The Development of a
Regional Perinatal Forum
Social Health Marketing
Campaign for the Hudson
Valley Region
Janine Lewis, MPH, PhD(c)
Northern Manhattan Perinatal Partnership:
Practice Matters
Disclosure of Relevant Financial
Relationships
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No commercial interests to disclose
Objective
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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
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Background/rationale for campaign
Steps completed to date
Future plans
Practice Matters
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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
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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
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Recommendation: elective deliveries (inductions and
Cesarean sections) not be performed before 39 weeks of
gestation, to minimize prematurity-related neonatal
complications.
Preterm Birth
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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
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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
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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)
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Most are considered late preterm (34-36 weeks)
Trends in Preterm Births
Relationship Between Cesarean section,
Inductions and Preterm Births
WMC Social Marketing Campaign
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Purpose: to reduce the number of primary elective
Cesarean births and inductions
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Secondary objective: reduction of total number of Cesareans,
late preterm births
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Mixed methods approach to data collection/market
research
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Deliverable: development of mock-ups/galleys
Development of Social Marketing Campaign
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Secondary data analysis (May – June)
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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
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Four total:
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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 - Demographics
Rockland
 African-American (AA),
Latinas
 Low SES
 Pregnant/Postpartum
Westchester #1
 White
 High SES
 nulligravidas
Orange
 White
 middle SES
 semi-rural
Westchester #2
 African-American
 mixed SES
 Pregnant/postpartum
Focus Group – Preliminary
Findings
Key Opinion Leader Interviews
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N = 10
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30 minutes in length
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Representatives from non-profit organizations
(community-based, voluntary health organizations, social
service); fathers
Key Opinion Leader Interviews –
Preliminary Findings
Next Steps
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Complete development of mock-ups/galleys
Print/distribution
Acknowledgements
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Mario Drummonds, Northern Manhattan Perinatal
Partnership/Practice Matters
Tamara Wrenn, Practice Matters
WMC Awareness Campaign working group:
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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