Reproductive Health Promotion Research Articles

The Effects of Contraception Knowledge and Contraception Self-Efficacy on Reproductive Health Promotion Behavior in High School Male Students

The Effects of Contraception Knowledge and Contraception Self-Efficacy on Reproductive Health Promotion Behavior in High School Male Students

EDUKASI TENTANG KESEHATAN REPRODUKSI PADA REMAJA AWAL DI SD NEGERI 2 JABON MOJOANYAR KABUPATEN MOJOKERTO

Reproductive health promotion is still not free to convey, and is considered taboo, so some formal school-level institutions are still hesitant to carry out reproductive health counseling for their students. Adolescents are a group that has a high vulnerability to reproductive health problems. The purpose of this activity as a form of community service carried out by the Lecturer Team and students of Majapahit College of Health Sciences is as an effort to educate students at SD Negeri 2 Jabon Mojoanyar Mojokerto Regency about reproductive health education in early adolescents. Education by lectures, discussions and counseling demonstration. The activity which was carried out for one month was able to improve students' understanding of reproductive health in early adolescents and how to overcome if they experience problems related to reproductive health. This activity is expected to be a concern, especially in the world of education, increasing education on reproductive health promotion programs
 Keywords: reproductive health, early adolescence, health promotion

Promotion of sexual and reproductive health in Pakistan-The role of technology and online awareness

Promotion of sexual and reproductive health in Pakistan-The role of technology and online awareness

Engaging young people with sexual health services in general practice surgeries - A qualitative study of health care professionals.

Evidence to date suggests that young people are becoming more sexually active and are forming relationships during the early stages of their lives, sometimes engaging in sexual risk-taking, which contributes to high rates of conception and sexually transmitted infections (STIs). Young people at risk of adverse sexual health outcomes are the least likely to engage with reproductive and sexual health promotion programmes and services (RSHPPs), especially in mainstream clinics such as general practice (GP) surgeries. The study aimed to explore the views and experiences of service providers. A qualitative approach to explore the views and experiences of designing and implementing RSHPPs for young people in GP surgeries was used. A total of seven participants were interviewed, including four general practitioners (GPs), two of whom were managers at the practice; one nurse; one healthcare and support worker; and one practice manager. The context of RSHPPs such as local health priorities and partnerships to address STIs and unplanned pregnancies among young people contribute to the implementation and engagement of young people with RSHPPs. Training of GPs, nurses, and support workers helps develop confidence and overcome personal factors by promoting effective engagement of young people with RSHPPs. Addressing local health priorities such as reducing teenage pregnancies and STIs requires organisations to provide RSHPPs in both non-clinical and clinical settings to ensure that RSHPPs are accessible to young people. There is room for improvement in access to RSH for young people in GP surgeries by addressing organisational and structural barriers to access.

The co-creation and evaluation of a recovery community center bundled model to build recovery capital through the promotion of reproductive health and justice

People who can get pregnant who use drugs face disproportionate harms such as violence, exploitation and trauma and have unmet reproductive health needs as they have the greatest burden of unintended pregnancy (>75%). Recovery community centers (RCCs) provide recovery support services and are primarily staffed with people with lived experience using drugs. RCCs employ recovery coaches who are entrusted with helping participants improve their recovery capital, health, and wellbeing through person-centered strengths-based approaches. Although reproductive health and the prevention of unintended pregnancy can greatly impact all domains of recovery capital, recovery coaches generally do not have training to address this complex issue. We aimed to fill this gap by co-creating and evaluating a bundled model as an intervention tailored for RCCs (training & low-barrier resources including pregnancy tests, prenatal vitamins, and emergency contraception) to promote more equitable outcomes in reproductive health. We described the training and used mixed methods to assess pre-post knowledge, belief, and comfort with the bundled model (n = 20) and further explored perceptions of the model qualitatively to inform future iterations (n = 58). Results included significant gains in all three domains following the training, as well as favorable perceptions that the model will enhance recovery capital. Most were empowered to champion the model, asking for more information about the three resources, perinatal health, and referral information. We seek to begin to expand the theoretical construct of recovery capital by pilot testing an intervention to promote recovery through enhancing reproductive health and justice for people who use drugs (PWUD) who can get pregnant.

