Go Before You Show
Health Plan of San Mateo &
San Mateo County Health System Family Health Services Division
Mary D. Giammona, MD, MPH and Liliana Ramirez, MPH
A disparity in timely entry into prenatal care exists among
Latina, African-American and Pacific Islander compared
with Caucasian women in San Mateo County. There is a
lack of awareness about presumptive eligibility
(PE)/temporary Medi-Cal among women in the
First Intervention We Tested:
Our Prenatal Social Marketing Committee had made efforts
to increase community awareness of temporary Medi-Cal
by developing a brochure on how to access prenatal care
for women without insurance. Although temporary MediCal was promoted, the committee felt more needed to be
San Mateo County statistics show that the proportion of
births in the county with adequate and timely prenatal
care is below the Healthy People 2010 target of 90%, thus
10% do not receive timely care. San Mateo County data
indicate that Latina (17.4%), African American (17.4%)
and Pacific Islander women (33.4%), have the highest
percentage of births without timely prenatal care in
comparison to Caucasians (7.7%).
Goals and Objectives
HPSM and San Mateo County intended to increase the
rate of timely entry into prenatal care by at least 5% in
2011 for Latina, African-American and Pacific Islander
women to decrease the health disparity that exists in
these communities; to be done by educating women
about accessing timely prenatal care through the
promotion of the Go Before You Show campaign.
Increase awareness about importance of timely
prenatal care in San Mateo County.
Increase timeliness of prenatal care among Heath Plan
of San Mateo (HPSM) members.
Improve HPSMs Timeliness to Prenatal Care 2011
HEDIS rates to 80% for the groups above, identified with
How We Tailored Care with New Intervention:
Developed the Go Before You Show campaign,
Redesigned the temporary Medi-Cal brochure,
Developed posters targeting Latina, African-American and
Pacific Islander women,
Created toll-free line, website, bus ads, movie theater ads,
a billboard, and grass roots outreach within community
agencies all focused on message of Go Before You Show.
What We Measured:
Distribution of materials--Quantity
Change in Enrollment into PE/temporary Medi-Cal numbers
Number of calls to toll-free number
Number of women enrolled in HPSM Prenatal Care Program
who started care in 1st trimester
What We Found:
Approximately 20,000 brochures and 2,000 posters were
distributed within San Mateo County.
We saw a notable increase in the number of presumptive
eligibility enrollments at the PE provider offices. We
collected PE enrollments from 6 provider offices precampaign and saw the overall enrollment double in
The 2011 HEDIS rate for Timeliness of Prenatal care (83%)
dropped slightly overall compared to 2010 HEDIS rate
(85%); however, data showed that, women who started
prenatal care in first trimester by ethnicity increased for:
Asian/Pacific Islanders (84% vs 66.6%); it stayed about the
same for African-Americans (81% vs 82.6%), and decreased
for Latinas for unclear reasons, which we will continue to
pursue (75% vs 82.6%).
HPSM and San Mateo County are committed to ongoing spread
of the Go Before You Show campaign and also work with
community clinics to encourage timely entry into prenatal care.
Our Prenatal Social Marketing Committee will continue to
distribute materials to clients through grass-roots outreach
We are currently developing a campaign specifically targeting
Tongan and Samoan women, where there still seems to be a lag
in timeliness to entry to prenatal care. This campaign should be
ready to launch in Fall 2011.
1)The most significant lesson learned was how powerful and
effective community collaborations can be. The support of all
the members of our Prenatal Social Marketing Committee led
to an extremely successful grass roots outreach effort in each
of the communities with disparities.
2) Ads inside buses generated the most response. The least
successful marketing effort for HPSM members was through
the movie theater ads; however, we do not know how much
of an impact that may have had on the general public.
We look forward to further analysis of our results, as more data
The Health Plan of San Mateo (HPSM) is a non-profit managed care health plan
that has provided health coverage to San Mateo Countys underserved
residents since 1987. Currently, HPSM has approximately 102,000 members
with 42% of the total membership identifying Spanish as their preferred
language. HPSM improves the health of our members through high quality and
preventive care. We have a vision, that healthy is for everyone.
The Family Health Services Division is part of the San Mateo County Health
System whose mission is to increase the longevity and quality in peoples lives
by preventing health issues before they occur, protecting the publics health,
providing services for vulnerable populations and partnering to build healthy
For more information, contact me:
Liliana Ramirez, MPH
650-616-0050 [email protected]
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