One Key Question® and the Desire to Avoid Pregnancy Scale: A comparison of two approaches to asking about pregnancy preferences

Stulberg, Debra; Datta, Avisek; VanGompel, Emily White; Schueler, Kellie; Rocca, Corinne H.

doi:10.1016/j.contraception.2019.12.010

Cited by 26 publications

(23 citation statements)

References 19 publications

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“…44 While the OKQ opens the door for conversations on pregnancy intention, a limitation is that it can be interpreted as a "yes" or "no" question and may not pick up the ambivalence towards pregnancy that some women experience. 44 Although this is an area for future research, an open-ended approach to evaluating pregnancy intention will likely allow for better characterization of pregnancy intention and the reasons underlying ambivalence. Furthermore, we hypothesize that addressing pregnancy ambivalence can be an effective approach to encouraging planned pregnancies in lupus.…”

Section: Discussionmentioning

confidence: 99%

“…43 In another high-risk population, women with HIV, patients were at lower risk for having an unplanned or ambivalent pregnancy if they had a discussion of their pregnancy intentions with their provider prior to pregnancy. 21 Providers-initiated questions can be somewhat helpful as demonstrated by the success of the One Key Question (OKQ), “Would you like to become pregnant in the next year?” 44 While the OKQ opens the door for conversations on pregnancy intention, a limitation is that it can be interpreted as a “yes” or “no” question and may not pick up the ambivalence towards pregnancy that some women experience. 44 Although this is an area for future research, an open-ended approach to evaluating pregnancy intention will likely allow for better characterization of pregnancy intention and the reasons underlying ambivalence.…”

Section: Discussionmentioning

confidence: 99%

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The importance of pregnancy planning in lupus pregnancies

Rajendran

Eudy

Balevic

et al. 2021

Lupus

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Objective In seeking new approaches to improve lupus pregnancy outcomes, we study the association between pregnancy planning, behaviors recommended by American College of Rheumatology’s Reproductive Health Guideline 2020, and pregnancy and infant outcomes. Methods Lupus pregnancies in a prospective registry (1/1/2018 to 4/1/2020) were classified as planned or not-planned using the patient-reported London Measure of Unplanned Pregnancy. These groups were compared for demographics, pre-pregnancy disease activity, pregnancy planning behaviors, and delivery outcomes. Results Among 43 women with 43 singleton pregnancies the average age was 29.4 years and 42% were Black. Overall, 60% were planned pregnancies and 40% were not-planned (16 ambivalent, 1 unplanned). Women with not-planned pregnancies had lower age, income, and education, and more required Medicaid. Women with not-planned pregnancies were more likely to conceive when lupus activity was higher (p = 0.001), less likely to receive pre-pregnancy counseling with a rheumatologist (p = 0.02), and less likely to continue pregnancy-compatible medications (p = 0.03). Severe PROMISSE adverse pregnancy outcomes (APOs) and severe neonatal outcomes were higher among women with not-planned than planned pregnancies (43% vs 0% p = 0.003; 70% vs 30% p = 0.06). Conclusion This study identifies pregnancy intention as a potentially modifiable risk factor for poor outcomes in women with lupus. It highlights a unique population of women with lupus at high risk for pregnancy and infant complications: those ambivalent about pregnancy. These women may not be effectively engaging in health behaviors that prevent pregnancy nor those that will prepare for a safe pregnancy. With effective pregnancy planning and contraception guidance, we may decrease their risk for maternal-fetal morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The importance of pregnancy planning in lupus pregnancies

Rajendran

Eudy

Balevic

et al. 2021

Lupus

View full text Add to dashboard Cite

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“…While the benefits of routine screening, such as normalising fertility discussion and preventing high‐risk pregnancies, have been expressed in recent guidelines, arguments against routine discussion of pregnancy intentions highlighted the importance of considering patients’ values, respecting their choices and privacy, and preventing unintentional emotional triggers for those with a history of pregnancy loss 42,43 . Although the predictive value of screening techniques for pregnancy intention such as ‘one key question’ and the ‘desire to avoid pregnancy scale’ have shown correlations with women's reproductive health behaviours, 44 health care practitioners (HCPs) will need to guide subsequent conversations appropriately, considering the range of responses that could be elicited. Overall, these findings suggest that HCPs should first assess if patients want to engage in a conversation before simply posing the question as a routine activity.…”