The self-care situation analysis of reproductive-aged women in Tehran: a survey study

BackgroundAlong with a global increase in the prevalence of infectious and non-communicable diseases, self-care with an emphasis on reproductive health Self-care has received special attention. Given the importance of women’s health, assessment of their self-care status using a valid and reliable tool seems to be necessary to determine the needs for future women’s reproductive health promotion interventions. The present study aimed to assess the women’s self-care at reproductive age in Tehran, to determine women’s health needs based on global guidelines for women’s health.MethodsThis was a descriptive cross-sectional study on 1051 women of reproductive age, living in Tehran. The Subjects were recruited using a multi-stage sampling method. The women completed a socio-demographic and valid and reliable questionnaire to assess their self-care status. The data were analyzed using SPSS 24 and by Pearson, Spearman, ANOVA, and regression tests.ResultsThe mean score of self-care was 49.57 ± 23.50% in the reproductive-aged women. The lowest scores were related to psychosocial health (32.12 ± 29.93%) and reproductive-sexual health (49.74 ± 27.99%) respectively. There were significant positive correlations between the self-care and women’s education level (r = 0.180; p < 0.01), and husband’s education level (r = 0.272; p < 0.01), while there was a negative significant correlation between the self-care and the family size (r = - 0.135; p < 0.01).ConclusionThe findings showed inadequate self-care among reproductive-aged women in Tehran. The most important challenge in their self-care behaviors was related to psychosocial and reproductive-sexual health. It seems to provide a package for promoting women’s self-care in four areas of physical, psychosocial, reproductive-sexual health, and screening tests, with an emphasis on the first two priorities, namely psychosocial and reproductive health necessary in Tehran.

Need for Sexual, Reproductive, and Mental Health Promotion Among Diverse College Students in a COVID-19 Era

In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.

Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial.

Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults. This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting. This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention. There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P<.001; Cohen d=0.40), knowledge (β=.12; P<.001; Cohen d=0.39), attitude (β=-.11; P=.001; Cohen d=0.31), perceived norms (β=-.06; P=.04; Cohen d=0.18), and prototype perceptions (β=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months. In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module. Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Is Instagram Effective for Reproductive Health Promotion in Adolescents during the COVID-19 Pandemic?

Background: The majority of teens have smartphones and are involved with digital media. Almost 45% of teens described being online "almost constantly." During the COVID-19 pandemic, access to learning reproductive health directly in schools is very limited. Various risks posed by the COVID-19 outbreak have an impact on changes in the new order of life. Teenagers learn more from home. Many teenagers use social media and the internet to learn about reproductive health. Objective: The purpose of this study was to determine the effectiveness of reproductive health promotion through Instagram during the COVID-19 Pandemic. Methods: An analytic observational study with a cross-sectional approach was conducted among 31 respondents from December 2021 to July 2022. The sample was all who are followers of PIKM Larashati Instagram and ready to be a respondent. The sampling technique was taken by accidental sampling. Data collection was carried out using Google Forms. Data were analyzed with both univariate and bivariate analysis. Results: The findings in this study indicate that adolescents who are followers of PIKM Larashati Instagram have good knowledge about adolescent reproductive health as much as 58.07%. This study also states that the positive attitude of adolescents who are followers of the Larashati PIKM Instagram toward reproductive health is 61.29%. It was found that there was no relationship between the knowledge and attitudes of adolescents because the value of sig = 0.072 which means it is greater than 0.05. Conclusion: Promotion of reproductive health through Instagram by PIKM Larashati regarding reproductive health during the COVID-19 Pandemic is effective for adolescents and adolescents are recommended to follow accounts containing health education.

