Daniel Frayne1, Phillip Hughes2, Brunilda Lugo2, Kathy Foley2, Stephanie Rosener3, Wendy B Barr4,5, Scott A Davis6, Heidi Knoll2, Kayla Krajick7, Ian M Bennett8. 1. Department of Family Medicine, UNC Health Sciences At MAHEC, 121 Hendersonville Road, Asheville, NC, 28803, USA. Dan.Frayne@mahec.net. 2. Department of Family Medicine, UNC Health Sciences At MAHEC, 121 Hendersonville Road, Asheville, NC, 28803, USA. 3. Middlesex Hospital Family Medicine Residency Program, Middletown, CT, USA. 4. Greater Lawrence Family Health Center, Lawrence, MA, USA. 5. Tufts University School of Medicine, Boston, MA, USA. 6. Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Asheville, NC, USA. 7. UNC Chapel Hill School of Medicine, Asheville, NC, USA. 8. Departments of Family Medicine and Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
Abstract
INTRODUCTION: Interconception care (ICC) is recommended to reduce maternal risk factors for poor birth outcomes between pregnancies. The IMPLICIT ICC model includes screening and brief intervention for mothers at well child visits (WCVs) for smoking, depression, multivitamin use, and family planning. Prior studies demonstrate feasibility and acceptability among providers and mothers, but not whether mothers recall receipt of targeted messages. METHODS: Mothers accompanying their child at 12- and 24-month WCVs at four sites of a family medicine academic practice were surveyed pre (2012) and post (2018) ICC model implementation. Survey items assessed health history, behaviors, and report of whether their child's physician addressed maternal depression, tobacco use, family planning, and folic acid supplementation during WCVs. Pre and post results are compared using logistic regression adjusting for demographics and insurance. RESULTS: Our sample included 307 distinct mothers with 108 and 199 respondents in the pre and post periods, respectively. Mothers were more likely to report discussions with their child's doctor post-intervention for family planning (31% pre to 86% post; aOR 18.65), depression screening (63-85%; aOR 5.22), and taking a folic acid supplement (53-68%; aOR 2.54). Among mothers who smoked, the percentage that reported their child's doctor recommended cessation increased from 56 to 75% (aOR = 3.66). DISCUSSION: The IMPLICIT ICC model resulted in increased reported health care provider discussions of four key areas of interconception health by mothers attending WCVs. This model holds promise as a primary care strategy to systematically address maternal risks associated with poor pregnancy outcomes.
INTRODUCTION: Interconception care (ICC) is recommended to reduce maternal risk factors for poor birth outcomes between pregnancies. The IMPLICIT ICC model includes screening and brief intervention for mothers at well child visits (WCVs) for smoking, depression, multivitamin use, and family planning. Prior studies demonstrate feasibility and acceptability among providers and mothers, but not whether mothers recall receipt of targeted messages. METHODS: Mothers accompanying their child at 12- and 24-month WCVs at four sites of a family medicine academic practice were surveyed pre (2012) and post (2018) ICC model implementation. Survey items assessed health history, behaviors, and report of whether their child's physician addressed maternal depression, tobacco use, family planning, and folic acid supplementation during WCVs. Pre and post results are compared using logistic regression adjusting for demographics and insurance. RESULTS: Our sample included 307 distinct mothers with 108 and 199 respondents in the pre and post periods, respectively. Mothers were more likely to report discussions with their child's doctor post-intervention for family planning (31% pre to 86% post; aOR 18.65), depression screening (63-85%; aOR 5.22), and taking a folic acid supplement (53-68%; aOR 2.54). Among mothers who smoked, the percentage that reported their child's doctor recommended cessation increased from 56 to 75% (aOR = 3.66). DISCUSSION: The IMPLICIT ICC model resulted in increased reported health care provider discussions of four key areas of interconception health by mothers attending WCVs. This model holds promise as a primary care strategy to systematically address maternal risks associated with poor pregnancy outcomes.
Authors: Stephanie E Rosener; Wendy B Barr; Daniel J Frayne; Joshua H Barash; Megan E Gross; Ian M Bennett Journal: Ann Fam Med Date: 2016-07 Impact factor: 5.166
Authors: Sukanya Srinivasan; Lisa Schlar; Stephanie E Rosener; Daniel J Frayne; Scott G Hartman; Michael A Horst; Jessica L Brubach; Stephen Ratcliffe Journal: J Am Board Fam Med Date: 2018 Mar-Apr Impact factor: 2.657
Authors: Kay Johnson; Samuel F Posner; Janis Biermann; José F Cordero; Hani K Atrash; Christopher S Parker; Sheree Boulet; Michele G Curtis Journal: MMWR Recomm Rep Date: 2006-04-21