218114 Collaboration to achieve health policy change: PHN and the NC Rural Communities Assistance Project

Sunday, November 7, 2010

Beth Lamanna, WHNP, MPH, RN , Public Health Nursing, The University of North Carolina Chapel Hill, Chapel Hill, NC
Lead has long been recognized as a dangerous and potentially lethal source of children's environmental poisoning. Increasingly sensitive biomonitoring, psycho-educational evaluation, and social epidemiological analysis have revealed the potential lifelong consequences of low level lead exposure in children,(defined as BLL<10 µg/dL). The 2010 Social Policy Report: Protecting Children from Exposure to Lead, Old Problem, New Data, and New Policy Needs, summarizes the “robust” evidence for the correlation between low BLL in children and negative impacts on cognitive development and behavior. It goes on to say that current federal and state-level child screening and lead level reporting practices are inadequate. Children's lead screening policy is under scrutiny by the CDC Childhood Lead Poisoning Prevention Branch. In North Carolina, two counties have successfully lowered the “action level”. In another NC county, the NC Rural Communities Assistance Project, (NCRCAP), partnered with a PHN faculty, the county health department, and medical providers to promote a similar policy change. NCRCAP successfully utilized a lay health advisor model to conduct in-home outreach visits to parents and caregivers. Through culturally competent health education programs in targeted highest risk areas, NCRCAP gathered data critical to implementing the health policy change. In 2008, the NCDEH sent “Report Cards” to all medical providers detailing their blood lead screening rates for Medicaid-eligible one and two year olds. These reports provided a catalyst for medical provider intervention described in this session. We describe the key steps used to promote environmental health policy change in an economically challenged rural NC county.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related public policy

Learning Objectives:
Discuss the use of the Precautionary Principle in children's lead screening policy Identify three measurable results of low level lead exposure in children Describe the lessons learned from the counties which changed their children's lead screening policies Assess the impact of the lay health advisor program in achieving behavioral change

Keywords: Policy/Policy Development, Lead

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have taught public health nursing at the University of North Carolina School of Nursing for over 10 years and I was actively involved in this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.