A Preconception Educational Intervention in a Community Health Setting - PowerPoint PPT Presentation


Title: A Preconception Educational Intervention in a Community Health Setting


1
A Preconception Educational Interventionin a
CommunityHealth Setting
  • Nancy Khosa Sarabeth Sheffler
  • Drexel University School of Public Health
  • Marjorie Angert BrIan Castrucci
  • Philadelphia Department of Public Health,
  • Division of Maternal, Child and Family Health

2
Statement of the Problem
  • Despite a consistent decline in infant mortality
    rates nationally and locally, infant mortality in
    Philadelphia is 56 higher than the United States
    average
  • Significant racial disparities in infant
    mortality

3
Trends in Infant Mortality Rate,United States,
1980-2001
Source NCHS, 2001
4
Trends in Infant Mortality Rate,Philadelphia,
1995-2002
Source PDPH, 2003
5
Background
  • The infant mortality rate is a marker of
  • general well being
  • good health of a nation
  • More specifically, it is a marker of
  • the quality of the health care system
  • accessibility to health care
  • adequacy of primary care

6
Why Preconceptional Education?
  • The incidence of unplanned pregnancy in the U.S
    is 49 percent
  • 70 percent of pregnancies in women under 20 years
    of age are unplanned
  • Usual entry into prenatal care is 3rd month after
    last menstrual period
  • Most of the organogenesis occurs in first three
    months post-conception

7
Role of Health Education
  • Review of 479 peer-review articles by Korenbrott
    et al.
  • Evidence for the efficacy of preconceptional care
    in terms of improving pregnancy outcomes
  • Recommended promoting preconceptional education
    among reproductive age couples

8
Goals of this Study
  • To evaluate the need for preconceptional care
    education
  • To determine which is more effective in educating
    women about preconceptional risk factors
  • written materials alone
  • written and video materials

9
Issues Addressed
  • Nutritional Issues General health, fitness,
    folic acid supplements, optimal weight at
    conception
  • Behavioral Issues smoking, alcohol use, over the
    counter medications
  • Immunization issues Rubella, Hepatitis B
  • Genetic risks Familial, ethnic and racial

10
Issues Addressed
  • Sexually transmitted diseases and HIV
  • Diabetes, hypertension, and epilepsy
  • Dental hygiene and urinary tract infections

11
Educational Tools
  • Preconceptional education pamphlet from the March
    of Dimes
  • Video from the March of Dimes on preconceptional
    care

12
Demographic Characteristics at Health Care
Center 5
  • Serves a population of 34,935 people
  • Located in Lower North Philadelphia
  • Population
  • 96.0 African American
  • 1.8 White
  • The infant mortality rate for this area is 17.8
    per 1000 live births

13
Location ofHealth Care Center 5
14
Study Design and Methodology
  • Study was a randomized educational trial
  • Women were enrolled from the family planning
    section of Health Care Center 5
  • Baseline questionnaire administered to assess
    pre-intervention awareness of preconceptional care

15
Inclusion and Exclusion Criteria
  • Inclusion
  • Women of reproductive age
  • Exclusion
  • Men
  • Pregnant women
  • Women whose native language was not English
  • Women identified as being at high risk of adverse
    birth outcome

16
Results and Data Analysis
  • 76 women between the ages of 18 and 45 were
    enrolled
  • 59.2 (n 45) were 18 to 24 years old, 27.6 (n
    21) were 25 to 34 years old and 13.2 (n 10)
    were 35 to 44 years of age

17
Awareness of General Health and Nutritional
Issues
18
Awareness of Behavioral Issues
19
Awareness of the Need for Prenatal and Dental
Care
20
Awareness of Sexually Transmitted Disease Issues
21
Awareness of Medical Issues
22
Intervention
  • All women received either
  • Written educational material
  • Written education material and watched a video
  • To date, only 20 women have completed post-test
    survey
  • Qualitative analysis pending
  • Early analysis reveals incremental gains in
    knowledge
  • Adequate data not available at this time to
    compare two study arms

23
Intervention Process Evaluation
  • Video
  • Too long
  • Not class, culturally sensitive
  • Need
  • 10 minutes
  • How to have a healthy baby
  • Appealing to urban audience

24
Study Limitations
  • Low retention
  • Inability to enroll women under 18 years of age
  • Duration of preconception education video (30
    minutes)
  • Instructions for follow up appointments were not
    always followed.
  • More educational sessions should have been
    devoted for health care provider education.

