Saginaw County Interconception ICC Program

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Saginaw County Interconception (ICC)Program
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Interventions and Assessment of the
Interconceptional Women

• Dawn M. Shanafelt, RN, BSN,BA

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ICC Program Overview

• Saginaw County is one of eleven target
  communities in the State of Michigan taking part
  in the Michigan Department of Community Healths
  Interconception Project

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ICC Program Overview

• Saginaw County project patterned after the
  Interconception Health Promotion Initiative
  funded by The Colorado Trust that was developed
  from 1995-2001 at Denver Health
• The objective of the Interconception Health
  Promotion Initiative was to create a home based
  case management program for women who have
  previously experienced a poor pregnancy outcome
  and who are currently in the interconceptional
  period

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Client Recruitment Criteria

• Have had a low birth weight baby and/or
• Have had a previous fetal demise
• Plan on having more children (Interconception)

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Case Management Domain Focused

• Medical/Obstetrical
• Family Planning
• Lifestyle
• Relationship Issues
• Life Necessities
• Maternal Role/Issues with baby
• Life Course

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Challenges

• Very high risk clientele
• Transient population
• Multiple risk factors
• Distrust of County agency
• Varying stages of grief process
• Maintaining project recommended case load of
  twenty-five clients
• Rapport/relationship building

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Successes

• Currently 11 clients enrolled
• Successful relationship building between nurse
  and clients
• Educational Support group for women who have
  experienced a poor pregnancy outcome and who are
  in the interconceptional period
• Developed new methods for recruitment
• Multiple referral sources

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Saginaw County Mini-PRAMS Study Dr. Renee Canady

• Understanding Maternal Attitudes and Pregnancy
  Experiences in a Sample of Post-Partum Women in
  Saginaw County

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Purpose of Study

• The Saginaw County Mini-PRAMS study was designed
  to assess maternal attitudes, pregnancy
  experiences and risks in recently delivered
  woman. The roles of race as contextualizing
  womens experiences was considered. The pilot
  study investigated characteristics and risks of
  women collected at the county level. The study
  was undertaken as part of a statewide infant
  mortality initiative and was funded by the
  Michigan Department of Community Health.

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Study Design and Method

• A convenience sample of recently delivered women
  (n441) women recruited from a community hospital
  participated in the study. The pilot study
  utilizes survey items that are modeled after the
  state of Centers for Disease Control and state of
  Michigan PRAMS (Pregnancy Risk Assessment
  Monitoring System) surveillance project. Survey
  items collected demographic information on race,
  gender and age and biometric measures such as
  weight and height

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Study Design and Method

• In addition, survey questions covered the
  following topic areas folic acid knowledge and
  use, pregnancy planning and contraception,
  patient education by providers, breastfeeding,
  HIV, cigarette and alcohol usage, social stress,
  domestic violence, dental hygiene, perceptions of
  race/racism.

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Descriptive Findings

• 55.5 20-29 years
• 27.7 30-39 years
• 15 Teen Moms with a negligible number of
  participants falling at or above 40 years

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Descriptive Findings

• 61.9 White American
• 22.9 African American
• 5.7 Multiracial
• 1.4 Hispanic Americans
• .4 Native Americans

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Findings Folic Acid

• 66.2 of the women in the study stated that they
  had not taken prenatal vitamins or multivitamins
  prior to conception
• 57.6 stated that they have heard or read that
  taking folic acid could decrease the risk of
  birth defects
• 48.1 of the women acknowledged that their nurse
  or physician had informed them of the benefits of
  taking folic acid

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Findings Pregnancy Planning

• 60.1 were not trying to conceive at the point
  they became pregnant
• 71.2 were not using contraceptives
• 46.7 of the women said they would mind if they
  got pregnant
• 10.4 said they believed they could not conceive
• 96.6 denying any side effects from birth control
  methods
• 97.1 said they had no difficulty accessing birth
  control resources

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Findings Health Behaviors

• 63.7 of the women state that they did receive
  HIV testing during their most recent pregnancy
• 64.9 of the women did not smoke prior to their
  pregnancy
• 79.6 did not smoke during their pregnancy
• 47.2 stated that they had abstained from alcohol
  prior to conception
• 93.2 deny using alcohol during their last three
  months of pregnancy

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Conclusion

• Further analysis of data findings will assist in
  both the educational and intervention needs in
  the provision of care to pregnant and postpartum
  women in Saginaw County, Michigan