Usability, acceptability and effect of a comprehensive preconception care intervention targeting low SES women

Abstract

Background: Preconception care (i.e., a healthy lifestyle among future parents before conception) improves healthy pregnancy and birth. However, future parents, especially those with a low socio-economic status, are unaware of it. Therefore, a comprehensive preconception care intervention was developed for female students of intermediate vocational education; the aim was to improve informed decision making about preconception care. Methods: The intervention was developed using Intervention Mapping and user-centered design. It consisted of: 1) A classroom educational lesson provided by trained midwifes (N = 9), 27 lessons were provided at 4 schools in school year 2015/2016; and 2) A tailored website ‘nietofwelzwanger.nl’. A pretest-posttest design using online surveys among students attending the lesson was used to evaluate intervention effects on informed decision making, as well as to examine intervention acceptability. Effects were analyzed by paired t-tests using multiple imputation. Google Analytics (October 2015/2016) were used to examine use of the website. Findings: At posttest, students (N = 298 from 2 schools) made a more informed decision regarding preconception care than at pretest (t = 3.06; p < 01). They were positive about the lesson (mean grade = 7.6; sd = 1.2) and website (mean grade = 7.2; sd = 1.1). The website was visited 3,035 times, of which 2,458 (81%) unique visitors. Discussion: Findings suggests that the intervention is a promising strategy to improve informed decision making about preconception care, and is positively evaluated by the target group. Implementation and further dissemination of the preconception care intervention is a logical next step.