Recently, all 50 states and 13 territories completed a needs assessment which included new state health priorities. One of the top priority items that appeared on many state lists was preconception health. AMCHP asked several states about their activities to get a sense of how states are planning to address this important issue through the Title V MCH Block Grant.
What are two preconception health related activities that your state is planning for the upcoming year?
Karen Trierweiler, MS, CNM
MCH Director, Center for Healthy Families & Communities
Colorado Department of Public Health & Environment
The Colorado Department of Public Health and Environment's Maternal Wellness Team and the Epidemiology, Planning and Evaluation Branch are working on a Health Watch publication to provide a population-level snapshot of preconception health in Colorado. Our analysis of Behavioral Risk Factor Surveillance System (BRFSS) data is aimed at determining if pregnancy intendedness, age or ethnicity influences preconception risk and protective behaviors of Colorado adult women.
Additionally, the Women's Health Unit and the Epidemiology, Planning, and Evaluation Branch developed a Life Plan tool for women of reproductive age. The Life Plan tool, which is similar to a journal, helps women with personal goal setting, education and life planning. Qualitative and quantitative evaluation of the Life Plan tool is underway to determine usefulness, relevance, and whether or not the tool increases knowledge, changes attitudes and spurs action among Colorado women to make better reproductive life choices.
Annette Phelps, ARNP, MSN
Division Director for Family Health Services
Florida Department of Health
The Florida Department of Health Family Planning Program is piloting a three year preconception health project in selected county health departments (CHDs) with high prevalence of Chlamydia (CT) and gonorrhea (GC). The goal is to screen for CT and GC when clients present to CHD family planning clinics for a pregnancy test or emergency contraception. Preconception health information will be provided at the time of the visit along with information for planning a pregnancy or referrals for prenatal care if the client is pregnant.
The department has also set aside a portion of the Title X grant funds to purchase long-acting reversible contraceptives, such as the intrauterine system, Mirena. The program is also providing additional funding for sterilization services to the CHDs. Both of these activities will increase the proportion of clients who use long-term contraceptive methods. Furthermore, this activity provides an opportunity to discuss preconception health and will allow low-income women to plan their pregnancy, as well as prevent additional pregnancies when unwanted.
Suzanna Dooley, MS, ARNP
Chief, Maternal & Child Health Services
Oklahoma State Department of Health
Preconception/interconception health rose to the top as a priority that the Oklahoma State Department of Health and its partners could address in an effort to improve the health status of all Oklahomans. The Preconception/Interconception Care and Education Workgroup was convened as part of the initiative to identify and implement strategies to positively impact this priority. Current activities of this group include development of:
· Television media spot focused on preconception choices
· Women’s health assessment tool
· Adolescent health assessment tool
The television spot entitled “One of These Days…” focuses on the importance of lifestyle choices made today, especially related to nutrition and physical activity. The script ties these choices to a healthy pregnancy and birth later on, points out that Oklahoma ranks 41 nationally in infant mortality, and encourages listeners to find out how preparing for a life time can start years before actually getting pregnant.
A colorful health assessment tool for women has been developed by the group for use in health care settings (clinic, physician office, health department) to assist women in identifying risk factors they have that may contribute to a poor pregnancy outcome. Women are encouraged to fill out the checklist on topics including family history, lifestyle history, nutrition, medical history, psychosocial history, and reproductive history while they wait for their scheduled appointment. During the appointment, the health care provider will review checked items with the client and highlight the brief accompanying information about each health risk identified. Resources are provided if clients desire more information about a particular health risk. Conversations have started with the Oklahoma Health Care Authority, Oklahoma’s state Medicaid agency, regarding additional reimbursement for Medicaid providers who take the time to provide preconception/interconception health counseling using this tool. Plans are to pilot this tool in public and private clinics settings in early 2011.
Workgroup members have also started revising and simplifying the Women’s Health Assessment tool to create a tool for use specifically with female adolescents. The adolescent version will be pocket sized with no more than two or three brief risk factors for each of the areas identified on the women’s version. The literacy level will be appropriate for adolescents and the size will be small enough to meet the needs of clients seeking confidential services. To learn more about “Preparing for a Lifetime, It’s Everyone’s Responsibility,” visit here.
Amy Nienhuis, LISW-CP, MSW
Perinatal Special Project Coordinator, MCH Bureau
South Carolina Department of Health and Environmental Control (SC DHEC)
South Carolina’s 2010 needs assessment states:
“Rather than attempting to deploy specific programs targeting a single aspect of pre/interconception health, MCH will focus on addressing this issue by building local infrastructure to enable programs and initiatives within selected geographic areas of the state. MCH will accomplish this by organizing and supporting a pre/interconception health coalition in each of the four perinatal regions.” These coalitions will be a multidisciplinary group and will be charged with:
· Conducting an initial assessment of pre/interconception health needs in each respective region
· Developing a regional plan to address the issue
· Implementing programs/initiatives to target need
· Evaluating the process and provide feedback to stakeholders
Regional activities will be rolled up into a state wide plan for improving pre/inter-conception health. These plans will also be used to support ongoing multi-state initiatives to address pre/inter-conception health issues.
In other exciting news, SC DHEC was recently awarded Personal Responsibility Education Program (PREP) funding to implement evidence-based programs to prevent teen pregnancy and sexually transmitted infections, including HIV/AIDS. The department anticipates issuing the funds in the summer of 2011. These funded projects will be well-suited to deliver preconception health messages.