Running head: HEALTHY PARENTS HEALTHY BABIES

Healthy Parents Healthy Babies Gerber Gang Ferris State University

HEALTHY PARENTS HEALTHY BABIES Abstract In the yearly survey done by the District Ten Health Department, Crawford County scored

significantly higher in the rate of women smoking while pregnant compared to the state average. Healthy Parents Healthy Babies is an organization formed to reduce the amount of women who smoke while pregnant and to encourage a healthy environment for the child after birth. By encouraging expecting parents to attend monthly checkups in addition to their weekly support groups, clients are not only learning to promote and live healthy lives, but also given incentive opportunities. This paper will explain the dynamics of this program including the mission, goals and objectives, required employees, and budget strategies.

HEALTHY PARENTS HEALTHY BABIES Healthy Parents Healthy Babies

Healthy People 2020 marks smoking as a leading health indicator (Healthy People 2020, 2013). This may be because there are approximately 43.8 million Americans who consider themselves smokers (CDC, 2012). Women who smoke while pregnant have higher risks associated with their pregnancies when compared to women who abstain from smoking while they are pregnant (March of Dimes, 2010). These risks include low birth rate, fetal addiction to tobacco, miscarriage, and other serious fetal health complications (March of Dimes, 2010). Smoking while pregnant is considered the number one most preventable risk factor for an unsuccessful pregnancy (Cnattingius, Lindmark, & Meirik, 1992) In a study done by the health department of District Ten, Crawford County scored below state average in the area measuring smoking while pregnancy (District Health Department #10, 2012). The rate of smoking while pregnant in Michigan in 2012 was 19.3% while Crawford County had the second highest rates in the state coming in at 47.4% (District Health Department #10, 2012). Healthy People 2020 strive for a goal of 1.4% in this category (District Health Department #10, 2012). It is evident by these numbers that Crawford County needs to take drastic measures to decrease the incidence of smoking while pregnant. Although there are some programs that exist in the state of Michigan regarding smoking cessation, Crawford County lacks a local organization that promotes smoking cessation. Through providing a program that focuses primarily on smoking cessation for expecting families may positively decrease the rates of smoking while pregnant. This countywide change could greatly improve the health of the community as a whole.

HEALTHY PARENTS HEALTHY BABIES Organization Healthy Parents Healthy Babies is an organization that focuses on promoting smoking cessation for expecting parents. This program is centered on pregnant women and their families who are current smokers. The purpose of Healthy Parents Healthy Babies is to decrease and ideally eliminate individuals smoking during pregnancy and to continue promoting that smoke

free environment after birth. Although funded by the state, this program is specific for Crawford County residents (Appendix A). After receiving a referral from their primary care physician, clients will attend an initial appointment. At this appointment, clients receive information about the organization and their expectations to receive incentives. Clients will then be required to attend weekly support groups in addition to their monthly checkups. Their eligibility for the incentives is based on their compliance and attendance. This process is displayed in Appendix A. Mission Statement To provide parents with support and increased opportunities to make healthy decisions related to smoking while pregnant. Philosophy We believe that through involvement in education and support, expectant parents will have the opportunity to take responsibility for making positive changes to develop a healthy family. By providing caring and trusting relationships, maintaining client dignity, and creating a supportive environment, this program will have a positive effect on the smoking rates during pregnancy in Crawford County.

HEALTHY PARENTS HEALTHY BABIES Goals The main goal of this organization is to decrease the number of pregnant women who smoke during pregnancy and to promote raising their child in a smoke free environment. The

basis of this goal is to decrease the rates of smoking during pregnancy in Crawford County, who records the second highest rate in Michigan. An additional goal of Healthy People Healthy Babies is to increase compliance of pre-natal care and screenings. Lastly, to ensure pre-natal education and resources are provided to expecting parents. This goal is important to make sure parents are completely aware of what is available to them and to help support them to make things as easiest as possible to provide a healthy life for their child. Objectives To reach the goals set by the Healthy Parents Healthy Babies organization, it is important to also establish objectives to meet these goals. The most important objective is to decrease the number of pregnant women who smoke from 47.4% to 30.0% in Crawford County. Meeting this objective will positively impact the health of families in this community. Another objective is to increase the compliance of prenatal care and screenings by 50%. Although smoking cessation is very important during pregnancy, it is also vital to get the appropriate prenatal care. To help ease craving from quitting smoking, nicotine patches or other alternatives will be provided to each client. The nurse will also follow up with the clients health-care provider with appropriate information to increase continuity of care. Lastly, Healthy Parents Healthy Babies will provide incentives to those families who maintain compliance throughout the program. These incentives may include diapers, bottles, gas cards, and other baby needs.

HEALTHY PARENTS HEALTHY BABIES Job Description The Healthy Parents Healthy Babies organization is comprised of one nurse educator, two registered nurses, and two secretaries. Amongst these paid employees are also volunteers

who donate their time to help run this organization. As it is important for healthcare providers to promote a healthy environment and lifestyle, a tobacco-free hiring policy was implemented. Nurse Educator Will provide ongoing education through support groups aimed at decreasing smoking in parents expecting. This education will be provided to both men and women, prenatal and postpartum, up to one year after birth. This is a part time position requiring occasional evening and weekend shifts. Approximately 15-20 hours of work are expected each week. A Bachelor of Nursing is required, although a Master of Nursing is preferred. A current Registered Nurse Licensure in the state of Michigan is also required, while an additional Certification in Perinatal Issues is encouraged. Healthy Parents Healthy Babies is requesting a minimum of three years experience, preferably in either community health or obstetrics. Registered Nurse Working as a primary health care professional working in collaboration with the primary health care providers of the clients. Tasks include doing routine check-ups on clients and babies and education regarding prenatal, nutrition, and smoking cessation information. RNs are also responsible for leading support groups and working in collaboration with the nurse educator. This position is part time, requiring 15-20 hours of work per week. A bachelor of nursing degree is required along with a current registered nurse licensure in the state of Michigan. Healthy Parents Healthy Babies is requesting a minimum of one year of experience for this position.

HEALTHY PARENTS HEALTHY BABIES Secretary Perform routine clerical and administrative functions such as drafting correspondence, scheduling appointments, organizing and maintaining paper and electronic files, or providing information to callers. Some tasks include answering phones, checking clients in and updating their contact information, and maintain electronic patient files. This is a part time position requiring 15-20 hours of work a week. Prior job experience is preferred. Knowledge in excel, word processor, and interpersonal skills. Volunteers Volunteer opportunities are available within this organization. Tasks of a volunteer may

include greeting clients, office maintenance, client support, discussing personal experiences that may be beneficial to the clients, transporting clients to appointments, and picking up donations. The hours are flexible and will be established at a month-by-month manner. Marketing Plan In order to obtain the appropriate staff for the various positions, various marketing ideas were considered. Initially, job postings will be placed in various newspapers to reach the greatest number of people. The job advertisements will reach Crawford County and surrounding areas, as well as larger cities throughout West Michigan. The initial goal is to place the advertisements in the Crawford County Avalanche as well as the Grand Rapids Press. If needed, additional locations and newspapers will be considered. In order to effectively market the open job positions, available funds must be considered. To publish a job advertisement in the Crawford County Avalanche for a Nurse Educator (Appendix B), it costs between $16 and $20 (Crawford County Avalanche, 2013). In comparison, it is much more expensive to advertise in the newspaper of a larger city. For

HEALTHY PARENTS HEALTHY BABIES instance, to publish a job advertisement in the Grand Rapids Press it costs $1500 to have the article printed one day in the paper with an additional 30 days on the website Mlive (Grand Rapids Press, personal communication, February, 3, 2014).

