title: Understanding Women's Awareness and Access to Preconception Health Care in a Rural Population: A Cross Sectional Study.
abstract: Despite evidence of the benefits of preconception health care (PCHC), little is known about awareness and access to PCHC for rural, reproductive-aged women. This study aimed to assess the prevalence of PCHC conversations between rural reproductive-age women and health care providers, PCHC interventions received in the past year, and ascertain predictors of PCHC conversations and interventions. Women (n = 868; 18-45 years) completed a questionnaire including reproductive history, health care services utilization, and interest in PCHC. The prevalence of health care providers' PCHC conversations was 53.9 %, and the mean number of interventions reported was 2.6 ± 2.7 (±SD). Significant predictors of PCHC conversation based on adjusted odds ratios from logistic regression were race (Native American 76 % greater than White), health care provider type (non-physician 63 % greater than physician), visits to a health care provider (3+ times 32 % greater than 1-2 times), and pregnancy planning (considering in next 1-5 years 51 % greater than no plans). Significant predictors of PCHC interventions received in the past 12 months based on adjusted risk ratios from negative binomial regression were race (Native American 22 % greater than White), PCHC conversation with a health care provider (yes 52 % lower than no), reporting PCHC as beneficial (yes 32 % greater than don't know), and visits to a health care provider in the past year (3+ times 90 % greater than 1-2 times). Increasing conversations about PCHC between health care providers and their reproductive-aged patients can improve awareness and increase their likelihood of receiving all of the recommended interventions.
authors.affiliation: College of Nursing, South Dakota State University, Box 2275, Wagner Hall #209, Brookings, SD, 57007, USA. cristina.lammers@sdstate.edu.
authors.forename: Cristina R
authors.initials: CR
authors.lastname: Lammers
authors.affiliation: College of Nursing, South Dakota State University, Box 2275, Wagner Hall #209, Brookings, SD, 57007, USA.
authors.forename: Polly A
authors.initials: PA
authors.lastname: Hulme
authors.affiliation: College of Nursing, South Dakota State University, Box 2275, Wagner Hall #209, Brookings, SD, 57007, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Wey
authors.affiliation: College of Nursing, South Dakota State University, Box 2275, Wagner Hall #209, Brookings, SD, 57007, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kerkvliet
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Shivaram P
authors.initials: SP
authors.lastname: Arunachalam
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D016742:Preconception Care; D012424:Rural Population / Q000706:statistics & numerical data*; D013023:South Dakota / Q000453:epidemiology; D055815:Young Adult
keywords: Access; Awareness; PCHC; Preconception health care; Rural population