title: Factors affecting the willingness of counselors to integrate preconception care into sexually transmitted disease clinics.
abstract: BACKGROUND
  The high rate of unintended pregnancy is an immediate barrier to providing preconception care (PCC). Failure to deliver additional PCC messages at sexually transmitted disease (STD) clinics might represent a major missed opportunity to target women at increased risk for unintended pregnancy for behaviors that also put them at risk for adverse pregnancy outcomes.
  
  
  METHODS
  Using a survey questionnaire, we assessed perceptions of PCC and factors influencing the willingness of STD counselors to integrate PCC as an intervention service provided by the STD clinics of 140 STD counselors. We used a cross-sectional design and selected survey participants with a minimum of 2 years' experience in providing HIV pretest and posttest counseling and syphilis interviewing using a nonprobability, purposive sample.
  
  
  RESULTS
  The level of occupational responsibility and the amount of time available seemed to affect counselor perceptions of the importance of PCC and whether it should be integrated as an intervention service provided by STD clinics. Findings suggested that, although most STD counselors reported that PCC was an important issue, there was significant variation in the perception of whether PCC should be delivered at STD clinics.
  
  
  CONCLUSIONS
  STD counselors perceived PCC to be an important intervention service that can be delivered at STD clinics. Additional study is needed to identify factors that might affect full integration into the STD clinic setting.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333, USA. cparker@cdc.gov
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parker
authors.forename: Sana
authors.initials: S
authors.lastname: Ghaddar
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Brandi
authors.initials: B
authors.lastname: Cooke
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001291:Attitude of Health Personnel; D003376:Counseling / Q000706:statistics & numerical data*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D016742:Preconception Care / Q000458:organization & administration*; D011247:Pregnancy; D011361:Professional Competence; D012731:Sex Counseling / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult