One Key Question: A strategy to emphasize the integration of reproductive health into primary care

The Oregon Foundation for Reproductive Health (OFRH) has developed an initiative to better integrate reproductive health into primary care. Called “One Key Question”, this initiative aims to improve both preconception care and contraceptive counseling by asking the question “Do you plan to become pregnant in the next year?” routinely during primary care visits. If a woman answers “yes”, she would be screened for conditions that would affect a pregnancy and be advised to take folic acid. If a woman answers “no”, the clinician would ensure that she is using a contraceptive method she is satisfied with, and that she is aware of and has access to Emergency Contraception. A pilot study of the training curriculum and the implementation strategy has been conducted that examined whether asking this question improves women's health by increasing access to contraception and increasing preconception care. The pilot examined the various ways this question could be asked during a primary care visit – written or verbal, by the MA, a nurse, health educator or the clinician – and various protocols for responding to the answer. OFRH has secured many professional endorsements for this initiative. This presentation will present the evidence from the pilot, describe plans for spread of this strategy to additional sites for implementation, and identify opportunities for other communities to adopt this strategy.