Preconception health and health care environmental scan : report on clinical screening tools and interventions
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Preconception health and health care environmental scan : report on clinical screening tools and interventions

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    Prepared for the Clinical Work Group on Preconception Health and Health Care.

    The aim of preconception care is to promote the health of women before conception occurs in order to reduce preventable adverse pregnancy outcomes. In 2006, the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care published an MMWR on Recommendations on Improving Preconception Health and Health Care – U.S., and defined preconception care as ‘interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management, emphasizing those factors which must be acted on before conception or early in pregnancy to have maximal impact’ (Johnson, Posner, Biermann et al., 2006). That same report included 10 recommendations that could lead to successful development and delivery of an array of evidence-based services and support that could improve the health of women in the preconception period (Johnson, Posner, Biermann et al., 2006).

    To assist in moving these recommendations forward, five work groups were designated to address clinical, consumer, public health, policy and finance, and research and surveillance components of preconception health and health care. Over the past six years, a national Preconception Health and Health Care (PCHHC) Initiative has evolved , including these work groups, creating substantial research, publications, policy changes, and community action implementing many of the plans and strategies proposed in 2006.

    After the 3rd National Summit on Preconception Health and Health Care in Tampa, Florida, June 12-14, 2011, the PCHHC Initiative Leadership decided to convene a strategic planning meeting in order to reaffirm the goals of the initiative and to develop a PCHHC Action Plan for 2012-2015. This report was developed in response to a request for an environmental scan that emerged from the Clinical Work Group at the strategic meeting, calling for collection, review, and compilation of promising tools with an existing evidence base, including both screening instruments and brief interventions.

    This environmental scan was conducted from December 2011 – March 2012 to identify preconception or interconception screening tools and brief interventions that had been previously evaluated. The goal of the environmental scan was to summarize the evidence base available for preconception/interconception screening tools and brief interventions. The process included: searches of the peer-reviewed and non-peer reviewed literature (e.g., grey literature issue briefs), collection of screening instruments available on-line and from published sources, discussions with content experts using a “snowball” method, and review by members of the PCHHC Initiative Clinical Work Group. Most of the peer-reviewed tools/interventions were obtained via one of several scanned databases, an Internet search engine, and through communication with content experts for non-peer reviewed tools/interventions. Pertinent information from the scan was consolidated into a database, which included evaluation information on the tools’ and interventions’ implementation setting, design, sample size, measures, and outcomes. The Clinical PCHHC Work Group members and the CDC liaison to the Work Group reviewed the database to verify entries relevant to the scan and identify missing entries from the database. The scan was limited to tools that had either been evaluated or were in the process of being evaluated as indicated by peer-reviewed and non-peer reviewed sources of information.

    This project was supported in part by an appointment to the Research Participation Program for the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an agreement between the Department of Energy and CDC.

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