I Care about Me: Integrating Innovative and Culturally Relevant Messaging Strategies for African American and Hispanic First-Time Parents

Background:

A multimedia and community engagement campaign was launched for the DC Department of Health (DC DOH) based on the need to educate African-American and Hispanic women, men, and first-time parents about behaviors associated with high-risk pregnancies. Despite drops in the infant mortality rate in the District, there is a need to continue public education efforts to shift behavioral norms. According to the DC DOH 2011 Infant Mortality Rate Report, the overall infant mortality rate (IMR) in the District is at 7.4 per 1,000 live births (69 of 9,289 children born in DC in 2011), a 43.5% decline since 2007 and a historic low for the District. The IMR for African-American mothers is 11.6 per 1,000 live births, a 31.8% decrease since 2007. The IMR for Hispanic mothers is at 5.2 per 1,000 live births in 2011. Several factors contributed to the District’s 2011 reduction in infant mortality, including the following:

• An 86.3% reduction in smoking among pregnant women
• Expansion of, and increased access to, the District’s primary-care prenatal services
• An 8.6% reduction in teen births in the District

Program background:  In 2012, DC DOH launched a media campaign that aimed at first-time mothers and fathers to increase awareness about the benefits and services available for preconception health as a means of increasing positive pregnancy outcomes.  A multimedia public information campaign was launched, I Care About Me.  Risk reduction messaging was integrated into traditional and social media strategies focused on nutrition, alcohol intake and fitness.  

Evaluation Methods and Results:  Formative reasearch revealed amongst first-time fathers:

• A lack of awareness or education about available services
• Fear and stigma of asking for help
• Not having a good relationship with the baby’s mother
• Growing up with the notion of only going to the doctor when absolutely necessary
• The stress of unemployment and child support take priority over health 

First-time mothers who participated in the research revealed that there was some hesitancy in accessing services in their immediate neighborhood given the economic stigma associated with unwanted pregnancies. For some mothers, their pregnancy became a status symbol bringing an escape from their challenging immediate surroundings. This paradox generated an interesting communications challenge. Messaging strategies were created based on results from focus groups and individual in-depth interviews with stakeholders and consumers.  I Care About Me was launched with a comunity engagement and social media strategy that had an immediate impact on drawing much attention to a health priority for the District.

Conclusions:  Evaluation data reveal a stong message saliency with the target audience.  Consumers were engaged through a Twittter campaign, story placement on an online soap opera, and local celebrity endorsements.  Transit/cinema ads and special events were executed that fueled a high level of community partner engagement.  The need for culturally relevant messaging strategies was well established by the formative research and the ongoing evaluation activities.

Implications for research and/or practice:  The practice and research of the media campaign reinforce the need  to develop messaging strategies that are culturally and peer driven for preconception health.  The second phase of the campaign warrants research.