Smoke Free Families Informational Webinar August 23, 2018

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The Ohio Perinatal Quality Collaborative Mission: Through collaborative use of improvement science methods, to reduce preterm births & improve perinatal and preterm newborn outcomes in Ohio as

1 The Ohio Perinatal Quality Collaborative Mission: Through collaborative use of improvement science methods, to reduce preterm births & improve perinatal and preterm newborn outcomes in Ohio as quickly as possible. Smoke Free Families Informational Webinar August 23, 2018 OPQC projects are funded by the Ohio Department of Medicaid and Ohio Department of Health, with support from the Ohio Colleges of Medicine Government Resource Center.

2 WELCOME Please sign in the question box with the names of all webinar participants and your organization affiliation. All lines will be placed on mute during the presentation and will open up for questions at the end. This call will be recorded.

3 Agenda Welcome and Introductions Perinatal Smoking in Ohio and Beyond What is Included in Participation Questions and Discussion Next Steps Mary Bauer Dr. Marcotte Mary Bauer Mary Bauer Mary Bauer

4 Smoke Free Families: Webinar Objectives Describe the goals and objectives of the Smoke Free Families Quality Improvement effort to reduce smoking among pregnant women and improve maternal and infant outcomes. Review the high level timeline and describe participant activities.

5 OPQC SFF Quality Improvement Team Clinical Faculty Dr. Heather Frey Columbus Dr. Jay Iams Columbus Dr. Michael Krew Quality Improvement Quality and Project Team Mary Bauer Stephanie Wilson Suzy Culbertson Canton Dr. Mike Marcotte Cincinnati

6 Causes of Infant Deaths in Ohio 2016

7 Smoking Prematurity & Infant Death CDC Says that Smoking: Makes It Harder to Get Pregnant. Increases Risk of Miscarriage. Increases Risk of Placental Abruption. Increases Risk of Low Birth Weight. Premature Birth Fetal Growth Restriction Is a Major Risk Factor for SUID. Increases Risk of Birth Defects. Division of Reproductive Health, National Center for Chronic Disease Prevention & Health Promotion

any point in pregnancy. 7.2% (1 in 14) pregnant women smoked in 2016.

8 Source: 2016 Data from the 2003 Revision of U.S. Standard Certificate of Live Birth Definition: Number of births to women who reported smoking cigarettes at any point in pregnancy. 7.2% (1 in 14) pregnant women smoked in Maternal Smoking Is Related to Maternal: Age Education Race & Ethnicity State of Residence

9 ACOG says USE the 5A s ASK ADVISE ASSESS ASSIST ARRANGE

Assessment of 5A s in Pregnant Women in Ohio WIC sites 38 Clinics Participated 2006-2010 71,526 Pregnant Smokers 23% QUIT

10 Assessment of 5A s in Pregnant Women in Ohio WIC sites 38 Clinics Participated ,526 Pregnant Smokers 23% QUIT Smoking! Quit Rates Increased Significantly after Staff Trained to Use 5As Birth Weights Increased Significantly in Women Who Quit

11 Conclusion: women who stopped smoking early in the first 2 trimesters experienced similar (recurrent) preterm birth rates compared with nonsmokers.

12 The Ohio Department of Health & The Ohio Department of Medicaid Want YOU to Help Prevent Infant Mortality To Look for Women with a History of Smoking or Tobacco Use! To Get Them Cessation Resources ASAP! To Fill Out a PRAF 2.0 ASAP!

13 WHAT PARTICIPATION WILL MEAN FOR YOU

14 Key Driver Diagram We will measure impact of Smoke Free Families by : % women smoking in third trimester Reduction in rate of preterm birth < 37 weeks Reduction in the rate of infants with restricted fetal growth (SGA <5 th %ile)

15 Key Driver Diagram How will we do this? Use 5As Motivational interviewing techniques Resources: QuitLine, BMTF

16 What Participation Will Mean for You Ask Advise Assess Assist Arrange Use Evidence Based Methods and Tools, Including the 5As to Assist Smoking Cessation Efforts

17 Motivational Interviewing

18 What Participation Will Mean for You Access to Additional Pregnancy Specific Smoking Cessation Resources

19 It Works! Participate in 4 Prenatal Quit Smoking Sessions. Quit Smoking and Stay Quit During My Pregnancy Take a Monthly Breath Test to Show That I m Tobacco-Free. Stay Smoke-Free After Birth to Get a Monthly Voucher for Free Diapers

20 What Participation Will Mean for You Network with State Agencies, Managed Care Providers, and Maternity Care Practices Throughout The State

21 What Participation Will Mean for You Attend Monthly Webinars Learn from your peers, subject matter experts and OPQC team members Share success and challenges Review your project specific data to help guide your improvement efforts and continued transformation

22 What Participation Will Mean for You Data for Your Practice Measures % of pregnant women identified who smoke or use tobacco % of women willingness to quit during pregnancy % of women who received smoking/ tobacco cessation self-help material % of referrals and enrollment to Ohio Quit Line % of referrals and enrollment to BMTF

23 What Participation Will Mean for You Data for Your Practice Measures from the Ohio Birth Certificate % of pregnant women smoking in the 3 rd trimester PTB % of deliveries by >37 wks, wks and <32 wks % of births with BW >2500g % of infants with restricted fetal growth (SGA <5th%ile)

24 Team Participation Timeline- Wave 2 OPQC Smoke Free Families Attend Informational Webinar Submit Team Registration Complete Onboarding Material Kick Off Meeting/Data Review Initiate Action Period Calls and Data Review Learning Session Action Period Calls and Data Review Continued QI Coaching Calls August September October November December January February March April May

25 Please Join Us! And Help Improve Outcomes for Moms and Babies in Ohio

27 Questions To ask a question: 1. Click on the Raised Hand icon 2. Type your question in to the Chat Box

28 Next Steps Complete the OPQC Team Registration Form We will send this to everyone from within the next week We ll follow-up w/you in the near future

29 It takes a village..

Help for Pregnant Women to Quit Smoking and Stay Quit

BABY & ME Tobacco Free Hendricks County Health Department 355 S. Washington St. #211 Danville, IN 46122 Phone: (317) 745-9222 Fax: (317) 745-9383 Help for Pregnant Women to Quit Smoking and Stay Quit UPDATED