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Pregnant & Breastfeeding Women: Understanding Audience

Motivations & Crafting Prevention Messaging

Sophia Lerdahl, Director of Strategic Initiatives Rescue Agency

2019 North American Cannabis Summit 2

OUR CHALLENGE

COMMUNICATING COMPELLING HEALTH RISKS IN THE AGE OF CANNABIS LEGALIZATION


10 Recreational, 33 Medical


https://www.businessinsider.com/legal-marijuana-states-2018-1

Concerns Over Perception of Risk


https://www.tandfonline.com/doi/abs/10.3109/15563650.2015.1004581

https://health.ucdavis.edu/publish/news/newsroom/11707

Search and You Shall Find


Search and You Shall Find


Research With Pregnant & Breastfeeding Women

Online Survey‒ N = 1,636‒ Substance use

not screened for


Focus Groups‒ N = 76‒ Multi-lingual‒ Past 12-month

marijuana use

Interviews‒ N = 10‒ Multi-lingual‒ Past 12-month

marijuana use

INSIGHT #1

Not all pregnant & breastfeeding women are at equal risk for marijuana use




of participants have used marijuana in the past 12 months

of participants have used marijuana in the past 30 days

of pregnant participants have used marijuana in the past 30 days

of breastfeeding participants have used marijuana in the past 30 days

32% 21% 25% 18%

Screen survey included question into previous marijuana use. May have encouraged more users to complete survey.



of participants have NOTused marijuana in the past 12 months

of participants have NOT used marijuana in the past 30 days

of pregnant participants have NOT used marijuana in the past 30 days

of breastfeeding participants have NOT used marijuana in the past 30 days

68% 79% 75% 82%

Screen survey included question into previous marijuana use. May have encouraged more users to complete survey.

WHICH MEANS…


WHEN WE TREAT OUR AUDIENCE AS ONE HOMOGENEOUS GROUP, WE WASTE FUNDS AND ENERGY TRYING TO REACH EVERYONE, WHICH RESULTS IN US EFFECTIVELY REACHING NO ONE.

INSIGHT #2

Pregnant & breastfeeding women use marijuana for many different reasons, many of which have nothing to do with their pregnancy.


Motivations for Use


Top Motivations for Marijuana Use % of Survey PopulationTo relax or calm nerves 57%

To manage stress 43%

To improve quality of sleep 30%

To have a good time 28%

To relieve chronic pain 25%

To get high 23%

To experiment 17%

Because of anger or frustration 12%

To get away from my problems 11%

To help with pregnancy-related symptoms 9%

Because it is something my friends do 9%

Because of boredom 9%

To inspire creativity 9%

Motivations for Use


Top Motivations for Marijuana Use % of Survey PopulationTo relax or calm nerves 57%

To manage stress 43%

To improve quality of sleep 30%

To have a good time 28%

To relieve chronic pain 25%

To get high 23%

To experiment 17%

Because of anger or frustration 12%

To get away from my problems 11%

To help with pregnancy-related symptoms 9%

Because it is something my friends do 9%

Because of boredom 9%

To inspire creativity 9%

ACCESS TO MARIJUANA


Where / From Obtained Marijuana

% of Survey Population

Friend gave it to me 44%

Bought from a friend 33%

Family gave it to me 29%

Bought at a dispensary 29%

Bought from a dealer 26%

Bought from family 19%

Grew it 5%

Bought from delivery service 4%

72%

16%

12%

Possess Medical Marijuana ID Card or Doctor's Recommendation

No, I never have

Yes, currently

Not now, but have inpast

INSIGHT #3

Users view marijuana use during pregnancy & breastfeeding as low risk.


ATTITUDES TOWARDS MARIJUANA


”[The people who judge when a pregnant woman uses,] many times it’s the older

people… They are from the old times. They don’t know. This new generation, almost

everybody, most people – children, teenagers – [use marijuana].”

Yea, you know… [treating symptoms] actually kind of outweighs the risks, I think… I did do

the research on that and how much THC actually gets through the bloodstream and

through the milk is minimal.”

ATTITUDES TOWARDS MARIJUANA


”I would not use medication or pills, no. Even if the doctor gave them to me, I’d rather smoke marijuana. I don’t know, I believe the pills do more harm than marijuana. It is more natural and healthier for the baby and for me too.”

”I’d lightly do it for the first few months just because the first few months are the most important when it comes to development."

PERCEIVED SAFETY OF USE


“Everyone’s tolerance is different. For example, I smoked marijuana with my son, the big one, and he’s 13 years old and he’s fine.

Also with the little one and he’s also alright… It depends on the person’s tolerance.”

“So if you’re just eating a little bit of oil or the herbal brownie or something like that, I feel

like it wouldn’t have that much effect if it’s very minimal.”

INSIGHT #4

Sources of health information vary, and for some users, medical advice is received with skepticism.


