by Alexis Ritvo, '05

I gratefully received RMHUC's Summer Community Service Fellowship to work this summer at Denver's Best Babies' Initiative -- a community health project created by the City Council in 1999 within the Denver Health system. It serves pregnant women who are at risk for poor pregnancy and parenting outcomes.

Several programs operate within Best Babies. Two of the programs are home visitation models serving Denver neighborhoods that are at the highest risk for poor birth outcomes and child development. Both home visitation models aim to enroll their clients as soon as they become pregnant, and the clients stay in the program until their babies reach two years of age. Each case manager has an average of twenty to twenty five clients at a time whom they visit every 1-2 weeks. The case managers provide their clients with emotional support, information on resources, such as housing and job opportunities, and education about how to have a healthy pregnancy and child. One of the home visitation models, Nurse-Family Partnership, consists of eight case managers who are all nurses and serves first-time mothers. The second home visitation model, Healthy Futures, consists of four case managers, two nurses and two social workers, and serves mothers who have previously had high-risk births.

There is also a large research component to Best Babies. The research team interviews women and children involved in the project and women and children who would be eligible but are not enrolled in the project. The research uses various methods to assess the mother's parenting attitude and behavior, the child's mental and motor development, and the interaction and attachment between the mother and child. The research hopes to establish whether or not the project's interventions are beneficial.

Another program under the direction of Best Babies is Prenatal Outreach. Two Prenatal Outreach workers roam the Denver neighborhoods and parks giving free pregnancy and HIV tests and informing the high-risk population about healthcare resources.

The complexity of the Best Babies project has enabled me to do a variety of work. I have spent a great deal of time working with the research team, entering data and making graphs. My personal assignment has involved the social support measure they used in the interviews. I recently have completed reviewing the research literature that pertains to social support. Next, I will enter the data collected from the social support questionnaires into the computer, analyze the data, and report my findings.

I have also enjoyed opportunities to observe and assist the case managers and outreach workers on their client visits. These visits have shown me the serious and complex problems that plague a large portion of the Denver population and what can be done to address these problems effectively. In addition, I have had the opportunity to observe the clinical work of the pediatrician, family practitioner and obstetrician who oversee Best Babies and provide medical care to its clients.

This fellowship has affirmed my aspiration to pursue a career in medicine and in particular has fueled my interest in community healthcare. I am extremely grateful that RMHUC's generous fellowship enabled me to work with Best Babies Initiative.