Imagine
Smoking during pregnancy -low birth weight -oral hygiene -cancer mortality
There are many different groups in the community that are affected by this higher incidence of smoking while pregnant. Since smoking in itself is at a higher incidence in Manistee county, 32.7%, compared to the 20.3% instance of the state of Michigan and the 7.8% incidence goal of Health People 2020, a larger portion of this county is affected in some way by this problem .When advising plans and techniques to provide knowledge and promote smoking cessation seminars and help decrease the smoking incidence, the focus will be for all smokers not just smoking during the course of pregnancy . This categorizes all smokers in Manistee as part of the group affected by this health problem. The more obvious group affected is the pregnant mother, the fetus, the family and friends of the pregnant mother, and all others that are in someway connected to each pregnancy. “23% of white women reported smoking during pregnancy compared with 18% African American and 12% Hispanic. (milhs.org)” in the state of Michigan, putting this race at a slightly higher risk when comparing the other two races inscidences of smoking during term. The minority groups, black (2.9%) and American indian (2.1%), which put the fetus at a higher risk for low birth weight automatically, are also affected by the higher rates of smoking because their risk becomes even more increased than it already is. “Babies born to African American mothers continued to have double the risk of being born at low-birth weight (14%) compared with whites (7%) or Hispanics (7%) (milhs.org)”, http://www.milhs.org/wp-content/uploads/2012/04/RSwithAppendix.pdf

There are an array of different facilities in Manistee county in which smoking cessation clinics and resources can be found, brochures and information on the dangers of smoking, preventative or cessation tools and products on smoking, and direct resources, such as health professionals and support people, can be found and utilize to address this problem.

A1 Nursing Services, Theres No Place Like Home, Manistee Family Health Care, Friends Who Care, Carelinc Home Medical Equipment & Supply, Lakeshore Home Health Care, West Shore Medical Center, Little River Bend Health Center

The main hospital, West Shore Medical Center, does provide community health programs pertaining to pregnancy which include childbirth and breast feeding education classes multiple times a month (http://www.westshoremedcenter.org/wellness/community.php). Manistee county also has an easy to use, free to the user, phone number 2-1-1, that links callers to specialist that can help get connected with whichever health service the caller needs.( http://www.allianceforeconomicsuccess.com/quality-of-life-health-human-services.html) This 211 number provides citizens with human services that seek to alleviate whatever health concern the caller has and is available 24 hours a day, 365 days a week.

There are programs implemented throughout the country to educate people about pregnancy . The focus of these programs and ability to coordinated with other programs that may need to be stressed more like smoking cessation could be connected more. The problem lies in the knowledge of
The statistics of smoking during pregnancy, Manistee more than doubles Michigan’s instance of smoking during pregnancy at 39.9% compared to Michigan’s rate of 18.2%, is the most important evidence for the need of nursing intervention at the community level.

How does smoking during pregnancy compare to district 10, Michigan, and healthy people 2020
Health indicators: low birth weight: Michigan: 8.5%, Manistee 9.6%; HP2020: 7.8%
Health behaviors: smoking: Michigan: 20.3% - Manistee: 32.7% HP2020: 12.0% Smoking during pregnancy: Mi: 18.2% - Manistee: 39.9% HP2020: 1.4%

What factors contribute to the identified difference: Lack of health care access and lack of primary care physicians compared to population (2051:1 compared to Mi 874:1. (perception that smoking is alright since it’s frequency is higher)

Model: Health belief Model

Who is affected: Pregnant mother and fetus?

What can we do to help fix this problem: Mail information related to the dangers of smoking while pregnant and smoking cessation information? Provide them with information on support services.

Likely partners: Health department, doctors offices, school systems, womens health clinic, WIC possible barriers: Smoking in general is high, smoking for days (shops), resistance, cost for getting help.

Problem Statement:

Who: pregnant women and fetus
What: Smoking during pregnancy
What indicators: Fewer smoking during pregnancy, potentially higher birth weights (lowering the stats on low-birth weight)

What existing resources are available to address this problem? Are they adequate? If so, why is there
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13 still a problem? What evidence indicates that this problem is appropriate for community nursing intervention? What other disciplines would be involved in addressing this problem? What community groups could be resources in addressing the issue?
 Key data clearly summarized.
 All resources correctly sourced
 Appropriate model/theory used
 What are strengths of community indicating likelihood of successfully addressing problem?
 What existing agencies are likely partners?
 What possible barriers are there?
 Does the analysis focus on a population?