236946 One Key Question: A strategy to emphasize the integration of reproductive health into primary care

Wednesday, November 2, 2011: 8:30 AM

Nicole Yonke, MD, MPH , Department of Family & Community Medicine, University of New Mexico, Albuquerque, NM
Helen Bellanca, MD, MPH , NARAL Pro-Choice Oregon, Oregon Foundation for Reproductive Health, Portland, OR
Sherril B. Gelmon, DrPH , Mark O. Hatfield School of Government, Portland State University, Portland, OR
Michele Stranger Hunter, Executive Director , NARAL Pro-Choice Oregon, Oregon Foundation for Reproductive Health, Portland, OR
Cat Livingston, MD, MPH , Department of Family Medicine, Department of Public Health and Preventive Medicine, Oregon Health & Sciences University, Portland, OR
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.

Learning Areas:
Administer health education strategies, interventions and programs
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the "One Key Question" strategy. Demonstrate the importance of specifically asking women in primary care about their intentions to become pregnant. Explain a tested protocol for implementing this strategy. Describe the results of a pilot implementation and plans for spread of this strategy.

Keywords: Contraception, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Family Physician who also completed a preventive medicine residency and an MPH. I designed and conducted the pilot, and the initial evaluation, as a requirement of my MPH curriculum.
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.