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Canadian Journal of Public Health

, Volume 108, Issue 4, pp 388–397 | Cite as

Preconception health interventions delivered in public health and community settings: A systematic review

  • Hilary K. Brown
  • Melissa Mueller
  • Sarah Edwards
  • Catriona Mill
  • Joanne Enders
  • Lisa Graves
  • Deanna Telner
  • Cindy-Lee Dennis
Systematic Review
  • 1 Downloads

Abstract

OBJECTIVES: The objective of this systematic review was to assess the effects of preconception health interventions, delivered to individuals of reproductive age in public health and community settings, on reproductive, maternal, and child health outcomes.

METHODS: A search of Ovid MEDLINE, CINAHL, EMBASE, PsychINFO, Scopus, Gender Studies Database, and SocINDEX from July 1999 through July 2016 was performed. We included studies that reported original data, used an interventional study design, included reproductive-aged women or men, were written in English, and were published in peer-reviewed journals. Two reviewers independently used standardized instruments for data extraction and quality assessment. A narrative synthesis was performed.

SYNTHESIS: Twelve studies met the inclusion criteria. These studies included randomized controlled trials and quasi-experimental, pre-post, and time- series designs. Most studies were conducted in the United States; all but one study included only women. Interventions were mainly educational initiatives focused on nutrition, immunization, and lifestyle behaviours and were delivered in a single contact. The studies reported positive effects on health knowledge (n = 9), behaviour change (n = 4), and health outcomes (n = 1). Study quality was weak (n = 11) or moderate (n = 1), with limitations related to selection bias, blinding, data collection methods, and participant attrition.

CONCLUSION: To develop a comprehensive, standardized approach to preconception health promotion and care in Canada, there is a clear need for high- quality research evaluating the effectiveness of preconception health interventions. Studies should use a health equity lens that includes all individuals of reproductive age and addresses the broad determinants of preconception health.

Key words

Health promotion preconception care public health 

Mots Clés

Promotion de la santé prise en charge préconceptionnelle santé publique 

Résumé

OBJECTIFS : Cette revue systématique vise à évaluer les effets d’interventions sanitaires préconceptionnelles, menées auprès de personnes en âge de procréer dans des contextes communautaires et de santé publique, sur les résultats de santé reproductive, maternelle et infantile.

MÉTHODE : Nous avons interrogé les bases de données Ovid MEDLINE, CINAHL, EMBASE, PsychINFO, Scopus, Gender Studies Database et SocINDEX entre juillet 1999 et juillet 2016. Nous avons inclus les études faisant état de données originales, utilisant un plan d’étude interventionnelle, incluant des femmes ou des hommes en âge de procréer, rédigées en anglais et parues dans des revues à comité de lecture. Deux évaluatrices ont utilisé de façon indépendante des instruments normalisés pour extraire les données et en évaluer la qualité. Une synthèse narrative a été effectuée.

SYNTHÈSE : Douze études ont répondu aux critères d’inclusion. Il s’agissait d’essais comparatifs randomisés, de démarches quasi expérimentales, d’études avant/après et d’analyses de séries chronologiques. La plupart avaient été menées aux États-Unis; toutes sauf une n’incluaient que des femmes. Les interventions étaient principalement des initiatives pédagogiques axées sur la nutrition, la vaccination et les comportements liés au mode de vie, et elles avaient été menées en un seul contact. Les études ont fait état d’effets positifs sur les connaissances en santé (n = 9), sur les changements de comportements (n = 4) et sur les résultats de santé (n = 1). Leur qualité était faible (n = 11) ou modérée (n = 1), avec des contraintes liées au biais de sélection, à l’insu, aux méthodes de collecte de données et à l’attrition des participantes.

CONCLUSION : Pour élaborer une méthode globale et normalisée d’aborder la promotion de la santé et les soins préconceptionnels au Canada, il est clairement nécessaire d’avoir des études de haute qualité qui évaluent l’efficacité des interventions sanitaires préconceptionnelles. Ces études devraient utiliser un prisme d’équité en santé qui inclut toutes les personnes en âge de procréer et qui aborde les grands déterminants de la santé préconceptionnelle.

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Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  • Hilary K. Brown
    • 1
    • 2
    • 3
  • Melissa Mueller
    • 4
    • 5
  • Sarah Edwards
    • 2
    • 4
  • Catriona Mill
    • 5
    • 6
  • Joanne Enders
    • 6
    • 7
  • Lisa Graves
    • 8
  • Deanna Telner
    • 9
  • Cindy-Lee Dennis
    • 3
    • 10
    • 11
    • 12
  1. 1.Interdisciplinary Centre for Health & SocietyUniversity of Toronto ScarboroughScarboroughCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Women’s College Research Institute, Women’s College HospitalTorontoCanada
  4. 4.Alberta Health ServicesEdmontonCanada
  5. 5.Toronto Public HealthTorontoCanada
  6. 6.Ontario Public Health AssociationTorontoCanada
  7. 7.Region of Waterloo Public Health and Emergency ServicesWaterlooCanada
  8. 8.Department of Family and Community Medicine, Homer Stryker M.D. School of MedicineWestern Michigan UniversityKalamazooCanada
  9. 9.Department of Family and Community Medicine, Faculty of MedicineUniversity of TorontoTorontoCanada
  10. 10.Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoCanada
  11. 11.Department of PsychiatryFaculty of MedicineTorontoCanada
  12. 12.Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada

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