SOURCES OF INFORMATION


Types of Marijuana-Related News or Information

% of Survey Population

Health benefits of marijuana 64%

Health risks of marijuana 57%

Laws that affect marijuana use 44%

Using marijuana while P/BF 43%

Legal places to use marijuana 22%

Places to get marijuana 21%

Marijuana and driving 20%

Ways to store marijuana 7%

Marijuana prices 6%

6%9%

14%

25%9%

37%

How often searched for news and information related to

marijuana

DailyWeeklyMonthlyA few times a yearEvery few yearsNever

UNEVEN TRUST IN PRENATAL CARE PROVIDERS


Top Statements Non-Users Past 30-Day UsersMy prenatal care provider gives me complete information so I can make my own informed decision

83% 65%

I trust my prenatal care provider so much, I always try to follow his/her advice 82% 59%

I trust my prenatal care provider’s judgements about my medical care 81% 61%

My prenatal care provider is usually considerate of my needs and puts them first 78% 65%

If my prenatal care provider tells me something is so, then it must be true 56% 45%

I sometimes distrust my prenatal care provider’s opinions 19% 42%

I sometimes distrust that my prenatal care provider may not keep the information we discuss totally private

13% 37%



79% 79%

58%50%

46%42%

36%

25%

62%57%

42%

26%

35%

25% 23%

40%

DIET EXERCISE BIRTHING PLAN ALCOHOL PRESCRIPTION MEDICATIONS

TOBACCO ROMANTIC RELATIONSHIP

MARIJUANA

Topics Discussed with Prenatal Care Provider

Non-User Past 30-Day User

INSIGHT #5

Marijuana is not used exclusively for treating pregnancy-related symptoms.


TREATMENT OF PREGNANCY-RELATED SYMPTOMS


Pregnancy-Related Symptoms % of Survey PopulationSleep problems 16%

Lack of appetite 16%

Severe nausea 15%

Mood swings 13%

Headaches 13%

Mild nausea 10%

Back/foot pain 9%

Fatigue 8%

Stomach cramps 5%

Treating Pregnancy Symptoms


of participants who used marijuana to relieve symptoms felt it was saferthan other methods

of participants reported that friends recommended using marijuana

of participants who tried other methods, but only marijuana relieved symptoms

of participants did not try other methods, but cannabis relieved symptoms effectively

49% 30% 39% 20%

*Among those who reported using marijuana to help with pregnancy-related symptoms

Multiple Reasons for Use


While some reported using marijuana to help with pregnancy-related symptoms, ‒ In focus groups, 0 women reported using exclusively for this

purpose‒ In the online survey, 3 (of 1,636) reported using for only this reason

Those who use for symptoms also tended to have other reasons for use, such as to relax or manage stress

WITH ALL OF THIS CONFUSION…

WE MUST FURTHER INVESTIGATE HOW TO EFFECTIVELY REACH HIGH-RISK PREGNANT & BREASTFEEDING WOMEN


Segmentation

The process of classifying a market into distinct segments that behave in similar ways or have similar needs.


Segmentation


WHAT THESE BRANDS KNOW

is that as consumers of information, we receive what we relate to.


INSIGHT #6

Personal values, motivations for marijuana use, and frequency of marijuana use cluster together.




Personal Value Statements Past 30-Day Users Non-UsersI am very close with my family 75% 82%

It is easier for me to give help than to receive it 74% 74%

I feel at peace with myself when I have helped others 74% 80%

It is important to me that people are treated equally and given the same opportunities in life

74% 78%

I make personal sacrifices to increase the happiness of those close to me 73% 78%

I always figure out, one way or another, how to meet my goals 73% 74%

By working hard, a person can overcome every obstacle that life presents 68% 72%

I believe my life is headed in the right direction 67% 80%

It is important for me to live in secure surroundings, I avoid anything that might endanger my safety

67% 77%

Segmentation Inputs


Values Statements

Motivations for Marijuana Use

Frequency of Substance Use

+

+Cluster Analysis

7Distinct

Segments

Size of Segments


Largest Segment Smallest Segment

Frequency of Use in Segments


Lowest Risk Highest Risk

22% of P/BF population

Habitual Users

Highest rates of use of all segments

Youngest segment with the least formal education. ‒ Half of those in this segment have a

high school education or less.

Segment skews Caucasian


Pregnant: 36%Breastfeeding: 64%25

Average Days of Use in Past 30 Days

Habitual Users


NaturalistsAverage Days of Use in Past 30 Days

Second highest rate of cannabis use. Evenly represented across age

groups, but have completed less formal education than other segments. Segment has more African American

participants and fewer Asian participants than the overall sample. More common in rural communities

than in urban communities.

Pregnant: 68%Breastfeeding: 32%


13

Naturalists


Sensation Seekers

More likely to be pregnant than to be currently breastfeeding. They are most commonly between

25-29 years old and are college educated. More Latina participants than the

overall sample. More common in urban

communities than rural communities. 2019 North American Cannabis Summit 42


Pregnant: 81%Breastfeeding: 19%4

Sensation Seekers


Reserved Medicators

More likely to be currently breastfeeding than to be pregnant. Slightly older than other

segments but are less likely to be college educated. This segment has more African

Americans represented.2019 North American Cannabis Summit 44


Pregnant: 33 (39%)Breastfeeding: 65 (76%)3

Reserved Medicators


Messaging Recommendations


AVOID TARGETING ALL PREGNANT AND BREASTFEEDING WOMEN AS A GROUP.

ENSURE THAT MESSAGING ADDRESSES THE UNIQUE MOTIVATIONS OF PREGNANT AND BREASTFEEDING CANNABIS USERS.

DEVELOP BALANCED MESSAGES WHENEVER POSSIBLE.

Messaging Recommendations


PROVIDE USERS WITH A TRUSTED SOURCE.

CONSIDER A CANNABIS PREVENTION CAMPAIGN THAT TARGETS A HIGH RISK BUT RECEPTIVE AUDIENCE.

CREATE MESSAGES THAT APPEAL TO THE SELECTED SEGMENT.

Thank YouSophia Lerdahl, Director of Strategic

Initiatives | Rescue [email protected]

Documents

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