Website-based application development as an alternative media for reproductive health promotion in adolescent

Background: Adolescents' knowledge about reproductive health is not comprehensive—and most adolescents still consider it taboo to discuss reproductive health issues with their parents. Today's adolescents are included in Generation Z; they like to look for alternative sources of information, especially through electronic media, as their social life cannot be separated from electronic media. This condition is the basis for developing a website as an alternative media for promoting adolescent reproductive health. Methods: This study combined qualitative and quantitative research methods with a type of R&amp;D (Research and Development). To determine the feasibility of the reproductive health website, a validity test was carried out by 1 material expert, 1 media expert, a small group trial of 8 adolescents, and a large group trial of 384 adolescents of 15-18 years with an android mobile. Results: The results of validation by the material expert with an average validation value of 81.04% (≥ 61%), the media expert with an average validation value of 82.70% (≥ 61%), a small group trial with an average validation value of 85.56% (≥ 61%), and a large group trial with an average validation value of 90.80% (≥ 61%). There are differences in knowledge before and after treatment; namely, reproductive health education was carried out (p=0.000). Conclusion: Product feasibility based on these indicators makes the website one of the media alternatives for conducting adolescent reproductive health education.

Practice and product: a social semiotic approach to visual communication in sexual and reproductive health promotion

This article investigates the use of visual communication in sexual and reproductive health information resources produced by an Australian Family Planning organization for different populations – people from culturally and linguistically diverse backgrounds (especially recent immigrants from Syria and Afghanistan), Aboriginal and Torres Strait Islander people, and young people from both these groups. Co-authored by a semiotician and the manager of the organization’s Health Promotion Team, it combines visual analysis of semiotic products with firsthand experience of the organization’s semiotic practices. The article shows how the same medical information leads to different health information products for different groups on the basis of ideas about what can be considered culturally acceptable to these groups. In this way, it demonstrates a social semiotic approach to the analysis of visual communication in which the findings of analysing visual products are understood in relation to the practices of their production.

Visual design for sexual and reproductive health promotion: a global perspective

Visual design for sexual and reproductive health promotion: a global perspective

Understanding Community Engagement in Sexual and Reproductive Health and Rights Promotion in the Eastern Cape, South Africa: A Conceptual Framework to Inform Practice

Understanding Community Engagement in Sexual and Reproductive Health and Rights Promotion in the Eastern Cape, South Africa: A Conceptual Framework to Inform Practice

P-380 Reproductive autonomy in Spain - reproduction as a negative right and the obligations of the State

Abstract Study question Even when considering the right to reproduction as a negative right are there actions to be taken in order achieve a better reproductive autonomy? Summary answer Specific actions become a necessary positivisation of the right to reproduction. Ensuring socio-economic stability and promoting specific education are key parameters for promoting fertility. What is known already The reproductive autonomy of individuals consists of being able to choose the number of children desired and the appropriate timing between deliveries. However, there are many factors that prevent reproductive autonomy from being fully developed in Spain, being the country with the second lowest fertility indicator in Europe. There are texts that argue that reproductive autonomy should be approached from a Human Rights perspective and urge governments to adopt positive measures in accordance. However, the European Court of Human Rights' rulings on this issue are far from this perspective. Nevertheless, states have obligations to enhance the reproductive autonomy of individuals. Study design, size, duration In order to stablish this position, we studied the Spanish demographic and fertility indicator data and examined the existing Spanish laws regarding assisted reproductive techniques (such as Law 14/2006), the European Court of Human Rights' ruling on this matter, United Nations consensus related to this field, the Guttmacher-Lancet commission and recommendations of scientific societies such as ESHRE. Participants/materials, setting, methods Bibliography was achieved using the European Court Human Rights' ruling HUDOC database, the Spanish State Official Newsletter and United Nations Library, between others. Socio-economic and demographic indexes were obtained with Eurostat and the Spanish National Statistics Office. Selected legal aspects were included in the revision and manuscript. Main results and the role of chance The Spanish socio-economic panorama is unfavorable for the emancipation of young people and the consequent formation of families with offspring, which aggravates the existing demographic crisis and generational turnover. Importantly, people are not being fully autonomous in their reproductive decisions, mainly due to a lack of information and foresight regarding real fertility and infertility expectations. States must ensure comprehensive sexual and reproductive health promotion, which includes reproductive autonomy. The wide range of rights that constitute the so-called reproductive rights is encompassed within the framework of human rights. However, the right to reproduction is not always considered as a positive right, although the legislator must ensure that people can fully exercise their autonomy. The fact that the full positivisation of the right to reproduction is not considered does not exempt the State from obligations to ensure the reproductive autonomy of its citizens. Therefore, the positivisation of the right to reproduction must ensure socio-economic stability and reproductive health education, thus preventing future infertility problems. Public and private clinics and health centers must be provided with the necessary means to diagnose possible reproductive pathologies. Education and economic stability are solutions to most of the problems related to population growth and infertility. Limitations, reasons for caution In this study we have interpreted international Law, soft-law and reccommendations according to the actual Spanish socio-economic and demographic context, which may not be adequate to extrapolate to other countries or populations. Wider implications of the findings To consider the right to reproduction as a positive right may mean converting the State into a provider of resources for this purpose. However, positivisation of the right to reproduction materializes in education and socio-economic stability, actions worth considering, such as creating public campaigns aimed at fertility education and awareness. Trial registration number Not applicable

