The Development of a Regional Perinatal Forum Social Health MarketingCampaign for the Hudson Valley Region

Janine Lewis, MPH, PhD(c)Northern Manhattan Perinatal

Partnership: Practice Matters

Disclosure of Relevant Financial Relationships No commercial interests to disclose

Objective Discuss the development of a social marketing

campaign targeting women of childbearing age and their families with messages promoting the reduction of primary elective Cesarean sections and inductions prior to 39 weeks’ gestation Background/rationale for campaign Steps completed to date Future plans

Practice Matters

Practice Matters is the management consulting arm of the Northern Manhattan Perinatal Partnership (NMPP), a MCH agency well-prepared to equip professionals, agencies, and organizations with the strategic and operational know-how needed to ensure healthy birth outcomes.

Practice Matters was formed in 2007 under the leadership of Mario Drummonds, MS, LCSW, MBA, the Executive Director of NMPP. 

NMPP’s Social Health Marketing Group, founded in 1997, is comprised of administrative, marketing, and case management staff skilled at developing marketing, outreach, and advertising campaigns for social service agencies, health facilities, and private businesses.

Trends in Cesarean Sections

•In 2007, there were 1.4 million Cesarean births, approximately 1/3 of all births in the US (CDC, 2010).•4-18% of Cesarean sections are conducted by maternal request (Fuchs and Wapner, 2006); 2.5% of all US births are Cesarean sections by maternal request ( Bettegowda et al, 2008)

Live Births by Method of Delivery, 2007

Source: NYS DOH Vital Statistics

Inductions In 2006, approximately 22% of all pregnant

women had their labor induced (ACOG, 2009) Inductions may increase the likelihood that

Cesarean sections may follow (Wilson et al, 2010; Yeast et al 1999)

Interventions related to Birth, 2008 (percentages)

Source: NYS DOH Vital Statistics

ACOG Practice Bulletin, 2009 Recommendation: elective deliveries

(inductions and Cesarean sections) not be performed before 39 weeks of gestation, to minimize prematurity-related neonatal complications.

Preterm Birth

Defined as infant born before 37 completed weeks of gestation

“Currently the most important problem in maternal-child health in the United States” (Wadhwa et al, 2001)

Has grown 27% since 1981 to a total of 12.4% of all live births African-Americans have a PTB rate of 1.5-2.4 times that of

Whites About 50% of PTB cases have no known etiology (but

we do know that higher order births, uterine/cervical abnormalities, previous preterm birth are top risk factors)

Preterm Birth Between 1996-2006, Cesarean section rates

for infants born late preterm (34 to 36 completed weeks of gestation) and term and over (37 or more completed weeks of gestation) rose by almost 50%. (CDC, 2010)

Cause of 85% of perinatal mortality and morbidity in the US (Arias et al, 2003) Most are considered late preterm (34-36 weeks)

Trends in Preterm Births

Relationship Between Cesarean section, Inductions and Preterm Births

WMC Social Marketing Campaign

Purpose: to reduce the number of primary elective Cesarean births and inductions Secondary objective: reduction of total number of

Cesareans, late preterm births

Mixed methods approach to data collection/market research

Deliverable: development of mock-ups/galleys

Development of Social Marketing Campaign

Development of Social Marketing Campaign Secondary data analysis (May – June)

Hospital-based data NYS DOH Vital Statistics Peer-reviewed literature review

Development and submission of IRB protocol (June – July)

IRB approval (September) Key Opinion Leader Interviews (October) Focus Groups (October) Topline Summary of Focus Groups/Interviews

(November) Development of campaign galleys/mockups

(November – December)

Focus Groups Four total:

Orange Rockland Westchester (2)

Women 18-44 years of age (nulligravidas, pregnant, or have child under 1 year of age)

90 minutes in length Hosted by Public Libraries/Community-Based

Organizations Recruitment by PM/HVRPF

Focus Groups - DemographicsRockland African-American

(AA), Latinas Low SES Pregnant/Postpartum Orange White middle SES semi-rural

Westchester #1 White High SES nulligravidas

Westchester #2 African-American mixed SES Pregnant/postpartum

Focus Group – Preliminary Findings

Key Opinion Leader Interviews N = 10

30 minutes in length

Representatives from non-profit organizations (community-based, voluntary health organizations, social service); fathers

Key Opinion Leader Interviews – Preliminary Findings

Next Steps Complete development of mock-ups/galleys Print/distribution

Acknowledgements Mario Drummonds, Northern Manhattan

Perinatal Partnership/Practice Matters Tamara Wrenn, Practice Matters WMC Awareness Campaign working group:

Dr. Heather Brumberg – PI Cheryl Hunter-Grant Caren Fairweather Fran Menillo

For more information:

Janine Lewis, MPH, PhD(c)708-261-7564

jlewis6@gmail.com