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

Interconception care (ICC) is an opportunity to improve future health outcomes through evidence-based screening, counseling, and disease management between pregnancies. This qualitative study explores primary care perspectives on desired elements and implementation needs for an ICC intervention in primary care.

We conducted, between January 2022 and June 2023, seven virtual, one-hour participatory design sessions with clinicians (n = 8), clinical support staff (n = 9), and patients (n = 4) from three Chicago-area primary care clinics: one Federally Qualified Health Center, one residency practice, and one non-teaching practice. Sessions were recorded, transcribed, and thematically analyzed using Dedoose.

Clinicians and staff emphasized the need for an intervention with multiple touchpoints to ensure patients don't fall through the cracks between obstetric and primary care. Desired elements included: an obstetrics-initiated assisted transition of patients to primary care; proactive primary care outreach to post-pregnancy patients; counseling tailored to ICC needs; and routine screening for reproductive-aged patients. Clinician education and improved screening tools focused on post-pregnancy health are needed for intervention implementation.

A multi-element intervention to proactively connect with patients, offer multiple engagement opportunities, and bridge obstetrics and primary care should be considered. Future work will explore intervention design and implementation in depth, including prototyping and piloting the intervention.