Today Is For Me. Using Research to Influence Behavior In Maternal Alcohol and Marijuana Consumption

Background: Unintended pregnancies are associated with many negative health and economic consequences. In New Hampshire (NH), 41% of pregnancies were unintentional or not planned (UI/NP) (2015), 68% of women reported drinking alcohol three months before pregnancy, and 10% in the last three months of pregnancy. Nationally, the proportion of admissions of pregnant women who report marijuana use is on the rise. Substance misuse poses significant health risks to childbearing-aged women and their un-born children; over 1/3 of all pregnant women reported that they did not receive information from their healthcare provider about the effects of illicit drugs on their baby. Research in NH females aged 18-44 sought to understand: knowledge, attitudes and practices (KAP) towards alcohol and marijuana use in general and during pregnancy (IG/DP), perception of harm of use IG/DP, self-efficacy of quitting alcohol or marijuana use during pregnancy, lifestyle characteristics of women possessing a low perception of harm of use during pregnancy, and demographic differences by use each of each substance. In order to inform a state-wide campaign to change behavior.

Program background: Literature review (25 articles) & environmental scan; terms: media, social marketing, health communication, and health education campaigns; health messages; pregnancy; women of childbearing age; women; marijuana and alcohol; a scan of current campaigns on pregnancy and marijuana use, pregnancy and alcohol use; review of new and emerging research. A statewide, online survey among 300 women aged 18-44 in NH was conducted to understand KAP. Statewide online survey of 250 women to tests messaging and creative. This resulted in a digital campaign results TBD, June 2019.

Evaluation Methods and Results: Messaging will be tested that emphasizes: 1) the health of the developing fetus, 2) the autonomy of pregnant women, and 3) self-efficacy. Previous alcohol/pregnancy messaging has made an impact. Preliminary engagement results show positive reactions to the campaign: engagement, interaction, return-visitation, increased knowlage.

Conclusions: Alcohol and marijuana use varied by age groups. Women who use alcohol and marijuana are not necessarily the same women who use either alcohol only or marijuana only. Many women engage in substance use when they are unaware they are pregnant/are not planning to become pregnant. Survey respondents were divided by like/dislike of the fetus first/autonomy messages.

Implications for research and/or practice: The Today Is for Me campaign is a catalyst to motivate women to make healthy, intelligent choices and decisions about behaviors impacting their health in general and their pregnancy specifically. The campaign emphasizes pregnancy and substance use do not mix. Avoiding all types of alcohol and marijuana throughout the whole pregnancy is the best way to prevent complications. Through a strategic mix of print materials and social media channels, women in NH received messaging encouraging them to visit the website for personal stories about staying healthy during pregnancy and to speak with their providers early about substance use. Healthcare providers will also receive resources to initiate open and honest discussions with their patients about substance use before, during and after pregnancy.