A Fresh Start for WIC: Tailoring Smoking Cessation for WIC Participants and Their Families Laura...
-
Upload
domenic-mosley -
Category
Documents
-
view
215 -
download
2
Transcript of A Fresh Start for WIC: Tailoring Smoking Cessation for WIC Participants and Their Families Laura...
A Fresh Start for WIC: Tailoring Smoking Cessation
for WIC Participants and Their Families
Laura A.Van Dyke, CSW Saint Vincent Catholic Medical Centers
New York City(212)604-7572
Background Information
Saint Vincent Catholic Medical Centers (SVCMC) received a three-year grant from NYS DOH
Three staff hired to implement smoking cessation program at system’s 9 WIC sites
WIC is a supplemental nutrition program for qualified women, infants and children
Program Planning
Met with WIC site directors in each region (Brooklyn/Queens, Manhattan and Staten Island) and conducted needs assessment
Researched perinatal smoking cessation techniques
Partnered with American Cancer Society to receive training in Make Yours A Fresh Start Family (MYFSF) model and ongoing technical assistance throughout the year
MYFSF Program Description MYFSF is a comprehensive package for
health care providers to assist them in counseling their pregnant and parenting clients to stop smoking
Based on U.S. Public Health Service Clinical Practice Guidelines for Treating Tobacco use and Dependence
Adaptation of MYFSF for
WIC Population Met with WIC directors and nutritionists
regarding capacity to implement brief cessation counseling
Collaborated with WIC staff on the development of data collection tools
Developed brochure to introduce program for WIC participants and offer phone counseling
Provided 3 MYFSF Training Sessions
to WIC Staff in each region Smoking facts and figures Smoking cessation and the process of behavior
change The 3-5 minute brief counseling technique (based
upon stage of change theory and 5A’s of intervention)
Use of progress chart to track smoking behavior/ exposure to ETS
System of chart identification (red dots or log) Role Plays
Expectations:
Smoking status asked at every visit and an intervention offered based on stage of smoking behavior
Materials/magazines offered to all smokers and those exposed to ETS
Efforts documented and filed in participant’s chart Red dots used to flag charts Follow-up at subsequent visits to facilitate
movement along stages of change
Technical Support Provided by Tobacco Cessation Program Phone support to all WIC staff Phone counseling to WIC participants seeking
additional support Participation in health fairs at WIC sites (nutrition
month and breastfeeding fairs) Attendance at WIC staff meetings Provide educational materials (brochures,
literature, videos) and varied incentives to quit smoking
Relationship Building: Creating a Partnership Between WIC Staff and
our Tobacco Cessation Program Enhanced by our status as employees of SVCMC Involved WIC directors and staff in every step of
program development Encouraged environment for open discussion of
concerns Prioritized staff recognition luncheons Identified environmental barriers to program
success (i.e. facilitated child-friendly environments)
Program Assessment
and Evaluation Conducted process evaluation with
nutritionists via focus groups and surveys Conducted chart review to determine
utilization of progress charts and assess follow-up
Our Findings
8 of 9 sites implemented program 90% of nutritionists think they can have positive
effect on smoker’s behavior 60% think brief cessation counseling is an
important part of their job the other 40% indicated that it is important, but
need more strategies for making time 292 charts (of women, infants and children) were
flagged as smokers or as exposed to second-hand smoke
Findings (continued)
Chart review conducted on 122 of the total 292 charts
52% asked about smoking status at subsequent visits
48% documented that materials were provided 56% of charts revealed some movement (micro-
movement) along the stages of change (this figure includes women who spontaneously quit due to pregnancy)
Barriers to
Program Implementation Limited time for counseling patients and
documenting efforts due to high caseloads (1:890)
Lengthy waiting period in often crowded and chaotic environment
Nutritionists’ personal views about smoking Introduction of new computer system
(WICSYS) impedes counseling process
Strategies
Modify intervention to core elements: ask, offer, document
Create child-friendly environments Empower nutritionists Meeting with WIC at state level to discuss
problems with computer tobacco screen
Ongoing Improvements
Maintain the partnership with ACS that has enabled us to achieve our success to date
Continue to build relationship with WIC staff and be responsive to their suggestions
Consultation with NYS WIC department as they pilot the MYFSF model in two WIC sites in NYS
Expansion into SVCMC outpatient clinics