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Barriers and facilitators to the provision of preconception care by healthcare providers : a systematic review

Joline Goossens (UGent) , Marjon De Roose (UGent) , Ann Van Hecke (UGent) , Régine Goemaes (UGent) , Sofie Verhaeghe (UGent) and Dimitri Beeckman (UGent)
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Abstract
Background: Healthcare providers play an important role in providing preconception care to women and men of childbearing age. Yet, the provision of preconception care by healthcare providers remains low. Objectives: To provide an overview of barriers and facilitators at multiple levels that influence the provision of preconception care by healthcare providers. Design: A mixed-methods systematic review. Data sources: PubMed, Web of Science, CINAHL, The Cochrane Library, and EMBASE were systematically searched up to April 27, 2017. The search strategy contained MeSH terms and key words related to preconception care and healthcare providers. Reference lists of included studies and systematic reviews on preconception care were screened. Review methods: Publications were eligible if they reported on barriers and facilitators influencing the provision of preconception care by healthcare providers. Data were extracted by two independent reviewers using a data extraction form. Barriers and facilitators were organized based on the social ecological model. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme Qualitative checklist for qualitative studies, the Quality Assessment Tool for quantitative studies, and the Mixed Methods Appraisal Tool for mixed methods studies. Results: Thirty-one articles were included. Barriers were more reported than facilitators. These were situated at provider level (unfavourable attitude and lack of knowledge of preconception care, not working in the field of obstetrics and gynaecology, lack of clarity on the responsibility for providing preconception care) and client level (not contacting a healthcare provider in the preconception stage, negative attitude, and lack of knowledge of preconception care). Limited resources (lack of time, tools, guidelines, and reimbursement) were frequently reported at the organizational and societal level. Conclusions: Healthcare providers reported more barriers than facilitators to provide preconception care, which might explain why the provision of preconception care is low. To overcome the different client, provider, organizational, and societal barriers, it is necessary to develop and implement multilevel interventions.
Keywords
Health knowledge, attitudes, practice, Health personnel, Preconception care, Review, Socio-Ecological Model (SEM), FOLIC-ACID SUPPLEMENTATION, OBSTETRICIAN-GYNECOLOGISTS, GENERAL-PRACTITIONERS, PHYSICIANS KNOWLEDGE, CLINICAL-PRACTICE, UNITED-STATES, ATTITUDES, WOMEN, VIEWS, PROFESSIONALS

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MLA
Goossens, Joline, Marjon De Roose, Ann Van Hecke, et al. “Barriers and Facilitators to the Provision of Preconception Care by Healthcare Providers : a Systematic Review.” INTERNATIONAL JOURNAL OF NURSING STUDIES 87 (2018): 113–130. Print.
APA
Goossens, Joline, De Roose, M., Van Hecke, A., Goemaes, R., Verhaeghe, S., & Beeckman, D. (2018). Barriers and facilitators to the provision of preconception care by healthcare providers : a systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES, 87, 113–130.
Chicago author-date
Goossens, Joline, Marjon De Roose, Ann Van Hecke, Régine Goemaes, Sofie Verhaeghe, and Dimitri Beeckman. 2018. “Barriers and Facilitators to the Provision of Preconception Care by Healthcare Providers : a Systematic Review.” International Journal of Nursing Studies 87: 113–130.
Chicago author-date (all authors)
Goossens, Joline, Marjon De Roose, Ann Van Hecke, Régine Goemaes, Sofie Verhaeghe, and Dimitri Beeckman. 2018. “Barriers and Facilitators to the Provision of Preconception Care by Healthcare Providers : a Systematic Review.” International Journal of Nursing Studies 87: 113–130.
Vancouver
1.
Goossens J, De Roose M, Van Hecke A, Goemaes R, Verhaeghe S, Beeckman D. Barriers and facilitators to the provision of preconception care by healthcare providers : a systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES. 2018;87:113–30.
IEEE
[1]
J. Goossens, M. De Roose, A. Van Hecke, R. Goemaes, S. Verhaeghe, and D. Beeckman, “Barriers and facilitators to the provision of preconception care by healthcare providers : a systematic review,” INTERNATIONAL JOURNAL OF NURSING STUDIES, vol. 87, pp. 113–130, 2018.
@article{8565749,
  abstract     = {Background: Healthcare providers play an important role in providing preconception care to women and men of childbearing age. Yet, the provision of preconception care by healthcare providers remains low.
Objectives: To provide an overview of barriers and facilitators at multiple levels that influence the provision of preconception care by healthcare providers.
Design: A mixed-methods systematic review.
Data sources: PubMed, Web of Science, CINAHL, The Cochrane Library, and EMBASE were systematically searched up to April 27, 2017. The search strategy contained MeSH terms and key words related to preconception care and healthcare providers. Reference lists of included studies and systematic reviews on preconception care were screened.
Review methods: Publications were eligible if they reported on barriers and facilitators influencing the provision of preconception care by healthcare providers. Data were extracted by two independent reviewers using a data extraction form. Barriers and facilitators were organized based on the social ecological model. The methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme Qualitative checklist for qualitative studies, the Quality Assessment Tool for quantitative studies, and the Mixed Methods Appraisal Tool for mixed methods studies.
Results: Thirty-one articles were included. Barriers were more reported than facilitators. These were situated at provider level (unfavourable attitude and lack of knowledge of preconception care, not working in the field of obstetrics and gynaecology, lack of clarity on the responsibility for providing preconception care) and client level (not contacting a healthcare provider in the preconception stage, negative attitude, and lack of knowledge of preconception care). Limited resources (lack of time, tools, guidelines, and reimbursement) were frequently reported at the organizational and societal level.
Conclusions: Healthcare providers reported more barriers than facilitators to provide preconception care, which might explain why the provision of preconception care is low. To overcome the different client, provider, organizational, and societal barriers, it is necessary to develop and implement multilevel interventions.},
  author       = {Goossens, Joline and De Roose, Marjon and Van Hecke, Ann and Goemaes, Régine and Verhaeghe, Sofie and Beeckman, Dimitri},
  issn         = {0020-7489},
  journal      = {INTERNATIONAL JOURNAL OF NURSING STUDIES},
  keywords     = {Health knowledge,attitudes,practice,Health personnel,Preconception care,Review,Socio-Ecological Model (SEM),FOLIC-ACID SUPPLEMENTATION,OBSTETRICIAN-GYNECOLOGISTS,GENERAL-PRACTITIONERS,PHYSICIANS KNOWLEDGE,CLINICAL-PRACTICE,UNITED-STATES,ATTITUDES,WOMEN,VIEWS,PROFESSIONALS},
  language     = {eng},
  pages        = {113--130},
  title        = {Barriers and facilitators to the provision of preconception care by healthcare providers : a systematic review},
  url          = {http://dx.doi.org/10.1016/j.ijnurstu.2018.06.009},
  volume       = {87},
  year         = {2018},
}

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