Preconception health assessments in occupational settings: Counseling versus written feedback

Our preconception care (PCC) initiative in Akita (Japan) was previously reported to improve health literacy and motivate behavioral changes. To make the check-up widely available, a more feasible and sustainable system is necessary. Our aim was to evaluate a resource-efficient preconception check-up implemented in Ehime Prefecture.

The Ehime PCC check-up included female employees aged 18-39 and took place between July 2023 and January 2024. Participants attended a lecture, underwent blood tests, and received written feedback. Pre- and post-intervention surveys were conducted for check-up evaluation.

Fifty-nine women (median age: 31 years) participated. The results revealed that their health was inadequate for future pregnancies, with 23% exhibiting anemia (hemoglobin <12.0 g/dL) and 29% iron deficiency (serum ferritin <12 ng/mL). Furthermore, all participants had low 25-hydroxyvitamin D levels (<30 ng/mL). After receiving written feedback, 66% manifested an intention to improve their lifestyle, 21% an intention to consult an obstetrician and gynecologist, and 32% expressed a desire to become pregnant sooner. The proportion of those without intention to change their future behavior was significantly higher in Ehime (23.7%) compared to Akita (4.9%, p = 0.018). Recommendation ratings were significantly lower in Ehime (strongly recommend: 18.2% vs. 65.9%, p < 0.001), with more reporting anxiety (10.5% vs. 4.9%, p = 0.02).

Preconception check-ups improved the intention to change behavior, even in resource-efficient settings. However, individual counseling may be more effective than written feedback in increasing the intention to change behavior and satisfaction. A resource-efficient feedback method that effectively motivates behavioral change and improves satisfaction is required.