Conference Abstract Compendium Examples from the ... - CityMatCH

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2009 CityMatCH Urban MCH Leadership ConferenceHealth care providers and preconception counseling: An evaluation of a folic acideducation program in North CarolinaPRIMARY CONTACT:CO-PRESENTER(S)/AUTHOR(S):Amy Mullenix, MSPH, MSWJeannine Herrick, jeannine.herrick@gmail.comState Coordinator, NC Folic Acid(Author)CampaignMarch of Dimes6504 Falls of Neuse RdSte. 100Raleigh, NC, 27615Phone: (919) 424-2158Fax: (919) 781-2317Email: amullenix@marchofdimes.comWebsite: getfolic.comCATEGORYPreconception health and health careBirth defectsFOCUSProgram Policy FocusISSUENorth Carolina has had historically high rates of neural tube defects (NTDs), up to 70% of which can beprevented if women of childbearing age take adequate amounts of folic acid prior to pregnancy. Only onethirdof women ages 18-45 report that their provider has discussed folic acid with them.SETTINGIn North Carolina, health care providers in private practices and public health centers participate intrainings offered by the North Carolina Folic Acid Campaign.PROJECTIn the Office Champion program, health educators called regional coordinators train health care providersto talk to their female patients about taking multivitamins with folic acid during their childbearing years.The program provides an in-office training and the appointment of a folic acid "office champion" (usuallya nurse) who volunteers to promote the folic acid message in the provider's office. In addition to basicfolic acid facts, the training addresses how and when to talk with women about folic acid. OfficeChampions then remind clinicians to talk to patients about folic acid and coordinate the distribution ofeducational materials for patients. Regional coordinators maintain contact with Office Champions to sharenew research and folic acid materials, providing a personal connection between the Campaign and localhealth providers.60
ACCOMPLISHMENTS/RESULTSMore than 500 practices have been trained by this program since 2003.2009 CityMatCH Urban MCH Leadership ConferenceAn internal evaluation took place in 2007-08 and included key informant interviews and a pre-post designsurvey of private practices. A total of 280 providers (physicians, mid-levels, and nursing staff) completeda pre-intervention survey; 104 providers completed a second survey 3-6 months after the intervention(training).The program was effective in increasing provider knowledge about folic acid and unintended pregnancy.The program also increased the proportion of providers who reported counseling women about folic acidfrom 51% to 67% at annual exams and from 48% to 60% at routine visits. The survey identified the mostcommonly discussed preconception health topics: folic acid, tobacco, alcohol, and nutrition/exercise.BARRIERS• Securing an appointment to provide training for a private practice can be challenging.• The success of the program in a specific practice often relies on the commitment of the OfficeChampion.LESSONS LEARNED• In-office trainings can influence provider knowledge and counseling behaviors.• This program can reach many more women than a traditional public health campaign; each providerwho receives the training has the potential to reach hundreds of women.• Rural practices are more receptive to this type of program than urban practices due to more flexiblescheduling and less attention from pharmaceutical representatives.• Trainings need to be kept short: 15-20 minutes. Many practices expect to receive a snack or lunch.• An important role of health educators is to facilitate dialogue during the training about who isresponsible for providing preconception health education for patients and how that can best beaccomplished.• Multiple visits rather than a single training by a regional coordinator can improve an office’s ability topromote preconception messages such as folic acid appropriately to female patients.INFORMATION FOR REPLICATIONThis program is one component of a comprehensive folic acid campaign in North Carolina. Fundingcomes from a Vitagrant settlement and ongoing state support. Many partners collaborate, including thestate health department (contract administration), a statewide MCH health non-profit (materialsproduction), and March of Dimes (program administration).61
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