Change in Women's Knowledge of General and Personal Preconception Health Risks Following Targeted Brief Counseling in Publicly Funded Primary Care Settings

Purpose. To explore knowledge of general and personal preconception health risks among women in publicly funded clinics and whether brief counseling can improve knowledge. Design. Interventional cohort study. Setting. Five publicly funded primary care clinics. Subjects. Two cohorts of low-income, nonpregnant African-American and Hispanic women of reproductive age (300 in each cohort). Intervention. Targeted brief counseling based upon risks identified via preconception health risk assessment. Measures. Correct responses on test of women's knowledge of general and personal preconception health risks pre-encounter vs. 3 to 6 months postencounter. Analysis. McNemar's test to compare proportion of women in each cohort who correctly answer questions of preconception health knowledge pre-encounter vs. 3 to 6 months postencounter. Results. Women in the intervention cohort experienced a significant increase in knowledge related to preconception health from baseline to 3 to 6 months postencounter, including recognition of the importance of folic acid supplementation, seeking medical care for chronic conditions, and review of medication in the preconception period that was not observed for the comparison cohort. Among women with chronic medical conditions, those in the intervention cohort significantly increased their knowledge that the condition could lead to problems in pregnancy (+43%) relative to the lesser improvement in knowledge observed for those in the comparison cohort (+4%) (p < .05). Conclusions. Women's knowledge of general and personal preconception health risks improved following screening and brief counseling in publicly funded primary care clinics.