Preconception Reproductive Knowledge Promotion

This current study titled the Preconception Reproductive Knowledge Promotion (PREKNOP) addresses two key areas of interest in the U.S. National Institute of Nursing Research’s strategic plan: 1) Promoting Health and Preventing Disease: Design intervention studies using community-based approaches and 2) Eliminating Health Disparities: Identify strategies that will reduce the long-term adverse consequences of poor maternal and reproductive health in minorities and undeserved populations.

Nearly half of all pregnancies in the United States are unplanned, a higher rate than that of other developed countries. Unplanned pregnancy in the U.S. was highest among poor and low-income women and minorities regardless of income. Unplanned pregnancy regardless of income has been associated with negative maternal behaviors and birth outcomes including poor preconception care, smoking and drinking during pregnancy, delayed initiation of prenatal care, preterm births and low birth weight. Even starker outcomes are reported among low income women and minority groups, who do not adequately receive routine and specialized prenatal care services, including preconception services. This research is to promote women’s reproductive health and positive pregnancy outcomes by reducing the risk of unplanned pregnancy and delayed pregnancy recognition.

This study proposes that women with knowledge of reproductive changes and high self-efficacy about their pregnancy planning will most likely follow through with actual planning. Albert Bandura’s social cognitive theory on self-efficacy and Nola Pender’s health promotion model guide this assumption. Several studies have identified knowledge and self-efficacy as important determinants of many health behaviors. For example, Weisman, et al concluded that women who perceive they can control future birth outcomes are more likely to use preconception interventions. This study will be one of the very few studies which will focus on reducing the risk of unplanned pregnancy and promoting early recognition of pregnancy by actively involving low-income women in their reproductive care, through monitoring of menstrual cycle & ovulation time, with the use of ovulation test kits during the preconception period.

This study is a community-driven health promotion effort that builds on previously conducted Calvin College Department of Nursing (CCDON) community needs assessments in three partnering low-income neighborhoods in Grand Rapids. In community surveys and focus group discussions, women identified unplanned pregnancies as a top health concern. Our prior work has shown that women often are not fully informed about their reproductive health. In our analysis of the Pregnancy Assessment Monitoring Survey (PRAMS) on reasons for unplanned pregnancy, 33% of the women felt they could not get pregnant at the time of conception. In fact, our focus group discussions in 2008 in the nursing program partnering neighborhoods showed that women want to “know their bodies” before they are pregnant. A pilot study was conducted during the spring semester in 2010 to address the issues identified by the women in the focus group discussions in the CCDON partnering neighborhoods. This pilot study titled “Knowing your body” was to establish the feasibility of conducting a study on increasing women’s knowledge of the reproductive changes occurring in their bodies as an important means to reduce the risk of unplanned pregnancy and to promote early pregnancy recognition.

This current study titled the Preconception Reproductive Knowledge Promotion (PREKNOP) addresses two key areas of interest in the U.S. National Institute of Nursing Research’s strategic plan: 1) Promoting Health and Preventing Disease: Design intervention studies using community-based approaches and 2) Eliminating Health Disparities: Identify strategies that will reduce the long-term adverse consequences of poor maternal and reproductive health in minorities and undeserved populations. Women of childbearing age, especially minorities and the low-income, need continuous monitoring and on-going educational approach to reduce disparity in health and improve pregnancy outcomes. This study is foundational for designing interventions among low-income women for whom regular monitoring of menstrual changes is incorporated as part of healthy lifestyle practice.

Researchers

Principle Investigator Adejoke B. Ayoola, Associate Professor of Nursing

Research Team

• Gail Zandee, Associate Professor of Nursing & Community Partnership Coordinator
• Cheryl Feenstra, previous Professor of Nursing
• Debra Bossenbroek, previous Assistant Professor of Nursing
• Dianne Slager, previous Assistant Professor of Nursing
• Krista Sneller, previous Assistant Professor of Nursing

Other Collaborators

• Neil Carlson, Center for Social Research
• Richard Remington, Consulting Statistician

Current Research Assistants

• Alex Lyons, Nursing student
• Cora Bruxvoort, Nursing student
• Elise Veurink, Nursing student
• Hannah Whyte, Nursing student
• Jennifer Lee, Nursing student
• Josephine Granner, Nursing student

Past Research Assistants

• Rebekah J. Sytsma, Nursing student
• Mariana P. Perez, Nursing student
• Tega D. Ebeye, Nursing student
• Kendra J. Kamp, Nursing student
• Emily K. Johnson, Nursing student
• Laura A. Schipper, Nursing student
• Rebecca J. Mpindi, Nursing student
• Susan E. Datema, Nursing student
• Erika L. Bosch, Nursing student
• Jurang Kim, Nursing student
• Narshil Choi, Nursing student
• Lyndsay G. DeGroot, Nursing student
• Megan A. Demaagd-Rodriguez, Nursing student
• Samantha Orozco, Nursing student
• Megan L. Hoekstra, Nursing student
• Colleen L. Skeba, Nursing student
• Josiane Ishongore, Nursing student
• Betsy C. Otten, Nursing student
• Katie M. Heille, Nursing student
• Victoria L. Ellens, Nursing student
• Jessie O. Yunus, Nursing student
• Megan R. Dykstra, Nursing student
• Kara E. Marshall, Nursing student
• Katharine G. Eiten, Nursing student
• Rebecca I. Broekhuis, Nursing student
• Yenupini Joyce Adams, Nursing Student
• Andrew B. Rienstra-Ehlers, Calvin Alum Project Coordinator  

Press

• Robert Wood Johnson Foundation Nurse Faculty Scholars: Adejoke Ayoola, Ph.D., R.N.
• A $350,000 Grant to Promote Pregnancy Planning
• Grand Rapids Press: Calvin College nursing professor wins $350,000 to educate low-income women about unplanned pregnancy
• Calvin College: Strategic Plan Stories - Partnerships

Questions/contact