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