Go Before You Show: A social marketing campaign to reduce disparities in timely prenatal care in a Medicaid population

Birth certificate and HEDIS data revealed that Health Plan of San Mateo's Medicaid members demonstrated ongoing disparities in timely onset of prenatal care. In 2008-2009, Caucasian women's rate of starting care in the first trimester was 93%; Latina and African-American women's rates were 82.6%, while Pacific Islander women's rate was 66.6%. Pregnant member survey data indicated near universal agreement that early prenatal care was important, but demonstrated a lack of understanding of what was “early.” Difficulty grasping how to obtain Medicaid was also a frequent complaint. We formed a collaborative with the county health department and agencies, community based organizations and clinics, giving us insight and feedback on our messages. We targeted two groups: teens/new moms, and experienced moms, pregnant with their second or greater child. Colorful, culturally sensitive images, focus-tested with specific community groups, helped us tailor our message to each group with disparities in timely onset of prenatal care. We proceeded to roll out a community-wide social marketing campaign aimed at encouraging women to “Go Before You Show.” We developed a toll free number and web site, produced brochures and posters, and used bus ads, movie theater ads and a billboard to get our message to the community. By 6 months, we had distributed over 25,000 brochures and 3,000 posters. We also emphasized the availability of “temporary Medicaid” when pregnancy is diagnosed. This led to a five fold increase in applications for this program within six months after our campaign began. We hope to see HEDIS improvement next.