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Leveraging Action to Support Dissemination of the Pregnancy Weight Gain Guidelines: Workshop Summary (2013)

Chapter: 6 Presentation on the First Thousand Days Program

« Previous: 5 Session 3: Implementing the Guidelines
Suggested Citation:"6 Presentation on the First Thousand Days Program." Institute of Medicine and National Research Council. 2013. Leveraging Action to Support Dissemination of the Pregnancy Weight Gain Guidelines: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18410.
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Page 55
Suggested Citation:"6 Presentation on the First Thousand Days Program." Institute of Medicine and National Research Council. 2013. Leveraging Action to Support Dissemination of the Pregnancy Weight Gain Guidelines: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18410.
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Page 56

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6 Presentation on the First Thousand Days Program Patrick Catalano introduced the next speaker, Richard Sass. Sass founded the Contact Wellness Foundation as his personal contribution to health care reform, reflecting his desire to move beyond his previous work in the delivery of innovative medical products to the creation of motivational tools leading to positive health behavior changes. RICHARD SASS, CHAIRMAN, CONTACT WELLNESS FOUNDATION The First Thousand Days program, which focused on children from conception through 2 years of age, includes a wellness algorithm and is based on the relatively new science of the developmental origins of health and disease. If the fetus is biologically programmed by the mother from the very point of conception, then it is all the more urgent to direct pregnant women who are at risk of diabetes, obesity, and other chronic conditions into preventive care as early as possible. Compared with the standard prenatal protocol, the First Thousand Days protocol increases both the frequency and the duration of time a woman is involved in prenatal care. The standard prenatal protocol consists of 11 10-minute visits; the First Thousand Days protocol calls for an additional 40 hours of visits. Using a mental health promotion approach, the program encourages each pregnant woman to assemble her own small group of six or eight people, which might include her mother, 55

56 DISSEMINATION OF THE PREGNANCY WEIGHT GAIN GUIDELINES grandmothers, husband or significant other, neighbors, or friends, and would meet weekly in a loving and supportive atmosphere to talk about weight gain and other health-related goals and objectives. To the extent that the group is successful in encouraging the woman to improve her metabolic function, normalize her glucose, exercise more, and make healthy behavioral choices, it can help set the stage for a healthy pregnancy and a healthy baby. The proposed protocol has three additional elements: (1) a facilitator for the group, who would meet with the group initially and then be available by cell phone and e-mail; (2) a toolkit that includes glucose monitoring, A1C monitoring, resources for calculating and tracking BMI and blood pressure measurements, and other tools to help the pregnant woman monitor her progress throughout her pregnancy; and (3) a $1,000 529 education savings plan for the baby as an incentive to motivate the mother to reach her goals for her 40 weeks of pregnancy. The money in the plan would be available for the child to use for higher education or vocational school. The Contact Wellness Foundation is seeking funding for the project from foundations and other sources, including Wall Street. The ultimate goal of the project is to develop a large demonstration across an entire state, which could be marketed to the rest of the country as a for-profit activity through the sales of the toolkit and social impact bonds.

Next: 7 Session 4: Collaborating for Action »
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Since 1990, when the last guidelines for weight gain during pregnancy were issued, the average body weight of women entering their childbearing years has increased considerably, with a greater percentage of these women now classified as overweight or obese. Women of childbearing age are also more likely to have chronic conditions such as high blood pressure or diabetes and to be at risk for poor maternal and child health outcomes. All of these factors increase the likelihood of poor pregnancy outcomes for women and their infants. As part of the continuing effort of The Institute of Medicine (IOM) and the National Research Council (NRC) to promote the revised pregnancy weight gain guidelines recommended in their 2009 study Weight Gain During Pregnancy: Reexamining the Guidelines, the IOM and NRC convened a workshop in March, 2013, to engage interested stakeholders, organizations, and federal agencies in a discussion of issues related to encouraging behavior change that would reflect the updated guidelines on weight gain during pregnancy. During the workshop, the IOM and NRC presented newly developed information resources to support guidance based on the recommendations of the 2009 report.

Leveraging Action to Support Dissemination of the Pregnancy Weight Gain Guidelines summarizes the workshop's keynote address and the various presentations and discussions from the workshop, highlighting issues raised by presenters and attendees. Interested stakeholders, organizations, health professionals, and federal agencies met to discuss issues related to encouraging behavior change that would reflect the updated guidelines on weight gain during pregnancy. This report discusses conceptual products as well as products developed for dissemination, ways to facilitate and support behavior change to achieve healthy weight pre- and postpregnancy, and how to put the weight gain guidelines into action to implement change.

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