The effect of a preconception care outreach strategy: the Healthy Pregnancy 4 All study

Sijpkens, Meertien K.; Voorst, Sabine F. van; Jong-Potjer, Lieke C de; Denktaş, Semiha; Verhoeff, Arnoud P.; Bertens, Loes C. M.; Rosman, Ageeth N.; Steegers, Eric A.P.

doi:10.1186/s12913-019-3882-y

Cited by 20 publications

(20 citation statements)

References 31 publications

(42 reference statements)

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“…[6][7][8] It could also be that we did not sufficiently reach high-risk women, since even though we did reach a diverse population, the majority had a Dutch and high educational background. 15 Our exploratory findings on subgroup differences are also reported by other studies; characteristics such as younger age, ethnic minority background, lower educational attainment, and a previous pregnancy seem to be associated with no use of folic acid supplementation and with smoking. [6][7][8][9]18,26,27…”

Section: Discussionsupporting

confidence: 83%

“…This strategy consisted of invitation letters sent by municipal health services and GPs (including translations in 8 languages), as well as referral by youth health care professionals and health educators. 15 Preconception care was offered at participating GPs and midwifery practices. The GPs and midwives received a training as well as self-study material and protocols.…”

Section: Designmentioning

confidence: 99%

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Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

et al. 2020

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Purpose: To evaluate the effects of preconception care (PCC) consultations by change in lifestyle behaviors. Setting and Intervention: Women in deprived neighborhoods of 14 Dutch municipalities were encouraged to visit a general practitioner or midwife for PCC. Sample: The study included women aged 18 to 41 years who had a PCC consultation. Design: In this community-based prospective cohort study, we assessed initiation of folic acid supplementation, cessation of smoking, alcohol consumption, and illicit drug use. Measures: Self-reported and biomarker data on behavioral changes were obtained at baseline and 3 months later. Analysis: The changes in prevalence were assessed with the McNemar test. Results: Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker-confirmed, P = .008) and for self-reported binge drinking ( P = .007). Conclusion: Our study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health.

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Section: Discussionsupporting

confidence: 83%

Section: Designmentioning

confidence: 99%

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

et al. 2020

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“…The HP4All programs aim to improve maternal and perinatal health by enhancing risk-guided care from the preconception period through to the interconception period [21, 22]. In the preceding HP4All-1 program, recruitment for and delivery of PCC at general practitioners (GPs) and midwifery practices was employed, which included some PCHC services distributing information leaflets about PCC [23, 24]. In total, 587 applications for PCC consultations were registered, mostly (n = 424) prompted by the 132,129 invitation letters from municipalities and general practitioners [24].…”

Section: Methodsmentioning

confidence: 99%

“…In the preceding HP4All-1 program, recruitment for and delivery of PCC at general practitioners (GPs) and midwifery practices was employed, which included some PCHC services distributing information leaflets about PCC [23, 24]. In total, 587 applications for PCC consultations were registered, mostly (n = 424) prompted by the 132,129 invitation letters from municipalities and general practitioners [24]. Only 6 consultations resulted from leaflets distributed at PCHC services.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2019

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BackgroundMost parents with young children pay routine visits to Well-Baby Clinics, or so-called Preventive Child Health Care (PCHC) services. This offers a unique opportunity to promote and deliver interconception care. This study aimed to integrate such care and perform an implementation evaluation.MethodsIn seven Dutch municipalities, PCHC professionals were instructed to discuss the possibility of an interconception care consultation during each routine six-months well-baby visit. The primary outcome of this study was coverage of the intervention, quantified as the proportion of visits during which women were informed about interconception care. Secondary outcomes included adoption, fidelity, feasibility, appropriateness, acceptability and effectiveness of the intervention, studied by surveying PCHC professionals and women considering becoming pregnant.ResultsThe possibility of interconception care was discussed during 29% (n = 1,849) of all visits, and 60% of the PCHC physicians adopted the promotion of interconception care by regularly informing women. About half of the PCHC professionals and most women judged integration of interconception care in PCHC appropriate and acceptable. Estimated feasibility was poor, since 13% of the professionals judged future integration in daily practice as probable. The uptake of interconception care consultations was low (n = 4 consultations).ConclusionsPromotion of interconception care was achieved in approximately one-third of the routine PCHC consultations and appeared promising with regards to adoption, appropriateness and acceptability. However, concerns on feasibility and uptake of interconception care consultations in daily practice remain. Suggestions for improvement may include further integration of interconception care health promotion in routine PCHC consultations, while allocating sufficient resources.

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“…The majority of our women with IBD or RD reported that PCC posters should be used to alert women in, amongst others, the waiting room of the midwife/GP. Sijpkens et al, showed that this could result in an increased number of women visiting a PCC consultation (27).…”

Section: Relevance Of the Ndingsmentioning

confidence: 99%

Facilitators and Barriers of Preconception Care in Women With Inflammatory Bowel Disease and Rheumatic Diseases

Admiraal

Rosman

Dolhain

et al. 2020

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Background: Preconception care (PCC) is care prior to conception to optimize parental health, and health of the future child, through biomedical and behavioral changes. Providing PCC to all women with a wish to conceive will improve perinatal health. PCC is especially important for women with a chronic disease, such as inflammatory bowel disease (IBD) and rheumatic diseases (RD). However, at present PCC is not part of routine care for these women. The aim of this study is to identify facilitators and barriers on a patient and professional level regarding the provision of PCC in women with IBD and RD.Methods: A survey study among women with IBD and RD, their treating physicians as well as obstetric professionals was performed. Patients, visiting the outpatient clinic of a university medical center and a secondary hospital located in the Netherlands with a wish to conceive, pregnant women or those with a recent pregnancy (<1 year ago) and involved physicians and obstetric professionals were eligible. Results: A total of 71% of the IBD patients (n=22/31) and 35% of the RD patients (n=20/58) received a PCC consultation. PCC consultation was considered easy to enter, short in time and patients felt comfortable. Patients (71% IBD; 62% RD) preferred a personal PCC consultation with their disease specific specialist together with an obstetrician. Patients specifically wanted to receive information about the safety of medication use and disease activity following delivery. A total of 67% (n=31) of the included healthcare professionals agreed PCC was applicable to their patients. Main barrier to providing PCC was lack of time and unavailability of professionals. In total 41% (n=16) of obstetric professionals felt they had the knowledge and skills to provide PCC compared to 33% (n=1) and 75% (n=3) of gastroenterologists and rheumatologists, respectively. Conclusion: Facilitators and barriers have been reported both on a patient and healthcare professional level. Despite the positive attitude towards PCC on both levels, realization of PCC remains difficult. In the future, in order to facilitate optimal PCC to high risk patients as standard of care, it is necessary to remove these barriers. Trial Registration: not applicable.

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The effect of a preconception care outreach strategy: the Healthy Pregnancy 4 All study

Cited by 20 publications

References 31 publications

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

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

Facilitators and Barriers of Preconception Care in Women With Inflammatory Bowel Disease and Rheumatic Diseases

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