Stephanie Mattfeld Beaudette M.Ed., RD Colorado Department of Public Health and Environment CDC Preconception Summit Jun

1. Stephanie Mattfeld Beaudette M.Ed., RD Colorado Department of Public Health and Environment CDC Preconception Summit June 21-23, 2005

2. Inadequate Prenatal Weight Gain and Low Birth Weight in Colorado In 2002, there were 68,420 births: • nearly 1 in 4 of pregnant women gained inadequately • 16,000 pregnant women in 2002! • 6,116 low birth weight births • 1,180 LBW births can be attributed to inadequate prenatal weight gain (19.3% PAR)

3. Colorado’s Social Marketing Campaign to Address Inadequate Prenatal Weight Gain:A Healthy Baby is Worth the Weight

4. Campaign Purpose & Goals • Increase the number of pregnant women in Colorado who gain an adequate amount of weight during pregnancy. • Decrease the number of low birth weight births in Colorado due to inadequate prenatal weight gain.

5. Campaign Evaluation Goals: • To increase adequate weight gain among pregnant women in Colorado. • Ultimately, to decrease low birth weight births in Colorado. How will we achieve these goals? • Motivate prenatal health care providers to discuss and monitor appropriate weight gain with patients. • Increase awareness about the importance of maternal weight gain among consumers.

6. Campaign Evaluation • Added a question to the 2004 PRAMS survey • How much weight did your doctor, nurse or other health care worker tell you to gain during your pregnancy? • ______ Pounds OR ______ Kilos • They did not tell me how much weight to gain • I don’t remember • Other, please tell us _________________________ • Colorado birth certificate (2006) added fields • pre-pregnancy weight • height

7. Campaign Process Initial consumer and provider Focus groups Advertising agency selected Materials created, tested and revised Campaign promotion & next steps! Provider Training Media Campaign Web site

8. Issues for Women in Addressing Inadequate Weight Gain Issues • Pregnant Women Focus Group Results, Summer 2002: • Concern about body image during pregnancy-fear of becoming overweight • Reported lack of education from health care providers, especially doctors • Questioned relationship between maternal weight gain and infant weight and health

9. “The women I know aren’t gaining… They need to know how important it is to gain.” “I know three pregnant women who have pictures of models on the inside of their kitchen cupboards so when they open the cupboard they don’t eat so much.” “The Hollywood stars give a false impression of what a pregnant lady should look like.”

10. Issues for Physicians in Addressing Inadequate Weight Gain • FP & OB/GYN Physician Focus Group Results, Spring 2001: • Skeptical about the impact of IWG on the number of low birth weight births • Lack of knowledge/training in nutrition • Lack of resources to provide intervention • Medicalization of issue (ultrasound)

11. Roll Out to the Medical CommunityFebruary-September 2004 • Provided MCH grant funds to several large local health departments to support a campaign coordinator within the agency • Adapted a Train-the-Trainer approach for county wide training • Collected data on number of providers trained, material evaluation, change in practice, etc.

12. 1990 Institute of Medicine’s Total Weight Gain Recommendations • Low BMI (<19.8) 28-40 pounds • Normal BMI (19.8-26) 25-35 pounds • High BMI (26-29) 15-25 pounds • Obese BMI (>29) 15 pounds Based on pre-pregnancy weight & height