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Healthy Women, Healthy Families: A Community Based, Consumer Focused Pre/Interconception Health Intervention. The 3rd National Summit on Preconception Health and Health Care: Improving Preconception Health in a New Era of Health Care June 12-14, 2011. Current Intervention.
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Healthy Women, Healthy Families:A Community Based, Consumer Focused Pre/Interconception Health Intervention The 3rd National Summit on Preconception Health and Health Care: Improving Preconception Health in a New Era of Health Care June 12-14, 2011
Current Intervention • Two hour session – 90 min content • Pre and Post test • Highly pictorial, reflective presentation • Follows Healthy Family Plan (RLP) booklet • Selected topics – focus on weight, folic acid and contraception
Intervention Logic • Poor birth outcomes persist despite availability of medical care • An algorithm of risk indicators and mapping shows neighborhoods with highest risk factors • Community leaders and CBO’s are uniquely effective in reaching more vulnerable women • Consumers must play a stronger role in elevating preconception health as a primary prevention strategy
Intervention Goals • Educate reproductive age women (13-50 years) on the importance of preconception health (knowledge) • Offer assistance in self-management approaches for avoiding adverse birth outcomes (behaviors) • Provide information and encouragement on accessing community resources and health care for improved wellbeing (self-efficacy)
Pilot Program Development • Principles from Community Based Participatory Research (CBPR) • Iterative, cyclical, consumer focused • Community input on broad concepts and fine details of intervention • Key informant /small group interviews • Presented “focus group” style to sample audiences • Groups appreciated opportunity
Pilot Evaluation Results Baseline N (%) Follow-up N (%) Knowledge of how factors can affect contraception and pregnancy Adverse effects of drinking : Beneficial effects of exercise: Adverse effects of mercury: 166/297 (56%) 158/212 (75%) 142/293 (48%) 244/282 (87%)* 189/212 (89%)* 256/276 (93%)* * P < 0.001
Pilot Evaluation Results Baseline N (%) Follow-up N (%) Self-efficacy answered “definitely”* I understand steps to take before getting pregnant I can find the needed resources to have a healthy baby 137/296 (46%) 160/300(53%) 217/280 (78%)† 214/281 (76%)† • * On a 5-tiered likert scale,† P < 0.001
Evaluation Results Access to services DH clinics provide care to those without insurance: Obtaining family planning at DH is “definitely” easy:† Baseline N (%) Follow-up N (%) 207/297 (70%) 31/204 (15%) 252/283 (89%)* 52/196 (27%)* *P < 0.001 † on a 5-tiered likertscale
Current Activities • Develop and conduct Training of Facilitators (TOF) for CBO staff • Recruit community partners to deliver sessions • Develop program quality (fidelity) measures • Revise and enhance evaluation • Document “Pilot to Community Program” process
Lessons • Needs for community project differ from needs for pilot • CBO capacity different than expected • A menu of products may be best • Single 90 minute session • 5 session series • 15 minute “on the spot” messages • Social Norming may provide approaches • Available knowledge on preconception needs to be mined
Implications Translating a pilot pre/interconception health program to an effective community-based training program has the potential of offering an effective method for increasing consumer-focused health education among at-risk populations. If successful, this program could be offered in other communities.
Developed by Judith Shlay, MD, MSPH, Beverly Tafoya-Domínguez, MSTheresa Mickiewicz, MSPH, Kellie Teter, MPA, Helen Burnside, MPH Funding for this project provided by the Center for Healthy Families and Communities, Prevention Services Division, Colorado Department of Public Health and Environment, Maternal Child Health Block Grant. Additional information: Kellie Teter, MPA kellie.teter@dhha.org 303-602-3709