Preconception Care Screening in the Primary Care Setting

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Kleier, Allison
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Purpose: The purpose of this quality improvement project was to implement and evaluate a Preconception Care (PCC) screening and education program in the primary care setting.|Background: PCC is defined as a preventive intervention that focuses on women’s health risk factors before becoming pregnant. PCC has been shown to reduce infant and maternal mortality and pregnancy complications; however, primary care providers are not implementing PCC widely.|Sample/Setting: The setting was a Midwestern family practice clinic. During routine office visits, female participants aged 19-50 were asked the question, “Are you considering pregnancy, or could you possibly become pregnant?”. One hundred and one women were screened for risk factors, provided with PCC education as necessary, and later contacted by phone to assess changes in health behavior following the visit.|Methods: This quality improvement study utilized the Model for Improvement Plan, Do, Study, Act (PDSA) design and was guided by the Health Belief Model.|Results: Forty-three percent of participants answered “yes” to the question “Are you considering pregnancy, or could you possibly become pregnant?”. Out of these participants, the following was reported: average BMI of 28.9; 35% were taking a folic acid supplement; 50% reported anxiety, and 40% reported depression. Seventeen women participated in the follow up phone call. Out of these participants, the majority believed that if they changed their health behaviors now, they would have a healthier baby; however, only half of these women reported making health behavior changes one month after receiving PCC.|Conclusion: Providers should screen patients for the need for PCC at every visit. Screening for risk factors related to obesity, smoking, alcohol use, IPV, race and ethnicity, and mental health should be assessed for further follow up. Encouraging and educating women to modify risk factors before pregnancy may contribute to healthier maternal and infant outcomes.
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