A Healthy Baby is Worth the Weight

Janice Ferguson, RNCRocky Mountain Health Plans In collaboration withColorado Department of Public Health and Environment

Mesa County Colorado statistics, 2004

Population =120,000Births in 2003 =1,653Delivering providers= 56 (Includes

Family Practice Residency)Low birth weight rate =7.4%Entry into care first trimester= 84%Tobacco abuse =18%Inadequate weight gain =24%

Implementation

Unique community for collaborative effortB4 Babies-early intervention, WIC appt,

Provider appt, smoking cessation counseling

Access to OB care providers already established

Used Stickers, Suckers, Smokers tobacco free pregnancy as prototype for office visits

Tools

Usefulness to our providers (BMI wheel, and grid)Evaluation built into campaignProcess and materials already developed

Need for Campaign

Prenatal packet ( free educational material on adequate weight gain in English and Spanish)No tools to show patient their weight gain trendLack of knowledge about problem of weight gain in community

Group training

Mesa County Health DepartmentPerinatal Unit at St Mary’s Hospital

Used Worth the Weight power point slides provided by campaign

Individual Obstetrical Provider Trainings

Ob/gyn offices and staffFamily Practice offices and staff

Average time 20 minutesAlways with FOODInitial and follow-up clinic practice

questionaire

Common provider concerns

Belief: “My patients are gaining an adequate amount of weight.”Solution: Share local statistics about inadequate weight gain share tools (5 A’s for prenatal weight gain counseling grid, brochures)

Belief: “Obesity is more of a problem in my patients.”

Solutions: Discuss issues around obesity and pregnancy complications but that this program is focusing on poor outcomes for low birth weight babies which are caused by inadequate weight gain.

Belief: “Appropriate weight gain doesn’t make a difference in birth outcomes.”

Solutions: Share statistics, resource list and evidence based research

Belief: ”WIC is telling my patients different information about weight gain then I am.”

Solution: Encourage communication by fax with template of hct and weight gain recommendation from WIC providers or phone.

Belief: “I can’t do one more thing during my patient’s OB appointment.”

Solution: Evaluate office flow with office staff, educate office staff on ways to counsel their patients about appropriate weight gain, use of tools, graphing weight on grid.

Worth the Weight is

Worth the time

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Successes

Met with each delivering providers officeGeneral acceptance of compaign toolsAdopted graph for use with COPIC formBMI wheels were most popularShared local resources for those women whose inadequate weight gain was based on lack of access (local food banks)Related issue of tobacco use in Mesa County and the impact and success of that program.

Lessons learned

Follow up is the key to implementation in offices

Always invite and involve office staff that have direct patient access

Adjust program to office flow and particular provider preferences

Examples

For more information

Please contact Janice Ferguson,BA,RNCPrenatal Care Coordinator970-244-7890 or jferguso @ rmph.orgRocky Mountain Health Plans2775 Crossroads BlvdGrand Junction, CO 81504