Christina Newby poster_FinalDraft
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Introduction Baby and Me Tobacco Free: An Evidence-Based Evaluation In the Montgomery County, Tennessee Area Student: Christina Newby, Prevention Science Track Site Supervisor: Joey Smith Montgomery County Health Department Objectives Implications, Discussion, Conclusions Project Design Smoking is one of the leading cause of preventable death in the United States. According to the Centers for Disease Control and Prevention, smoking during pregnancy can lead to several problems for both the mother and her baby, such as pregnancy complications, premature births, sudden infant death syndrome (SIDS), and low-birth weight infants. When tobacco use is avoided during pregnancy, the risk of a miscarriage is decreased, the baby’s lungs grow stronger, premature delivery is prevented, the baby’s birth weight is improved, and the baby’s overall health is better. Based on hospital data from the Tennessee Department of Health, in the last three years, 500 women (15.2%) from Montgomery County reported smoking during pregnancy. The delivery cost for underweight babies due to smoking in Montgomery County is over 2.9 million dollars each year. To increase knowledge, save money, and decrease the prevalence of smoking among pregnant women in Montgomery County, the Department of Health decided to collaborate with a program entitled, Baby & Me Tobacco Free, which will assist with providing the necessary prenatal services needed to stop this deadly habit. Baby & Me Tobacco Free is a research-based smoking cessation program that was launched in 2002, and is currently partnering with health facilities and organizations in the U.S. Since 2002, the program has improved lives and strengthened communities by helping thousands of women (1). Figure 1: Baby & Me Tobacco Free Poster • Assist the County Director at the Montgomery County Health Department with the collection of data from patients who participated in the Baby & Me Tobacco Free program. • Examine data collected to determine relationships, patterns and trends. • Actively participate in meetings pertaining to current progress and future goals of the Baby & Me Tobacco Free program. • Compare data with other participating county health departments. Lessons Learned Data Collection, Data Sources Project Status Update The County Director gathered healthcare workers from the Montgomery County Health Department to discuss a management plan referred to as “Plan-Do- Check-Act” (PDCA) for the control and continuous improvement needed along the Baby & Me Tobacco Free process. Since this was a new project, this helped verify and prioritize problems along the way. The following recommendations were made: • Budgeting for Marketing/Advertising for Pre-Natal Anti-Smoking, therefore proposing more money in next years grant for this project. • Tracking how many months pregnant each participant is at the start of the program and at each session attended. • Developing ways to retrieve more hospital data of the baby’s gestational weeks and birth weights from participants who report a CO reading of 0-6ppm versus those who drop out. Conclusion The Baby & Me Tobacco Free data collected at the Montgomery County Health Department can be used to provide healthcare professionals with related trends, perceived knowledge, habits and behaviors seen in pregnant smokers. Acknowledgements: Special thanks to the Montgomery County Director, Joey Smith, as well as other participating staff members for their support. I would like to also show my appreciation to the EMPH staff for their assistance with this experience. Summer 2015 Overall Goal The purpose of this practicum experience was to analyze and evaluate data collected during the first year of the Baby & Me Tobacco Free project at the Montgomery County Health Department. The overall goal is to reduce the number of low birth weight births attributed to women who smoke during pregnancy. Motivating pregnant women to stop smoking and continue to be smoke-free following pregnancy is also an important goal for change. Data Collection All data throughout this practicum were collected from the Montgomery County Director and participating staff, who documented, as well as recorded, findings resulting from client registration forms, CO monitoring tests, and other communication from patients during their health department visits. Data Sources Data came from the following target population : • Health department patients • WIC & social support service participants • Residents that heard about the program • Residents to the health department for a pregnancy tests. Figure 2: The Baby & Me Tobacco Free Logo How the Baby & Me Tobacco Free Program Works: Pregnant women, who visit the Montgomery County Health Department and are interested in the Baby & Me Tobacco Free program complete the following unique approach: 1. Agree to quit smoking and complete an application. At this time, the program manager will arrange for the women’s first appointment, where she will receive specific information about the program and an initial intake session will then be held. 2. Each participant will receive at least four, monthly prenatal cessation counseling sessions, support needed, and carbon monoxide (CO) monitoring. A CO breath test shows the amount of carbon monoxide in the breath (ppm), which is an indirect, non-invasive measure of blood Carboxyhemoglobin (%COHb), which is the level of CO in the blood (2). 