Preconception WHEELS - "Working to Help Educate and Empower healthy Life Styles"

Background: Risk factors amenable to preconception care are prevalent among pregnant women and women likely to become pregnant; however, they are not getting preconception care education. Per San Diego's Perinatal Periods of Risk analysis pre-pregnancy maternal health status contributed to fetal-infant mortality. A preconception wheel was created to increase knowledge of healthy lifestyle choices that impact health and pregnancy outcomes. Methods: Culturally and linguistically appropriate preconception wheel messages and curriculum were developed using local program data, stakeholders' input and multi-cultural focus groups. Birth data was used to identify outreach efforts. Using standardized protocols and curriculum 44 providers/organizations were trained to provide preconception education to 8,000 women. Focus groups two months post-project and client/staff surveys were conducted to measure effectiveness. Results: The interactive preconception wheel is effective in increasing preconception health knowledge and changing behavior using trained staff. 59% of focus group participants reported using tips from wheel (e.g., taking folic acid, scheduling visits, writing pre-visit questions and using de-stressing techniques). 88% of the 321 clients surveyed agreed they learned new information and wheel was easy-to-use. 91% of staff surveyed stated it was easy to incorporate into their routine and facilitated client healthy behavior discussions. Conclusions: Results indicate that the wheel is an effective tool in increasing knowledge and changing behavior. Designing the wheel with client-in-mind assisted in the tool's acceptance by clients. It's a promising practice that can be replicated in other counties and incorporated into various settings. Additional research needs to be conducted to determine longer-term project effectiveness.