Acceptability and Potential Impact of Brief Preconception Health Risk Assessment and Counseling in the WIC Setting

Abstract

Purpose.

To determine the reproductive risks of women using the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the acceptability of delivering preconception screening and counseling with the WIC encounter.

Design.

A mixed methods approach to include quantitative analysis of reproductive risks and qualitative analysis of postcounseling interviews.

Setting.

A WIC clinic in Clayton County, Georgia

Participants.

A quota sample of 150 African-American women 18 to 44 years of age recruited from the attendees of WIC nutrition classes for postpartum and breastfeeding women and mothers of children under 5.

Intervention.

A brief individual counseling based upon identified risks.

Method.

Participants were administered a risk assessment questionnaire by a member of the study team to determine topics for brief counseling. Following standardized brief counseling, participants completed an individual semistructured interview. The risk assessment questionnaire was analyzed quantitatively; transcripts from the postcounseling interviews were analyzed thematically.

Results.

Reproductive risks were prevalent among women of reproductive age seeking WIC services: unintended pregnancy (27%), history of sexually transmitted infection (49%), inadequate folic acid supplementation (66%), intimate partner violence (47%), tobacco use (21%), binge drinking (10%), and illicit drug use (5%). The vast majority of WIC clients found the preconception risk assessment and brief counseling to be acceptable and important.

Conclusion.

WIC constitutes a suitable location for identifying low-income African-American women in need of preconception and reproductive health services and at risk for poor reproductive health outcomes.