3. The mother will return monthly, after the baby is born, to continue CO monitoring. If the CO test results prove that she has remained smoke-free , she receives a $25 monthly voucher for diapers up to 6-12 months postpartum. References: 1. Baby & Me Tobacco Free. (2013). Press in the News. Retrieved from http://babyandmetobaccofree.org/Pages/Press.html 2. Bittoun, R. (2008). Carbon monoxide meter: The essential clinical tool-the ‘stethoscope”-of smoking cessation. Journal of Smoking Cessation, 3(2),69-70. DOI 10.1375/jsc.3.3.69 The Baby & Me Tobacco Free made its debut at the Montgomery County Health Department in May 2014. Since January 2015, the following have been reported: By the numbers 47 pregnant women enrolled 18 women completed all four prenatal counselling sessions 29 women dropped out * 27 women received vouchers for diapers for remaining smoke-free after postpartum month 1 *Major reasons for drop-outs: lack of family support, other household smokers, stress, apathy/lack of motivation, transportation problems, early delivery. Figure 3 illustrates the charts that explain results from CO monitoring tests from participants after each of the four total sessions. A B C D E County Number of mothers who reported smoking anytime during Percent smoking anytime during pregnancy Goals for reduction Number of pregnant smoking ‘quitters’ needed to meet county Montgomery 500 15.2% Reduce 10% 50 The Montgomery County Health Department Response: Table 1: MEETING THE COUNTY GOAL Step 1: Record your county in Column A, record the number of mothers who reported smoking in Column B, and the percentage in Column C. Step 2: Plug in the reduction goal in Column D. Multiply Column D by Column B. Insert result in Column E. A B C D E County goal – Number of smoking pregnancies to be reduced (Column E above) Percent of low birth weight births attributable to smoking Number of low birth weight births attributable to smoking Average hospital charges for low birth weight babies above normal delivery costs Cost savings due to reduction in meeting county goal 50 25% 13 $70,000 $910,000.00 Table 2: CALCULATION OF COST SAVINGS (RETURN ON INVESTMENT) Step 1: Insert selected county goal for number of smoking pregnancies to be prevented from Column E in Table 1 into Column A. Step 2: Calculate number of low birth weight births to be attributable to smoking based on your state statistics (derived from Tennessee State Health Department’s Maternal and Child Health, every 1 out of 4 babies) . Multiply Column A by Column B and insert Column C. Step 3: Calculate estimated cost savings based on your state estimates. Multiply average additional hospital charges Column D by county goal in Column C and insert in Column E. SESSION 1 0-6ppm 7-11ppm 12-20ppm 20+ ppm SESSION 2 0-6ppm 7-11ppm 12-20ppm 20+ ppm SESSION 3 0-6ppm 7-11ppm 12-20ppm 20+ ppm SESSION 4 SESSION 4 0-6ppm 7-11ppm 12-20ppm 20+ ppm CO (ppm) Cigarette Consumption 0-6 Non-Smoker 7-10 Light Smoker 11-20 Heavy Smoker 20+ Very Heavy Smoker # of participants: 47 # of participants: 47 # of participant drop outs: 15 # of participants remaining: 32 # of participants: 32 # of participant drop outs: 12 # of participants remaining: 20 # of participants: 20 # of participant drop outs: 2 # of participants remaining: 18 An analysis of the Baby & Me, Tobacco Free program at the Montgomery County Health Department can help provide insight to residents of the community and positively impact several mothers’ lives, as well as those of their babies and families. Table 3: CO Monitoring Test Levels Figure 3: CO Monitoring Test Results
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Transcript of Christina Newby poster_FinalDraft
Introduction
Baby and Me Tobacco Free: An Evidence-Based EvaluationIn the Montgomery County, Tennessee Area
Student: Christina Newby, Prevention Science Track Site Supervisor: Joey SmithMontgomery County Health Department
Objectives
Implications, Discussion, Conclusions
Project Design
Smoking is one of the leading cause of preventable death in the United States. According to the Centers for Disease Control and Prevention, smoking during pregnancy can lead to several problems for both the mother and her baby, such as pregnancy complications, premature births, sudden infant death syndrome (SIDS), and low-birth weight infants. When tobacco use is avoided during pregnancy, the risk of a miscarriage is decreased, the baby’s lungs grow stronger, premature delivery is prevented, the baby’s birth weight is improved, and the baby’s overall health is better.
