are referring to Beth Collins-Sharp: Depression Symptoms and not about a Diagnosis Diagnosis per se. This is because for a number of reasons. One is that many women may have depression symptoms and not have a diagnosis. Beth Collins-Sharp: And the other reason is that the data source is the PRAMS Beth Collins-Sharp: The pregnancy risk assessment monitoring system. And I'll give you a reference for that shortly. Beth Collins-Sharp: And the infant birth certificate, where the data sources and the PRAMS is a survey questionnaire that is self reported symptoms by the woman, so thus postpartum depressive symptoms. Beth Collins-Sharp: So they asked to very simple sets of questions. Two questions have to since your new baby was born. How often have you felt down depressed or hopeless. Beth Collins-Sharp: How often have you had little interest or pleasure and doing things and she answered to these two questions always often sometimes rarely or Denver.

Beth Collins-Sharp: And then those women who responded, as always, are often were quoted as having postpartum depressive symptoms. Beth Collins-Sharp: Then the next set of questions asked during any of your prenatal care visits did a doctor, nurse or healthcare worker asked if you were feeling down or depressed. Beth Collins-Sharp: And during your postpartum checkup did a doctor, nurse or other healthcare worker asked if you were feeling down or depressed and obviously this is a yes or no question.

So let's see what some of the Beth Collins-Sharp: See what some of the findings were there were 31 sites that contributed data a site is most often a state, but it could also be a very large city like New York City or Beth Collins-Sharp: Commonwealth or territory, like a Puerto Rico. So in the 31 sites that presented data in 2018-2017 and 18 the prevalence of self reported postpartum depressive symptoms.

Beth Collins-Sharp: Was 13.2% Beth Collins-Sharp: Ranging from a low of 9.7% in Illinois and 10.3 in Massachusetts to highs in West Virginia and Mississippi Beth Collins-Sharp: There were some sites that had been reporting since 2002 and amongst those sites, there was a significant very small but significant increase in the annual percentage point of Beth Collins-Sharp: postpartum depressive symptoms that were reported so either postpartum depressive symptoms were on the rise, or they were being reported more often. Beth Collins-Sharp: The groups that exceeded 20% which would be in a very important to see Beth Collins-Sharp: With these high risk groups are those less than 19 years old American Indians in Alaska Natives. Those who smoke during or after pregnancy. Beth Collins-Sharp: Those who experienced intimate partner violence before or during pregnancy. Those who experienced depression before or during pregnancy and those for whom the infant had died since birth.

Beth Collins-Sharp: Now there's two questions about did the provider ask about depressive symptoms during the Beth Collins-Sharp: Prenatal visits the number of Beth Collins-Sharp: Providers who asked about depressive symptoms increased significantly from 76 to 79% across 22 sites and for the postpartum visit it increased from 84 to 88% Beth Collins-Sharp: And it varied from a low of 50 points seven in Puerto Rico a midpoint of about 73 two in New York and highs in Minnesota and Vermont.

Now we just looked at some develop some demographic characteristics. Beth Collins-Sharp: That really line up quite closely with these results as well. You can look up your states in the article and your surrounding states. If you want to see what's going on in your area. Beth Collins-Sharp: So the take home messages that 13% of the women reported postpartum depressive symptoms and although there's still been there's been improvements still Beth Collins-Sharp: One in five men and women reported they weren't asked about depression during prenatal visits and one in eight reported that they were not asked about depression.

Beth Collins-Sharp: During postpartum visits. So this tells us that screening of all women the perinatal period can increase the identification of women. Beth Collins-Sharp: perinatal period. I should have said, I'ma start over. So I say that correctly screening of all women and the perinatal can increase identification of women at risk for depression and providing Beth Collins-Sharp: A referral for the appropriate diagnosis. Beth Collins-Sharp: So now let's look at some of the HHS activities and resources that may inform your submission for the challenge. Beth Collins-Sharp: Let's start with the National Institutes of Health, which is very well known, of course, as the largest biomedical research agency in the world. And of course, with recent events. We've heard a lot from the NIH lately and I, ah, and the National Institute of Child Health and Human Development. Beth Collins-Sharp: That Institute has a program called moms mental health matters which focuses on depression and anxiety during pregnancy and after birth.

