Content and frequency of preconception health counseling in private practices in North Carolina

Background: Little is known about preconception counseling in private practices in North Carolina. However, many studies have concluded that health care providers should counsel women of childbearing age about healthy behaviors in order to achieve optimal health before pregnancy. Methods: Private practices were randomly selected from a statewide database. Those selected were offered an in-service about folic acid. Anonymous, written surveys were administered prior to the in-service. More than 300 providers in 70 practices completed the survey. Health care providers were defined as any type of health care professional who counsels patients about healthy behaviors: physicians, mid-level providers, registered nurses, and “other” staff. Results: This study examines provider counseling behaviors regarding: the use of calcium and iron supplements, tobacco, multivitamins, alcohol, nutrition and exercise, prevention of sexually transmitted infections, and dental health. It also provides a bivariate analysis of these preconception topics in relation to the type of patient visits (annual, sick, other routine visits) in which the topics are routinely discussed. Additionally, the study examines the types of providers that are most/least likely to provide preconception health counseling. Finally, this study reports providers' knowledge about preconception health topics (e.g. amount of folic acid recommended, rate of unintended pregnancy). These data will be compared to national studies. Conclusions: These data will serve as a baseline measure of private providers' preconception health counseling practices in North Carolina, contribute to the development of preconception health counseling guidelines, and inform the development of North Carolina's preconception health action plan.