Abstract
BackgroundThere is growing evidence to support the introduction of pre-conception interventions to optimise the health of mothers and their future children. At present, there is poor awareness regarding the importance of pre-conception care (PCC) amongst healthcare professionals and couples planning a pregnancy. Community pharmacies are ideally placed to reach a range of prospective couples planning a pregnancy and could effectively provide information about PCC.MethodsThis study assessed feasibility of an intervention to raise awareness of PCC in community pharmacies in Northern Ireland over 3 months. Inclusion criteria: women of childbearing age (16–45 years) engaging with services at participating pharmacies. Study resources: campaign posters, information cards, crib sheets for pharmacy staff. A mixed methods approach was employed, including, brief information provision for women, record of staff interactions with customers, customer feedback cards and qualitative interviews with pharmacy staff. Descriptive statistics assessed distribution of study resources and staff interviews were analysed using a thematic analysis framework.ResultsThere were eight participating pharmacies, three of which consented to post-study interviews. Three pharmacies chose not to deliver the planned intervention. Distribution of campaign cards (n = 456) varied (0–86%). Analysis of customer feedback cards (n = 9) demonstrated that the majority of respondents were happy to receive information on pre-conception health. Of the women who responded to this question (n = 8), all were ‘extremely likely’ or ‘likely’ to act on the information provided. Four main themes emerged from analysis of staff interviews: (1) training and experience in providing health advice, (2) intervention resources, (3) understanding the aims of the intervention, (4) perceived value of the intervention. Barriers to intervention delivery included non-engagement from pharmacies and need for additional training of staff.ConclusionsAn intervention to raise awareness of PCC within a community pharmacy setting was feasible and acceptable to both women and staff in participating pharmacies. This study indicates that a number of factors must be considered to enhance implementation and effectiveness of PCC interventions in this setting. In particular, better understanding of non-engagement, provision of adequate training and support for staff, and exploring incentives for pharmacies to prioritise PCC.
Highlights
There is growing evidence to support the introduction of pre-conception interventions to optimise the health of mothers and their future children
To enable progression to a randomised controlled trial, ongoing health promotion and additional pilot studies within different community settings are required. These should focus on exploring how to overcome key barriers identified by this research; provision of adequate training and support for staff delivering pre-conception interventions, and methods to incentivise pharmacies to prioritise and actively promote pre-conception care
Acceptability of the intervention This study demonstrates the acceptability of a preconception care (PCC) intervention in a community pharmacy setting
Summary
There is growing evidence to support the introduction of pre-conception interventions to optimise the health of mothers and their future children. Given the overlap with peri-conception and inter-pregnancy care, the authors extend the definition of PCC to “any intervention provided to women and couples of childbearing age, regardless of pregnancy status or desire, before pregnancy, to improve health outcomes for women, new-borns and children” [7]. Such a broad definition presents a number of challenges, including, who should have access to PCC, how they are targeted and when they should be targeted. Efforts are required to raise awareness of PCC and the need to change lifestyle behaviours prior to conception
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