Promoting Preconception and Health Using State-Based Social-Marketing Initiatives Makeva M. Rhoden, BS, MPH, CHES Public Health Analyst Department of Health.

Promoting Preconception and Health Using State-Based

Social-Marketing Initiatives

Makeva M. Rhoden, BS, MPH, CHESPublic Health Analyst

Department of Health and Human ServicesHealth Resources and Services Administration

Maternal and Child Health BureauDivision of Healthy Start and Perinatal Services

3rd National Summit on Preconception Health and HealthcareJune 12, 2011

PURPOSE OF FIRST-TIME MOTHERHOOD/NEW PARENTS

INITIATIVE• To develop and evaluate social

marketing approaches that concurrently increase awareness of existing preconception /interconception, prenatal care, and parenting services/programs.

• To address the relationship between such services and health/birth outcomes and a healthy first year of life.

Background• Campaign Type: statewide, countywide or

targeted public awareness campaigns

• Topic Areas: Preconception health, Interconception health, Life-course perspective, Expectant Parents (including fathers), and First-time Mothers

• Only State Title V Programs were eligible to apply

ADVANTAGES OF PRECONCEPTION/

INTERCONCEPTION HEALTH• Preconception Health:

– Provides awareness to men and women on reproductive health and risks to childbearing

– Ensures that women and men are in the best health condition possible to conceive

• Interconception Health:– Promotes family planning between pregnancies– Promotes wellness for the mother and family during the

postpartum period – Provides services to women who may have had an

adverse outcome in a previous pregnancy

FIRST-TIME MOTHERHOOD/NEW PARENTS INITIATIVE - KEY OBJECTIVES:

• Re-examine pregnancy risk factors in the context of women’s health development by integrating the life-course perspective into current maternal and child health awareness campaigns.

• Increase the public’s and provider’s knowledge of the importance of integrating the life-course perspective into preconception/interconception care to reduce adverse pregnancy outcomes and improve reproductive health.

• Increase the pregnant woman’s and expectant parent’s awareness of and access to economic and social resources that will assist them before, during, and after pregnancy.

FIRST-TIME MOTHERHOOD/NEW PARENTS INITIATIVE - KEY OBJECTIVES

(cont.):• Provide linkages to preconception/interconception,

prenatal, family support and social services for men and women contemplating becoming parents to reduce the occurrence of risky behaviors and increase the likelihood of a healthy pregnancy.

• Increase public awareness of the importance of preparing couples for transitioning into their roles as new parents.

• Increase public awareness of family support and parenting education programs available to expectant/new parents.

INCLUDED PRECONCEPTION CARE RECOMMENDATIONS

• Recommendation 1. Individual Responsibility Across the Lifespan. Each woman, man, and couple should be encouraged to have a reproductive life plan.

• Recommendation 2. Consumer Awareness. Increase public awareness of the importance of preconception health behaviors and preconception care services by using information and tools appropriate across various ages; literacy, including health literacy; and cultural/linguistic contexts.

Source: CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care Recommendations

INCLUDED PRECONCEPTION CARE RECOMMENDATIONS (cont.)

• Recommendation 5. Interconception Care. Use the interconception period to provide additional intensive interventions to women who have had a previous pregnancy that ended in an adverse outcome (i.e., infant death, fetal loss, birth defects, low birth weight, or preterm birth).

• Recommendation 6. Pre-pregnancy Checkup. Offer, as a component of maternity care, one pre-pregnancy visit for couples and persons planning pregnancy.

• Recommendation 8. Public Health Programs and Strategies. Integrate components of preconception health into existing local public health and related programs, including emphasis on interconception interventions for women wit previous adverse outcomes.

Source: CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care Recommendations

STATES FUNDED IN CYCLE 1

• The 2-year demonstration project is funded in 13 states: – Arizona, California, Connecticut, Florida,

Maine, Massachusetts, Nebraska, Nevada, North Carolina, Pennsylvania, Oregon, Utah, Wisconsin

• Project Period: September 1, 2008 – August 31, 2010

• Funding Amount: $350,000 - $500,000

STATES FUNDED IN CYCLE 2

• The MCHB received funding in FY 2010 to begin a new 3-year project period

• New Projects began in September 2010 and end August 2013.

• 11 States funded: – Washington, District of Columbia, Virginia,

Missouri, Michigan, New Mexico, Alabama, Indiana, New York, Delaware, and Hawaii

First-time Motherhood/New Parents Initiative:

Preliminary Results from Cycle 1

PROJECT METHODOLOGY

• Public awareness campaigns were created by State Health Departments and Community Partners by integrating reproductive health messages into existing health promotion campaigns.

• Formative research was used to obtain information from target audiences on parenting, pregnancy, and knowledge of pre/interconception health.

• Work plans were submitted and included a logic model.

PROGRAM EVALUATION

• Year One Evaluation – Process (inputs) – In year one (FY 2008-09), focus groups

were held to assess the target populations knowledge and understanding of key issues: pre-/interconception health, life-course perspective, family planning, etc.

– Some states (PA) conducted “street intercept” interviews to test a persons knowledge of the key issues.

