title: Preconception Care in Publicly Funded U.S. Clinics That Provide Family Planning Services.
abstract: Federal recommendations for providing quality family planning services were published in 2014 and included preconception care (PCC). This paper aims to describe the prevalence of PCC delivery among publicly funded clinics, prior to the recommendations.
  
  
  
  Prevalence of providing occasional or frequent PCC in the last 3 months and having written protocols for recommended PCC screenings were estimated in 2015 using survey data collected from a nationally representative sample of publicly funded clinic administrators (2013-2014, N=1,615). Analyses included examination of differential distributions of outcomes by clinic characteristics (p<0.05) and multivariable regression.
  
  
  
  Prevalence of occasional or frequent PCC delivery was 81% for women and 38% for men. The percentage of clinics with written protocols for specific PCC screenings ranged from 74% to 88% (women) and 66% to 83% (men). Prevalence of having written protocols for all PCC screenings was 29% for women and 22% for men. Characteristics negatively associated with having written protocols for all PCC screenings for women and men (respectively) were as follows: not receiving Title X funding (adjusted prevalence ratio [APR]=0.6, 95% CI=0.50, 0.76; APR=0.6, 95% CI=0.47, 0.77) and being a community health center (APR=0.5, 95% CI=0.37, 0.72; APR=0.5, 95% CI=0.30, 0.67); health department (APR=0.7, 95% CI=0.61, 0.87; APR=0.6, 95% CI=0.49, 0.76); or hospital/other (APR=0.6, 95% CI=0.50, 0.79; APR=0.6, 95% CI=0.43, 0.75) (versus Planned Parenthood).
  
  
  
  Provision of PCC appears to differ by clinic characteristics and by interpretation of the phrase "preconception care," suggesting opportunities for education and improvement.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia. Electronic address: ggf9@cdc.gov.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Robbins
authors.affiliation: Office of Population Affairs, U.S. DHHS, Rockville, Maryland.
authors.forename: Loretta
authors.initials: L
authors.lastname: Gavin
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Zapata
authors.affiliation: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia.
authors.forename: Marion W
authors.initials: MW
authors.lastname: Carter
authors.affiliation: Office of Population Affairs, U.S. DHHS, Rockville, Maryland.
authors.forename: Christina
authors.initials: C
authors.lastname: Lachance
authors.affiliation: Office of Population Affairs, U.S. DHHS, Rockville, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Mautone-Smith
authors.affiliation: Office of Population Affairs, U.S. DHHS, Rockville, Maryland.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Moskosky
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000191:economics; D003151:Community Health Centers / Q000191:economics; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government / Q000191:economics*; D017408:Guidelines as Topic / Q000592:standards*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D016742:Preconception Care / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D014481:United States