Interconception Care for Mothers at Well Child Visits After Implementation of the IMPLICIT Model

Frayne, Daniel J.; Hughes, Phillip; Lugo, Brunilda; Foley, K.; Rosener, Stephanie E.; Barr, Wendy; Davis, Scott; Knöll, H; Krajick, Kayla; Bennett, Ian M.

doi:10.1007/s10995-021-03137-z

Cited by 9 publications

(12 citation statements)

References 9 publications

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“…We believe that this compatibility arises from family‐oriented care, given its consideration of the entire family unit. In the previous study of ICC during WCVs, contraception was the area that yielded the most prominent change from usual WCVs because maternal family planning has never been recommended as part of pediatric regular WCVs 17 . Furthermore, smoking and maternal depression are issues that impact not only the mother but also her entire family.…”

Section: Discussionmentioning

confidence: 99%

“…14 The IMPLICIT network (Interventions to Minimize Preterm and Low birth weight Infants using Continuous quality Improvement Techniques) is a family medicine learning collaborative interested in improving birth outcomes and promoting women's health through innovative models of care. [15][16][17] One of its works is developing the IMPLICIT ICC model, which focuses on screening mothers for maternal risk factors during well-child visits (WCVs) from 0 to 24 months. WCVs are preventive health examinations regularly scheduled throughout a child's life, generally ending around 20 years old.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…ICC is defined as care provided to mothers between pregnancies to improve the health outcomes of mothers, newborns, and children 14 . The IMPLICIT network (Interventions to Minimize Preterm and Low birth weight Infants using Continuous quality Improvement Techniques) is a family medicine learning collaborative interested in improving birth outcomes and promoting women's health through innovative models of care 15–17 . One of its works is developing the IMPLICIT ICC model, which focuses on screening mothers for maternal risk factors during well‐child visits (WCVs) from 0 to 24 months.…”

Section: Introductionmentioning

confidence: 99%

“…This model is ideally suited for family medicine; however, any practice that offers WCVs can take advantage of this unique model. The IMPLICIT ICC model includes screening and brief interventions for smoking, maternal depression, family planning, and prenatal vitamins with folate use 16,17 . The IMPLICIT ICC model has been broadly advocated but not widely implemented, and further studies are needed in various settings.…”

Section: Introductionmentioning

confidence: 99%

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Interconception care during well‐child visits by family physicians in the United States: A cross‐sectional study

Kuroda,

Morley,

Bailey

2023

J of Gen and Family Med

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BackgroundInterconception care (ICC) by family physicians during well‐child visits (WCVs) has been broadly advocated in principle but has not been widely implemented. We aimed to investigate ICC at WCVs by family physicians at our facility, focusing on four maternal risk factors, including maternal tobacco use, maternal depression, contraception, and folic acid supplementation.MethodsMothers who visited WCVs with children up to the age of 24 months at our university‐affiliated clinic were screened for the four maternal risks. Brief interventions were provided to mothers with positive screening results. We investigated mothers at WCVs from December 1, 2020, to November 30, 2022. We performed descriptive and binary logistic regression analyses to determine the maternal demographic factors associated with positive screenings.ResultsOf 1143 WCVs, 205 mothers were evaluated. Screening was positive in the following rates: tobacco use 5.9%, depression 11.5%, contraception 73.6%, and folic acid supplementation 40.5%. Single marital status was associated with positive screening for smoking (odds ratio [OR] 8.689, p = 0.016) and maternal depression (OR 3.470, p = 0.035). Maternal education level lower than a high school diploma was associated with positive screening for folic acid intake (OR 4.975, p = 0.004).ConclusionsICC conducted during WCVs by family physicians offers valuable opportunities to identify maternal risk factors and address modifiable factors that can influence future birth outcomes. Single marital status and educational level less than a high school diploma were more potent risk factors for maternal behavior in ICC. More research is needed to assess the outcomes of the interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Backg Rou N Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interconception care during well‐child visits by family physicians in the United States: A cross‐sectional study

Kuroda,

Morley,

Bailey

2023

J of Gen and Family Med

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“…They created and implemented an innovative model of ICC which seeks to capitalize on the opportunity presented to family medicine and other primary care clinicians to reach mothers during their child's well child visits (WCVs). 83 84 Mothers regularly attend their child's health care visits even if they do not seek care for themselves between pregnancies. 85 Given children typically attend 8 to 10 WCVs in the first 2 years of life, the WCV offers a consistent and repeated point of maternal contact and chance for intervention.…”

Section: Improving Equitable Access To Care Through Icc Programsmentioning

confidence: 99%

Interconception Health: Improving Equitable Access to Pregnancy Planning

Black

Middleton²,

LibSt

et al. 2022

Semin Reprod Med

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Challenges remain with the implementation of preconception care, as many women do not plan their pregnancies and clinicians do not initiate preconception consultations. However, the interconception period may present a more opportune time to address health issues that impact on pregnancy outcomes and may influence future conceptions. It is also an important time to focus on pregnancy complications that may influence a person's health trajectory. This review discusses the evidence pointing to a need for greater attention on interconception health and focuses on five areas of care that may be particularly important in affecting equitable access to good care before a subsequent pregnancy: interpregnancy intervals, contraception, weight, nutrition, and gestational diabetes follow-up. Several programs internationally have developed models of care for interconception health and this review presents one such model developed in the United States that explicitly seeks to reach vulnerable populations of women who may otherwise not receive preconception care.

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A Quality Improvement Innovation for Reproductive Health Planning in the Time of COVID

Davis

Knöll

Ireland

et al. 2023

Matern Child Health J

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Objectives To see if an outreach approach with telehealth is feasible and acceptable to patients to talk about their reproductive health; and as a secondary outcome, capture data on time spent on the visit and what kind of information was discussed. Methods A registry was created from three family physicians’ panels of all adult patients with anticipated ability to become pregnant ages 18–45 who had not had a documented reproductive health discussion in the previous 6 months. Using that registry, outreach was performed to schedule a telehealth visit to discuss their reproductive health with their primary care provider. The visit was standardized using the One Key Question approach. For patients who agreed to participate in the research, the patient completed a survey about their experience. The provider also completed a survey on the time spent and the issues addressed. Results Two hundred and six patients were called. Ninety patients (44%) could not be reached. Of the remaining patients, 34 scheduled either a telehealth or in-person visit and 7 also agreed to participate in the survey. New information was uncovered in the visit in 86% of participants. The most common need uncovered during the visit was unrelated medical needs (71%), followed by preconception health education/advice (43%) and contraception needs/counseling (29%). Most participants found the telehealth visit valuable. Conclusions An outreach methodology can uncover unmet health needs, both reproductive and otherwise. We found that people who had the visit often needed something, but a majority of patients declined the visit saying that they did not think they needed it. It is possible that patients are not aware of the value of reproductive health discussions, and therefore clinicians need to take every opportunity to have these discussions whenever possible, whether through outreach or inreach (during already scheduled visits).

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Interconception Care for Mothers at Well Child Visits After Implementation of the IMPLICIT Model

Cited by 9 publications

References 9 publications

Interconception care during well‐child visits by family physicians in the United States: A cross‐sectional study

Interconception care during well‐child visits by family physicians in the United States: A cross‐sectional study

Interconception Health: Improving Equitable Access to Pregnancy Planning

A Quality Improvement Innovation for Reproductive Health Planning in the Time of COVID

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