• Year Two Evaluation– Outcome/Impact - In year two (FY 2009-10), projects tested

the actual messages and formats (e.g., websites, Photo Novella, Digital Stories, etc.) selected for their campaigns.

HIGHLIGHTS/RESULTS OF STATE PROJECTS

PENNSYLVANIA HEALTH DEPARTMENT

• Campaign Tagline: iDECIDE• Target Audience: Women age

13-25 yrs (Delaware County, PA)

• Topics Addressed: preconception health

• Innovative Technology: website newsletter, videos, radio ads

• Social Media: Twitter, Facebook, MySpace

• Results: Street intercept interviews helpful in crafting message s for campaign; Preconception message well received.

• Challenges: Lack of communication within the schools and community groups presented some issues.

Website: http://idecide.crozer.org or on Facebook and Twitter.

ARIZONA DEPARTMENT OF HEALTH SERVICES

• Campaign Tagline: Live It, Change It

• Target Audience: African American men and women age 18-30

• Topics Addressed: Preconception health and life-course perspective

• Innovative Technology: website, brochures, posters, powerpoint presentations

• Results: – Social marketing campaign did

not specifically increase any awareness on preconception health among the target population.

– Finding culturally appropriate referral sources was difficult.

– Underestimated staff time. – Difficulty scheduling with

churches.

Website: www.liveitchangeit.com

CONNECTICUT STATE HEALTH DEPARTMENT

• Campaign Tagline: Someday• Target Audience: 18-45 yrs of age

Hispanic and African Americans women of childbearing age and men from racial and ethnic minority groups

• Topics Addressed: preconception, interconception and prenatal services

• Innovative Technology: TV, radio advertising, PSA, bus shelter, grocery store checkout TV monitoring advertising

• Results: – Unanticipated delays with

implementation did not allow enough time to evaluate effectiveness of improved birth outcomes.

– Had to find new evaluator and change focus from behavior change to increased public awareness.

Website: www.ctparenting.com

NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES

• Campaign Tagline: TUNE • Target Audience: 18-25 yr.

olds• Topics Addressed: Life-

course• Innovative Technology:

songs on various preconception health topics

• Results:– Conducted songwriting

contest for campaign; life-course lyrical concepts provided for contest;

– Processed paperwork to get tagline “TUNE” trademarked

Website: www.tunemylife.org

WISCONSIN DEPARTMENT OF HEALTH AND FAMILY SERVICES

• Campaign Tagline: ABCs for Health Families/ Journey of a Lifetime

• Target Audience: African American women of child bearing age and partners (men) and families

• Topics Addressed: life-course perspective and reducing stress

• Innovative Technology: text messages, radio ads, email blasts

• Social Media: Facebook, MySpace• Results:

– Support Circles created for both fathers and mothers;

– Created community ambassadors to discuss health topics

Website: www.myspace.com/journeyofalifetime

NEVADA HEALTH DIVISION • Campaign Tagline: My Life,

My Health, My Plan• Target Audience: Latinos

and African Americans • Topics Addressed:

Preconception Health• Innovative Technology:

website, PSA– Key informant surveys

conducted – Campaign feeds into Nevada

211 referral line Website: www.mylifemyhealthmyplan.org

NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

• Campaign Tagline: Are You Ready? What’s Your Plan?

• Target Audience: rural community; health professional; men and women ages 15-29 yrs.

• Topics Addressed: Preconception health and life-course

• Updates: – Trained 84 health care providers in

June 2009– Community training occurred in

November 2009 – Faith-based campaign uses the

Ready, Set, Plan! curriculum– Print materials created include

reproductive life plan booklet and men’s health journal “Body Maintenance”

Website: www.whb.ncpublichealth.com

FLORIDA DEPARTMENT OF HEALTH • Campaign Tagline: Florida Right

from the Start• Target Audience: rural

community; health professional; men and women ages 15-29 yrs.

• Topics Addressed: Preconception/ interconception care and parenting skills

• Innovative Technology: websites, hotlines, kiosks, web-based modules

• Results:– First time mothers and fathers

identified by Florida's high risk screening

– Significant differences found in knowledge levels for consumers surveyed in pre- and post tests

Website: http://www.healthystartflorida.com/rfts/Eng/default.asp

MASSACHUSETTS STATE DEPARTMENT OF PUBLIC HEALTH

• Campaign Tagline: Massachusetts New Parent Initiative

• Target Audience: health providers, new mothers.

• Topics Addressed: Several critical perinatal issues (4 domains): Parent and child mental health, Nurturing early care giving, Family violence, and Family planning. Goal to improve the health of new parents, infants and their families across the lifespan.

• Innovative Technology: Digital storytelling

Website: http://www.mass.gov/dph/newparents

MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES

• Campaign Tagline: New Family Initiative• Target Audience: Youth and young adults 16-25 • Topics Addressed:

Preconception/Interconception Health• Innovative Technology: PSA• Social Media: Facebook, YouTube• Results:

– Community partners played a significant role– FG took longer because of people getting

comfortable wit sharing their feelings

For more information on the First-time Motherhood and New Parents Initiative contact:

Makeva Rhoden, BS, MPH, CHESPublic Heath Analyst

Maternal and Child Health Bureau(301) 443-9847

[email protected]