Genesee County REACH Windshield Tours: enhancing health professionals understanding of community conditions that influence infant mortality.

The Genesee County Racial and Ethnic Approaches to Community Health (REACH) program is a community-based program designed to reduce African American infant mortality rates in Flint, Michigan. Genesee County REACH activities address three core themes: fostering community mobilization, reducing racism, and enhancing the maternal-infant health care system. The REACH Community Action Plan was generated using a community-based participatory approach, and is based on a socio-ecological model with interventions focused at the individual, organizational, health system, and community levels. Genesee County REACH's Community Windshield Tours were developed to raise awareness of social and environmental barriers to health promotion among health care system staff in Flint, Michigan. These tours provide a close-up examination of the community's environmental conditions and the experiences of mothers, children, and families at risk for poor birth outcomes. In this article, we report our findings from pre-/post-tour surveys, as well as long-term follow-up surveys, to assess the impact of this REACH activity on participants' knowledge and beliefs about Genesee County residents, and to determine any resultant individual, policy, system, or environmental changes. We used t tests to compare participants' responses before and after the tours. We found that several individual- and systems-level changes have resulted from these tours, reflecting greater cultural sensitivity and increased understanding of patients' circumstances. African American infant mortality rates in Genesee County declined to a historic low in 2005, and they remain lower than in previous years. Although REACH coalition partners recognize that this reduction cannot be attributed to a single intervention or activity, REACH activities such as the Community Windshield Tours addressing multiple levels of the socio-ecological model may have had a synergistic effect.

Undoing Racism Through Genesee County's REACH Infant Mortality Reduction Initiative.

BACKGROUND: Genesee County Racial and Ethnic Approaches to Community Health Program (REACH) is a Community-Based Public Health partnership for reducing African American infant mortality rates that hosts the Undoing Racism Workshop (URW). OBJECTIVES: Assess the URW's effectiveness in promoting an understanding of racism, institutional racism, and how issues related to race/ethnicity can affect maternal and infant health. METHODS: Recent URW participants (n=84) completed brief preassessment and postassessment forms; participants (n=101) also completed an on-line, long-term assessment (LTA). RESULTS: URWs promoted understanding of racism and institutional racism, although they were less effective in addressing racism as related to maternal and infant health. CONCLUSIONS: The URWs were most effective in the domains related to their standard content. Additional effort is necessary to customize URWs when utilized for activities beyond their original purpose of community mobilization.