Deirdre A Quinn1, Stephanie W Edmonds2,3,4, Xinhua Zhao5, Sonya Borrero5,6, Ginny L Ryan7, Laurie C Zephyrin8, Lisa S Callegari7,9,10. 1. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Building #30, Pittsburgh, PA, 15240, USA. deirdre.quinn@va.gov. 2. Office of Nursing Research and Evidence-Based Practice, University of Iowa Health Care, Iowa City, Iowa, USA. 3. Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, IA, USA. 4. College of Nursing, University of Iowa, Iowa City, Iowa, USA. 5. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Building #30, Pittsburgh, PA, 15240, USA. 6. Center for Research On Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA. 8. The Commonwealth Fund, New York, NY, USA. 9. Health Services Research and Development, VA Puget Sound Health Care System, Seattle, WA, USA. 10. Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA.
Abstract
OBJECTIVES: To identify the prevalence of women Veterans reporting receipt of counseling about health optimization prior to pregnancy, topics most frequently discussed, and factors associated with receipt of this care. METHODS: We analyzed data from a nationally representative, cross-sectional telephone survey of women Veterans (n = 2302) ages 18-45 who used VA for primary care in the previous year. Our sample included women who were (1) currently pregnant or trying to become pregnant, (2) not currently trying but planning for pregnancy in the future, or (3) unsure of pregnancy intention. Multivariable logistic regression was used to examine adjusted associations of patient- and provider-level factors with receipt of any counseling about health optimization prior to pregnancy (prepregnancy counseling) and with counseling on specific topics. RESULTS: Among 512 women who were considering or unsure about pregnancy, fewer than half (49%) reported receiving any prepregnancy counseling from a VA provider in the past year. For those who did, the most frequently discussed topics included healthy weight (29%), medication safety (27%), smoking (27%), and folic acid use before pregnancy (27%). Factors positively associated with receipt of prepregnancy counseling include history of mental health conditions (aOR = 1.96, 95% CI: 1.28, 3.00) and receipt of primary care within a dedicated women's health clinic (aOR = 2.07, 95% CI: 1.35, 3.18), whereas factors negatively associated include far-future and unsure pregnancy intentions (aOR = 0.35, 95% CI: 0.17, 0.71 and aOR = 0.33, 95% CI: 0.16, 0.70, respectively). CONCLUSIONS FOR PRACTICE: Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care.
OBJECTIVES: To identify the prevalence of women Veterans reporting receipt of counseling about health optimization prior to pregnancy, topics most frequently discussed, and factors associated with receipt of this care. METHODS: We analyzed data from a nationally representative, cross-sectional telephone survey of women Veterans (n = 2302) ages 18-45 who used VA for primary care in the previous year. Our sample included women who were (1) currently pregnant or trying to become pregnant, (2) not currently trying but planning for pregnancy in the future, or (3) unsure of pregnancy intention. Multivariable logistic regression was used to examine adjusted associations of patient- and provider-level factors with receipt of any counseling about health optimization prior to pregnancy (prepregnancy counseling) and with counseling on specific topics. RESULTS: Among 512 women who were considering or unsure about pregnancy, fewer than half (49%) reported receiving any prepregnancy counseling from a VA provider in the past year. For those who did, the most frequently discussed topics included healthy weight (29%), medication safety (27%), smoking (27%), and folic acid use before pregnancy (27%). Factors positively associated with receipt of prepregnancy counseling include history of mental health conditions (aOR = 1.96, 95% CI: 1.28, 3.00) and receipt of primary care within a dedicated women's health clinic (aOR = 2.07, 95% CI: 1.35, 3.18), whereas factors negatively associated include far-future and unsure pregnancy intentions (aOR = 0.35, 95% CI: 0.17, 0.71 and aOR = 0.33, 95% CI: 0.16, 0.70, respectively). CONCLUSIONS FOR PRACTICE: Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care.
Authors: Lisa S Callegari; Abigail R A Aiken; Christine Dehlendorf; Patty Cason; Sonya Borrero Journal: Am J Obstet Gynecol Date: 2016-10-21 Impact factor: 8.661
Authors: Lisa S Callegari; Sonya Borrero; Gayle E Reiber; Karin M Nelson; Laurie Zephyrin; George G Sayre; Jodie G Katon Journal: Womens Health Issues Date: 2015-06-27
Authors: Lisa S Callegari; Erica V Tartaglione; Sara L Magnusson; Karin M Nelson; David E Arteburn; Jackie Szarka; Laurie Zephyrin; Sonya Borrero Journal: Womens Health Issues Date: 2019-04-10
Authors: Sonya Borrero; Lisa S Callegari; Xinhua Zhao; Maria K Mor; Florentina E Sileanu; Galen Switzer; Susan Zickmund; Donna L Washington; Laurie C Zephyrin; E Bimla Schwarz Journal: J Gen Intern Med Date: 2017-04-21 Impact factor: 5.128