Based on hospital data from the Tennessee Department of Health, in the last three years, 500 women (15.2%) from Montgomery County reported smoking during pregnancy. The delivery cost for underweight babies due to smoking in Montgomery County is over 2.9 million dollars each year.
To increase knowledge, save money, and decrease the prevalence of smoking among pregnant women in Montgomery County, the Department of Health decided to collaborate with a program entitled, Baby & Me Tobacco Free, which will assist with providing the necessary prenatal services needed to stop this deadly habit. Baby & Me Tobacco Free is a research-based smoking cessation program that was launched in 2002, and is currently partnering with health facilities and organizations in the U.S. Since 2002, the program has improved lives and strengthened communities by helping thousands of women (1).
Figure 1: Baby & Me Tobacco Free Poster
• Assist the County Director at the Montgomery County Health Department with the collection of data from patients who participated in the Baby & Me Tobacco Free program.
• Examine data collected to determine relationships, patterns and trends.• Actively participate in meetings pertaining to current progress and future
goals of the Baby & Me Tobacco Free program. • Compare data with other participating county health departments.
Lessons Learned
Data Collection, Data Sources
Project Status Update
The County Director gathered healthcare workers from the Montgomery County Health Department to discuss a management plan referred to as “Plan-Do-Check-Act” (PDCA) for the control and continuous improvement needed along the Baby & Me Tobacco Free process. Since this was a new project, this helped verify and prioritize problems along the way. The following recommendations were made:
• Budgeting for Marketing/Advertising for Pre-Natal Anti-Smoking, therefore proposing more money in next years grant for this project.
• Tracking how many months pregnant each participant is at the start of the program and at each session attended.
• Developing ways to retrieve more hospital data of the baby’s gestational weeks and birth weights from participants who report a CO reading of 0-6ppm versus those who drop out.
ConclusionThe Baby & Me Tobacco Free data collected at the Montgomery County Health Department can be used to provide healthcare professionals with related trends, perceived knowledge, habits and behaviors seen in pregnant smokers.
Acknowledgements: Special thanks to the Montgomery County Director, Joey Smith, as well as other participating staff members for their support. I would like to also show my appreciation to the EMPH staff for their assistance with this experience.
Summer 2015
Overall Goal The purpose of this practicum experience was to analyze and evaluate data collected during the first year of the Baby & Me Tobacco Free project at the Montgomery County Health Department. The overall goal is to reduce the number of low birth weight births attributed to women who smoke during pregnancy. Motivating pregnant women to stop smoking and continue to be smoke-free following pregnancy is also an important goal for change.
Data CollectionAll data throughout this practicum were collected from the Montgomery County Director and participating staff, who documented, as well as recorded, findings resulting from client registration forms, CO monitoring tests, and other communication from patients during their health department visits.
Data SourcesData came from the following target population :• Health department patients• WIC & social support service participants• Residents that heard about the program• Residents to the health department for a pregnancy tests.
Figure 2: The Baby & Me Tobacco Free Logo
How the Baby & Me Tobacco Free Program Works:Pregnant women, who visit the Montgomery County Health Department and are interested in the Baby & Me Tobacco Free program complete the following unique approach:
1. Agree to quit smoking and complete an application. At this time, the program manager will arrange for the women’s first appointment, where she will receive specific information about the program and an initial intake session will then be held.
