Nicki Croel, Suad Ali, Tyler Baerwolf , Dan Herbert, Erin White, Nikki McDonald

1. Mecosta County Cares One baby. One family. One community. Nicki Croel, Suad Ali, Tyler Baerwolf, Dan Herbert, Erin White, Nikki McDonald

2. Mecosta County CaresOne baby. One family. One community. Mission statement: To reduce the number of pregnant women that smoke in Mecosta County by using evidence-based counseling methods and support. Philosophy: We are a non-profit organization who believes in using evidence-based practice to support pregnant women in Mecosta County. We believe in promoting the health of the children for the future.

3. Pregnant Women • 31.4% of women in Mecosta County smoked while pregnant • 19.3% of women in Michigan smoked while pregnant • Healthy People 2020 goal is to decrease smoking while pregnant to 1.4% as a nation. • In 2004, estimated $122 million in healthcare costs related to infant hospitalization attributed to smoking

4. Effects of smoking while pregnant Pregnancy complications • Placenta previa • Placental abruption • Premature rupture of membranes • Preterm delivery Infant complications • Low birth weight • Cleft lip/Cleft palate • SIDS

5. Strategic Plan • Hire Staff • Teach 5 A’s Counseling Program • Collaborate with offices and clinics in Mecosta County • Start date: October 1, 2014 • Continuous quality improvement of program and effectiveness

6. Five A’s Counseling Steps • Ask • Determine a women’s smoking status • Advise • Urge smokers to quit using a clear, strong, and personalized messages • Assess • Willingness to quit smoking in the next 30 days • If unwilling, reinforce at subsequent visits

7. Steps Continued • Assist • Provide materials and social support • Arrange • Continue follow up and reinforcement • Hospital Based Cessation - The 5 A’s https://www.youtube.com/watch?v=Ky5P9n40eh0&feature=youtu.be

8. Goals & SMART Objectives: • Organizational Goals • 2-3yrs- Implement a prevention and smoking cessation program within Mecosta county aimed at women who smoke while pregnant. • 5yrs- 5% decrease of smoking while pregnant • 10yrs- At parity with the state of Michigan with smoking while pregnant • Organizational Objective • SMART- The rate of smoking while pregnant will decrease by 5% after implementation of smoking cessation programs for pregnant women in Mecosta county in 5yrs.

9. Organizational Chart

10. Advertisement • Newspaper and Journals • The Pioneer • The American Journal of Nursing • Gain volunteer interest • Flyers around community

11. Budget

12. Cost Conscious Strategies • Work space • Needed • Trained counselors • Promotional & Educational Materials • Community Interests • WIC & MIHP

13. Conclusion • Mecosta county has a high rate of smoking while pregnant due to many factors • Lack of prenatal care • High poverty levels • Lack of an effective smoking cessation program available to them • By implementing the 5 A’s smoking cessation program and utilizing the resources already available we will be able to reduce this number significantly • Within 5 years there should be a rate reduction of 5% among pregnant smokers and by 10 years Mecosta County should be on par with the state of Michigan’s rate of smoking while pregnant

14. References American Lung Association. (n.d.). About smoking: Health effects. In Stop Smoking. Retrieved February 22, 2014, from http://www.lung.org/stop- smoking/about-smoking/health-effects/smoking.html Centers for Disease Control and Prevention. (2009, October 29). PedNSS health indicators. In Pediatric and Pregnancy Nutrition Surveillance System. Retrieved October 2, 2013, from http://www.cdc.gov/pednss/what_is/pednss_health_indicators.htm Centers for Disease Control and Prevention. (2004). Highlights: Impact on unborn babies, infants, children, and adolescents. In Smoking and Tobacco Use. Retrieved February 22, 2014, from http://www.cdc.gov/tobacco/data_statistics/sgr/2004/highlights/children/index.htm District Health Department 10, (2012). Health profile chartbook 2012: Mecosta county. Retrieved from website: http://dhd10.org/images/Mecosta_Chartbook_Dec_14_2011-1.pdf East Tennessee State University. (n.d.). 5 A's guide. In Tennessee Intervention for Pregnant Smokers. Retrieved October 2, 2013, from https://www.etsu.edu/tips/participating/intervention.aspx

15. References Continued Melvin, C., Dolan-Mullen, P., Windsor, R., Whiteside, H. P., & Goldenberg, R. (2000). Recommended cessation counselling for pregnant women who smoke: A review of the evidence. Tobacco Control, 9, Retrieved from www.tobaccocontrol Snattingius, S. (2004). The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research, 6(2), S125-S140. doi: 10.1080114622200410001669187 Tong, V. T., Dietz, P. M., Morrow, B., D'Angelo, D. V., Farr, S. L., Rockhill, K. M., & England, L. J. (2013). Trends in Smoking Before, During, and After Pregnancy — Pregnancy Risk Assessment Monitoring System, United States, 40 Sites, 2000–2010. CDC, 62(6), 2. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6206a1.htm U.S. Department of Health and Human Services. (2013, August 28). Family planning. In Healthypeople.gov. Retrieved October 2, 2013, from http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=13  Yoder-Wise, P. (2011). Leading and managing in nursing. (5th ed.). St. Louis, MO: Elsevier Mosby.