Improving interconception care: a qualitative study in United States primary care.

Area of Science:

• Reproductive Health
• Primary Care Medicine
• Health Services Research

Background:

• Interconception care (ICC) offers a vital opportunity to enhance maternal health outcomes through evidence-based interventions between pregnancies.
• Primary care settings are crucial for delivering continuous, comprehensive care to women of reproductive age.

Purpose of the Study:

• To explore primary care perspectives on essential components and implementation requirements for an interconception care intervention.
• To identify desired elements and practical needs for integrating ICC into primary care workflows.

Main Methods:

• Qualitative study involving seven virtual participatory design sessions with clinicians, support staff, and patients.
• Sessions were conducted between January 2022 and June 2023 across three diverse Chicago-area primary care clinics.
• Data were thematically analyzed using Dedoose software following transcription of recorded sessions.

Main Results:

• Clinicians and staff highlighted the necessity of multiple contact points to prevent care gaps between obstetric and primary care.
• Key desired elements included obstetrics-initiated patient transitions, proactive primary care outreach, specialized counseling, and routine screening.
• Intervention implementation requires enhanced clinician education and improved screening tools for postpartum health.

Conclusions:

• A multi-component intervention is recommended to proactively engage patients and integrate obstetrics with primary care.
• Future research should focus on intervention design, prototyping, and piloting for successful implementation.
• Addressing implementation needs is critical for effective interconception care delivery in primary care settings.