Transcript Document 7191839

Smoke Free Start for
Families Program
San Mateo County
Health Services Agency
Sheila R. Tuna, MPH, [email protected], 650-573-2012;
Todd Rogers, PhD, [email protected]; Ellen Feighery, MS RN,
[email protected]; Kerry Barba, MPH, [email protected]
Smoke Free Start for Families Program (SFSF)
Background
• Fall 1995, group of health care providers and
educators identified critical gap in services for
pregnant smokers
• April 1997, San Mateo County was funded to
develop a perinatal cessation program
• December 1997, SFSF began providing services
to pregnant and postpartum women
Smoke Free Start for Families Program
Purpose
To assist pregnant and postpartum women to
stop smoking or reduce tobacco consumption
Smoke Free Start for Families Program
Participation Criteria
• Pregnant and currently smoking
• Pregnant and recently quit smoking
• Postpartum and currently smoking (12 months
postpartum cut-off)
• Postpartum and recently quit for relapse
prevention services
• Currently live in San Mateo County
Smoke Free Start for Families Program
Services
• Individualized phone counseling
• Face to face counseling
• Available in English and Spanish
Smoke Free Start for Families Program
Referral Process
• Fax referral or phone call by health care provider
to the Program Coordinator
• The health care provider distributes a program
brochure, referral card or Rx slip to the patient
who may call the Program Coordinator directly
(Self Referral)
• Info table at clinics or community fairs (Self
Referral)
Smoke Free Start for Families Program
Community
Outreach
ALA
Cessation
Classes
Provider
Office
Outreach
Telephone
Cessation
Counseling
Systems
Change
Strategy
Screening
Feedback
to referral
source
Telephone Relapse
Prevention
Counseling
Smoke Free Start for Families Program
Cessation Protocol
• Culturally and linguistically appropriate
counselor
• Unlimited number of sessions
• Harm reduction model
• Education materials and incentives
Smoke Free Start for Families Program
Service Provision for
Pregnant and Postpartum Clients
December 1, 1997 to October 31, 2002
Postpartum
Total
375
98
473
249
62
311
(66%)
(63%)
(66%)
179
47
226
(72%)
(76%)
(73%)
70
15
85
Pregnant
Total Referrals
Accepted Services
Cessation
Relapse Prevention
(28%)
(25%)
(27%)
Smoke Free Start for Families Program
Client Demographics
December 1, 1997 to October 31, 2002
Pregnant
Postpartum
(n=249)
(n=62)
Age (yr)
Mean
Median
Age Range
28.2
28.0
16-43
28.0
26.0
15-44
Race/Ethnicity (%)
Non-Hispanic White
Hispanic/Latino
African American
Asian/Pacific Islander
Other
39.8
24.5
19.3
9.6
6.8
45.9
21.3
6.6
13.1
13.1
Primary Language (%)
English
Spanish
87.1
12.4
86.9
11.5
Smoke Free Start for Families Program
Acceptance Rates by Referral Source
December 1, 1997 to October 31, 2002
Source
Referred
Accepted
Percent
accepted
51
43
84
Public Health Programs
166
115
69
Private Health Care Clinics and Hospitals
128
87
68
Public Clinics and Hospitals
128
59
46
Total
473
304
64
Self/Other
Smoke Free Start for Families Program
Definition of “Quit”
Clients who have completed three or
more intervention sessions and quit
Smoke Free Start for Families Program
Self-Reported Quit Rates
December 1, 1997 to October 31, 2002
Pregnant Quit Rate
35%
Pregnant Relapse Prevention
84%
Postpartum Quit Rate
29%
Postpartum Relapse Prevention
64%
Smoke Free Start for Families Program
Program Success
• Quit rates
• Individualized, cessation interventions
• Community and provider outreach activities
Smoke Free Start for Families Program
Smoke Free Start for Families Program
Program Success
• Social marketing campaign
• Systems change at County Hospital
• Evaluation
Smoke Free Start for Families Program
Program Challenges
• Dependence on referrals from overextended
health care providers
• Client retention:
- Poverty
- Low educational attainment
- Unstable living conditions
Smoke Free Start for Families Program
Plans for the Future
• Continue intensity and efficiency of outreach
activities
• “True Decliner” follow-up
• Review of cessation protocol
• Referral source satisfaction surveys
• Expansion of program to general population with
a specific emphasis on household smokers