Lessons Learned from the First Five Years of Interconception Care Activities in Healthy Start Projects

BACKGROUND: Since 1992, Healthy Start grantees have designed a variety of approaches to reduce infant mortality in some of the nation's highest risk communities. Since 2001, interconception care has been one of the nine core components of Healthy Start. The purpose of the Healthy Start interconception care component is to improve the health of high-risk women and their infants from the end of one pregnancy to either the next pregnancy or 24 months postpartum. From 2001-2005, six grantees received enhanced funding, and twenty-nine grantees additional were required to provide interconception care services. DESIGN AND METHODS: The purpose of study was to review the activities and results from 35 selected Healthy Start grantees with interconception care components between 2001-05. Quantitative and qualitative analysis of the data and narrative impact reports submitted to HRSA is the primary method. The existing evidence is adequate to review and discuss 22 sites. PRELIMINARY FINDINGS: These 22 Healthy Start grantees undertook a variety of activities, including those recommended by federal guidance and additional approaches. The number of program participants ranged from <50 to >2000. Emphasis was generally supporting women to use preventive care for themselves and their infants, as well as reducing risk factors. All used outreach and case management, including home visits, community outreach, and other methods. Fewer sites (16 of 22) provided direct clinical services; however, screening for a range of conditions from diabetes to STIs to domestic violence.