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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Acceptability and usability of ‘One Key Question’® in Australian primary health care

Jessica Fitch https://orcid.org/0000-0002-8758-1359 A * , Edwina Dorney https://orcid.org/0000-0002-2891-4782 B , Marguerite Tracy A and Kirsten I. Black B
+ Author Affiliations
- Author Affiliations

A Speciality of General Practice, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.

B Faculty of Medicine and Health, Central Clinical School, The Tavern, Medical Foundation Building K25, The University of Sydney, Sydney, NSW 2006, Australia.

* Correspondence to: jessica.fitch@newcastle.edu.au

Australian Journal of Primary Health - https://doi.org/10.1071/PY22112
Submitted: 6 June 2022  Accepted: 17 October 2022   Published online: 9 November 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background: Around one-third of pregnancies in women attending antenatal care are unintended. This means a substantial number of women enter pregnancy without optimising their health prior to conception. Primary care practitioners are uniquely placed to counsel women about how to plan for pregnancy and about how to avoid unintended conception. The One Key Question® (OKQ®) tool facilitates a discussion of pregnancy intention and opens up subsequent discussions regarding preconception or contraception care. This study aimed to assess the acceptability and usability of the OKQ® tool in the Australian primary care setting.

Methods: We undertook a pilot study consisting of quantitative and qualitative components across two general practice settings in Sydney, New South Wales, Australia. We documented women’s responses to being asked the OKQ® as part of their consultation. We collected data on the characteristics of the participating GPs and their experience of using the OKQ® tool and conducted semi-structured interviews with all participating GPs.

Results: Fifty-six patients were asked the OKQ®, with the majority stating they were happy to be asked about their reproductive choices and felt it was relevant to their general health. The 10 participating GPs felt the OKQ® was easy to use and although 62.5% reported it extended the consultation time, the medium time taken was 2 min. GPs felt framing the OKQ® helped introduce pregnancy intention discussions into a consultation.

Conclusions: The OKQ® is acceptable to patients and easy for GPs to use. This tool facilitates a proactive and routine discussion to enhance the delivery of preconception care and contraceptive counselling.

Keywords: communication, general practice, One Key Question®, preconception, pregnancy intention, pre-pregnancy, primary care, screening.


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