Building Healthy Babies: A Mixed-Methods Needs Assessment for a Pre-Conception Program in Ontario

Angela Li; Vrati M Mehra; Claire Jones; Amanda Selk; Joel Ray; Natalie Morson; Eyal Cohen; Maian Roifman; John W Snelgrove; Ellen M Greenblatt

doi:10.1016/j.jogc.2024.102417

Building Healthy Babies: A Mixed-Methods Needs Assessment for a Pre-Conception Program in Ontario

J Obstet Gynaecol Can. 2024 Feb 23;46(6):102417. doi: 10.1016/j.jogc.2024.102417. Online ahead of print.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON. Electronic address: angela.li@medportal.ca.
² Temerty Faculty of Medicine, University of Toronto, Toronto, ON.
³ Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON.
⁴ Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON; Department of Medicine, St. Michael's Hospital, Toronto, ON.
⁵ Department of Family and Community Medicine, University of Toronto, Toronto, ON; Ray D Wolf Department of Family Medicine, Sinai Health System, Toronto, ON.
⁶ Department of Paediatrics, The Hospital for Sick Children, Toronto, ON; Department of Paediatrics, University of Toronto, Toronto, ON.

PMID: 38403165
DOI: 10.1016/j.jogc.2024.102417

Abstract

Objectives: The objective of this study was to gather Ontario clinicians' and public members' views on the design of a pre-conception patient education program.

Methods: In this mixed-methods study, online surveys comprised of rank order, multiple choice, and short answer questions were completed by clinicians and public members. Semi-structured focus groups consisting of 2-6 participants each were then held via videoconference. Demographic variables and survey responses were analyzed quantitatively using descriptive and summary statistics. Descriptive thematic qualitative analysis using the constant comparative method of grounded theory was completed on each transcript to generate themes.

Results: A total of 168 public members and 43 clinicians in Ontario completed surveys, while 11 clinicians and 11 public members participated in the focus groups. A pre-conception program in Ontario was felt to be important. An individual appointment with a primary care provider was the favoured program format per survey responses, whereas a virtual format with an interactive component was preferred among focus group participants. Important topics to include were pre-conception health (infertility, genetic screening, folic acid), prenatal and postpartum counselling (diet, activity, substance use, prenatal care, postpartum course), and medical optimization in pregnancy (high-risk medical conditions, medications, mental health). Both groups emphasized the need to consider accommodations for marginalized populations and various cultures and languages.

Conclusion: A standardized pre-conception patient education program is felt to be of high value by Ontario clinicians and public members. A pre-conception program may help improve obstetrical outcomes and decrease rates of major congenital anomalies in Ontario.

Keywords: obstetrics and gynecology; patient education; pediatrics; public health; qualitative; survey.