Beth Collins-Sharp: I'm going to circle back around to this program at the end. But for now I'll just show you a couple of their Beth Collins-Sharp: Materials. Here we go. Here's one with the red, green, green, yellow, green, as in traffic lights to help women, plan an action have an action plan for what to do if they have some of these depressive symptoms. Beth Collins-Sharp: And here's some general nice Beth Collins-Sharp: Posters Beth Collins-Sharp: infographics about post postpartum depression and anxiety that are very woman friendly. Beth Collins-Sharp: Now let's go to the Health Resources and Services Administration –HRSA– provides Health Care Services Organization Institute. It's provides health care to women to women and people people overall who are geographically isolated and or economically or medically vulnerable. Beth Collins-Sharp: This includes their Maternal Child Health Bureau, which has Beth Collins-Sharp: Blocked service programs on Title Five and they're very well known for their Beth Collins-Sharp: Maternal infinite early childhood home visiting program which during their home visits will screen for postpartum depression.

Beth Collins-Sharp: Validated tools. Beth Collins-Sharp: This is an example of some of their Beth Collins-Sharp: Materials that they have across the the office. Beth Collins-Sharp: And this is a repeat, but it's also about the child help the the home visits the statistic that is important from the home visiting programs that 82% Beth Collins-Sharp: Of women were screened for depression within three months of enrollment or three months of delivery in 2019 which was an increase from 75% Beth Collins-Sharp: So this is an excellent screening rate as addition, they have a number of awards and recently they provided in addition to this award and additional 4.5 million to support Southern states.

Beth Collins-Sharp: In implementing the screening and treatment for maternal depression and related behavioral disorders program. This program provides real time psychiatric consultation care coordination and training to help frontline providers screen assess refer and treat postpartum women for depression. Beth Collins-Sharp: Indian Health Service is not unlike Beth Collins-Sharp: Herself in that they provide services for American Indians and Alaska Natives and this is there. Beth Collins-Sharp: This is their page about postpartum depression. And Beth Collins-Sharp: Of course, we have the Food and Drug Administration FDA is a regulatory agency. They don't provide health services like the two agencies that we just talked about. Beth Collins-Sharp: Of course, then their focus is on Food and Drugs use during pregnancy and during lactation in the postpartum period, and this is their page which provides a number of good resources about foods and drugs during pregnancy and lactation. Beth Collins-Sharp: The Centers for Disease Control. We've heard a lot from the Centers for Disease Control lately. Beth Collins-Sharp: CDC conducts and supports public health activities. They're a public health agency. They focus on promoting health preventing disease and preparing for new health threats.

Beth Collins-Sharp: So they as well have a number of resources, one of the strongest resources that they have our data. And here are four data sources that may be of interest to you. The first though, of course, is the most relevant to this particular projects. Beth Collins-Sharp: And PRAMS as I mentioned earlier, was the source for that. Beth Collins-Sharp: Vital Signs MMWR report that we reviewed a little bit Beth Collins-Sharp: They also support research and this is prison project is a protocol is a program being Beth Collins-Sharp: A program of an RCT– randomized control trial. Beth Collins-Sharp: Related to perinatal depression in OB settings. So, like many agencies, even if they're not primarily Research Agency, they do support research in order to inform their public health activities. Beth Collins-Sharp: SAMHSA is a public health agency, a more. So a policy agency that they do provide some mostly provide support of health care services that Beth Collins-Sharp: Focus of course on behavioral health and to improve the lives of individuals living with mental Beth Collins-Sharp: Health and Substance use disorders and their families. They focus on programs, policies information data funding and personnel in order for these services to be delivered.

