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Preconception Health - A Survey among Health Care Practitioners. Presented at CityMatCH annual conference September 12, 2005 Steve Abelman, MBA. Acknowledgements. Jennifer Williams, Eliazbeth Fasset - CDC Joann Petrini - March of Dimes Cheryl Stone - Cheryl Stone Marketing
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Preconception Health - A Survey among Health Care Practitioners Presented at CityMatCH annual conference September 12, 2005 Steve Abelman, MBA
Acknowledgements Jennifer Williams, Eliazbeth Fasset - CDC Joann Petrini - March of Dimes Cheryl Stone - Cheryl Stone Marketing Margaret Watkins, Kathryn Lyon Daniel, Christine Pure, Joe Mullinare - CDC Karla Damus - March of Dimes
Objectives • Knowledge of unintended pregnancies • Practice regarding recommendations for healthy behavior prior to pregnancy • Knowledge of aspects of folic acid - benefits, dosage, timing of consumption
Objectives • WHO • WHY • WHEN • HOW
Methodology • Random Sample Telephone Surveys • 2002 - 611 OB/GYNs and 250 FPs • 2003 • 200 CNMs • 101 NPs • 55 PAs • 144 RNs
% Eligible Patients Seen for Preconception Care Mean % Seen for Preconceptional Visit Providers-2003: 22% MDs-2002: 20%
Association: Perceived % of Unintended Pregnancies and % of Patients Seen for Preconception Care • % prenatal patients seen for preconceptional care -------------------- % Unintended Pregnancies in US -------------------- The chart shows the mean % of patients seen for preconceptional care by segments of providers estimating the % of unintended pregnancies at about 25%, 50%, 75%, or “don’t know/not sure” – by type of provider.
Issues “Always” or “Usually” Addressed at Annual Well-Woman Exam
Association:Frequency of Addressing Multivitamins in Well-Woman Visit and % Seen for Preconceptional Care • % prenatal patients seen for preconceptional care ---------- How Often Recommend Multivitamins in Well-Woman Visit ----------
When (How) Do Providers Recommend Multivitamins or Folic Acid?
Perceived Nutrient Requirements for Non-Pregnant Women of Childbearing Age
Reasons Providers Don’t Always Recommend Folic Acid or Multivitamins
Summary of Findings • Good knowledge on timing and benefits of folic acid • Incomplete knowledge on rate of unintended pregnancies and appropriate dosage of folic acid • Low rate of prenatal patients seen preconceptionally • Inconsistency in addressing preconception issues during a well-woman exam • Lack of knowledge and lack of time in addressing preconception issues
Summary of Findings • WHO - all women of childbearing age • WHY - prevention of birth defects among other issues • WHEN - all patient encounters • HOW - Verbal and written communication
Lessons Learned • Lack of knowledge and practice regarding some preconception issues on a timely basis • Providers of health care to women of childbearing age need to be educated about the rate of unintended pregnancies • Providers need to be encouraged to address preconception and prenatal planning issues during every patient encounter
Next Steps Focus groups among leadership and practitioners of selected professional organizations to identify reasons for the gap between knowledge and practice; identify how providers who do incorporate practice guidelines regarding folic acid and preconceptional care are able to do so; assess barriers to change; and brainstorm strategies or interventions that would lead to significant improvement in implementation of these guidelines within health care practices.