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

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.