Primary Care Utilization Within 1 Year After a Facilitated Postpartum-to-Primary Care Transition

Abstract

Objective: To evaluate the effect of a behavioral science-informed intervention designed to facilitate postpartum-to-primary care transitions on primary care visits and screenings within 1 year postpartum for individuals with chronic conditions or pregnancy conditions with long-term health risks.

Methods: This was a planned secondary analysis of a randomized controlled trial of a behavioral science-informed intervention designed to increase primary care practitioner (PCP) visits within 4 months postpartum compared with routine care. The intervention included default PCP visit scheduling with nudge reminders and use of tailored language. The primary outcome for this secondary analysis was attending an annual examination or health care maintenance visit with a PCP within 1 year postpartum. Visits with a PCP for any reason and receipt of screenings or services by a PCP (eg, weight, blood pressure, mood screening) were also compared. Outcomes were compared between groups with χ2 testing.

Results: All 353 participants were followed through 1 year after their due dates: 173 in the control group and 180 in the intervention group. More patients in the intervention group attended an annual examination with a PCP within 1 year compared with the control group (59.0% vs 39.3%, P<.001) and had a PCP visit for any reason (72.8% vs 61.3%, P=.02). A significantly higher rate of mental health disorder screening was observed in the intervention group (63.9% vs 55.5%, P=.046); significant differences in other screenings were not observed.

Conclusion: This relatively simple and low-cost intervention designed to facilitate transition from postpartum to primary care within the first 4 months demonstrated benefits for PCP engagement within the first year postpartum.

Clinical trial registration: ClinicalTrials.gov, NCT05543265.