A comprehensive overview by region of condoms, natural family planning, and spermicide as a contraceptive method among men aged 13–54 years attending contraceptive services in England

ObjectivesThis study aimed to (1) provide a comprehensive overview of contraceptive methods self-reported by men in England, over 5 years, focusing on condoms in comparison to any male method; and (2) explore condom as a contraceptive method by region and ethnicity. Study designData were from the Sexual and Reproductive Health Services (Contraception) England census data set from 2014/15 to 2018/19. Once missing data were removed, this left a total of 365,292 men. Two binomial logistic regression models were performed. Model 1 examined ethnicity, region, and time on condom as a method of contraception; and Model 2 examined ethnicity, region, and time by any male contraceptive. Descriptive statistics were run for natural family planning and spermicide. ResultsModel 1 revealed a significant model, χ2 (15) = 30,976, P < 0.001, and predicted that condoms as a method decreased in London with a greater decrease in Midlands. London saw the lowest rate of decline among the non-White ethnic group, whereas North and South regions increased probability over time. The North started at a higher probability and the South at the lowest. Model 2 also revealed a significant model, χ2 (15) = 32,472, P < 0.001, with a similar pattern to Model 1. Contingency tables showed natural family planning and spermicide were the least reported methods and decreased over time. ConclusionsAs any male contraceptive method appears to be decreasing in both models, reproductive health promotion is required. This study has implications for commissioning funds and for identifying regional areas of further investigation.

The role of community health nurses in promoting school learners' reproductive health in North West province.

Reproductive health education is a major component in schools, which is delivered through Life Orientation and Life Science subjects. Providing sexual and reproductive health education and services remains a challenge in schools of many countries, as well as South Africa. Community health nurses have the responsibility to initiate and participate in reproductive health promotion initiatives in schools. To explore the roles of community health nurses in the promotion of school learners' reproductive health in schools. This study was conducted in the clinics of Madibeng municipality in North West province, South Africa. An exploratory qualitative research study was conducted using in-depth interviews for data collection. The population included community health nurses who were sampled purposively. Community health nurses revealed that their primary role was to provide health education to learners, particularly in clinics. Furthermore, they revealed that they did not visit schools and had no communication with teachers regarding learners' reproductive health issues. The Department of Education has opened a platform for the provision of reproductive health education in schools through various teacher-led initiatives. However, this has posed a significant challenge to teachers as they may not be willing to deliver sensitive and sexually themed information to learners. To ensure effective delivery of reproductive health education in schools, community health nurses, teachers and other relevant stakeholders must collaborate in schools. This article highlights the importance of community health nurses visiting schools to promote the reproductive health of school learners.

