PCHHC Newsletter

May 2014

Reproductive Life Planning & Contraception

In 2006, the National Preconception Health and Health Care Initiative created a vision for improving preconception health and pregnancy outcomes. Key to this vision was that all women and men would have a reproductive life plan and that all pregnancies would be intended and planned. The reports and projects described in this issue highlight several key resources that help us move this work forward.

CDC/OPA Providing Quality Family Planning Services
Guidelines Released

The Centers for Disease Control and Prevention (CDC) and the Office of Population Affairs (OPA) have released

Providing Quality Family Planning Services, 2014 (QFP). QFP is designed to help individuals achieve their desired number and spacing of children, and to increase the chances that children will be born healthy.

A webinar describing QFP will take place on May 8, 2014 at 1pm EST. Register here for the webinar.

QFP has several important features that will improve the quality of care provided to patients and help them achieve their desired number and spacing of healthy children. It defines what services should be offered in a family planning visit, which includes services to both prevent and achieve pregnancy, preconception, and STD services. Preconception health services are considered family planning services because they improve women's and men's health and can influence an individual's ability to conceive or to have a healthy birth outcome.

The preconception health services recommended for women in the QFP are those that the Select Panel on Preconception Care (Jack, et al, 2008) assigned an A or B recommendation, meaning that there was either good or fair evidence to support the recommendation. The recommended services include: Counseling about daily folic acid intake; discussion of a reproductive life plan; medical history; sexual health assessment; and screening for intimate partner violence, tobacco use, alcohol and other drug use, chlamydia, gonorrhea, and syphilis, HIV/AIDS, hepatitis C, diabetes, immunizations, depression, height/weight/BMI, and blood pressure.

Preconception health services for men are also recommended. When selecting these services, CDC and OPA considered whether the service was included in recommendations made by experts in male preconception health (Frey, et al, 2008) and addressed health conditions that directly affect reproductive capacity or pregnancy outcomes. They include: Discussion of a reproductive life plan; medical history; sexual health assessment; and screening for tobacco use, alcohol and other drugs, depression, height/weight/BMI, chlamydia, gonorrhea, syphilis, HIV/AIDS, hepatitis C, and diabetes.

Primary care and reproductive health providers can find job aids, training tools, and continuing education at www.fpntc.org.

Linked by Life Webinar: May 6th, 2:00-3:30pm EST
Wiscon

sin: Turning the Ship Towards Implementing Life Course Theory, Social Determinants of Health, and Preconception Care

This webinar will illustrate how the Wisconsin Department of Health Services adopted and implemented life course theory to expand preconception care throughout the state, connecting MCH and early childhood models of care while addressing the social determinants of health. Speakers will describe how they combined the assets of their MCH and chronic disease divisions to improve overall women's health. The presenters will communicate why other local and state health departments should adopt this strategic intent in order to reduce racial disparities in birth outcomes by becoming a MCH Life Course Organization.

The webinar will be moderated by Mario Drummonds, Co-Chair of the PCHHC Public Health Workgroup, and presenters include Lisa King from HRSA's Maternal and Child Health Bureau, and Kate Gillespie, Terry Kruse, and Patrice Mocny Onheiber of the Wisconsin Department of Health Services.

Click here to access the webinar. For audio, dial 1-800-988-9658 Passcode: #5218751

Throughout the Reproductive Life Course: Opportunities and Challenges for Empowering Girls and Women

From April 2-3, 2014, a technical meeting in Washington, DC, hosted by USAID and HRSA, brought together U.S. domestic and international reproductive health experts to share program learning across agencies.

The agenda focused specifically on HRSA's model of interconceptional care and USAID's approach to integrating family planning (FP) into maternal and child health interventions throughout the life cycle in multiple countries. Attendees examined emerging best practices and experiences in reproductive and interconceptional health care from both domestic and international programs through panels and sessions in six thematic areas: Youth; Using FP to Prevent High-Risk Pregnancies; Community-Based Services; FP Integration with Health Services; Multi-sectoral FP Links with Non-Health Activities;

and Integration of Empowerment or Motivational Components. Participants contributed to small working group sessions on the thematic areas in order to share lessons learned and draw from the diversity of field experience.

