Since its inception in 2001, the Wisconsin Women’s Health Foundation’s (WWHF) First Breath program has helped thousands of pregnant and postpartum people in Wisconsin reduce or quit smoking tobacco and helped them quit alcohol, cannabis and other substances.
With grant funding from the University of Wisconsin School of Medicine and Public Health’s Wisconsin Partnership Program, First Breath continues to grow and adapt to meet the evolving needs of the people it serves.
While policy and social changes have greatly reduced smoking rates overall, some groups have not benefited as much. There are still gaps in smoking cessation rates among certain populations, explained Danielle McCarthy, PhD, professor of medicine at the UW School of Medicine and Public Health and academic partner on the project.
“Tobacco use is now concentrated among populations experiencing socioeconomic disadvantages,” McCarthy said. “One of the really important things about First Breath is that it serves pregnant and postpartum people in groups that haven’t benefited from all of the gains in tobacco cessation.”
Since First Breath began 25 years ago, the Wisconsin Women’s Health Foundation program has evolved. Recognizing that other health issues complicate the process, support for quitting alcohol and other drugs was added to the topics covered by First Breath health educators. In 2018, an initial grant from the Wisconsin Partnership Program helped the First Breath program expand its geographic reach.
There are currently First Breath health educators located around the state, near Chippewa Falls, Marinette, Milwaukee and Madison. They work with a network of 1,400 trained providers at about 300 clinics around Wisconsin, who refer pregnant and postpartum patients who want help quitting tobacco and other substances. The health educators offer intensive support to about 400 women a year who are ready to reduce or quit smoking, and less intensive support to many more who are thinking about reducing their use.
“Eventually a lot of them do end up quitting what they’re using because of the support they’re getting,” said WWHF program director Tessa Vance. “They realize that they can do hard things. The consistent support component of the program really is impactful, because a lot of people don’t have much social support when they come into our program, so we are able to provide that support piece, as well as connection to additional resources and services they may need.”
But participants have asked for more long-term support for behavioral health issues that often underlie the use of alcohol, tobacco and other drugs. Now, a second Community Impact Grant from the Wisconsin Partnership Program is helping First Breath pilot a program to offer mental health support to participants.
Through Bridging Gaps in Perinatal Care: A First Breath Pilot Addressing Substance Use and Mental Health, First Breath health educators will be able to provide participants with education around mental health, teaching them how to advocate for themselves and connecting them with services that they may not know they are eligible for. The counseling is designed as a bridge to help connect participants with more long-term mental health care.
“Navigating mental health services can be really tricky at any education level,” Vance said, “and even more so if you have lower health literacy.”
McCarthy, the grant’s academic partner, will help design evaluations to determine if the mental health program is effective and to gather participants’ feedback, a hallmark of the First Breath program since it began.
This grant allows us to pilot and implement a mental health support component of the program that participants and providers have been asking about for years.
- Tessa Vance, Wisconsin Women’s Health Foundation program director
McCarthy said that building mental health support into the program is the next logical step. “First Breath has gone through an iterative process to identify unmet needs and expand the scope and services to meet those needs,” McCarthy said. “It started focusing on tobacco use just during the prenatal period, then demonstrated through rigorous research that adding postpartum care helps reduce postpartum relapse rates, and so that became part of the core program.”
“Next they realized other substance use is a huge barrier to quitting smoking, so they integrated those services, and now behavioral health is being added.”
Vance said participant feedback guides the changes that First Breath makes in its programs. “This grant allows us to pilot and implement a mental health support component of the program that participants and providers have been asking about for years,” Vance said.
Sometimes participants’ feedback comes in the form of baby pictures and heartwarming holiday cards. “Last year, before the holidays, we had someone send in their success story, and there was a picture of a puppy,” Vance said. “She said she’d been working for three years to cut down on smoking, and with the money she saved quitting tobacco, she got her kids a puppy.”
Wisconsin Women’s Health Foundation was founded nearly 30 years ago by former Wisconsin first lady Sue Ann Thompson. Today it serves about 7,000 women every year in all 72 Wisconsin counties.
