Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, ON, N1G 0E1, Canada.
Matern Child Health J. 2019 Dec;23(12):1581-1586. doi: 10.1007/s10995-019-02806-4.
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.
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.
(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).
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.
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.
为改善生殖、孕产妇和儿童健康，创新且与各年龄段相关的孕前保健（PCH）至关重要。为此，惠灵顿-杜弗林-格陵兰公共卫生（WDGPH）开发并测试了一种基于证据的 PCH 电子干预措施，在初级保健环境中实施。本研究的目的是：（1）确定育龄妇女中 PCH 风险的流行率，（2）确定 PCH 干预对知识和行为的影响，（3）评估干预措施的实施情况。
PCH 干预措施设计为使用混合方法的队列研究。来自七个初级保健地点的 300 名年龄在 15-49 岁的妇女参与了该研究。干预措施采用三部分模型实施。
（1）在平板电脑上完成风险评估（RA），结果发送到他们的电子病历，（2）与初级保健提供者（PCP）讨论结果，（3）收到带有结果和关键信息的传单。数据来自参与者（RA 和两项调查）和 PCP（访谈）收集。
RA 筛查了 34 种 PCH 风险因素。每位参与者识别的风险数量从 4 到 24 不等，平均为 15。大多数人报告说使用 RA 的体验良好，并会推荐该干预措施。PCP 报告了许多实践益处。该研究强调了 PCP 对 PCH 的积极影响。
PCH 干预措施是加拿大首创。该干预措施是一种基于证据的人群健康方法，可能有助于改善生殖、孕产妇和儿童健康。需要进一步的研究、评估和推广。