Section: Role Of Health Care Professionals Across Disciplines For Pre...mentioning

confidence: 99%

The preconception period as a platform for preventing diabetes and non‐communicable diseases

Jacob

Hanson

2022

Practical Diabetes

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Increasing evidence suggests that parental risk factors for non‐communicable diseases (NCDs) in the period before conception could affect their lifelong health and increase the risk of NCDs in the offspring. While many of these risks such as obesity, smoking and dietary patterns are influenced by wider socio‐economic factors, screening and identification of risk factors can be conducted in the clinical setting to provide appropriate preventive interventions. This article discusses the role of health care practitioners in preventing the risk of NCDs and opportunities for action in the preconception period.

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“…One Key Question ® (OKQ) is a pregnancy intention screening tool used by providers to ascertain a patient's preferences surrounding pregnancy and provide reproductive counseling accordingly. 7 , 9 The tool prompts patients to answer one question, “do you wish to become pregnant in the next year?,” and providers are trained to provide counseling based on patient responses of “yes,” “no,” “unsure,” or “ok either way.” 7 , 9…”

Section: Introductionmentioning

confidence: 99%

“…Patient responses to the OKQ screening correlates with a validated 14-question measure of a patient's desire to avoid pregnancy, 10 and due to its short length, it may be a practical tool for routine clinical use. 7 One community health center that incorporated OKQ into its electronic medical record saw increases in contraceptive counseling and decreases in patient satisfaction. 11 …”

Section: Introductionmentioning

confidence: 99%

Facilitators of and Barriers to Successful Implementation of the One Key Question^® Pregnancy Intention Screening Tool

Ferketa

Schueler

Song

et al. 2022

Women's Health Reports

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Background: One Key Question ® (OKQ) is a tool that embeds a patient-centered screening into routine visits with the goal of making pregnancy intention screening universal, but widespread implementation has not yet been adopted. We aimed to explore the barriers and facilitators of OKQ implementation to better understand how to best implement the tool across different settings. Methods: We invited staff and clinicians from one obstetrics and gynecology clinic and one family medicine clinic, which previously implemented OKQ, to complete surveys and qualitative interviews about their experiences with the tool. The interview guide and thematic analysis of the interview transcripts were informed by the Consolidated Framework for Implementation Research (CFIR). Main Findings: Major facilitators of OKQ implementation are the simplicity of the tool, engagement of clinic leadership, and compatibility between the perceived goals of the tool and those of practice staff and clinicians. Although participants indicated that OKQ had a minimal impact on clinic workflow during its implementation, preimplementation time concerns were a major barrier to implementation in both clinics. Barriers seen in the family medicine practice included OKQ distracting from the visit agenda, and concerns about the OKQ gold standard protocol of screening each patient at every visit. Participants even suggested asking OKQ only during annual check-up appointments. Conclusions: The perceived alignment between the tool's goals and those of clinic stakeholders was an important facilitator of OKQ implementation success. However, characteristics of the clinic setting, such as competing medical priorities and time constraints, influenced initial attitudes toward the feasibility of the intervention. Clinical Trial Registration Number: NCT03947788

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One Key Question® and the Desire to Avoid Pregnancy Scale: A comparison of two approaches to asking about pregnancy preferences

Cited by 26 publications

References 19 publications

The importance of pregnancy planning in lupus pregnancies

The importance of pregnancy planning in lupus pregnancies

The preconception period as a platform for preventing diabetes and non‐communicable diseases

Facilitators of and Barriers to Successful Implementation of the One Key Question^® Pregnancy Intention Screening Tool

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One Key Question® and the Desire to Avoid Pregnancy Scale: A comparison of two approaches to asking about pregnancy preferences

Cited by 26 publications

References 19 publications

The importance of pregnancy planning in lupus pregnancies

The importance of pregnancy planning in lupus pregnancies

The preconception period as a platform for preventing diabetes and non‐communicable diseases

Facilitators of and Barriers to Successful Implementation of the One Key Question® Pregnancy Intention Screening Tool

Contact Info

Product

Resources

About

Facilitators of and Barriers to Successful Implementation of the One Key Question^® Pregnancy Intention Screening Tool