Improving the uptake of preconception care and periconceptional folate supplementation: what do women think?

<p>Abstract</p> <p>Background</p> <p>Despite strong evidence of the benefits of preconception interventions to improve pregnancy outcomes, the delivery and uptake of preconception care in general and periconceptional folate supplementation in particular remains low. The aim of this study was to determine women's views of the barriers and enablers to the uptake of preconception care and periconceptional folate supplementation.</p> <p>Methods</p> <p>Focus groups were undertaken in 2007 with 17 women of reproductive age (18-45 years). To identify key issues and themes within the data, focus groups were analysed using an inductive process of thematic analysis.</p> <p>Results</p> <p>Most women were unaware of the need to attend for preconception care and were surprised at the breadth of issues involved. Women also felt general practitioners (GPs) should be more proactive in promoting preconception care availability but acknowledged that they themselves had to be thinking about pregnancy or becoming pregnant to be receptive to it. Barriers to periconceptional folate supplementation included confusion about reasons for use, dose, duration, timing and efficacy of folate use. Enablers included the desire to do anything they could to ensure optimum pregnancy outcomes, and promotional material and letters of invitation from their GP to advise them of the availability and the need for preconception care.</p> <p>Conclusion</p> <p>A number of important barriers and enablers exist for women regarding the delivery and uptake of preconception care and periconceptional folate supplementation. It is essential that these patient perspectives are addressed in both the implementation of evidence based clinical practice guidelines and in the systematic design of an intervention to improve preconception care delivery.</p

Reliability, validity, and structure of the self report form of the child Health Questionnaire (CHQ-CF87) in a Dutch adolescent population

The Child Health Questionnaire (CHQ)-87-item child and adolescent self-report (CF87) is an increasingly used health-related quality-of-life instrument for measuring the self-perceived physical and psychosocial well-being of children aged 10 years and older. The aims of this study were to evaluate structure, reliability and validity of the Dutch version of the CHQ-CF87 among adolescents in the general Dutch population. Thus, the study extends the data on the psychometric properties of the instrument and reports on the underlying structure and the applicability of the summary score measures, both of which were not reported in previously published studies. Questionnaires were sent to a random sample of 1696 adolescents aged 12-15 years, the response rate was 78%. The mean age of the resulting sample was 14 years and approximately half were boys. A large majority (95.2%) of the subjects were born in The Netherlands, 21% reported a chronic health condition. Results demonstrated good internal consistency of items and scales, and discriminant and concurrent validity. Factor analysis at scale level supported the measurement model of the CHQ for the secondary factors of physical health and psychosocial health. Factor analysis at item level yielded somewhat less univocal results. It is concluded that further evaluation of the CHQ-CF is recommended. Meanwhile, the results, together with the results of earlier studies, suggest that the instrument can be used in pediatric outcome studies, provided practitioners and researchers are aware of the reported limitations. © 2007 Future Drugs Ltd