182859 Perceived Barriers to Preconception Care: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

Wednesday, October 29, 2008

Angie Denisse Otiniano, MPH , School of Public Health Department of Community Health Sciences, University of California Los Angeles, Los Angeles, CA
Eunice Muthengi, MPH, MSW , Department of Community Health Sciences, University of California at Los Angeles, Los Angeles, CA
Fathima Wakeel, PhD , Department of Community Health Sciences, University of California Los Angeles School of Public Health, Los Angeles, CA
Luu Cortes Doan , Department of Community Health Sciences, University of California Los Angeles School of Public Health, Los Angeles, CA
Karen M. Coller, PhD MPH , Division of General Internal Medicine and Health Services Research, UCLA School of Medicine, Los Angeles, CA
Michael C. Lu, MD, MPH , Department of Community Health Sciences and Department of Obstetrics and Gynecology, University of California Los Angeles School of Public Health and School of Medicine, Los Angeles, CA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Cynthia Harding, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Yvonne Y. Lau, MPH, RD , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Chandra Higgins, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Marian Eldahaby , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Giannina M. Donatoni, PhD, MT(ASCP) , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Erin Rains , Department of Community Health Sciences, University of California at Los Angeles, Los Angeles, CA
Diana E. Ramos, MD, MPH , Reproductive Health, Los Angeles County-Department of Public Health, Los Angeles, CA
OBJECTIVE: To identify perceived barriers among women who did not receive preconception care. METHODS: We used data from the first wave of 2007 Los Angeles Mommy and Baby (LAMB) Survey. LAMB is a mail sample survey with telephone follow-up for non-respondents based on multistage clustered design. Our preliminary analyses were based on the responses of 721 women with a live birth in 2007 in Los Angeles County. Women were asked to identify the reasons why they did not receive a checkup in the six months prior to their most recent pregnancy. The relationship between reported barriers and insurance status was examined using Pearson's chi square tests. RESULTS: More than two-thirds (69.6%) of women surveyed did not receive a checkup in the 6 months prior to their most recent pregnancy. Among these women, the top reasons given for not receiving care were: 1) knowing how to prepare for pregnancy already (65%), 2) not having a regular doctor or nurse (26%), 3) having too many other things going on (18%), and 4) lack of money or insurance (14%). More than half (51%) of uninsured women cited not having a regular provider as a reason for not receiving care, as compared to 20% of women with MediCal and only 12% of women with private health insurance (P< 0.001). DISCUSSION: Efforts to promote preconception care will need to address perceived barriers including the lack of regular providers and health insurance.

Learning Objectives:
By the end of this session, the participants will be able to • Discuss the importance of preconception care to maternal health and pregnancy outcome; • Discuss perceived barriers among women who did not receive preconception care in a population-based survey of women with a recent live birth in Los Angeles County; • Discuss the relationship between regular source of care and preconception care utilization.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I do not have a conflict of interest.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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