1. A Healthy Baby is Worth the Weight Janice Ferguson, RNC Rocky Mountain Health Plans In collaboration with Colorado Department of Public Health and Environment

2. Mesa County Colorado statistics, 2004 zPopulation =120,000 zBirths in 2003 =1,653 zDelivering providers= 56 (Includes Family Practice Residency) zLow birth weight rate =7.4% zEntry into care first trimester= 84% zTobacco abuse =18% zInadequate weight gain =24%

3. Implementation zUnique community for collaborative effort zB4 Babies-early intervention, WIC appt, Provider appt, smoking cessation counseling zAccess to OB care providers already established zUsed Stickers, Suckers, Smokers tobacco free pregnancy as prototype for office visits

4. Tools zUsefulness to our providers (BMI wheel, and grid) zEvaluation built into campaign  Process and materials already developed

5. Need for Campaign zPrenatal packet ( free educational material on adequate weight gain in English and Spanish) zNo tools to show patient their weight gain trend zLack of knowledge about problem of weight gain in community

6. Group training zMesa County Health Department zPerinatal Unit at St Mary’s Hospital Used Worth the Weight power point slides provided by campaign

7. Individual Obstetrical Provider Trainings zOb/gyn offices and staff zFamily Practice offices and staff zAverage time 20 minutes zAlways with FOOD zInitial and follow-up clinic practice questionaire

8. 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)

9. 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.

10. Belief: “Appropriate weight gain doesn’t make a difference in birth outcomes.” Solutions: Share statistics, resource list and evidence based research

11. 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.

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

13. Worth the Weight is Worth the time ******************

14. Successes zMet with each delivering providers office zGeneral acceptance of compaign tools zAdopted graph for use with COPIC form zBMI wheels were most popular  Shared local resources for those women whose inadequate weight gain was based on lack of access (local food banks) zRelated issue of tobacco use in Mesa County and the impact and success of that program.

15. Lessons learned zFollow up is the key to implementation in offices zAlways invite and involve office staff that have direct patient access zAdjust program to office flow and particular provider preferences zExamples

16. For more information Please contact Janice Ferguson,BA,RNC Prenatal Care Coordinator 970-244-7890 or jferguso @ rmph.org Rocky Mountain Health Plans 2775 Crossroads Blvd Grand Junction, CO 81504