Delivering Interconception Care During Well-Child Visits: An IMPLICIT Network Study

Srinivasan, Sukanya; Schlar, Lisa; Rosener, Stephanie E.; Frayne, Daniel J.; Hartman, Scott; Horst, Michael; Brubach, Jessica L.; Ratcliffe, Stephen D.

doi:10.3122/jabfm.2018.02.170227

Cited by 37 publications

(30 citation statements)

References 15 publications

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“…Maternal depression screening at the WBV is already a reimbursable service through the child's Medicaid 20 . In addition to depression screening at the WBV, family practice practitioners 21 and other practitioners 3 have begun to introduce additional screening tools at the WBV to address women's health needs including smoking cessation, folic acid supplementation, and contraception 21‐24 . Research has already demonstrated that women and physicians are receptive to colocating maternal contraception services with pediatric care 3,11,23,24 .…”

Section: Discussionmentioning

confidence: 99%

A two‐generation approach to postpartum care: Building on the well‐baby visit

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Bergo

Dominik

et al. 2021

Birth

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Background Although postpartum (PP) care is essential for the health and well‐being of women and their infants, many women in the United States do not receive PP care. In order to ensure that women's PP needs are met, it is essential to develop delivery models that address their barriers to care. The objective of the current study was to obtain women's feedback and perspectives about delivering women's health care at the well‐baby visit (WBV) using a modified mixed‐methods approach including open‐ended interviews and surveys. Methods Twenty brief open‐ended interviews were conducted with PP women at a large urban medical center in Chicago. The interviews were recorded, transcribed, and coded following a mixed deductive and inductive approach and analyzed using Dedoose. Following the interview analysis, surveys with 50 immediate PP women and 50 who were 2‐4 months PP were conducted. Statistical analyses included frequencies and chi‐square tests to determine differences between participants interviewed at the two time periods. Results Key themes that emerged from the open‐ended interviews include the tension between the desire for continuity of care (prenatal to PP) and the desire for convenient care. The surveys found that 86%‐94% of women would be interested in receiving PP care at the same clinic site and time as their new baby. Conclusions One approach to addressing women's PP health and need for convenient care is the provision of components of women's health care at the WBV. Therefore, we present an innovative two‐generation model for PP care focusing on needs of both the woman and infant.

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Section: Discussionmentioning

confidence: 99%

A two‐generation approach to postpartum care: Building on the well‐baby visit

Handler

Bergo

Dominik

et al. 2021

Birth

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“…For instance, other studies focusing on the promotion of folic acid supplementation in routine PCHC practice have shown promising results with regards to increased use and intention [18, 19]. Other encouraging, recently reported, ICC related practices that were aimed at mothers during well-child visits, include screening and addressing tobacco use, depression risk and contraception use [39, 40]. As such, standardization of certain ICC items in PCHC could make it accessible for all women while warranting sufficient management support and resources, which could improve feasibility.…”

Section: Discussionmentioning

confidence: 99%

Integrating interconception care in preventive child health care services: The Healthy Pregnancy 4 All program

et al. 2019

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BackgroundMost parents with young children pay routine visits to Well-Baby Clinics, or so-called Preventive Child Health Care (PCHC) services. This offers a unique opportunity to promote and deliver interconception care. This study aimed to integrate such care and perform an implementation evaluation.MethodsIn seven Dutch municipalities, PCHC professionals were instructed to discuss the possibility of an interconception care consultation during each routine six-months well-baby visit. The primary outcome of this study was coverage of the intervention, quantified as the proportion of visits during which women were informed about interconception care. Secondary outcomes included adoption, fidelity, feasibility, appropriateness, acceptability and effectiveness of the intervention, studied by surveying PCHC professionals and women considering becoming pregnant.ResultsThe possibility of interconception care was discussed during 29% (n = 1,849) of all visits, and 60% of the PCHC physicians adopted the promotion of interconception care by regularly informing women. About half of the PCHC professionals and most women judged integration of interconception care in PCHC appropriate and acceptable. Estimated feasibility was poor, since 13% of the professionals judged future integration in daily practice as probable. The uptake of interconception care consultations was low (n = 4 consultations).ConclusionsPromotion of interconception care was achieved in approximately one-third of the routine PCHC consultations and appeared promising with regards to adoption, appropriateness and acceptability. However, concerns on feasibility and uptake of interconception care consultations in daily practice remain. Suggestions for improvement may include further integration of interconception care health promotion in routine PCHC consultations, while allocating sufficient resources.

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“…18 Monitoring mood and supporting mothers through technology such as mobile apps may also be a useful approach. 19 The IMPLIC-IT network has demonstrated that well-child visits in family medicine clinics can be used to identify and support high-risk mothers and children 20 and that mothers are interested in health advice from their child's physician even if they receive their health care from a different provider. 21 Enhancing the knowledge base of PDs on these approaches may be one avenue to promote change given the association we found between the self-reported knowledge of PDs on this topic and the comprehensiveness of the approach to resident training on this topic.…”

Section: Discussionmentioning

confidence: 99%

Training Residents in Maternal Depression Care to Improve Child Health: A CERA Study

Edge

Kraleti

McKelvey

et al. 2019

Fam Med

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Background and Objectives: Untreated maternal depression negatively impacts both the mother and her children’s health and development. We sought to assess family medicine program directors’ (PDs) knowledge and attitudes regarding maternal depression management as well as resident training and clinical experience with this disorder. Methods: Data were gathered through the Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) national survey of family medicine PDs in US and Canadian programs, from January through February, 2018. Results: Surveys were completed by 298 PDs (57.1% response rate) who were majority male (58.9%) and white (83.8%). Nearly all (90.2%) PDs agreed that family physicians should lead efforts to minimize the impact of maternal depression on child well-being. According to PD report, in the family medicine clinics where residents train, most (77.3%) have a clinic process that ensures that routine screening for depression occurs, and 54.4% do some screening of mothers during pediatric visits. Only 18.2% report routinely taking steps to minimize the impact of the mothers’ depression on child well-being. Finally, 41.3% of PDs reported being familiar with the literature on the impact of maternal depression on children; self-reported familiarity was significantly associated with more comprehensive resident training on this topic. Conclusions: Family medicine residency program directors are supportive of training in maternal depression, though their current knowledge is variable and there are opportunities to enhance care of mothers and children impacted by this common and serious disorder.

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Delivering Interconception Care During Well-Child Visits: An IMPLICIT Network Study

Cited by 37 publications

References 15 publications

A two‐generation approach to postpartum care: Building on the well‐baby visit

A two‐generation approach to postpartum care: Building on the well‐baby visit

Integrating interconception care in preventive child health care services: The Healthy Pregnancy 4 All program

Training Residents in Maternal Depression Care to Improve Child Health: A CERA Study

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