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Research ArticleOriginal Research

Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study

Stephanie E. Rosener, Wendy B. Barr, Daniel J. Frayne, Joshua H. Barash, Megan E. Gross and Ian M. Bennett
The Annals of Family Medicine July 2016, 14 (4) 350-355; DOI: https://doi.org/10.1370/afm.1933
Stephanie E. Rosener
1Middlesex Hospital Family Medicine Residency Program, Middletown, Connecticut
MD
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  • For correspondence: stephanie.rosener@midhosp.org
Wendy B. Barr
2Lawrence Family Medicine Residency Program, Lawrence, Massachusetts
MD, MPH, MSCE
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Daniel J. Frayne
3MAHEC Family Medicine Residency Program, Asheville, North Carolina
MD
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Joshua H. Barash
4Department of Family & Community Medicine, Jefferson Medical College, Philadelphia, Pennsylvania
MD
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Megan E. Gross
5Messiah College, Mechanicsburg, Pennsylvania
MPH, BSN, RN
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Ian M. Bennett
6Department of Family Medicine, University of Washington, Seattle, Washington
MD, PhD
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Abstract

PURPOSE Interconception care (ICC) is recommended to improve birth outcomes by targeting maternal risk factors, but little is known about its implementation. We evaluated the frequency and nature of ICC delivered to mothers at well-child visits and maternal receptivity to these practices.

METHODS We surveyed a convenience sample of mothers accompanying their child to well-child visits at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network. Health history, behaviors, and the frequency of the child’s physician addressing maternal depression, tobacco use, family planning, and folic acid supplementation were assessed, along with maternal receptivity to advice.

RESULTS Three-quarters of the 658 respondents shared a medical home with their child. Overall, 17% of respondents reported a previous preterm birth, 19% reported a history of depression, 25% were smoking, 26% were not using contraception, and 58% were not taking folic acid. Regarding advice, 80% of mothers who smoked were counseled to quit, 59% reported depression screening, 71% discussed contraception, and 44% discussed folic acid. Screening for depression and family planning was more likely when the mother and child shared a medical home (P <.05). Most mothers, nearly 95%, were willing to accept health advice from their child’s physician regardless of whether a medical home was shared (P >.05).

CONCLUSIONS Family physicians provide key elements of ICC at well-child visits, and mothers are highly receptive to advice from their child’s physician even if they receive primary care elsewhere. Routine integration of ICC at these visits may provide an opportunity to reduce maternal risk factors for adverse subsequent birth outcomes.

  • mothers
  • infant
  • preconception care
  • premature birth
  • pregnancy
  • depression
  • smoking
  • folic acid
  • contraception
  • continuity of patient care
  • practice-based research
  • primary care
  • Received for publication May 30, 2015.
  • Revision received October 21, 2015.
  • Accepted for publication January 4, 2016.
  • © 2016 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 14 (4)
The Annals of Family Medicine: 14 (4)
Vol. 14, Issue 4
July/August 2016
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Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study
Stephanie E. Rosener, Wendy B. Barr, Daniel J. Frayne, Joshua H. Barash, Megan E. Gross, Ian M. Bennett
The Annals of Family Medicine Jul 2016, 14 (4) 350-355; DOI: 10.1370/afm.1933

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Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study
Stephanie E. Rosener, Wendy B. Barr, Daniel J. Frayne, Joshua H. Barash, Megan E. Gross, Ian M. Bennett
The Annals of Family Medicine Jul 2016, 14 (4) 350-355; DOI: 10.1370/afm.1933
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Subjects

  • Domains of illness & health:
    • Prevention
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  • Person groups:
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    • Children's health
  • Methods:
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Keywords

  • mothers
  • infant
  • preconception care
  • premature birth
  • pregnancy
  • depression
  • smoking
  • folic acid
  • contraception
  • continuity of patient care
  • practice-based research
  • primary care

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