Acceptability and usability of 'One Key Question'® in Australian primary health care

Aust J Prim Health. 2023 Jul;29(3):268-275. doi: 10.1071/PY22112.


Background: Around one-third of pregnancies in women attending antenatal care are unintended. This means a substantial number of women enter pregnancy without optimising their health prior to conception. Primary care practitioners are uniquely placed to counsel women about how to plan for pregnancy and about how to avoid unintended conception. The One Key Question® (OKQ®) tool facilitates a discussion of pregnancy intention and opens up subsequent discussions regarding preconception or contraception care. This study aimed to assess the acceptability and usability of the OKQ® tool in the Australian primary care setting.

Methods: We undertook a pilot study consisting of quantitative and qualitative componentsacross two general practice settings in Sydney, New South Wales, Australia. We documented women's responses to being asked the OKQ® as part of their consultation. We collected data on the characteristics of the participating GPs and their experience of using the OKQ® tool and conducted semi-structured interviews with all participating GPs.

Results: Fifty-six patients were asked the OKQ®, with the majority stating they were happy to be asked about their reproductive choices and felt it was relevant to their general health. The 10 participating GPs felt the OKQ® was easy to use and although 62.5% reported it extended the consultation time, the medium time taken was 2min. GPs felt framing the OKQ® helped introduce pregnancy intention discussions into a consultation.

Conclusions: The OKQ® is acceptable to patients and easy for GPs to use. This tool facilitates a proactive and routine discussion to enhance the delivery of preconception care and contraceptive counselling.

MeSH terms

  • Australia
  • Female
  • General Practice*
  • Humans
  • New South Wales
  • Pilot Projects
  • Pregnancy
  • Primary Health Care