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 testHighly pictorial, reflective presentationFollows 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 interventionKey informant /small group interviewsPresented “focus group” style to sample audiencesGroups appreciated opportunity
Pilot Evaluation Results
Knowledge of how factors
can affect contraception
and pregnancy
Adverse effects of drinking :
Beneficial effects of exercise:
Adverse effects of mercury:
Baseline
N (%)
Follow-up
N (%)
166/297 (56%)
158/212 (75%)
142/293 (48%)
244/282 (87%)*
189/212 (89%)*
256/276 (93%)*
* P < 0.001
Pilot Evaluation Results
Self-efficacy
answered “definitely”*
I understand steps to take
before getting pregnant
I can find the needed
resources to have a
healthy baby
Baseline
N (%)
Follow-up
N (%)
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 likert scale
Current ActivitiesDevelop 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
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