Pre and Interconception Education and Counseling: Strategies from Florida

1. Pre and Interconception Education and Counseling:Strategies from Florida Presented by: Betsy Wood, BSN, MPH Infant, Maternal & Reproductive Health Unit Florida Department of Health

2. Recommendation #8: Integrate components of preconception health into existing local public health and related programs, including emphasis on interconception interventions for women with previous adverse birth outcomes. Florida’s Healthy Start Standards and Guidelines Chapter 21: Healthy Start Services Interconceptional Education and Counseling A collaborative initiative between Florida’s Department of Health and local Healthy Start Coalitions

3. Healthy StartInterconceptional Counseling and Education Topics • Access to Care • Baby Spacing • Nutrition • Physical Activity • Maternal Infections • Smoking • Substance Abuse • Mental Health • Concerns • Environmental • Risk Factors • Chronic Health • Problems http://www.doh.state.fl.us/family/mch/training/icc/icc.html

4. Key Implementation Components: • Culturally Sensitive • Considerate of client’s educational and literacy needs • Inclusive of father, family, and/or significant other • Tailored to the clients needs

5. Interconception Education Target Audience • Women with previous poor birth outcome • Women with behavioral or environmental issues contributing to poor birth outcomes that have not been resolved during pregnancy regardless of birth outcome

6. Changed definition of Healthy Start client to women from conception to two years postpartum Developed guidance via chapter in Standards and Guidelines Allows (but does not require) provision of care coordination and enhanced services, such as smoking cessation, nutritional counseling, psychosocial counseling, etc. No additional funding for these services Implementation

7. Opportunities for Interconception Education • Family Planning • WIC • Federal Primary Care Clinics • Prenatal Care • STD and HIV Clinics and Care Coordinators • Children’s Medical Services Clinics and Care Coordinators • Pediatric Care • Child Care Facilities

8. Recommendation #2: Increase public awareness of the importance of preconception health behaviors and preconception care services by using information and tools appropriate across various ages; literacy, including health literacy; and cultural/linguistic contexts. Preconception Education Target Audience • Women of childbearing age • Families of women of childbearing age • General public

9. Vitagrant Program • Multivitamin settlement - $2 million • Partnership between March of Dimes and Department of Health • MOD staff housed at DOH • Vitamin with folic acid distribution expanded to include preconception education

12. Implementation • Technical Assistance Guidelines were developed for use by all 67 County Health Departments (CHD) • Education can be provided in any CHD setting where women are accessing care • Mostly used in family planning clinics

13. Other Opportunities for Preconception Education • Primary Care Clinics • School Health Programs • STD and HIV Clinics • Care Coordinator interactions • Health Fairs

14. Next Steps Children’s Medical Services: • provided preconception brochures, resource lists, and information sheet to Early Steps for distribution at their statewide meeting • provided a 1.5 hour inservice on preconception topics to CMS providers (therapists, MD's, mental health providers, case managers, etc) at their bi-annual meeting in June, 2006. • invited to join the March Healthy Start Interconception Education and Counseling “webinar”

15. Next Steps, cont. School Health • provided preconception brochures and link to online training. • provided a 30 in-service on the School Health Meet Me Call on March 2, 2006 Doulas • will be providing a training for the local Doula Program. • training both Birth and Postpartum doulas • focusing on ensuring providers are able to reinforce education about interconception issues when interacting with their clients

16. Next Steps, cont. WIC and Breastfeeding support paraprofessionals • will be providing training with these groups. • provided a link to our online training • invited to join the March Healthy Start Interconceptional Education and Counseling webinar Community Colleges – • contacting community college and university health centers to distribute preconception brochures • starting a "Sticker Campaign" that would involve placing a sticker reminding women to take folic acid on all birth control pill packs dispensed from their pharmacies. (This is still in the planning stage.)

17. Questions?