Informing public health messages and strategies to raise awareness of pre-conception health: a public consultation

Abstract

Background
Despite growing scientific and policy recognition that optimising health before a potential pregnancy (ie, pre-conception health) improves the lifelong health of reproductive-aged people and any children that they might have, public awareness of pre-conception health is lacking. To inform appropriate public health messages and strategies to increase public awareness, this project aimed to develop recommendations on language use, and identify and prioritise strategies.

Methods
A public consultation was undertaken through semistructured online group discussions with people (of any gender) aged 18–50 years in England who were not currently expecting a child. Public contributors were recruited through patient and public involvement groups, Facebook support groups (eg, for people with fertility issues or chronic conditions), and an LGBTQ+ charity. The first round of discussions (Feb 4–March 25, 2021) explored public contributors' knowledge about pre-conception health, their recommendations on appropriate language for public health messages, and ideas on public health strategies. All contributors were invited for a second discussion round (May 24–28, 2021) to refine the language recommendations and prioritise the suggested strategies. Discussions were summarised based on notes taken by two researchers. Ethics approval was not required for this public consultation.

Findings
54 people joined the first discussion round. Of these, 36 participated in the second round (24 [67%] female, seven [19%] male, five [14%] transgender or non-binary; 13 [36%] from an ethnic minority background). Discussions confirmed a substantial lack of awareness of pre-conception health, but also revealed curiosity and an interest to learn more. Agreed language recommendations included avoiding unfamiliar terms without further explanation (eg, pre-conception health, medical terms); using language that is positive, encouraging, inclusive, and gender-neutral when possible; and using messages that are specific and realistic. School-based education and social media campaigns supported by a trusted source such as the NHS emerged as strategic priorities.

Interpretation
This public consultation revealed a desire among diverse groups to learn about pre-conception health and normalise preparation for pregnancy. The views obtained were predominantly from public contributors living in the Southampton area, and did not include people of reproductive age younger than 18 years (ie, those aged 15–17 years). Raising public awareness about pre-conception health should begin in schools and will require adaptation of curricula, alongside development of public awareness campaigns, to reach all people across their reproductive years. Further research is needed to inform and develop these initiatives.

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Identifiers

ORCID for Danielle Schoenaker: orcid.org/0000-0002-7652-990X

ORCID for Olatundun Gafari: orcid.org/0000-0003-3416-5084

ORCID for Elizabeth Taylor: orcid.org/0000-0002-7680-2865

ORCID for Nisreen Alwan: orcid.org/0000-0002-4134-8463

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