2. Each participant will receive at least four, monthly prenatal cessation counseling sessions, support needed, and carbon monoxide (CO) monitoring.
A CO breath test shows the amount of carbon monoxide in the breath (ppm), which is an indirect, non-invasive measure of blood Carboxyhemoglobin (%COHb), which is the level of CO in the blood (2).
3. The mother will return monthly, after the baby is born, to continue CO monitoring. If the CO test results prove that she has remained smoke-free , she receives a $25 monthly voucher for diapers up to 6-12 months postpartum.
References: 1. Baby & Me Tobacco Free. (2013). Press in the News. Retrieved from
http://babyandmetobaccofree.org/Pages/Press.html 2. Bittoun, R. (2008). Carbon monoxide meter: The essential clinical tool-the ‘stethoscope”-of smoking cessation.
Journal of Smoking Cessation, 3(2),69-70. DOI 10.1375/jsc.3.3.69
The Baby & Me Tobacco Free made its debut at the Montgomery County Health Department in May 2014. Since January 2015, the following have been reported:
By the numbers 47 pregnant women enrolled18 women completed all four prenatal counselling sessions29 women dropped out *27 women received vouchers for diapers for remaining smoke-free after postpartum month 1 *Major reasons for drop-outs: lack of family support, other household smokers, stress, apathy/lack of motivation, transportation problems, early delivery.
Figure 3 illustrates the charts that explain results from CO monitoring tests from participants after each of the four total sessions.
A B C D E
County
Number of mothers who reported
smoking anytime during pregnancy
Percent smoking anytime during
pregnancy
Goalsfor
reduction
Number of pregnant smoking ‘quitters’
needed to meet county goal
Montgomery 500 15.2%Reduce 10% 50
The Montgomery County Health Department Response:Table 1: MEETING THE COUNTY GOALStep 1: Record your county in Column A, record the number of mothers who reported smoking in Column B, and the percentage in Column C.Step 2: Plug in the reduction goal in Column D. Multiply Column D by Column B. Insert result in Column E.
A B C D E
County goal – Number of smoking
pregnancies to be reduced (Column E
above)
Percent of low birth
weight births attributable to
smoking
Number of low
birth weight births attributable to
smoking
Average hospital charges for low
birth weight babies above normal delivery costs
Cost savings due to
reduction in meeting county
goal
50 25% 13 $70,000 $910,000.00
Table 2: CALCULATION OF COST SAVINGS (RETURN ON INVESTMENT)Step 1: Insert selected county goal for number of smoking pregnancies to be prevented from Column E in Table 1 into Column A.Step 2: Calculate number of low birth weight births to be attributable to smoking based on your state statistics (derived from Tennessee State Health Department’s Maternal and Child Health, every 1 out of 4 babies). Multiply Column A by Column B and insert Column C. Step 3: Calculate estimated cost savings based on your state estimates. Multiply average additional hospital charges Column D by county goal in Column C and insert in Column E.
SESSION 1
0-6ppm 7-11ppm12-20ppm 20+ ppm
SESSION 2
0-6ppm 7-11ppm12-20ppm 20+ ppm
SESSION 3
0-6ppm 7-11ppm12-20ppm 20+ ppm
SESSION 4
SESSION 4
0-6ppm 7-11ppm12-20ppm 20+ ppm
CO (ppm) Cigarette Consumption
0-6 Non-Smoker
7-10 Light Smoker
11-20 Heavy Smoker
20+ Very Heavy Smoker
# of participants: 47 # of participants: 47# of participant drop outs: 15# of participants remaining: 32
# of participants: 32# of participant drop outs: 12# of participants remaining: 20
# of participants: 20# of participant drop outs: 2# of participants remaining: 18
An analysis of the Baby & Me, Tobacco Free program at the Montgomery County Health Department can help provide insight to residents of the community and positively impact several mothers’ lives, as well as those of their babies and families.
Table 3: CO Monitoring Test Levels
Figure 3: CO Monitoring Test Results
