Recorded presentation

Donald A. Cibula, PhD, Onondaga County Health Department, 421 Montgomery St, Civic Center, 9th Floor, Syracuse, NY 13202, 315-435-3648, hldcibu@health.ongov.net

The Onondaga County Health Department (OCHD) conducted a study using longitudinal birth files to individually identify and provide interconceptional interventions to post-partum women in Syracuse, NY who are at elevated risk for poor birth outcomes, based on risk factors recorded for their previous pregnancies. A database query composed of ten, evidence-based risk criteria for low birth weight was used to screen records of approximately 2000 births, and yielded 336 women at elevated risk (WER). The Public Health Teams (PHT) visited a representative group of 109 of these women and conducted assessment and referral. In addition, the PHT administered a survey to obtain additional information about social and economic determinates of health. One important finding is that access to health care is problematic for many of these WER. Nearly half of the women had visited an emergency room for care on two or more occasions during the previous 12 months. Furthermore, 29% of the WER reported interruptions in their health insurance (mostly Medicaid) coverage during the previous two years. Another documented barrier to care that may affect these women is a reluctance to disclose certain lifestyles or habits to physicians; 41% of these women thought that their doctors and staff were very critical of them and their lifestyles. Other issues documented for these women include unreliable transportation, pervasive neighborhood crime and violence, prevalent vaginal infection and sexually transmitted disease, unstable living situations and lack of food security. These results and others are being used to inform local health services planning.

Learning Objectives:

• List six indicators that identify women who are at elevated risk for poor perinatal outcomes.
• Describe how longitudinal birth files can be used to identify women in greatest need of interconceptional care, based on their previous reproductive history.
• Redesign the content and delivery of interconceptional care for high risk women based on survey information from these women.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation