It Takes a Village Project
It Takes A Village: Giving Our Babies the Best Chance
It Takes a Village (ITAV): Giving our babies the best chance is a community education and engagement series specifically designed for Utah's Native Hawaiian/Pacific Islander (NHPI) communities who are facing birth outcomes disparities. The ITAV project raises awareness and educates NHPI families and community members about maternal and infant health in the context of Pacific Islander cultural beliefs and practices.
The ITAV project consists of four in-person workshops facilitated by trained community members. The workshops content includes cultural concepts, videos, PowerPoint presentations, interactive activities, and assignments. The ultimate goal of the workshops is to motivate and support NHPI community members to become resources in their communities to address birth outcomes disparities. For more information visit the ITAV website.
Utah's Native Hawaiians/Pacific Islanders (NHPI) experience significantly higher rates of infant mortality compared with Utah overall. However, no health promotion interventions exist in Utah or the U.S. tailored to Pacific Islanders to address this and other birth outcomes disparities.
Since 2012, the Utah Office of Health Disparities (OHD), in collaboration with public health and health care professionals and community partners, has been working to address this issue. The outcome of these efforts is the It Takes a Village: Giving our babies the best chance (ITAV) project.
In 1997, the Federal Office of Management and Budget (OMB) revised the standards for collecting race and ethnicity. The Utah Department of Health (UDOH) was one of the first agencies to change all of its surveillance systems to collect data according to the new standard. To put this into perspective, the 2000 U.S. census was the first census that separated out Asian and Pacific Islander populations; prior to that, in 1999, UDOH was already collecting disaggregated data for Asians and Pacific Islanders.
Utah’s practices with data disaggregation and the subsequent data-driven projects for NHPI communities including the 2011 statewide Pacific Islander Health Survey and It Takes a Village project were cited as key examples leading to California, Governor Brown signing a health data disaggregation bill in September 2016 empowering the CA Department of Public Health to separate specific Pacific Islander group data from the broader "Asian-Pacific" category.
The Utah Office of Health Disparities (OHD) is able to identify and monitor birth outcomes disparities among Utah's Native Hawaiian/Pacific Islander communities because the Utah Department of Health practices data disaggregation for Asians and Pacific Islanders. OHD produces reports on Utah's health status by race and ethnicity every five years.
Implementing It Takes a Village
The UDOH Office of Health Disparities (OHD) developed an ITAV Implementation Guide for organizations. It includes a readiness assessment with questions regarding support, experiences, resources, and plans for sustainability.
The OHD created instructions with templates and examples for recruitment packets. Organizations may modify and use them to recruit facilitators and participants.
The OHD provides training for ITAV facilitators and created the ITAV Facilitator Training Preparation Checklist to complement the training experience.
This document includes information for NHPI facilitators about how to prepare for and implement the workshops in the NHPI community.
The participant workbook is for community members who are participating in the ITAV project, to help them gain a better understanding of the cultural concepts and health issues being discussed. It also provides some critical thinking skills as participants record their answers, notes, thoughts, and questions throughout the workshops.
Documentation and Evaluation
In spring 2015, OHD in collaboration with the MAHINA (Maternal Health and Infant Advocates) Task Force conducted a pilot project, consisting of six workshops for 23 members of NHPI communities to raise awareness about birth outcomes disparities.
After evaluating the pilot project, OHD created a Native Hawaiian/Pacific Islander (NHPI) Birth Outcomes Advisory Committee to revise and expand the pilot project and create video production. In spring 2016, phase I of the It Takes a Village: Giving our babies the best chance (ITAV) project was implemented among 80+ NHPI community members along the Wasatch Front.
After phase I, OHD focused on developing a promising practice, by conducting focus groups and a quantitative analysis of vital records to inform final revisions of the curriculum. OHD also hired a project assistant from the NHPI community to help ground the curriculum in NHPI culture and tradition. Between May 2017 and March 2018, OHD conducted a second implementation and evaluation of the ITAV project, which reached 63 NHPI community members.
MAHINA Pilot Program: Raising Awareness about Birth Outcomes Disparities Among Pacific Islander Communities in Utah
This is a summary of OHD's collaboration with the MAHINA (Maternal Health & Infant Advocates) Task Force on a pilot project to raise awareness about birth outcomes disparities among Utah Native Hawaiian/Pacific Islander communities.
This report is a summary of the activities and outcomes of the first phase of the ITAV project.
This report is a summary of the activities and outcomes of the second phase of the ITAV project.
Since discovering the birth outcomes disparities faced by Utah’s Native Hawaiian/Pacific Islander (NHPI) communities, OHD has worked in collaboration with community partners on several studies to better understand the community’s experiences, socio-cultural context, and perspectives.
Pacific Islanders' Point of View: Perspectives and perceived control about addressing infant mortality disparities
This report shares findings from facilitated community discussions on infant mortality and the community's scope of engagement for prevention.
African American and Pacific Islander Postnatal Interview Study: How the Rest of their Lives Affects Pregnancies of Pacific Islanders and African Americans in Utah
Utah's first-ever qualitative study with Utah African American and Pacific Islander mothers who have experienced an adverse birth outcome; this study focused on identifying social determinants of health factors.
This peer-reviewed article explains the methods and implications of the 2011 Pacific Islander Study. Journal of Public Health Management & Practice: March/April 2013 - Volume 19 - Issue 2 - p E25-E31 doi: 10.1097/PHH.0b013e318252ee60
This report outlines an in-depth conversation with local Pacific Islanders about perspectives surrounding birth outcomes from the results of two surveys and five focus groups.
The first statewide health survey conducted in three languages, interviewing 605 adult Utah Pacific Islanders in English, Tongan, and Samoan.
The It Takes a Village (ITAV) Logo was designed and created by a local Pacific Islander to demonstrate the deep cultural meaning behind the project.
One community member commented: “The logo represents a family that is encircled by a tānoʻa (kavabowl), a kaliloa (headrest), and a village/fonua (three fales). In ancient times, the kavabowl and the headrest were the two sites for learning Indigenous knowledge and history. The logo conveys the idea of the fonua (placenta, land and its people, ecology), or the environment that nurtures and nourishes people. The vā, socio-spatial relations between people and their fonua are symmetrical, harmonious, reciprocal, and above all, beautiful in the performance of fatongia (communal responsibilities). I love the idea of honoring our forebears and ancestral knowledge/praxis."