The Implementation of Interconception Care in Two Community Health Settings: Lessons Learned

Abstract

Purpose.

This study reports on an evaluation of the implementation of a pilot interconceptional care program (ICCP) in Chicago and the experiences of the participants in their first postpartum year.

Design.

A longitudinal, multi-method approach was used to gather data to measure success in achieving project benchmarks and to gain insights into women's experiences after an adverse pregnancy outcome.

Setting.

The ICCP interventions were provided in two different health care settings.

Subjects.

Low-income African-American women with a prior adverse pregnancy outcome were recruited to participate. Data on services delivered are available for 220 women; linked interview data are also available for 99 of these women.

Intervention.

The ICCP focused on the integration of social services, family planning, and medical care provided through a team approach.

Measures.

An interview questionnaire asked detailed information about interconceptional health status, attitudes, and behaviors. A services database documented all services delivered to each participant. Key informant interviews were conducted with the ICCP project staff.

Analysis.

Simple frequencies were generated. Chi-square and t-tests were used to compare participants and benchmarks at the two different sites.

Results.

The planned delivery of interventions based on women's unique interconceptional health needs was often replaced by efforts to address women's socioeconomic needs. Although medical care remained important, participants viewed themselves as healthy and did not view medical care as a priority. Women's perceptions of contraceptive effectiveness were not always in sync with clinical knowledge.

Conclusions.

Interconceptional care is a complex process of matching interventions and services to meet women's unique needs, including their socioeconomic needs.