In addition to newspapers, the job advertisements specific to nursing will be placed in the American Nurses Association (ANA) Journal. The total price to publish a Nurse Educator position in the ANA Journal is $2,700 (American Nurses Association, 2013). This is a pricey option and the positions will not be published here unless the newspapers are unsuccessful and do not reach proper applicants. Budget There are many different areas to take into account when determining a budget for running an organization. Supplies that have been budgeted for include chairs, tables, office supplies, a computer system, computers, and phones. An initial start up cost for these supplies was budgeted at $5000, with an additional $300 each month. The budget for rent was set at $1500 monthly, with utilities included. Additionally, there will be $2500 set aside for initial advertising of the program. This may include flyers, newspaper and Internet advertisement. Each month $100 will be budgeting for ongoing advertisement. The majority of the budget contributes to the wages of the employees. With five total employees, the total budget for wages was set at $7200 a month. All positions have an FTE of 0.5, meaning all employees are working about 20 hours a week, making them part time. The nurse educator position will make $30 an hour. The two nurse positions will each make $20 an hour, leaving the two secretary positions to make $10 an hour. There will be no benefits, vacation time, holiday pay, or on call time offered.

HEALTHY PARENTS HEALTHY BABIES Government funding will be used in addition to grants to pay for this program. The government funding will be both federal and state, and will be based on participation numbers and outcomes of the county. The outcomes will be based on the district 10 health department

survey done yearly. Improvement in the numbers regarding smoking while pregnant will warrant reimbursement. The grant used to fund this program comes from the American Lung Association. The Social-Behavioral Research Grant would Provides seed monies for junior investigators working on epidemiological, behavioral or economic studies examining risk factors affecting lung health (American Lung Association, 2014). The grant assistance covers approximately 75% of the costs for this organization, with the government reimbursement covering the remaining 25%.

HEALTHY PARENTS HEALTHY BABIES Appendix A Organizational chart for Organization

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Federal Govenment State of Michigan District 10 Crawford County Healthy Parents, Healthy Babies

Organizational chart for program

Referral from primary physician or clinic

Intake assessment appointment with nurse

Monthly check-up with nurse

Weekly support group meetings

Compliance to get incentives

HEALTHY PARENTS HEALTHY BABIES Appendix B

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CRAWFORD COUNTY AVALANCHE

C
L A S S I F I E D S
REGISTERED NURSE: Seeking a caring and motivated individual whom is interested in improving the health of expecting parents and their children. Our mission is to provide parents with support and increased opportunities to make healthy decisions related to smoking while pregnant. Job Description: Leader of weekly support groups that will provide on-going education aimed at promoting smoking cessation in expecting parents. 15-20 hours per week with occasional evening/weekends. Pay rate negotiable. Job Qualifications: Education: BSN (required), MSN (preferred) Preferred certificate in prenatal issues Minimum of 3 years experience (preferably in Community Health or Obstetrics) If interested, please send resume and references to Healthy Parents, Healthy Babies. 1234 Main Street, Grayling, MI 49738. Attn: Vetka Gerba.

HEALTHY PARENTS HEALTHY BABIES References American Lung Association. (2014). Professional grant opportunities. Retrieved from http://www.lung.org/finding-cures/grant-opportunities/ American Nurses Association (2013). 2013 tan advertising rates/product rate card. Retrieved from

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http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/T AN/tanrate5784.html Centers for Disease Control and Prevention, (2012). Current cigarette smoking among adultsUnited States, 2011. Morbidity and Mortality Weekly Report 2012, 61(44): 889-894. Cnattingius, S., Lindmark, G., & Meirik, O., (1992). Who continues to smoke while pregnant?. Journal Of Epidemiology & Community Health, 46(3). 218-221. Crawford County Avalanche. (2013). Contact us . Retrieved from http://www.crawfordcountyavalanche.com/contact_us/ District Health Department #10, (2012). Crawford county health profile summary 2012. Retrieved from http://dhd10.org/images/Summary%20Crawford%20Chartbook%20April%2030%20201 3.pdf Grand Rapids Press. (2014, February 3). Personal Communication. March of Dimes Foundation, (2010). Smoking, alcohol and drugs. Retrieved from http://www.marchofdimes.com/pregnancy/smoking-during-pregnancy.aspx

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