Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Survey of Maternal, Child and Family Health Nurses’ attitudes and practice relating to preconception health promotion

Karin Hammarberg A B D and Leanne Taylor C
+ Author Affiliations
- Author Affiliations

A School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, Vic. 3004, Australia.

B Victorian Assisted Reproductive Treatment Authority, Level 30, 570 Bourke Street, Melbourne, Vic. 3000, Australia.

C City of Whittlesea, Locked Bag 1, Bundoora MDC, Vic. 3083, Australia.

D Corresponding author. Email: karin.hammarberg@monash.edu

Australian Journal of Primary Health 25(1) 43-48 https://doi.org/10.1071/PY18078
Submitted: 1 June 2018  Accepted: 30 November 2018   Published: 4 February 2019

Abstract

Environmental factors including poor nutrition, obesity, smoking, exposure to toxins and drug and alcohol use at the time of conception can adversely affect the future health of the offspring. As primary health care (PHC) professionals who interact with women of reproductive age, Maternal, Child and Family Health Nurses (MCaFHNs) are ideally placed to promote preconception health to women who want another child. The aim of this study was to assess MCaFHNs attitudes towards preconception health promotion, whether and under what circumstances they talk to their families about this, and what might help them start a conversation about preconception health. Of the 192 respondents, most (65%) agreed it is part of the MCaFHNs role to promote preconception health but only one in eight (13%) felt very confident that they knew as much as they needed and less than half (46%) ‘routinely’ or ‘sometimes’ promoted preconception health in their clinical practice. Almost all agreed that more information and education on the topic would increase their confidence to discuss preconception health. The findings suggest that, with adequate educational and structural support, most MCaFHNs are willing to deliver preconception health promotion in their clinical practice. As most new mothers access MCaFHNs, the potential health benefits of this are considerable.

Additional keywords: environmental factors, health promotion, pregnancy health, primary care.


References

Agricola E, Pandolfi E, Gonfiantini MV, Gesualdo F, Romano M, Carloni E, Mastroiacovo P, Tozzi AE (2014) A cohort study of a tailored web intervention for preconception care. BMC Medical Informatics and Decision Making 14, 33

Barker M, Dombrowski SU, Colbourn T, Fall CHD, Kriznik NM, Lawrence WT, Norris SA, Ngaiza G, Patel D, Skordis-Worrall J, Sniehotta FF, Steegers-Theunissen R, Vogel C, Woods-Townsend K, Stephenson J (2018) Intervention strategies to improve nutrition and health behaviours before conception. Lancet 391, 1853–1864.
Intervention strategies to improve nutrition and health behaviours before conception.Crossref | GoogleScholarGoogle Scholar | 29673875PubMed |

Day J, Savani S, Krempley BD, Nguyen M, Kitlinska JB (2016) Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype. American Journal of Stem Cells 5, 11–18.

Dunlop AL, Logue KM, Miranda MC, Narayan DA (2010) Integrating reproductive planning with primary health care: an exploration among low-income, minority women and men. Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives 1, 37–43.
Integrating reproductive planning with primary health care: an exploration among low-income, minority women and men.Crossref | GoogleScholarGoogle Scholar |

Ekstrand Ragnar M, Niemeyer Hultstrand J, Tydén T, Larsson M (2018) Development of an evidence-based website on preconception health. Upsala Journal of Medical Sciences 123, 116–122.

Family and Community Development Committee (2018) Inquiry into perinatal services: final report. Parliament of Victoria: Melbourne, Vic., Australia. Available at www.parliament.vic.gov.au/fcdc/inquiries/article/2822 [Verified 8 January 2019]

Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, Barker M, Saffery R, Yajnik CS, Eckert JJ, Hanson MA, Forrester T, Gluckman PD, Godfrey KM (2018) Origins of lifetime health around the time of conception: causes and consequences. The Lancet 391, 1842–1852.
Origins of lifetime health around the time of conception: causes and consequences.Crossref | GoogleScholarGoogle Scholar |

Fraser S, Grant J, Mannix T (2016) Maternal Child and Family Health Nurses: delivering a unique nursing speciality. Maternal and Child Health Journal 20, 2557–2564.
Maternal Child and Family Health Nurses: delivering a unique nursing speciality.Crossref | GoogleScholarGoogle Scholar | 27406150PubMed |

Genuis SJ, Genuis RA (2016) Preconception care: a new standard of care within maternal health services. BioMed Research International 2016, 6150976
Preconception care: a new standard of care within maternal health services.Crossref | GoogleScholarGoogle Scholar | 27800487PubMed |

Grant J, Mitchell C, Cuthbertson L (2017) ‘National Standards of Practice for Maternal, Child and Family Health Nursing Practice in Australia.’ (Flinders Press: Adelaide, SA, Australia)

Hammarberg K, Norman RJ, Robertson S, McLachlan R, Michelmore J, Johnson L (2017) Development of a health promotion programme to improve awareness of factors that affect fertility, and evaluation of its reach in the first 5 years. Reproductive Biomedicine & Society Online 4, 33–40.
Development of a health promotion programme to improve awareness of factors that affect fertility, and evaluation of its reach in the first 5 years.Crossref | GoogleScholarGoogle Scholar |

Harrison CL, Skouteris H, Boyle J, Teede HJ (2017) Preventing obesity across the preconception, pregnancy and postpartum cycle: implementing research into practice. Midwifery 52, 64–70.
Preventing obesity across the preconception, pregnancy and postpartum cycle: implementing research into practice.Crossref | GoogleScholarGoogle Scholar | 28666192PubMed |

