1 / 20

Why Do Women Decline Preconception Care Counseling? The L os A ngeles M ommy and B aby Project

Why Do Women Decline Preconception Care Counseling? The L os A ngeles M ommy and B aby Project. Shin Margaret Chao, Ph.D., M.P.H. Los Angeles County Department of Public Health Maternal Child, and Adolescent Health Programs .

idola
Download Presentation

Why Do Women Decline Preconception Care Counseling? The L os A ngeles M ommy and B aby Project

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Why Do Women Decline Preconception Care Counseling? TheLosAngelesMommyand BabyProject Shin Margaret Chao, Ph.D., M.P.H. Los Angeles County Department of Public Health Maternal Child, and Adolescent Health Programs

  2. This project was supported by the Health Resources and Services Administrative (HRSA) # R40MC06635, Productivity and Investment Fund, and MCAH General grants.

  3. Background • Preconception care counseling (PCC) provides opportunities for women to gain awareness and understanding of how their health behaviors and family histories impact pregnancy • Benefits of PCC well documented • Little knowledge on who does/does not receive PCC in Los Angeles County and why

  4. Study Questions • What are the characteristics of women who do not have preconception care counseling? • What are the reasons women do not have preconception care counseling?

  5. PROCEDURES Methods LAMB INSTRUMENT Questions primarily drawn and adapted from validated survey instruments Focus groups; piloted Survey translated into Spanish, and Chinese. Telephone translation service for other languages. LA resident mothers 0-7 months after a live birth Stratified random sample Over sample LBW/PT births, African American, Asian/PI and Native American births Mail survey with telephone follow-up for non-respondents $20 gift certificate

  6. During the six months before you got pregnant with your new baby, did you talk to a doctor, nurse, or other health care worker about how to prepare for a healthy pregnancy and baby? If yes, tell us why you did not see a doctor, nurse, or other health care worker to prepare for this baby. Preconception Counseling Questions • Knew how to prepare myself for pregnancy already • Didn’t expect to get pregnant • Did not have enough money or insurance to pay for a check-up • Did not have a regular doctor or nurse to talk to • Had no way to get to the clinic or the doctor’s office • Couldn’t take time off from work • Had no one to take care of my children • Too many other things going on • Couldn’t find a doctor or nurse who spoke my language • Other

  7. Statistical Analyses • Prevalence rates of women who had no PCC • Maternal characteristics associated with no PCC; perform multivariate analysis • Major reasons why women had no PCC • Sample weighting to adjust for sampling probabilities

  8. Results

  9. LAMB Demographics Race/Ethnicity Family Income N = 6,264

  10. Women who had no Preconception Care Counseling, by Race/Ethnicity, 2007 LAMB Survey N = 4,264

  11. Multivariate Model: Racial Disparities in no PCC Adjusted Odds Ratios and Confidence Limits for Race/Ethnicity aOR N = 4,264 • White mothers is the reference group • The multivariate model included: mother’s education, age, marital status, and insurance status • African American mothers more likely than white mothers to have no PCC visit

  12. Selected Maternal Characteristics by PCC Status • <=12 yrs education • Unmarried • Uninsured before pregnancy • Unintended pregnancy • Young age • Not a first time mother N = 6,264

  13. Reasons for No PCC 2007 LAMB Survey N = 4,264

  14. Reasons For No PCC by Race/Ethnicity 2007 LAMB Survey N = 4,264

  15. Reasons For No PCC by Parity 2007 LAMB Survey N = 4,264

  16. Conclusions • Over 70% of recently delivered mothers had no PCC • Major reasons: • Not expecting to get pregnant • Knew how to prepare • No regular doctor • Not enough money or insurance for check-up • Too much else going on • Racial/ethnic disparities • Younger age, lower education level, unmarried, unintended pregnancy, not a first time mother

  17. Public Health Implications

  18. Implications • Identify subpopulations of women in need of outreach during the preconception period • Integrate PCC as part of family planning services • Need for awareness campaigns on importance of PCC • Social policy changes to promote funding and access to PCC • Maximize public health surveillance and related research mechanisms to evaluate the effectiveness of PCC

  19. Michael C. Lu, MD, MPH 2007 LAMB Principal Investigator Cynthia Harding, MPH Director, Los Angeles County MCAH Programs Diana Liu, MPH, Chandra Higgins, MPH, Marian Eldahaby, BA, Carmen Gutierrez, Alex Chen, MS Martha Martinez, Rozana Ceballos, BA Our Community Partners . . . and of course, mothers who completed the survey! Special Thanks to:

  20. Contact Us • Toll-free number: 1-866-706-LAMB • For information about LAMB, visit: http://lapublichealth.org/mch/LAMB/LAMB.html • Margaret Chao schao@ph.lacounty.org 213-639-6470

More Related