Core State Preconception Health Indicators: A Voluntary, Multi-state Selection Process
This report describes the consensus-based selection process undertaken by a voluntary committee of policy/program leaders and epidemiologists from seven states to identify core state indicators to monitor the health of reproductive age women (aged 18–44 years). Domains of preconception health were established based on priority areas within maternal and child health and women’s health. Measures (i.e., potential indicators) addressing the domains were identified from population-based, state level data systems. Each indicator was evaluated on five criteria: public health importance, policy/program importance, data availability, data quality, and the complexity of calculating the indicator. Evaluations served as the basis for iterative voting, which was continued until unanimous consent or a super majority to retain or exclude each indicator was achieved. Eleven domains of preconception health were identified: general health status and life satisfaction; social determinants of health; health care; reproductive health and family planning; tobacco, alcohol and substance use; nutrition and physical activity; mental health; emotional and social support; chronic conditions; infections; and genetics/epigenetics. Ninety-six possible indicators were identified from which 45 core indicators were selected. The scope of preconception care and the public health components to address preconception health are still under development. Despite this challenge and other measurement limitations, preconception health and health care indicators are urgently needed. The proposed core indicators are a set of measures that all states can use to evaluate their preconception health efforts. Furthermore, the indicators serve as a basis for improving the surveillance of the health of reproductive age women.
KeywordsHealth indicators Preconception health Public health surveillance Reproductive health Women’s health
The authors wish to acknowledge our fellow Core State Preconception Health Indicators Working Group members: Moreen Libet, PhD and Kiko Malin, MPH, MSW, Maternal, Child and Adolescent Health Program, Center for Family Health, California Department of Public Health; Deborah Ehrenthal, MD, FAACP, Christiana Care Health Services, Delaware; Alvina Long Valentin, RN, MPH and Sarah McCracken Cobb, MPH, Women’s and Children’s Health Section, North Carolina Division of Public Health; Gita G. Mirchandani, PhD, MPH and Julie Stagg, MSN, Office of Program Decision Support, Division of Family and Community Health Services, Texas Department of State Health Services; and Laurie Baksh, MPH, Lois Bloebaum, MPA, BSN, Shaheen Hossain, PhD, and Nan Streeter, MS, RN, Maternal and Child Health Bureau, Division of Community and Family Health Services, Utah Department of Health. The authors also acknowledge the Senior Scientific Advisory Committee for invaluable input. The lead author and project coordinator was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement U60/CCU007277.
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