Hemsing N, Greaves L, Poole N (2017) Preconception health care interventions: a scoping review. Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives 14, 24–32.
Preconception health care interventions: a scoping review.Crossref | GoogleScholarGoogle Scholar |

Heyes T, Long S, Mathers N (2004) Preconception care – practice and beliefs of primary care workers. Family Practice 21, 22–27.
Preconception care – practice and beliefs of primary care workers.Crossref | GoogleScholarGoogle Scholar | 14760039PubMed |

Hooker L, Taft A, Small R (2016) Reflections on maternal health care within the Victorian Maternal and Child Health Service. Australian Journal of Primary Health 22, 77–80.
Reflections on maternal health care within the Victorian Maternal and Child Health Service.Crossref | GoogleScholarGoogle Scholar | 26567477PubMed |

Hsieh H-F, Shannon S (2005) Three approaches to qualitative content analysis. Qualitative Health Research 15, 1277–1288.
Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar | 16204405PubMed |

Lane M, Robker RL, Robertson SA (2014) Parenting from before conception. Science 345, 756–760.
Parenting from before conception.Crossref | GoogleScholarGoogle Scholar | 25124428PubMed |

Lang AY, Boyle JA, Fitzgerald GL, Teede H, Mazza D, Moran LJ, Harrison C (2018) Optimizing preconception health in women of reproductive age. Minerva Ginecologica 70, 99–119.

McPhie S, Skouteris H, Millar L, Olsson C, Campbell K, van der Pligt P, Dodd J, Hill B (2017) Preconception weight management: an untapped area of women’s health. Australian Journal of Primary Health 23, 61–65.
Preconception weight management: an untapped area of women’s health.Crossref | GoogleScholarGoogle Scholar | 27491461PubMed |

Meng Y, Groth SW (2018) Fathers count: the impact of paternal risk factors on birth outcomes. Maternal and Child Health Journal 22, 401–408.
Fathers count: the impact of paternal risk factors on birth outcomes.Crossref | GoogleScholarGoogle Scholar | 29218490PubMed |

Morse JE, Moos M-K (2018) Reproductive life planning: raising the questions. Maternal and Child Health Journal 22, 439–444.
Reproductive life planning: raising the questions.Crossref | GoogleScholarGoogle Scholar | 29512053PubMed |

Ojukwu O, Patel D, Stephenson J, Howden B, Shawe J (2016) General practitioners’ knowledge, attitudes and views of providing preconception care: a qualitative investigation. Upsala Journal of Medical Sciences 121, 256–263.
General practitioners’ knowledge, attitudes and views of providing preconception care: a qualitative investigation.Crossref | GoogleScholarGoogle Scholar |

Schmied V, Fowler C, Rossiter C, Homer C, Kruske S (2014) Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey. Australian Health Review 38, 177–185.
Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey.Crossref | GoogleScholarGoogle Scholar | 24589385PubMed |

Sedgh G, Singh S, Hussain R (2014) Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning 45, 301–314.
Intended and unintended pregnancies worldwide in 2012 and recent trends.Crossref | GoogleScholarGoogle Scholar | 25207494PubMed |

Sher J (2016a) Missed periods. Scotland’s opportunities for better pregnancies, healthier parents and thriving babies the first time and every time. (NHS Greater Glasgow & Clyde (Public Health)): Glasgow, Scotland) Available at http://www.nhsggc.org.uk/media/237840/missed-periods-j-sher-may-2016.pdf [Verified 8 January 2019]

Sher J (2016b) Prepared for pregnancy? Preconception health, education and care in Scotland. (NHS Greater Glasgow & Clyde (Public Health)): Glasgow, Scotland) Available at http://www.nhsggc.org.uk/media/237841/prepared-for-pregnancy-j-sher-may-2016.pdf [Verified 8 January 2019]

Srinivasan S, Schlar L, Rosener SE, Frayne DJ, Hartman SG, Horst MA, Brubach JL, Ratcliffe S (2018) Delivering interconception care during well-child visits: an IMPLICIT Network Study. Journal of the American Board of Family Medicine 31, 201–210.
Delivering interconception care during well-child visits: an IMPLICIT Network Study.Crossref | GoogleScholarGoogle Scholar | 29535236PubMed |

Stephenson J, Heslehurst N, Hall J, Schoenaker DAJM, Hutchinson J, Cade JE, Poston L, Barrett G, Crozier SR, Barker M, Kumaran K, Yajnik CS, Baird J, Mishra GD (2018) Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. Lancet 391, 1830–1841.
Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.Crossref | GoogleScholarGoogle Scholar | 29673873PubMed |

Stranger Hunter M (2017) Would you like to become pregnant in the next year? The One Key Question® initiative in the United States. IJBPE 4, 19–22.

Tydén T, Verbiest S, Van Achterberg T, Larsson M, Stern J (2016) Using the reproductive life plan in contraceptive counselling. Upsala Journal of Medical Sciences 121, 299–303.
Using the reproductive life plan in contraceptive counselling.Crossref | GoogleScholarGoogle Scholar |

van Dijk MR, Koster MP, Rosman AN, Steegers-Theunissen RP (2017) Opportunities of mHealth in preconception care: preferences and experiences of patients and health care providers and other involved professionals. JMIR mHealth and uHealth 5, e123
Opportunities of mHealth in preconception care: preferences and experiences of patients and health care providers and other involved professionals.Crossref | GoogleScholarGoogle Scholar | 28818820PubMed |