Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands

Abstract

Objectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in the Netherlands. The purpose of this study was to identify facilitators and barriers for implementation of interconception care in Preventive Child Health Care services. Methods We organized four focus groups in which Preventive Child Health Care physicians and nurses, related health care professionals and policymakers participated. A semi-structured interview approach was used to guide the discussion. The transcribed discussions were analyzed. Results All four groups agreed that several facilitators are present, such as the unique position to reach women and the expertise in preventive health care. Identified barriers include unfamiliarity with interconception care among patients and health care providers, as well as lack of consensus about the concept of interconception care and how it should be organized. A broad educational campaign, local adaptation, and general agreement or a guideline for standard procedures were recognized as important for future implementation. Conclusions for practice This study identifies potentially important facilitators and barriers for the implementation of interconception care in Preventive Child Health Care services or comparable pediatric settings. These factors should be considered and strategies developed to achieve successful implementation of interconception care.Electronic supplementary materialThe online version of this article (doi:10.1007/s10995-016-2046-5) contains supplementary material, which is available to authorized users.

Integrating interconception care in preventive child health care services: The Healthy Pregnancy 4 All program

“…time) and too little prioritization by their organizations. This is in line with the expected barriers based on the previously published study on determinants for implementation of ICC in PCHC [28]. Together, above-mentioned studies call for a national guideline on ICC in PCHC.…”

“…This study was based on four focus group discussions with in total 33 stakeholders representing different backgrounds (i.e. PCHC physicians, PCHC nurses, pediatricians, gynecologists, midwives, GPs, and policymakers)[28]. Barriers that emerged from this study included the lack of consensus about how ICC should be organized, possible financial and logistical barriers in PCHC services that are normally organized around child care instead of maternal care, and municipal differences in PCHC services.…”

“…Barriers that emerged from this study included the lack of consensus about how ICC should be organized, possible financial and logistical barriers in PCHC services that are normally organized around child care instead of maternal care, and municipal differences in PCHC services. Another important expected barrier was the anticipated unfamiliarity with ICC among PCHC professionals and the target group of women who consider becoming pregnant again [28]. Based on this study we provided several educational sessions and accompanying materials prior to the start of this intervention study.…”

The Impact of Kidney Development on the Life Course: A Consensus Document for Action

“…4 Implement routine preconception care in the immediate postpartum period following every delivery or pregnancy loss (interconception) [282]. This approach would have the following advantages/aims:…”

What characterizes the work culture at a hospital unit that successfully implements change – a correlation study

“…Another study identified educational campaigns, local adaption, and general agreement or guidelines for standard procedures as important tools for successful implementation [4]. To identify and describe barriers to implementation in healthcare, a structured decision-support procedure has been specified as crucial [5].…”