|Health Factors:||Access to Care|
|Decision Makers:||Educators Healthcare Professionals & Advocates Nonprofit Leaders Public Health Professionals & Advocates|
|Population Reach:||20-49% of WI's population|
|Impact on Disparities:|
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Preconception education interventions provide information about the risks and benefits of behaviors that affect a woman’s health before, during, and after pregnancy; improving certain health behaviors prior to pregnancy reduces risks to mothers’ and infants’ health. Preconception education interventions cover a variety of topics related to those behaviors, such as nutrition, exercise and weight management, birth control methods, STI prevention, controlling chronic disease, reducing alcohol consumption, quitting smoking and other tobacco use, or improving mental health. Interventions can be delivered in clinical or community settings, and may be presented by medical providers, public health professionals, lay people, or others with relevant education and training (e.g., community health workers). Ongoing well-woman care, as well as education for men partnered with women of child bearing age, often compliment these interventions.
There is some evidence that preconception education interventions increase healthy behaviors among participating women (Temel 2014, Cochrane-Whitworth 2009). Additional evidence is needed to confirm effects on behaviors and birth outcomes, and determine which types of health behaviors and conditions these interventions address most effectively.
Preconception interventions that address multiple risk factors appear to alter targeted behaviors (Temel 2014). For example, participants in the Central Pennsylvania Women’s Health Study’s Strong Women program reported increases in their intent to eat healthier and be physically active, as well as increased physical activity, consumption of folic acid, and self-efficacy following the program’s 6 bi-weekly education sessions (Hillemeier 2008). An intensive intervention covering both alcohol consumption and contraception appeared to reduce binge drinking among risky drinkers (Cochrane-Whitworth 2009). Interventions targeting smoking may also reduce smoking pre-pregnancy (Temel 2014).
Preconception nutrition interventions appear to increase consumption of folic acid. A study of nutrition lessons for non-pregnant low income women, for example, appeared to increase their intake of dietary folate (Temel 2014). Various other individual programs, usually involving both education and supplement provision (Temel 2014), and collective interventions (e.g., public education campaigns and fortification of food products) have been shown to increase consumption of folic acid and reduce the risk of birth defects (Temel 2014, CG-Birth defects).
Risk assessment followed by individualized counseling as needed appears to increase participant’s knowledge of healthy behaviors. In five urban primary care clinics, for example, risk assessment and brief counseling for low income black and Hispanic women appeared to increase knowledge of the importance of folic acid, the need to treat and control chronic health conditions, and the importance of preconception medication review with a provider (Dunlop 2013b). In a greater Atlanta area-based study, black women attending WIC clinic nutrition classes who received brief counseling based on their risk assessment results reported that counseling was both acceptable and important (Dunlop 2013a).
Integrating preconception and interconception care into diabetic women’s ongoing usual care may reduce congenital malformation, preterm delivery, and perinatal infant mortality (Wahabi 2010), however, additional evidence is needed to confirm effects (Cochrane-Tieu 2013, Cochrane-Tieu 2010).
Several states have developed preconception health campaigns that incorporate education as one component, including Every Woman California, Delaware Thrives, Every Woman North Carolina, Arizona’s Power Me A2Z, and Utah’s Power Your Life, Power Your Health.
Many university and non-profit organizations also provide preconception education interventions. The University of Oklahoma’s Healthy Women, Healthy Futures program, for example, provides education, care coordination, and other support services for non-pregnant women living in poverty (OU-HWHF). PASOs, a program serving the Latino community in South Carolina, includes a culturally appropriate preconception health education workshop as part of its wider preconception health efforts (Torres 2013a).
The Show Your Love national campaign encourages healthy behaviors for all women (Show Your Love).
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