Women’s views on content and delivery methods for interventions to improve preconception health: a qualitative exploration

Daly, Michael P.; Kipping, Ruth R.; White, James; Sanders, Julia

doi:10.3389/fpubh.2024.1303953

Cited by 5 publications

References 42 publications

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What does ‘preconception health’ mean to people? A public consultation on awareness and use of language

Schoenaker,

Gafari,

Taylor

et al. 2024

Preprint

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Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. Methods: A public consultation was undertaken with people of any gender aged 18-50 years living in the UK who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined, and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Results: 54 people joined the initial discussion round (66% women, 21% men, 13% non-binary or transgender; 55% aged 18-30 years, 30% 31-40 years, 15% 41-50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term preconception health, understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g. preconception health, medical terms), using language that is positive, encouraging and gender-sensitive where possible, and using messages that are specific, non-judgmental and realistic. The phrases health and wellbeing during the childbearing years, health and wellbeing before pregnancy and parenthood and planning for parenthood resonated with most public contributors. School-based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. Conclusion: This public consultation produced recommendations from a diverse group of people of reproductive age in the UK to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co-development of public awareness campaigns and guidance for healthcare professionals.

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What does ‘preconception health’ mean to people? A public consultation on awareness and use of language

Schoenaker,

Gafari,

Taylor

et al. 2024

Preprint

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Developing consensus on priorities for preconception care in the general practice setting in the UK: study protocol

Schoenaker,

Lovegrove,

Santer

et al. 2024

Preprint

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BackgroundPreconception medical, behavioural and socioeconomic risk factors are common among people of reproductive age and can impact pregnancy and offspring outcomes. In line with clinical guidance, primary care practitioners are encouraged to support patients to manage and optimise their health prior to pregnancy. Due to barriers, including lack of time and resources, this support is not currently part of routine practice.AimAs a first step towards the co-development of practical and realistic best practice guidance, this study aims to achieve consensus on a list of priority risk factors that can be used in general practice to guide opportunistic preconception care for patients of reproductive age.MethodsThis study protocol was developed with a Public Advisory Group of people of reproductive age, researchers and primary care practitioners. The consensus study will consist of three steps: 1) identifying an initial long-list of candidate risk factors and defining principles for scoring the importance of each risk factor, through a literature review, workshops with people of reproductive age, and interviews with primary care practitioners; 2) stakeholder participant prioritisation of each candidate risk factor for its importance for preconception care through a three-round eDelphi survey; and 3) agreeing on the final priority list through consensus meetings with a selected group of stakeholders. Participants living in the UK will be recruited across two stakeholder groups: people of reproductive age (through the Public Advisory Group and charities) and primary care professionals (through professional organisations).Ethical approvalThis study has been approved by the University of Southampton Faculty of Medicine Ethics Committee (ERGO 83699 and 92950).DisseminationAll study findings will be shared through stakeholder participants, peer-reviewed publication, lay summary, meetings and conference presentations, and relevant professional and community organisations. Ongoing research will inform implementation of the priority list in clinical practice.

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What support is needed for preconception health improvement, and by whom? A qualitative study of women’s views

Daly,

Kipping,

White

et al. 2024

Preprint

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BackgroundSystematic reviews suggest preconception health interventions may be effective in improving maternal and infant outcomes. However, few studies have explored women’s views on the types of support required for preconception health improvement, nor when and to whom this support should be provided.MethodsWe purposively sampled women aged 18-48 years in the West of England from respondents to a survey, and conducted semi-structured in-depth interviews to explore their views on support needs in the preconception period and target populations for this support. We analyzed the data using a data-driven framework analysis.ResultsThe women we interviewed (N=20) broadly supported promoting greater awareness of preconception health and felt the limited focus on health before pregnancy downplays its importance relative to antenatal health. Some women opposed support services and structural interventions to improve preconception health, due to concerns these are less impactful than encouraging individual responsibility for health. Women who supported structural interventions highlighted broader determinants of health and socioeconomic barriers to preconception health improvement. Men were considered a key target population for preconception support, to help share the burden for preconception health improvement. Women broadly supported ‘age-appropriate’, school-based preconception health education, highlighting young women as an under-served group in need of additional preconception education.ConclusionOur findings indicate a need to deliver early preventive support ahead of first pregnancy through services, interventions and policies co-produced with women and women’s partners. Future research should explore how to increase public understanding of the socioeconomic, environmental and commercial determinants of preconception health.HIGHLIGHTSWomen broadly supported promoting greater awareness of preconception healthNeoliberal views on responsibility underlay opposition to structural interventionsAwareness of wider health determinants underlay support for structural interventionsSuggested support included preconception health checks and community support groupsYoung women were considered an under-served group in terms of preconception support

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Women’s views on content and delivery methods for interventions to improve preconception health: a qualitative exploration

Cited by 5 publications

References 42 publications

What does ‘preconception health’ mean to people? A public consultation on awareness and use of language

What does ‘preconception health’ mean to people? A public consultation on awareness and use of language

Developing consensus on priorities for preconception care in the general practice setting in the UK: study protocol

What support is needed for preconception health improvement, and by whom? A qualitative study of women’s views

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