Implementation of a Preconception Education Campaign in Primary Care

Problem: In the United States, 50% of pregnancies are unplanned and maternal death rates are increasing. Preconception education informs women before pregnancy about healthy lifestyle behaviors to promote healthy pregnancies and avoid complications. Delivery of preconception health education to patients in all healthcare settings, including primary care is inadequate. The purpose of this project is to improve the quality and distribution of preconception education provided to women in the primary care setting. Methods: A quality improvement project was implemented at a local primary care clinic. First, a needs assessment survey was distributed to assess current understanding of preconception education. Then, campaign materials, including a website, brochure, and poster, were developed and distributed. Women over the age of 18 arriving at the clinic for appointment were given a preintervention and a postintervention survey before and after reviewing campaign materials to assess their knowledge and perceptions of preconception health. Results: Thirty-one needs assessments were collected and indicated preconception education was needed. Twenty-eight pre-/postintervention surveys were collected and analyzed with a paired t-test and a multivariate linear regression model. The postintervention survey results showed significant improvement in scores after reviewing campaign materials (Pre: 84.4% vs Post: 92.9%; p = <0.001). The likelihood for utilizing preconception health practices increased in all categories; however, maintaining healthy weight (Pre: 84.9 vs Post: 94.9; p = <0.001) and obtaining vaccinations (Pre: 83.1 vs Post: 90.1; p = < 0.01) showed a statistically significant increase. The majority (54%) of participants reported the website was the most effective method of education compared to the brochure and poster. The multivariate linear regression model showed those with a high school education had a greater increase in postintervention survey scores compared to those with other education levels. Conclusion: Use of written and online educational materials is an effective delivery method for providing preconception education to patients in a busy clinic setting where providers may be unwilling or unable to provide this education in traditional methods due to time restraints. Women may benefit from receiving preconception education before starting college and education for this younger population may be more effective when given electronically. Limitations include a small sample size and the study being implemented at one clinical site. Further study needs to be conducted to assess the effectiveness of website, written, and other forms of educational materials in other primary clinics and among a larger population of women.