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Validating PreCHAT: A Digital Preconception Health Risk Assessment Tool to Improve Reproductive, Maternal and Child
Cynthia Montanaro1, Liz Robson2, Leslie Binnington1
1153297Wellington-Dufferin-Guelph Public Health, Guelph, ON, Canada.
Study Background:
Despite the growing understanding of preconception care, numerous barriers to its delivery still exist, including a lack of evidence-based, accessible screening tools.
Purpose:
To validate a new digital Preconception Health Assessment Tool (PreCHAT) against the current best practice, physician-delivered tool in Ontario, Canada, and explore how PreCHAT's design impacts its risk identification abilities relative to the comparison tool.
Methods:
A criterion validation study was conducted with 53 female participants aged 18-44 years. Participants completed both tools in a controlled setting. PreCHAT was completed on a tablet individually by participants, while the comparison tool was administered by a physician. Three physicians administered the comparison tool. Measures of strength of agreement between PreCHAT and the comparison tool were calculated using percent agreement, Cohen's Kappa, and prevalence-adjusted and biased-adjusted kappa (PABAK).
Results:
PreCHAT identified 135 individual risk factors, while the comparison tool identified 102. Both tools shared the same 14 domains of preconception care and 88 risk factors; of the 88 risk factors, PreCHAT identified an average of 3.42 (p < 0.0001) more risks per participant than the comparison tool. PABAK scores indicated almost perfect agreement between PreCHAT and the comparison tool.
Conclusions:
This study suggests that PreCHAT is valid against the current best practice tool and is broader in its risk identification among individuals of reproductive age. PreCHAT's patient-facing, digital, EMR-integrated design may offer unique benefits to providers and patients. PreCHAT offers providers an innovative approach to deliver preconception care and may positively impact reproductive, maternal, and child health.
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