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Reducing Tobacco Use in Pregnancy in YK Delta Women

Program Type: Promising Practice -Programs not formally evaluated (or formal evaluation is not yet complete) but identified by experts as programs with results suggesting efficacy and worthy of further study in broader pilot implementation efforts.

From August 2009 through July 2012, using a culturally relevant education intervention, the Yukon Kuskokwim Health Corporation [YKHC] focused on increasing awareness of the harmful effects of tobacco on personal and fetal health in order to reduce the prevalence of tobacco use among pregnant Alaska Native women in the Yukon Kuskokwim Delta. In 2007, the Alaska Department of Health and Social Services [ADHSS] reported that 46 percent of Alaska Natives in Southwestern Alaska were tobacco users compared to 42 percent statewide. ADHSS also reported at that time that 20 percent of pregnant Alaska Native women in the region smoked cigarettes compared to 28 percent statewide, but that relationship inverts when looking at smokeless tobacco usage with 47 percent of pregnant Alaska Native women in the region using compared to just 18 percent statewide.2 The overarching goal of the YKHC project was to reduce the prevalence of any tobacco use in the last three months of pregnancy among Alaska Native women to less than 30 percent in three years.Program activities included communications through the development and distribution of culturally appropriate direct mail to all pregnant women living in the region, anti-tobacco literature from other organizations placed in clinics and hospital, anti-tobacco posters placed in 58 area high schools using slogans developed for teens by teens, and posters displayed in local newspapers promoting tobacco abstinence among local women and teens. Two new radio ads were created each month using local personalities and produced in Yup’ik and English airing twice daily on the local radio station. Women were also presented information on the risks of tobacco use during group classes. Resources were shared with health care providers to facilitate screening for tobacco use and for making referrals to tobacco cessation counseling. Referrals to counseling and nicotine replacement therapy offered through the hospital were also made by the program counselor. Data were collected using anonymous surveys of pregnant women staying in the pre-maternal home and by surveying a sample of pregnant Alaska Native women who did not stay at the pre-maternal home. Program/Activity Outcome The program almost reached its goal of reducing tobacco use among pregnant Alaska Native women to less than 30 percent. By the end of the third year, the program saw that rate reduced from 47 percent to 32 percent. In addition, the program achieved the following outcomes: Reducing Tobacco Use in Pregnancy in YK Delta Women. Through the surveys conducted, YKHC found that more than 90 percent of women in the Delta were aware of the harmful effects of tobacco use. The program increased the percentage of pregnant women who receive cessation counseling from 10 percent in the first year to 21 percent by the end of the third year. The surveys conducted also allowed program staff to measure the extent of their marketing efforts by asking pregnant women about their exposure to fliers, posters, and radio ads. The results of the program also indicate that partnerships with other organizations in the community improved the conditions for success, and leveraging existing programs proved an effective approach

Age Group(s):

Site Type(s):

Health Indicator(s):
Tobacco Use

Service Area:

Tobacco cessation

Overall Cost: $100,000.00

Name: Laura Ellsworth
Site or Location Name: Yukon-Kuskokwim Health Corporation
P.O. Box 528
Bethel, AK 99559
Phone: 907-543-6193