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Maternal and Child Health Journal

, Volume 23, Issue 12, pp 1581–1586 | Cite as

Preconception Care: A Technology-Based Model for Delivery in the Primary Care Setting Supported by Public Health

  • Cynthia MontanaroEmail author
  • Lyn Lacey
  • Liz Robson
  • Amy Estill
  • Sonja Vukovic
From the Field

Abstract

Introduction

To improve reproductive, maternal, and child health, preconception health (PCH) care that is innovative and generationally relevant is essential. In response, Wellington-Dufferin-Guelph Public Health (WDGPH) developed and tested an evidence-based PCH electronic intervention delivered in a primary care setting. The purpose of this study was to: (1) identify the prevalence of PCH risks among women of reproductive age, (2) determine the impact of the PCH intervention on knowledge and behaviour, and (3) assess the implementation of the intervention.

Methods

The PCH intervention was designed as a cohort study using a mixed method approach. 300 women aged 15–49 years participated across seven primary care sites. The intervention was implemented using a three-part model. Participants: (1) completed a Risk Assessment (RA) on tablet with results sent to their electronic medical record, (2) discussed results with primary care providers (PCPs), (3) received handout with results and key messages. Data were collected from participants (RA and two surveys), and PCPs (interviews).

Results

The RA screened for 34 PCH risk factors. The number of risks identified per participant ranged from 4 to 24, averaging 15. The majority reported a positive experience using the RA and would recommend the intervention. PCPs reported many practice benefits. The study highlights the positive influence that PCPs have around PCH.

Discussion

The PCH intervention is the first of its kind in Canada. The intervention is an evidence-based population health approach that may help to improve reproductive, maternal and child health. Further research, evaluation and promotion is needed.

Keywords

Preconception care Reproductive health Primary care Public health Health information technology 

Notes

Acknowledgements

The authors gratefully acknowledge the support from the WDGPH research team members, Boston University Medical Center, CognisantMD, primary care research sites, advisory committee members, and Women’s College Hospital-Women’s Xchange $15 K Challenge grant.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Filner, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84(5), 478–485.CrossRefGoogle Scholar
  2. Frayne, D. J. (2017). A paradigm shift in preconception and interconception care: Using every encounter to improve birth outcomes. ZERO TO THREE, 37(4), 4–12.Google Scholar
  3. Jack, B. W., Atrash, H., Coonrod, D. V., Moos, M. K., O’Donnell, J., & Johnson, K. (2008). The clinical content of preconception care: An overview and preparation of this supplement. American Journal of Obstetrics and Gynecology, 199(6), S266–S279.CrossRefGoogle Scholar
  4. Jack, B., Bickmore, T., Hempstead, M., Yinusa-Nyahkoon, L., Sadikova, E., Mitchell, S., et al. (2015). Reducing preconception risks among African American women with conversational agent technology. The Journal of the American Board of Family Medicine, 28(4), 441–451.CrossRefGoogle Scholar
  5. Ontario Public Health Association. (2014). Shiftenhancing the health of Ontarians: A call to action for preconception health promotion and care. Retrieved July 9, 2018 from http://opha.on.ca/getmedia/e835a9ea-a121-46a4-af27-dd2ff1f58870/OPHA-Shift-Enhancing-the-health-of-Ontarians-A-call-to-action-for-preconception-health-promotion-and-care.pdf.aspx.
  6. Poston, L., Caleyachetty, R., Cnattingius, S., Corvalán, C., Uauy, R., Herring, S., et al. (2016). Preconceptional and maternal obesity: epidemiology and health consequences. The Lancet Diabetes & Endocrinology, 4(12), 1025–1036.CrossRefGoogle Scholar
  7. Public Health Agency of Canada. (2017a). Perinatal health indicators for Canada 2017: A report of the Canadian perinatal surveillance system . Retrieved July 9, 2018 from http://publications.gc.ca/collections/collection_2018/aspc-phac/HP7-1-2017-eng.pdf.
  8. Public Health Agency of Canada. (2017b). Family-centred maternity and newborn care: National guidelines. Retrieved July 9, 2018 from https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/healthy-living/maternity-newborn-care/maternity-newborn-care-guidelines-chapter-2-eng.pdf.
  9. Statistics Canada. (2012–2016). Table 13-10-0368-01 Infant mortality, by birth weight. Canada, provinces, territories, health regions. Retrieved July 9, 2018 from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310036801.
  10. Statistics Canada. (2016). Table 13-10-0451-01. Canadian health characteristics, annual estimates. Retrieved July 9, 2018 from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009601.
  11. UNICEF Office of Research. (2013). Child well-being in rich countries: A comparative overview, Innocenti Report Card 11. Retrieved July 9, 2018 from https://www.unicef-irc.org/publications/pdf/rc11_eng.pdf.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Wellington-Dufferin-Guelph Public HealthGuelphCanada

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