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Delivering Interconception Care During Well-Child Visits: An IMPLICIT Network Study.

Sukanya Srinivasan1, Lisa Schlar2, Stephanie E Rosener2

  • 1From the University of Pittsburgh Medical Center (UPMC) St. Margaret Family Medicine Residency, Pittsburgh, PA (SS); UPMC Shadyside Family Medicine Residency, Pittsburgh (LS); Middlesex Hospital Family Medicine Residency Program, Middletown, CT (SER); MAHEC Family Health Centers, Asheville, NC (DJF); Department of Family Medicine, University of Rochester, Rochester, NY (SGH); Lancaster General Research Institute, Lancaster, PA (MAH); IMPLICIT Network and UPMC McKeesport, Shadyside and St. Margaret Family Health Centers, Pittsburgh (JLB); Lancaster General Family Medicine Residency, Lancaster (SR). srinivasans@upmc.edu.

Journal of the American Board of Family Medicine : JABFM
|March 15, 2018
PubMed
Summary
This summary is machine-generated.

Well-child visits offer a key opportunity to screen mothers for health risks that impact birth outcomes. This approach to Interconception Care (ICC) successfully identified and addressed maternal risks between pregnancies.

Keywords:
Interconception CareMaternal AssessmentPreterm BirthUnplanned PregnancyWell-Child Visits

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Area of Science:

  • Maternal Health
  • Public Health Interventions
  • Preventive Medicine

Background:

  • Preterm birth, birth defects, and unintended pregnancies contribute significantly to infant and maternal morbidity and mortality.
  • Interconception Care (ICC) is recommended to improve birth outcomes by managing maternal health risks between pregnancies, but a standardized model is lacking.
  • The IMPLICIT Network developed a novel ICC model integrated into well-child visits (WCVs).

Purpose of the Study:

  • To assess the feasibility and impact of implementing Interconception Care (ICC) during well-child visits (WCVs).
  • To identify and address maternal health risks that could affect future birth outcomes.
  • To establish a reliable point of contact for maternal health screening and intervention.

Main Methods:

  • Mothers attending WCVs with their children up to 24 months were screened for four key risk factors: tobacco use, depression risk, contraception use, and multivitamin/folic acid use.
  • Brief interventions or referrals to treatment were provided for mothers screening positive for any risk factors.
  • Data were collected from eleven eastern US family medicine residency programs.

Main Results:

  • Mothers attended 92.7% of WCVs, and screening for ICC risks occurred at 69.1% of these visits.
  • Significant rates of risk factors were identified: tobacco use (16.2%), depression risk (8.1%), lack of contraception (28.2%), and lack of multivitamin (45.4%).
  • Interventions were documented for a substantial proportion of positive screens, with high rates for tobacco use (80.0%) and depression risk (92.8%).

Conclusions:

  • Well-child visits serve as a consistent touchpoint for engaging mothers in their health.
  • Integrating Interconception Care screening and intervention into WCVs is a viable strategy to address maternal risks.
  • This approach offers a unique opportunity to improve future birth outcomes by proactively managing maternal health.