So this is a lovely resource coming out of SAMHSA. Beth Collins-Sharp: And then circling back to my office. Beth Collins-Sharp: We have a very active social media presence as well as our website is very popular and evidence based website all content is vetted through an evidence based process. So this is our page for postpartum depression. Beth Collins-Sharp: I'm going to take you to the page here. This is the live page for this particular Beth Collins-Sharp: Page I have, I intend to take all of the references that I have made reference to today, and I will be adding them to this resource sections here. So, this can be your go to place for these resources. After, after the Beth Collins-Sharp: Webinar is done, it'll take take two, three days to get these up. So first of next week, given the holiday those resources should be there.

Now, in terms of what we're doing. Beth Collins-Sharp: We Beth Collins-Sharp: Are planning a postpartum depression campaign in in about two years where we'll be building off of the Mom's Mental Health Matters campaign, which is what I started off with from NIH and will be building Beth Collins-Sharp: Video digital storytelling in order to increase the impact and the representation of the materials that are already developed Beth Collins-Sharp: Alright, so thank you very much. That was a lot in a little bit of time, feel free to contact me afterwards or visit our website starting next week and good luck with your submissions.

James Elliott: Alright, thank you very much, Beth. Excellent. Very informative. I would like to just remind everyone, because there was so much information there James Elliott: That the the slides will be made public. After today's webinar as well as the recording, so you'll be able to access all those links and resources and Thank you Beth for working to put those up on the Office of Women's Health website that's also very helpful. James Elliott: We're going to jump now into some challenge logistics. I'll be walking through the timeline and price structure. James Elliott: The submission requirements for the two different submission types and the evaluation criteria and then a brief overview of how to submit your proposal or your submission.

So looking at the prize pot. As mentioned, we have two different types of prizes. I'm sorry. One other thing to mention James Elliott: Just webinar wise at the bottom of your screen. For those of you logged into zoom I you should see a Q and A button. James Elliott: If you have questions throughout the webinar, you can feel free to submit them now and we will feel them as we get to the end of the webinar. James Elliott: So two different categories for submissions success story categories and program proposals, but the success stories we will have up to five finalists receiving $15,000 each James Elliott: And for the program proposals, we will have up to two finalists receiving $50,000 each for a total prize purse of $170,500 James Elliott: So as of today, we are a month and a half into the challenge we launched in mid May today is the second of three webinars, there will be a another webinar in early August hosted by AHRQ James Elliott: And the submission deadline is September 15th at 5pm eastern time there will be a review and judging happening just after that.

And then we expect that the winners will be announced in November 2020 James Elliott: Okay, looking now at the submission requirements. James Elliott: The when we get to the evaluation criteria, the majority of the evaluation criteria are the same for both the success story and the program proposal here, we want to talk about the major differences. James Elliott: So when we look at submission requirements. We're looking now at the success story.

So looking at that description of your solution. The first item here. James Elliott: This will be the majority of your submission and so you're submitting up to five pages. James Elliott: And that includes the description of your solution. So what did you do, and how did you do it, how did you improve postpartum mental health. James Elliott: In the community that you're describing, and then the next item down is a description of that community.

So this is where you can bring in data and evidence and and absolutely talk about the morality of that community. James Elliott: For morality, you should be using the rural areas, defined by the Health Resources and Services Administration herself. James Elliott: Then get into the barriers so it doesn't have to be this ensure that all of these, these items are included in your submission James Elliott: So in AHRQs design of this challenge competition and the research that they conducted to design a good challenge. James Elliott: They found that the barriers past access to care, child care and stigma were the ones that stuck out the most so feel free to highlight those as you as you write up your submission however you're leaving it open to other barriers. If you are aware about that. James Elliott: It is important to qualify and quantify those barriers barriers that as arc is fully aware of the barriers that are here, but it's important for you to be able to demonstrate how your solution was successful to show how you overcame those barriers, you have to qualify James Elliott: The partners engaged.

This is a good one. It's important. This is innovation challenge. So are the non traditional partners, how did your partnership come about. James Elliott: What's, what's a little bit of a backstory in how you are to do James Elliott: started going after. Jennifer Adona: Jamie, can I Jennifer Adona: interrupt your sound keeps breaking up and we're getting some people commenting on it. I don't know if you can adjust a little bit Okay. James Elliott: I am not sure.

One second. Let me just try this. Jennifer Adona: Still very scrappy. Jennifer Adona: Now it's it's still very faint and very scratchy Jennifer Adona: Finish some of this. Jennifer Adona: Priscilla is offering Priscilla Novak: Hi, everyone Priscilla Novak again. Can you hear me okay Sounds great. Priscilla Novak: Okay, so we'll, we'll give James Elliot a minute or two to work on his sound and I can just keep going to the fly. Priscilla Novak: So in this category. We're really looking for comprehensive description of the solution and how the solution. Priscilla Novak: improves both fundamental health how the community is impacted by the program, including proof that the community is a real community and then a description of the barriers that are reduced for women through the program. Priscilla Novak: We would also like to see a description of the partners that are engaged in the program or solution and how a solution meets the needs that the challenge seeks to address, including under diagnosis of postpartum mental health problems treatment of postpartum mental health problems.

Priscilla Novak: The apparent disparity in diagnosis and treatment between privately and publicly insured individual Priscilla Novak: And I just mentioned that for that particular sub criteria. And if you look on our website, our backgrounds under the challenge page, there are references and in those references it specifically References Priscilla Novak: A study by Dr. Sherman and MM Ali and in their study Sherman in a we had a large sample size of approximately a million people.

Priscilla Novak: And they compared diagnosis and treatment between women with Medicaid and women who had private insurance. And what they found was that there was a higher burden of postpartum mental health problems among women with Medicaid, however, women with Medicaid made it longer to get treatment. Priscilla Novak: Another solution that your particular submission my address is how your solution help solve real health workforce shortages.

Priscilla Novak: And you can submit with a document. Your document can also have a short video included but the short video is not mandatory. But if you would like to include it as a part of your submission, you're certainly welcome to do that. Priscilla Novak: And I'm getting a message that James Elliot is back. Are you there? Priscilla Novak: Yes, I am. Can you hear me now. James Elliott: Yes. You are so much Priscilla Novak: Better. Thank you so much. I think we're ready for the next Priscilla Novak: All right. Thank you very much. James Elliott: And apologies, everyone. Thank you for covering that persona. James Elliott: So looking now at the program proposal.

This is two slides long James Elliott: So very similar in that the same elements need to be discussed, but differences in James Elliott: In the way that you approach them, which is what we want to highlight here. So again, the program proposal is also a five page submission James Elliott: You will have the opportunity for an appendix for the program proposal, which we'll discuss in just a minute.

So again, the description of the community to be impacted and that James Elliott: Shall include morality with those HRSA rural areas, as mentioned before, but in case you couldn't hear me, those are the rural areas, defined by the Health Resources and Services Administration. James Elliott: The description of the plan to improve postpartum mental health diagnosis and treatment.

The plan for the proposal. James Elliott: It's not that it's more important than and how you went about achieving your success story, but the plan has to have certain elements to show why you're going to be successful. And that's what makes it important, and in the program proposal, so James Elliott: This is not a grant so you do not need to submit a budget, but you should be in some ways narrating the project plan that can describe how you control how you control scope, how that scope will speak to solving this problem in a given community. James Elliott: So it is a it is somewhat of a different mindset to go after the program proposal then success story. James Elliott: So then the plan should include how you will reduce those barriers for women, losing the same barriers, as discussed in the success story. And again, if you have others feel free to show them please qualify and quantify them so that we can see how your plan will be affected.

James Elliott: A description of the team. So again, a little bit different here. You're talking about the partnerships, how you all work together through the plan, and James Elliott: Whose their different roles and responsibilities. Were different roles and responsibilities will fall in that team and how you work over the designated timeline. James Elliott: And then a description of the plan to engage community resources in the success story talks about how you did this, but how will James Elliott: You know, a big focus of innovation challenges and something that the AHRQ is certainly focused on is the concept of user centered design bringing users. James Elliott: Into your solution building as you're doing it and getting that good feedback to make sure that your solution is the right one for that community James Elliott: And being able to iterate and and change if you need to, based on that feedback.

So how you engage your community and bring those elements in James Elliott: How the plan meets the needs of the challenge. So this is under diagnosis disparity in diagnosis and treatment. James Elliott: Between privately and public the insured individuals and then the Rural Health Workforce shortage. This is another area where if there are others you can define them as well. But again, qualifying and quantifying, it's very important to show that impact. James Elliott: The next piece is the appendix that I mentioned for the partnership or you can provide an appendix of letters of support from this community partners and you may also as with this story submit a short video. This is an optional step. James Elliott: But encouraged as anything else. So those are the submission requirements will now go into the evaluation criteria. James Elliott: So the evaluation criteria are very, very similar between the two submission types success stories and program proposals.

The only difference is past tense versus future tense. James Elliott: So I will cover these this one, but both are included in the slide deck. And so first the community assessment. How the submission describes the community of interest. So this is where you're providing data and evidence about that community, what the need is James Elliott: What those challenges are those barriers in that community partnership. What does that partnership look like, how is it formed and and how are you achieving these goals together. James Elliott: The logic model. So this is, this is really the evidence of the success of your solution, right, or the success of your plan as as proposed, so James Elliott: For example, here is the inputs processes outputs and outcomes. James Elliott: These are important to focus on every one of these and an important thought exercise in writing up your proposal is okay. What were our inputs. James Elliott: What were our drivers for this. Where did we get our information from, how did we get information from the community in order to build this out and then evidence of meeting the program articles so James Elliott: The success story and the program proposal both have a beginning and an end.

And in the beginning, there was a problem, and in the end. James Elliott: You know, as best. The problem is eradicated, however, we know healthcare. So how did you move the needle. How will you move the needle. How will you be effective and how we continue to be effective. So that's the evidence of meeting to programmatic goals. James Elliott: Capacity to disseminate. So this is what the video– James Elliott: Telling a clear and compelling story in your in your actual video and also in new documents. James Elliott: This the innovation, part of this is perhaps doing something non traditional perhaps doing something that's been done before, but in a non traditional way with non traditional partners, how do you capture that essence of innovation.

James Elliott: That we're at and category identification. These are past fails to again evidence that it's in a rural area and we have the link here to the James Elliott: Person rural areas and the category identification. This piece is important here. It's clearly defined when you end up submitting and the platform, which I'll show you but ours is asking that each team submit only one either success story or a program proposal. James Elliott: So, James Elliott: Please take that into account as you're considering what your submission should be James Elliott: OK. James Elliott: So again, the evaluation criteria for the proposal are identical. James Elliott: The partnership piece for the program proposal calls out digital partners evidence that the partner support for partnership is provided. So that's, you know, your agreements that you don't have to provide your agreements, we just need to know that agreements do exist. James Elliott: And then the same past fails exist. James Elliott: And evaluation metrics, actually this is a tad bit different. So what metrics would be collected during the implementation.

So this is how you will demonstrate success as you implement your project. Okay. James Elliott: Lastly, we're going to get into just the submission process, this is these are just screenshots of the platform. So once you have reviewed all the materials and gone through the entire website. James Elliott: And you've written up your proposal and you have your supporting documents you will go back to the AHRQ website and click to enter the challenge will be brought to our challenge platform and you will click join challenge. James Elliott: Once you're ready, you can click Submit solution. So you're joining the challenge will create an account on the platform, you can create teams on the platform. If you have a team. James Elliott: of people, which likely do it is not required that every team member have an account in the platform. But if you would like to, James Elliott: One person can submit, on behalf of the team. James Elliott: So you'll click Submit solution.

James Elliott: And then here is the the submission builder page. This may be a little bit difficult to see. Number one is your submission title and then your submission type is number two. So that's the success story or program proposal. So by completing that fields, you will, by default path. James Elliott: As long as you submit one type for your team. James Elliott: And the enter your URL for an optional videos or videos will not be uploaded to the point we should post them somewhere. James Elliott: It is possible to post them on YouTube or Vimeo or if you have a private site in a private mode so that only those with the link can view it. If you don't want the video to be public. James Elliott: And then choose a file to upload.

So this is where you upload your submission for your success story. This should be your up to five page. James Elliott: Right up for your proposal. This would also be a five page right up. But you can submit additional and so you can submit those letters of support if they're not all combined into one docket. James Elliott: And then once you've uploaded click Submit. So all of those files rolled into one submission and then you can see on the submission page once you've submitted your submissions so James Elliott: At the time of the closing 5pm Eastern on September 15 are for each individual or for each team will take the most recently submitted submission James Elliott: So if you have multiple we will take the one that sits at the top and you can feel free. Just to be safe if you're multiple to withdraw or remove folder submissions.

James Elliott: And with that we will now turn it over to questions. James Elliott: So again, feel free to use the Q & A icon at the bottom of your screen. And we will feel the questions here. James Elliott: So the first question can solutions be submitted that haven't yet been used with rural populations but seem promising operations or does there need to be a certain amount of encouraging data on already. James Elliott: So this I'm making an assumption here but this sounds like a proven proposal submission type. And if that's the case then as long as you feel that there is sufficient data or or sufficient evidence that your plan could work. Then we absolutely encourage you to submit James Elliott: And I do think if you have it says solutions haven't been used with rural populations. Another assumption is that James Elliott: The submission has been used with other types of populations. So I think if it is evident that it has worked with others and with any gaps you can demonstrate how you could make it work with a rural population.

James Elliott: I certainly think it's it's worth submitting Priscilla, did you have anything to add. Priscilla Novak: Hi, it's Priscilla Novak: So I think in regard to this question. What I would say is that the evaluation criteria and community assessment would be very important. Priscilla Novak: And then also any available references on lively intervention that's proposed it would work. So any sort of evidence that you can supply that something similar was attempted in a similar community an explanation of a logic model that documents that the input or the activities. Priscilla Novak: Are based on prior best practices are evidence based curriculum or an evidence based intervention. So I think that it could be something that hasn't been used in a rural population. Yet, if that's the question. Priscilla Novak: If it's just about something that's evidence base that you're you're doing with a real population for the first time. James Elliott: That would be a possibility. Priscilla Novak: But in any case, I think that you have to make that clear case of why you believe that the program would work.

Priscilla Novak: For the population that you intend to use it with James Elliott: Thanks. James Elliott: So the next question. When would funding starts January 2021 can PhD students or postdocs apply. So this, again, is not a grant proposal. James Elliott: And this is also not a phased challenge in that archives run other phase two challenges where a proposal is submitted a certain number of ideas are selected and receive a kind of first round of James Elliott: Award money and then go off to do the work. And at the end of that phase demonstrate to compete for James Elliott: Who was the most successful in that face. This is not that kind of challenge and challenge competitions by nature are worth money not grant money so they are not in any way committed to work to be performed beyond the challenge close date so funding would be distributed James Elliott: Probably within 30 days of the announcement, which we anticipate to be November of this year.

And yes, PhD students or postdocs are eligible to apply. James Elliott: And then the next question kind of ties into this, which is, is this open for profits as well as non for profits. Absolutely. James Elliott: We do encourage you to your website to the challenge websites and view the basic eligibility criteria for all submitters to make sure that you meet those before submitting your solution. James Elliott: The next question in a video required for the success story, the capacity to disseminate features video important critically important criteria, the video for both success story and program proposal is optional. James Elliott: However, encouraged, it's always helpful to be able to showcase your work in another way. James Elliott: So we do encourage it. But it is not required.

James Elliott: Okay. James Elliott: So a question our proposals limited to us world populations or can proposes include international world communities. Priscilla want to take this one. Priscilla Novak: This is limited to us rural populations. James Elliott: Next question, can we build a current research or demonstration project with specific for mothers or does this need to be a new project. James Elliott: Here. Priscilla Novak: Would you like me to Priscilla Novak: Provide an answer to this question. Yes. James Elliott: Thank you. Priscilla Novak: So all submissions will be evaluated based on the evaluation criteria that are listed on our website. And in terms of the question of whether it could be something existing or something new, you would need to explain if it's a success story how your existing Priscilla Novak: Submission was successful. So it's like Jamie said that pretty much the different sub parts of the evaluation criteria are the same from those success stories and program proposals. Priscilla Novak: It program proposal to start doing something new in a community where it's not done before.

But you did something similar in some other community, you would likely include metrics on the impact of your prior work. Priscilla Novak: But then would also need to bring in the community assessment for the community where you supposed to actually do the new intervention. Priscilla Novak: So you would have to have some sort of evidence that your intervention will work. And then also a description of the community that would be impacted by the program. Thank you. James Elliott: So the next question would Puerto Rico be an acceptable proposal area for this award. James Elliott: Priscilla, would you take that one.

Priscilla Novak: So that a part of the eligibility criteria is the area where the program. It has been done. If it's a success story would be done if if the program proposal is defined by the Health Resources and Priscilla Novak: Services Administration as a note area this is somewhat related to the to another question that also came in about what qualifies as a community. Priscilla Novak: The chief demographic area would catchment area where the program was done if its success, success story, or will be done if it's a program proposal. Priscilla Novak: Must be defined by the Health Resources and Services Administration as well and it must be part of the United States and affiliated territories.

So, Puerto Rico is acceptable as long as the intended Priscilla Novak: catchment area where the program would be done is defined as room. Priscilla Novak: So the next question. James Elliott: Do you have to be partnered with a mental health agency to dissipate and the challenge. James Elliott: So, Priscilla Novak: It is James Elliott: Absolutely possible for an individual to participate. James Elliott: It is only important to note that you have to be able to demonstrate everything that we went over in the submission requirements and review evaluation criteria and that is your ability to James Elliott: To engage a community and get feedback from them and carry out a successful project plan. We have seen it done. We have absolutely seen it done with individuals. James Elliott: And just want to note that. And so, yes, it is. You do not have to be partnered with a mental health agency. We just want to call out your ability to demonstrate all of the things that we went over. James Elliott: Okay, at this time, we have no other open questions, we'll leave it open for a few more minutes to see if any others comment.

James Elliott: Another question that's come In James Elliott: You have a new question the submission relies on a software that has yet to be built. Do we need to have a contract in place to build the software for put the award be used to execute that James Elliott: I believe, Priscilla, I will ask you to jump in here, but I believe that James Elliott: As long as your, your program proposal demonstrates your capacity to reduce the barriers. James Elliott: For mental health in a rural community using that software solution and a clear implementation plan for that software solution and its rollout.

James Elliott: and the user acceptance that will happen to take that software in order to integrate it with existing health systems. I do believe that it's absolutely possible to to do what you're what you're talking about. James Elliott: Priscilla. Priscilla Novak: Thank you. So it could be an app or software type of solution. But the main thing to keep in mind is that approximately 20% Priscilla Novak: Of the evaluation points come from the community assessment. So, if it is an app or software related intervention that's going to be used to Priscilla Novak: Deliver the intervention to a rural area. It's very important to be able to supply the information and data on that little area that would be benefited by your app by your software. James Elliott: So very good point. Thank you for so James Elliott: Sure. James Elliott: This time we have no other open questions I'd like to leave it open for maybe another 30 seconds just to see if any new questions come in.

James Elliott: And once we reach a point if no other questions come in, we will James Elliott: Get final words for that for the webinar. Priscilla Novak: So we did get another question. And the question was, Priscilla Novak: Are there any particular credentials, you might need to have to participate as an individual. Priscilla Novak: The credentials of the individual are not considered within the evaluation criteria you are free to inform us of whatever credentials, you might have Priscilla Novak: But it's not part of the formal evaluation criteria and all submissions will be evaluated based on the criteria, that's listed on our website.

Priscilla Novak: So, since there are no other questions coming in. I want to thank all of you for joining us on this webinar, especially want to thank Dr. Collins Sharp for your wonderful presentation. Priscilla Novak: So it was very informative and also engaging. So we thank you so much for your support of this challenge, and to all those of you who have participated in the zoom meeting. We will be posting the slides and the recording on our website, probably in the next 10 business days and if Priscilla Novak: Our next webinar in the series will be on August 5 2020 Priscilla Novak: Thank you all. You may disconnect at this time..

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