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Esther Maki, RN, MS, PHN, CHES May 15, 2008 Minnesota Department of Health  Alcohol Exposed Pregnancy Prevention Project Funded by the Centers for Disease Control     Reducing Harm to Minnesota Women  Who Drink Too Much :  The Smart Women Smart Choices Program University of Minnesota  Powell Center for Women’s Health  3 rd  Annual Women's Health Nursing Conference
Presentation Objectives ,[object Object],[object Object],[object Object],[object Object]
“ The impact of two drinks on a man  is roughly equivalent  to one drink on a woman.” Center on Addiction and Substance Abuse,  2006  Women and Problem Drinking
Minnesota  Women’s Drinking ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rise in College Women’s  Binge Drinking  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Women’s Alcohol Related  Preventable Risks ,[object Object],[object Object],[object Object],[object Object],[object Object]
Preventable Health Risks Unintended Pregnancy and FASD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Need for Effective Interventions  for Risk/Problem Drinking  Problem Drinking Research   Sobell, LC and Sobell, MB.  Problem Drinkers: Guided Self-Change Treatment, 1996. New York, NY: Guilford Press .
Defining   Risk/Problem Drinking   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Binge Drinking is “Dangerous” Drinking ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Distribution of Alcohol Use  in Adults Sobell, LC and Sobell, MB.  Problem Drinkers: Guided Self-Change Treatment, Guilford Press,  New York, NY 1996.
Drinking and Young Adults Ages of 18 and 29 years.   ,[object Object],[object Object],[object Object],[object Object],[object Object],NIAAA , January 2008
Problem Drinkers  Are Not Alcoholics ,[object Object],[object Object],[object Object],[object Object],[object Object],Risk/problem drinkers do not fit criteria  For chemical dependency treatment
Problem Drinkers May be open to Self-Change ,[object Object],[object Object],[object Object],Problem drinkers do not self-identify  as alcoholic and are likely to resist suggestions for addiction treatment services.   S obell, LC and Sobell, MB, 1996
The Need for New Approaches ,[object Object],[object Object],[object Object],[object Object],[object Object]
Reasons Women Are  Not Screened or Counseled for Alcohol Use ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alcohol Exposed Pregnancy  Prevention Project Minnesota Department of Health Funded 2003-2008 through a Cooperative Agreement with the Centers for Disease  Control and Prevention  National Center on Birth Defects and  Developmental Disabilities
Alcohol Exposed Pregnancy  Prevention Project Goals ,[object Object],[object Object],[object Object]
CDC Behavior Change Intervention  to Prevent Alcohol Exposed Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object]
CDC Intervention  Based on Alcohol Treatment Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CDC AEP Intervention  Based on Alcohol Treatment Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alcohol Treatment Research   Guided Self-Change Treatment ,[object Object],[object Object],Sobell LC and Sobell MB, 1996 “ Motivation for change occurs when people  perceive a discrepancy between where they are and  where they want to be.” ,[object Object]
[object Object],[object Object],[object Object],[object Object],Components of Guided Self-Change Sobell LC and Sobell MB, 1996
Adapting the Intervention  for Minnesota Women Minnesota Department of Health  Research Findings
Minnesota Women  Formative Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Key Findings and Challenges   Sexual Activity and Birth Control Use ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Key Findings and Challenges   Alcohol Use
Key Findings and Challenges   Linked Drinking and Sex ,[object Object],[object Object],[object Object],[object Object],Minnesota Statewide Woman MN Department of Health Focus Group, 2005
Key Findings and Challenges   Campus Drinking Norms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Key Findings and Challenges   Women’s  Perception of Risks Source: Women’s personal surveys completed at focus group sessions. 37% 23% —  34% 38% 12% 16% NA 29% 72% 61% 61% 61% 45% 45% 45% 39% NA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Statewide (N= 38) College (N= 18) I worry some or a great deal about:
Key Findings and Challenges Perceived No Risk or Need for Change ,[object Object],[object Object],[object Object],[object Object]
Key Findings and Challenges Knowledge and Risk Perception ,[object Object],[object Object],[object Object],[object Object]
What College Women Said Would Work There are places that deal with drinking.  There are places you go for birth control.  There are plenty of both... So the combining of the two is the only thing that really makes the program .“ Minnesota College Woman   MN Department of Health Focus Group, 2005
Who Needs Information  About Drinking and Contraception on Campus ,[object Object],[object Object],[object Object]
Focus Group Findings   Liked Media vs. Face-to-Face Delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Minnesota College Women MN Department of Health Focus Group, 2005
Focus Group Findings   Mad About Self Rated Quizzes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Minnesota College Woman MN Department of Health Focus Group, 2005
Application of Focus  Group Findings  Designing and Delivering  a Self-Change Program  for College Women
[object Object],[object Object],[object Object]
What is the Program Smart Women Smart Choices? ,[object Object]
What is the Program Smart Women Smart Choices? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is the Program Smart Women Smart Choices? ,[object Object],[object Object],[object Object],[object Object]
Program Development Decisions Program Content ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Minnesota College Woman MN Department of Health Focus Group, 2005
Program Development Decisions Program Marketing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices Benefits to Women ,[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Women  Eligible ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Women  Ineligible ,[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices Program Steps   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Program Steps ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Incentive Gift Cards ,[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Measuring Success ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Outcomes:  Women Followed-up ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],March 2007 to April 15, 2008
Smart Women Smart Choices   Behavior Change ,[object Object],[object Object],[object Object],[object Object],[object Object],16 out of 19 completes
Smart Women Smart Choices   Change in Frequency of Risk Drinking ,[object Object],March 2007 to April 21, 2008 ,[object Object],[object Object]
Shifts in Knowledge & Readiness to  Change Drinking ,[object Object],March 2007 to April 21, 2008 ,[object Object],[object Object]
Smart Women Smart Choices   Participant Comments ,[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Participant Comments ,[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices   Participant Comments ,[object Object],[object Object],Program Participant, August 2007
Program Promotion  and Marketing
Challenges  College Women See No Need for Change ,[object Object],[object Object],[object Object],[object Object],[object Object]
Motivate Women to and Enroll ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Naming the Program & Website ,[object Object],[object Object],[object Object],[object Object]
Website iPartySmarter.com http://www.ipartysmarter.com /
Smart Women Smart Choices   Program Promotion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Website Designed  to Increase Risk Perception
Redefine Binge/Risk Drinking ,[object Object],[object Object],[object Object],[object Object],[object Object]
Focus Group Recommendations Use a Thought Provoking Risk Message ,[object Object],[object Object]
Deliver Message with Humor ,[object Object],[object Object],[object Object],[object Object]
Posters & Facebook Ads
Smart Women Smart Choices   Campus Media Ads ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Integrating Self-Guided Change (SGC) into Primary Care Practice  Smart Women Smart Choices
The Promise of Integrating SGC Interventions into Primary Care Settings ,[object Object],[object Object],[object Object],[object Object]
Integrating SGC for  Problem Drinking into Practice Setting ,[object Object],[object Object],[object Object],[object Object]
Supporting Providers to Integrate  SGC for Problem Drinking  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Free  Provider Education ,[object Object],[object Object],American College of Obstetricians and Gynecologists and the Centers for Disease Control http://www.cdc.gov/ncbddd/fas/acog_toolkit.htm Clinical Tools, Inc. Supported by the American Society of Addiction Medicine (ASAM)  www2.tobaccocme.com/TopicReq?id=749 ,[object Object],[object Object]
Helen Hayes “ Childhood is a short season. The hardest years in life are those between ten and seventy!”
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Minnesota Department of Health AEP Prevention Project Staff ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices Adaptation/Development Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Smart Women Smart Choices Adaptation/Development Team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
References  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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About A Science-Based Multimedia Behavior Change Program

  • 1. Esther Maki, RN, MS, PHN, CHES May 15, 2008 Minnesota Department of Health Alcohol Exposed Pregnancy Prevention Project Funded by the Centers for Disease Control Reducing Harm to Minnesota Women Who Drink Too Much : The Smart Women Smart Choices Program University of Minnesota Powell Center for Women’s Health 3 rd Annual Women's Health Nursing Conference
  • 2.
  • 3. “ The impact of two drinks on a man is roughly equivalent to one drink on a woman.” Center on Addiction and Substance Abuse,  2006  Women and Problem Drinking
  • 4.
  • 5.
  • 6.
  • 7.
  • 8. The Need for Effective Interventions for Risk/Problem Drinking Problem Drinking Research Sobell, LC and Sobell, MB. Problem Drinkers: Guided Self-Change Treatment, 1996. New York, NY: Guilford Press .
  • 9.
  • 10.
  • 11. Distribution of Alcohol Use in Adults Sobell, LC and Sobell, MB. Problem Drinkers: Guided Self-Change Treatment, Guilford Press, New York, NY 1996.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. Alcohol Exposed Pregnancy Prevention Project Minnesota Department of Health Funded 2003-2008 through a Cooperative Agreement with the Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. Adapting the Intervention for Minnesota Women Minnesota Department of Health Research Findings
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34. What College Women Said Would Work There are places that deal with drinking. There are places you go for birth control. There are plenty of both... So the combining of the two is the only thing that really makes the program .“ Minnesota College Woman MN Department of Health Focus Group, 2005
  • 35.
  • 36.
  • 37.
  • 38. Application of Focus Group Findings Designing and Delivering a Self-Change Program for College Women
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59. Program Promotion and Marketing
  • 60.
  • 61.
  • 62.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.
  • 70.
  • 71. Integrating Self-Guided Change (SGC) into Primary Care Practice Smart Women Smart Choices
  • 72.
  • 73.
  • 74.
  • 75.
  • 76. Helen Hayes “ Childhood is a short season. The hardest years in life are those between ten and seventy!”
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83.