Maine Prenatal Collaborative
Center for Outcomes Research and Evaluation
Maine Medical Center
Principal Investigator: Susan Swartz, MD, MPH
Funding period: 1/1/03-12/31/05
Background
Target Population of Providers
Intervention Model
Evaluation Model
Documents Available for Dowload
Contact Information
Background
Maine ranks first in the proportion of pregnant women receiving early prenatal care, but also has one of the highest rates of smoking by pregnant women receiving Medicaid, at 38.2% (PRAMS data; 18.3% among all pregnant women). The Center for Outcomes Research and Evaluation of Maine Medical Center is conducting a demonstration project to improve the systematic delivery of tobacco treatments among prenatal practices. This is a collaborative project between Maine Medical Center, MaineHealth, the Maine Medicaid program, the Center for Tobacco Independence, and the Partnership for A Tobacco Free Maine (PTM), Maine's statewide tobacco prevention and control program. As the state's largest health system, MaineHealth includes 10 hospitals, a Physician Hospital Organization, and a Medical Services Organization providing administrative support to over 30 practices.
Target Population of Providers
Obstetric and Family Practice clinics from around the state will participate in the Maine Prenatal Collaborative, bringing together physician, nursing and administrative staff (Teams) for three Learning Sessions over the course of a year. Approximately 20 practice Teams will work to identify goals and objectives to improve adherence to the 2000 Public Health Service (PHS) Guidelines for Treating Tobacco Use and Dependence. Fur practices will participate in a pilot phase to identify and develop messages that resonate with clinicians and staff around delivering brief tobacco interventions.
Intervention Model
The project will implement a Clinical Practice Collaborative, with the primary objective of enhancing interventions with pregnant smokers during prenatal care. Teams will have the mutual goals of sharing information, goal setting and problem solving. Project staff will introduce the PHS Guidelines and provide technical assistance in quality improvement processes and monitoring outcomes. In the pilot phase, social marketing experts from the Sutton Group will conduct formative evaluation with the pilot practices, as well as be involved in the first Collaborative group. Emphasis will be placed on practical strategies that can be integrated into routine practice, and tracking progress in the real world of busy, complex clinical practice settings. The project aims to improve interventions by raising clinical staff self-efficacy, promoting a team approach, improving delivery system design, and using patient self-management tools.
Evaluation Model
The effectiveness of the Collaborative will be evaluated by assessing practice-level outcomes among a diverse group of clinical sites, including changes in self-reported and observed practice behavior. The Assessment of Chronic Illness Care evaluation tool will be applied to assess status of systems prior to and upon completion of the program. We will also track utilization of a Medicaid add-on reimbursement for providers delivering brief tobacco treatment intervention.
Documents Available for Download:
Maine Prenatal Collaborative Charter
Core and Optional Measures
Resources
Contact Information
Collaborative Organizational Chart
5/03 Press Release
Tobacco Treatment Flow Sheet
Roles in Tobacco Cessation
Site Visit Slides
Wave I (August '03 - July '04):
Participating Teams
Recruitment Brochure A
Recruitment Brochure B
Storyboard Suggestions
Newsletter - June '03, October '03
Monthly Team Report with Instructions
Learning Session I (September 12, 2003)
Harraseekett Inn, Freeport
Agenda
Collaborative Introduction
Nicotine Dependence
Monitoring Improvement
Model for Improvement
Action Period 1
The 5 "A's"
Case Studies - Pregnancy
Motivating Patients
References
Tobacco Use in Pregnancy
Questions and Answers
Evaluation
Learning Session 2 ( January 23, 2004)
Sheraton Inn, South Portland
documents coming soon!
Wave II (March '04 - February '05):
documents coming soon!
Contact:
Judy Soper, RT(R), RDMS, BS
Project Director
Center for Outcomes Research and Evaluation
Maine Medical Center
22 Bramhall Street
Portland, Maine 04101
Phone: (207) 871-6001
Email: soperj@mmc.org