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Education Intervention of Preconception Screening in Primary Care

Problem: The risk of a poor pregnancy outcome among women of reproductive age in Providence, Rhode Island is indicated by the high rates of unintended pregnancies, low multivitamin use prior to pregnancy, obesity, and smoking. Although recommended, health professionals often fail to routinely screen and educate women of reproductive age for preconception risk factors. Purpose: Evaluate the efficacy of an educational intervention on preconception risk factors, lifestyle modifications, and current screening recommendations; and introduce a preconception tool and education sheet among a population of health care providers. Method: Preconception health material and a modified preconception screening tool was presented to seven primary care providers. A pre-test, post-test design was used to evaluate the effectiveness of the intervention, followed by an informal interview about current practices. Preconception referrals were compared two months prior and two months after the intervention. A follow-up survey was given to each provider. Findings: Although all of the providers agreed preconception screening is necessary, only two stated they screened all their patients of reproductive age. Four providers stated they could see themselves using the tool; however, barriers included time and frustration with another form. The posttest did indicate an increased provider knowledge in lifestyle modifications and risk factors for adverse pregnancy outcomes. Preconception referrals remained the same. The education sheet was made into a poster for each exam room following the intervention. Conclusion: The intervention was successful at educating providers on preconception risk factors and lifestyle modifications; however, mailing the preconception tool with the new patient packet could potentially increase sustainability in the future at this primary care facility. Keywords: Preconception health, preconception screening, reproductive aged