Implementation of Premarital Counseling Description in Grobogan District, Central Java, Indonesia

Background: Pre-marital period is the best time to prepare for the quality of family health; however, In Indonesia, examinations and promotion of reproductive health and pre-marital counseling have yet to be carried out in all districts. Objectives: This study aimed to identify the description of reproductive health services and marriage counseling in Grobogan Regency, Central Java. Methods: This study used an assessment method of the implementation of the Reproductive Health Service Program for the bride, which includes IEC (Communication, Information, and Education) and medical examination of the bride and groom by health workers conducted in community health centers (Puskesmas) and other health care facilities, and office of religious affair (KUA), with the In-depth Interview Method. The subject was the KUA Officer under the Department of Religious Islamic Education in the Marriage Guidance program. Results: The interviews with KUA officers obtained results in 2017. There were still underage marriages, and the number increased in 2018. Prospective brides have submitted forms (N1, N2, N3, and N4) to KUA. Most of the brides were not physically examined (pulse, breathing frequency, blood pressure, body temperature) by health workers (63.7%), and blood groups were not examined (91.4%). Half of the respondents examined blood sugar, HIV, IMS, Hepatitis, and TORCH (56.8%). The bridegrooms were not examined for mid-upper arm circumferences (MUAC) (17.2%) and for signs of anemia (8.6%). The brides were not immunized against Hepatitis B (72.4%). Almost all brides get TT immunization at the Puskesmas (94.8%). Health workers stated that only some brides had been getting counseling about the bride's mental health (29,3%). Only 17.2% of the officers stated that the bride still needs to get a certificate of following the reproductive health IEC. Conclusions: KUA has conducted pre-marriage courses for couples according to the rules of the Ministry of Religion. Some PUSKESMAS had carried out activities for the bride and groom on a scheduled basis (for example, every Tuesday/Wednesday) but have not been carried out routinely, even stopped due to budgetary problems. The certificate is given after the bride and groom take the marriage guidance course, but it has yet to be required for marriage registration.

LITERASI PENDEWASAAN USIA PERKAWINAN DAN HAK-HAK REPRODUKSI REMAJA

Cases of early marriage in Indonesia experienced an increase in the previous decades due to the COVID-19 pandemic. Reproductive health for adolescents has been mostly carried out in formal such as schools. STT as one of the traditional non-formal organizations needs to be targeted in reproductive health promotion. The purpose of community dedication is to increase literacy in reproductive health knowledge so as to bring positive changes to adolescents. The method of activity is education, discussion, questions and answers, role play, giving pre-post test questionnaires. The results of the activity showed changes in the knowledge, attitudes and intentions of adolescents after literacy was carried out. The increase in knowledge can be seen from the average post-test score of 6 which is higher than the average pre-test score of 5.32 (p=0.02). An increase in attitude can be seen from the average post-test score of 62.75, which is higher than the average pre-test score of 61.85 (p=0.03). The increase in the intention to mature at marriage age and use reproductive rights can be seen from the average post-test score of 13,20, which is higher than the average pre-test score of 12,82 (p=0.03). It is hoped that adolescents will get a good understanding so that they can go through their adolescents years without experiencing problems and become healthy and quality adolescents.&#x0D; Keywords: youth, maturing age at marriage, reproductive rights

Information-seeking behavior of reproductive health based on socio-demographic among adolescents in Jakarta, Indonesia.

The main characteristic of today's adolescents in seeking information is through online media. The pattern of their information-seeking behavior is diversified based on socio-demographic factors. The objective of this study is to describe the information-seeking behavior of reproductive health based on socio-demographics among adolescents. This online-based survey was conducted with a cross-sectional study in 2021 among 438 adolescents 18-24 years of age in Jakarta, Indonesia, by purposive sampling technique. Data were collected by distributing Google forms and analyzed using the Chi-square test. The main source of information media used by adolescents in their daily lives was online media (97.3%), with Instagram being the highest proportion (66.0%). Based on education, there were significant differences in preference topics on Human Immunodeficiency Virus-Acquired Immuno Deficiency Syndrome (HIV-AIDS) and other sexually transmitted diseases (P = 0.012), reproductive system and puberty (P = 0.045), source of information from Facebook (P = 0.034), and source of information from mother (P = 0.045). Based on parents' income, there was a significant difference in preference topics on child marriage, prevention of pregnancy, and abortion (P = 0.015). There is a need to improve reproductive health promotion by maximizing online media and certain figures along with promotion target mapping based on socio-demographic characteristics.

Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants.

Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal-fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. This is a qualitative research with key informant interviews. Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.