Journal of Community Health

, Volume 42, Issue 3, pp 489–499 | Cite as

Understanding Women’s Awareness and Access to Preconception Health Care in a Rural Population: A Cross Sectional Study

  • Cristina R. Lammers
  • Polly A. Hulme
  • Howard Wey
  • Jennifer Kerkvliet
  • Shivaram P. Arunachalam
Original Paper


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.


Preconception health care PCHC Awareness Access Rural population 



The authors wish to thank Taylor Mertz, APRN, CNM, for her work on data entry and preparation for analysis.


The study was supported by a grant from SDSU Office of Research, Grants and Sponsored Programs—Li-U-Funded Research-10-11.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from each study participant using methods prescribed by the South Dakota Institutional Review Board.

Research Involving Human Participants

The South Dakota State University Institutional Review Board approved the study before collecting data.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Cristina R. Lammers
    • 1
  • Polly A. Hulme
    • 1
  • Howard Wey
    • 1
  • Jennifer Kerkvliet
    • 1
  • Shivaram P. Arunachalam
    • 2
  1. 1.College of NursingSouth Dakota State UniversityBrookingsUSA
  2. 2.Department of RadiologyMayo ClinicRochesterUSA

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