The effect of a preconception care outreach strategy: the Healthy Pregnancy 4 All study

BMC Health Serv Res. 2019 Jan 23;19(1):60. doi: 10.1186/s12913-019-3882-y.

Abstract

Background: Preconception care has been acknowledged as an intervention to reduce perinatal mortality and morbidity. However, utilization of preconception care is low because of low awareness of availability and benefits of the service. An outreach strategy was employed to promote uptake of preconception care consultations. Its effect on the uptake of preconception care consultations was evaluated within the Healthy Pregnancy 4 All study.

Methods: We conducted a community-based intervention study. The outreach strategy for preconception care consultations included four approaches: (1) letters from municipal health services; (2) letters from general practitioners; (3) information leaflets by preventive child healthcare services and (4) encouragement by peer health educators. The target population was set as women aged 18 to 41 years in 14 Dutch municipalities with relatively high perinatal morbidity and mortality rates. We evaluated the effect of the outreach strategy by analyzing uptake of preconception care consultations between February 2013 and December 2014. Registration data of applications for preconception care as well as participant questionnaires were obtained for analysis.

Results: The outreach strategy led to 587 applications for preconception care consultations. The majority of applications (n = 424; 72%) were prompted by the invitation letters (132,129) from the municipalities and general practitioners. The effect of the municipal letter seemed to fade out after 3 months.

Conclusions: Outreach strategies amongst the general population promote uptake of preconception care consultations, although on a small scale and with a temporary effect.

Keywords: Health behavior; Health care utilization; Implementation; Preconception care; Primary care.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Child Health Services / statistics & numerical data
  • Child, Preschool
  • Facilities and Services Utilization
  • Female
  • General Practitioners / statistics & numerical data
  • Health Promotion / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Netherlands / ethnology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Preconception Care / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications / ethnology
  • Pregnancy Complications / prevention & control
  • Pregnancy Outcome / ethnology
  • Preventive Health Services / statistics & numerical data
  • Prospective Studies
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult