Lifestyle Changes for Optimal Preconception Health: A Path to a Healthier You

by the North Carolina Preconception Health Campaign

Each year, many of us begin making resolutions to eat less, exercise more and manage our stress. ‘Taking care of yourself to become a healthier you’ is a key mantra of the North Carolina Preconception Health Campaign (NCPHC). This message is communicated all year through education and trainings on health topics such as healthy weight, folic acid supplementation, tobacco cessation, reproductive life planning, early prenatal care and having a medical home. Each topic recommendation may help lower one’s risk of having a premature baby.

Although health care providers are on the front lines of promoting general health and wellbeing prior to pregnancy, it is not enough to casually mention these recommendations to patients without counseling them on these topics. The NCPHC encourages providers to promote preconception health as part of their routine visits with all patients of reproductive age. The Campaign’s health educators teach motivational interviewing techniques to foster ongoing discussion and rapport building as a ground rule for each of these patient-provider encounters.

However, research has shown that health care provider advice only accounts for a part of actual behavior change made by their patients. Provider advice is sometimes based on managing the presenting health condition or it could be impacted by the providers’ own struggles with that specific health behavior change.(1, 2) If we all ask ourselves the personal question, “what is my motivation to change,” whether it is to create more work-life balance or to choose healthier food options, we know that our responses could be quite different depending on personal/family responsibilities, access to resources, and those influencers around us.

Health care providers are one of the many influencers who can promote preconception health. Nontraditional partners, such as barbers, hairstylists, and faith leaders, can also help guide young women or men of reproductive age towards healthy behavior changes now.(3)  Other key influencers, like family members, can be very instrumental in improving future pregnancy outcomes. Since future birth outcomes are often predicated on family history, the concept of patient-and family-centered care is important for preconception health.

Patient-and family-centered care recognizes the patient and family as informed, supported participants, and decision makers in their own care. The promotion of patient-and family-centered care is considered a standard of health care delivery. In the 2011 report, “Towards Improving the Outcome of Pregnancy III,” March of Dimes recommends that providers embrace patient- and family-centered care across the spectrum of perinatal care, including preconceptionally.(4) Changing health behavior is not quite as simple as it sounds. Strategies that involve others in a patient’s network are often successful in helping that person achieve her pre-determined goals.

As each of us considers our plans for good health in 2016 and beyond, let us remember who we can tap into for support. As providers, let us begin to reinforce healthy behaviors and promote preconception health during each patient encounter. Taking good care of yourself to become a healthier you is not merely about the individual choice to eat right, exercise, and plan a pregnancy, it is a collective reminder of the importance to do so and how best one can work to achieve results.

Citations:

1.    Fallon EA, Wilcox S, Laken M. Health care provider advice for African American adults not meeting health behavior recommendations. Prev Chronic Dis [serial online] 2006 Apr. Available from: URL: http://www.cdc.gov/pcd/issues/2006/apr/05_0103.htm.
2.    Vickers KS, Kircher KJ, Smith MD et al. Health behavior counseling in primary care: provider-reported rate and confidence. Fam Med 2007;39(10):730-5.  2007 Nov-Dec. Available from: URL: http://www.stfm.org/fmhub/fm2007/november/kristin730.pdf.
3.    North Carolina Department of Health and Human Services, Division of Public Health. North Carolina Preconception Health Strategic Plan Supplement, 2014-19. Available from: URL: http://publichealth.nc.gov/docs/North%20Carolina%20PreconceptionHealth%2....
4.    Berns SD, editor. Toward Improving the Outcome of Pregnancy III: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives. Reissued edition. White Plains, NY: March of Dimes Foundation; 2011.