After her first two years of undergraduate study at UC Berkeley, Dailey realized that the nurse's domain was the part of medicine that she loved best. "I realized that I was more interested in caring more directly for patients, in preventing problems as well as treating disease." Dailey transferred to the undergraduate nursing program at the University of San Francisco and never regretted her decision. Indeed, upon graduation she chose a career in public health nursing, precisely because she could work with people in their own environment. "It's powerful to work one-on-one with people. There's a level of connection and trust you build by working in the community."

Dailey's decision to return to UCSF's School of Nursing after 15 years in practice - she is now a third-year student in the doctoral nursing program - reflects both

her continuing commitment to public health and an acknowledgment that some problems need academic research to solve. "African American infants have double the risk of dying before their first birthday," Dailey says. "That kind of clinical reality dredged up questions for me. I wanted to find out the reasons why. I wanted to generate new knowledge and test more effective interventions."

Being a graduate student, however, has not meant giving up on the communities she has been working with for years. Dailey drives two days a week to Parnassus Heights for classes, but a portion of her time is spent managing four programs for the Contra Costa Public Health Department. Two of the programs target pregnancy directly: One, the Black Infant Health program, is dedicated to perinatal case management for pregnant and parenting African American women in Contra Costa; the other is a broad-based education campaign to inform all women about the importance of folic acid in preventing neural tube defects.

TheFolic Acid Campaign combines both one-on-one home visits as well as community-wide educational outreach - such as working with local theaters that agreed to provide on-screen advertising. "We are trying to be really broad and work with the diverse cultures in the county," Dailey says. In addition to replicating the English-language folic acid campaign in Spanish, the program provides information in Vietnamese, Laotian, Russian and Persian. This includes tailoring messages about which of the various traditional foods are high in folate.

Dailey's other two programs, which center on infant and fetal mortality, are more emotionally demanding, if no less necessary. The Fetal Infant Mortality Review Program consists of a case-review process leading to system improvements, while the Sudden Infant Death Syndrome Program offers in-home bereavement support for families. "The hardest part of my job is getting that phone call that tells me that another family has lost a child," Dailey says.

Although working with bereaved families would be difficult for anyone, Dailey's training and empathic personality make her a reassuring conversationalist. That this compassion blends with determination is no surprise either, considering that her programs are hampered by the limited resources that hobble many such county programs throughout the state. Dailey does not dwell on the frustrations of the job. "I tend not to work like that - you have to look at opportunities or you get burned out," Dailey says. "Lack of resources is, of course, a frustration, but it also forces us to expand our thinking, to go about things in new ways."

Dailey says the toughest parts of her job are also the ones that lift her up. "In all honesty, the greatest satisfaction is what I learn from the parents I provide bereavement support to. I learn from their courage and the challenges they face," she says.

"They often want to share their experience for the sole reason of helping other parents in the same situation," Dailey says. "It's a wonderful gift to give."

After earning her PhD at UCSF, Dailey hopes to continue her research on health disparities and birth outcomes with new eyes. In short, she wants to make sure that what works also lasts. "I'm very interested in the sustainability of community-based interventions," Dailey says. Many lives will depend on it.