Virtual Preconception Risk Assessment and Counseling In Primary Health Care

Background: Professional association recommendations call for integrating preconception health promotion with primary care, yet there are scarce tools and implementation research to support practices in doing so.

Purpose: To evaluate the feasibility of integrating a preconception health digital risk assessment and virtual coaching into women’s primary care encounters.

Methods: In the Emory Family Medicine Clinic, female patients 21 to 40 years of age with a well-woman or chronic condition encounter scheduled between 9/1/2022 and 5/1/2023 were invited to participate. Consenting patients were provided the Frame Your Future weblink to complete the digital risk assessment followed by virtual counseling, and their family physicians were provided with a PDF summary to discuss during the primary care encounter. Demographic and clinical information was collected via medical record abstraction and patient and physician experiences via survey.

Results: Of 46 enrolled patients, 44 (96%) made a FRAME™ account, 38 (86%) completed the risk assessment, 34 (89%) completed virtual coaching, and 24 (71%) had a physician discuss their preconception health assessment during the primary care encounter. Nearly 80% of patients reported an increase in confidence in discussing fertility with their physician, and 50% reported they would not otherwise have brought up fertility and preconception health during the encounter. Both patients and physicians were satisfied with the process and viewed it as helping motivate positive changes in patient health and health behaviors.

Conclusion: The completion of preconception digital risk assessment and virtual counseling facilitates discussion of preconception health during primary care encounters and shows promise for improving women’s health.