25
Discussion
  • 53 were not aware of the importance of folic
    acid in preventing adverse birth outcomes
  • 80 did not believe being over weight could be
    detrimental to their infants
  • 27 did not know that you could safely become
    pregnant if you are HIV-positive

26
Discussion
  • Continued focus on alcohol, tobacco and other
    drug cessation
View by Category
About This Presentation
Title:

A Preconception Educational Intervention in a Community Health Setting

Description:

Title: Feasibility and N Author: Preferred Customer Last modified by: kmcintosh Created Date: 4/16/2004 6:01:35 PM Document presentation format: Custom – PowerPoint PPT presentation

Number of Views:17
Avg rating:3.0/5.0
Slides: 27
Provided by: Preferr450
Learn more at: http://www.citymatch.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: A Preconception Educational Intervention in a Community Health Setting


1
A Preconception Educational Interventionin a
CommunityHealth Setting
  • Nancy Khosa Sarabeth Sheffler
  • Drexel University School of Public Health
  • Marjorie Angert BrIan Castrucci
  • Philadelphia Department of Public Health,
  • Division of Maternal, Child and Family Health

2
Statement of the Problem
  • Despite a consistent decline in infant mortality
    rates nationally and locally, infant mortality in
    Philadelphia is 56 higher than the United States
    average
  • Significant racial disparities in infant
    mortality

3
Trends in Infant Mortality Rate,United States,
1980-2001
Source NCHS, 2001
4
Trends in Infant Mortality Rate,Philadelphia,
1995-2002
Source PDPH, 2003
5
Background
  • The infant mortality rate is a marker of
  • general well being
  • good health of a nation
  • More specifically, it is a marker of
  • the quality of the health care system
  • accessibility to health care
  • adequacy of primary care

6
Why Preconceptional Education?
  • The incidence of unplanned pregnancy in the U.S
    is 49 percent
  • 70 percent of pregnancies in women under 20 years
    of age are unplanned
  • Usual entry into prenatal care is 3rd month after
    last menstrual period
  • Most of the organogenesis occurs in first three
    months post-conception

7
Role of Health Education
  • Review of 479 peer-review articles by Korenbrott
    et al.
  • Evidence for the efficacy of preconceptional care
    in terms of improving pregnancy outcomes
  • Recommended promoting preconceptional education
    among reproductive age couples

8
Goals of this Study
  • To evaluate the need for preconceptional care
    education
  • To determine which is more effective in educating
    women about preconceptional risk factors
  • written materials alone
  • written and video materials

9
Issues Addressed
  • Nutritional Issues General health, fitness,
    folic acid supplements, optimal weight at
    conception
  • Behavioral Issues smoking, alcohol use, over the
    counter medications
  • Immunization issues Rubella, Hepatitis B
  • Genetic risks Familial, ethnic and racial

10
Issues Addressed
  • Sexually transmitted diseases and HIV
  • Diabetes, hypertension, and epilepsy
  • Dental hygiene and urinary tract infections

11
Educational Tools
  • Preconceptional education pamphlet from the March
    of Dimes
  • Video from the March of Dimes on preconceptional
    care

12
Demographic Characteristics at Health Care
Center 5
  • Serves a population of 34,935 people
  • Located in Lower North Philadelphia
  • Population
  • 96.0 African American
  • 1.8 White
  • The infant mortality rate for this area is 17.8
    per 1000 live births

13
Location ofHealth Care Center 5
14
Study Design and Methodology
  • Study was a randomized educational trial
  • Women were enrolled from the family planning
    section of Health Care Center 5
  • Baseline questionnaire administered to assess
    pre-intervention awareness of preconceptional care

15
Inclusion and Exclusion Criteria
  • Inclusion
  • Women of reproductive age
  • Exclusion
  • Men
  • Pregnant women
  • Women whose native language was not English
  • Women identified as being at high risk of adverse
    birth outcome

16
Results and Data Analysis
  • 76 women between the ages of 18 and 45 were
    enrolled
  • 59.2 (n 45) were 18 to 24 years old, 27.6 (n
    21) were 25 to 34 years old and 13.2 (n 10)
    were 35 to 44 years of age

17
Awareness of General Health and Nutritional
Issues
18
Awareness of Behavioral Issues
19
Awareness of the Need for Prenatal and Dental
Care
20
Awareness of Sexually Transmitted Disease Issues
21
Awareness of Medical Issues
22
Intervention
  • All women received either
  • Written educational material
  • Written education material and watched a video
  • To date, only 20 women have completed post-test
    survey
  • Qualitative analysis pending
  • Early analysis reveals incremental gains in
    knowledge
  • Adequate data not available at this time to
    compare two study arms

23
Intervention Process Evaluation
  • Video
  • Too long
  • Not class, culturally sensitive
  • Need
  • 10 minutes
  • How to have a healthy baby
  • Appealing to urban audience

24
Study Limitations
  • Low retention
  • Inability to enroll women under 18 years of age
  • Duration of preconception education video (30
    minutes)
  • Instructions for follow up appointments were not
    always followed.
  • More educational sessions should have been
    devoted for health care provider education.

25
Discussion
  • 53 were not aware of the importance of folic
    acid in preventing adverse birth outcomes
  • 80 did not believe being over weight could be
    detrimental to their infants
  • 27 did not know that you could safely become
    pregnant if you are HIV-positive

26
Discussion
  • Continued focus on alcohol, tobacco and other
    drug cessation
About PowerShow.com