The program featured remarks from: Robert Clay, Deputy Assistant Administrator, Bureau of Global Health (USAID); Katie Taylor, Deputy Assistant Administrator, Bureau for Global Health (USAID); Dr. Michael Lu, Associate Administrator, Maternal and Child Health Bureau (HRSA); and Dr. Hani Atrash, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau (HRSA).

To view the presentations from the two-day meeting, click here. The full program guide can be downloaded here.

Now Available: Core State Preconception Health Indicators - PRAMS and BRFSS, 2009

On April 24, 2014, CDC authors published the MMWR Surveillance Summary "Core State Preconception Health Indicators - Pregnancy Risk Assessment Monitoring System (PRAMS) and Behavioral Risk Factor Surveillance System (BRFSS), 2009". Foundational to this report was the establishment of a comprehensive, nationally recognized set of preconception health indicators. In 2010, a volunteer group of policy and program leaders and epidemiologists identified 45 core state preconception health indicators, of which 41 rely on PRAMS or BRFSS as data sources. This report includes 39 of the 41 core state preconception health indicators for which data are available through PRAMS or BRFSS.

Key findings include:

Approximately 1 in 5 women with a recent live birth reported tobacco use in the 3 months before pregnancy, 1 in 4 women reported pre-pregnancy binge drinking, and more than half (54%) reported consuming some alcohol during the 3 months before pregnancy.
One in four women with a recent live birth was overweight and approximately 1 in 5 was obese before they became pregnant.
Approximately 3% of women reported ever being diagnosed with diabetes, and 10% reported ever being diagnosed with hypertension.
One in four women with a recent live birth did not have health-care coverage during the month before pregnancy.
All preconception health indicators varied by reporting area, age group, and race/ethnicity.

The findings in this report underscore opportunities for improving the preconception health of U.S. women. Ongoing surveillance and research in preconception health are needed to monitor the influence of improved health-care access and coverage on women's pre-pregnancy and interpregnancy health status, pregnancy and infant outcomes, and health disparities. These data can be used to evaluate the effectiveness of preconception health state and national programs and to assess the need for new programs, program enhancements, and policies.

Using a Reproductive Life Planning Tool?

Delaware Health and Social Services would like to know what tools are being used around the country to help women and men make a reproductive life plan. They have developed a very brief survey to learn more. Please click here to participate. Results will be shared in a future newsletter.

The Gabby Project

Boston Medical Center is inviting 18-34 year old African American women to be a part of a study about an online women's health program, called The Gabby Project (BUMC IRB protocol #H-31633). The online program features an interactive character

named "Gabby" that shares information on health topics that affect the health of women now and the health of their babies if they get pregnant. They need YOUR help in recruiting participants.

For more information contact the research team at: pccstudy@bmc.org or text GabbyStudy to: 857-293-9874

Please join Every Woman Southeast for a webinar on
May 21st
12-1:00pm EST,
about innovative preconception care programs in the US, with a focus on the "Gabby" preconception care system. Results from previous studies and opportunities for involvement in the current study will be presented.

Click here to access the webinar.

Archived presentations from the 2014 AMCHP Conference are now available, including

New Resources and Strategies for Improving Preconception Health by Sarah Verbiest, DrPH, MSW, MPH, Senior Consultant, Preconception Health and Health Care Initiative.

Sign Up for Bi-Weekly Preconception Updates to Your In-Box

To receive a bi-weekly media and literature update on preconception and interconception health through a listserv, please email Cheryl Robbins.

Do you work on issues related to reproductive life planning and contraception?
Please email us - we would love to know more about your work and to connect you with the PCHHC Initiative.

About the Newsletter

Thanks for reading! Is your organization doing exciting work to promote preconception health? We would love to feature you in an upcoming newsletter. Email us for details, or if you have any questions about the newsletter.

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