Preconception Care Program

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Preconception Healthcare: Healthy Families for a Healthy Future

Lara Angelo, Heather Archer-Dyer, Jessica Colon, Simone Edwards, Emeka Anthony Mmuo, Karyn Monahan, Oby Nwankwo

New York Medical College
School of Health Sciences and Practice

Executive Summarypage 3
Case Study 1 (Problem-Based)pages 4 – 17
Case Study 2 (Reference Case)pages 18 – 45
Project Reportpages 46 - 147

Executive Summary
According to the World Health Organization, preconception healthcare is most effectively channeled through the individual and should incorporate healthy lifestyle messages beginning in childhood. If preconception healthcare education is introduced in a community clinical care setting there is an increased chance of an improvement in birth outcomes. The aim of this project, Preconception Health Care: Healthy Families for a Healthy Future (PCH-HF2), is to provide a comprehensive year long program for three Community Health Centers in Westchester County, New York. PCH-HF2 will focus primarily on the mid-size CHC as the model. The recommended interventions will target women and their families prior to conception (preconception), early in pregnancy (prenatal) and in-between pregnancies (interconception). PCH-HF2 program recommendations focus on three key interventions: (1) improvement of the educational materials distributed at the center; (2) incorporation of free local initiatives; and (3) increased wellness education during visits across the center’s providers.  The PCH-HF2 strategic approach is to proactively expand reproductive healthcare within the Community Health Centers beyond prenatal care by leveraging the current strengths and existing resources. This program has the potential to be successful in contributing positively to the goals set by Healthy People 2010 / 2020. This program can also be tailored for the patients in the other Community Health Center locations. All recommended materials will support the 5-Cs model: Comprehension, Confidence, Compliance, Consistency and Continuity. Importantly, the resources are designed to work in conjunction with information provided by the model Community Health Center physicians and not as a replacement for physician-based healthcare recommendations within the organization.

CASE STUDY 1: Problem-Based
Community Health Center Background
A Community Health Center (CHC) is defined by the National Association of Community Health Centers (NACHC) (2010) as “A Federally Qualified Health Center (FQHC) that provides comprehensive primary and preventive health care as well as dental, mental health and pharmacy services.” The FQHCs are deemed to be a cost effective method of providing increased access to care. FQHCs provide educational tools, support and information that are vital to the health status of underserved communities. In an effort to increase access to care, transportation services and language translations are also provided to registered patients as needed. FQHCs are patient centered and as reported by the Community Health Care Association of New York State (CHCANYS) (2009) “at least 51% of the board members of a federally qualified community health center must be consumers of the health services, ensuring patient and community involvement in service delivery.” The target Community Health Centers of Westchester consist of three FQHC designated facilities located in three distinct, underserved communities in Westchester County, New York. CHCs are a vital resource for provision of health care in the populations that they serve. The CHC population consists predominantly of minorities, uninsured, underinsured, undocumented, low-to-no-income and Medicaid recipients. For the purposes of confidentiality in the report, the interventions will focus on the model CHC, one of the three FQHCs in Westchester County, New York. The CHC provides comprehensive primary and preventive health care...
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