A Perspective of Preconception Health Activities i

Authors: Sheree L Boulet Kay Johnson Christopher Parker Samuel F Posner Hani Atrash

Publish Date: 2006/06/08

Volume: 10, Issue: 1, Pages: 13-20

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Abstract

Objectives Information regarding the type and scope of preconception care programs in the United States is scant We evaluated State Title V measurement and indicator data and abstracts presented at the National Summit on Preconception Care June 2005 in order to identify existing programs and innovative strategies for preconception health promotionMethods We used the webbased Title V Information System to identify state Performance Measures and Priority Needs pertaining to preconception health as reported for the 2005–2010 Needs Assessment Cycle We also present a detailed summary of the abstracts presented at the National Summit on Preconception CareResults A total of 23 states reported a Priority Need that focused on preconception health and health care Fortytwo states and jurisdictions identified a Performance Measure associated with preconception health or a related indicator eg folic acid birth spacing family planning unintended pregnancy and healthy weight Nearly 60 abstracts pertaining to preconception care were presented at the National Summit and included topics such as research programs patient or provider toolkits clinical practice strategies and public policyConclusions Strategies for improving preconception health have been incorporated into numerous programs throughout the United States Widespread recognition of the benefits of preconception health promotion is evidenced by the number of states identifying related indicatorsThe June 2005 National Summit on Preconception Care sponsored by the Centers for Disease Control and Prevention CDC and the March of Dimes assembled an array of health care providers public health practitioners and researchers in an effort to promote the exchange of information and ideas related to preconception care at the local state and national levels A key issue emerging from conference discussions was the perceived lack of information pertaining to the nature and scope of preconception health services currently being provided in the United States whether explicitly defined or falling under another umbrella of services Another issue was the recognition that a compilation of local state and national resources would provide important information related to the ability of current public health systems to address preconception care needs as well as allow for the description of innovative models for the delivery of such servicesAttended by more than 400 registered participants representing a myriad of agencies and organizations the summit generated significant response within the public health and clinical communities and reflects a perspective that cannot be readily gleaned from literature reviews or the inspection of existing programmatic guidelines that is the topic of preconception health has garnered substantial interest and support and has already been incorporated into numerous existing programs policies and strategies in the United States Unique to the summit was an opportunity to learn about the development and administration of preconception care programs within clinical and populationbased settings as Medline PubMed and other Internet searches have revealed very little information regarding the development and implementation of preconception care programs within a local context However as evidenced by the numerous programmatic components featured in the conference abstracts such programs are being introduced in many different formats among various private and public organizations and across the entire nationThe Maternal and Child Health Bureau website http//mchbhrsagov/ was used to ascertain the proportion of states including preconception health indicators in State Performance Measures and Priority Needs as reported in the State Title V Maternal and Child Health Service MCH Block Grant FY 2004 Annual Report and FY 2006 Application Form 14 The webbased Title V Information System https//perfdatahrsagov/mchb/mchreports/Search/core/ measureindicatemenuasp was used to search State Title V Performance Measures and Priority Needs for indicators related to preconception health Initial search parameters included all keywords and all populations and were further refined by selecting for birth outcomes reproductive health and women Those indicators for which infants newborns children men or service providers represented the sole target population were excluded The remaining measures were evaluated based on their relevancy to preconception health Indicators using the term “preconception” or “preconceptual” and those that did not use such terminology but adequately captured the concept were considered to fall within the domain of preconception health and health care States identifying preconception health Priority Needs were depicted on a national map States reporting relevant Performance Measures were identified and selected measures were described in tabular format Finally a comprehensive list of State Title V Performance Measures and Priority Needs related to preconception health that reflected the tone and language of multiple states was developed

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