Study looks at ways to support delivery of health care before pregnancy
Pregnancy-related heart problems affect the health of many women in the United States, with some communities facing a greater burden than others. Preconception counseling, or health education and promotion before a woman is pregnant, can help identify and address risk factors and contribute to a healthier pregnancy. To make this positive impact, preconception counseling needs to be accessible and meaningful to patients and families. That is why researchers from the Morehouse School of Medicine, representing CEAL’s Maternal Health Community Implementation Program, set out to identify the factors that make preconception heart health counseling more impactful, focusing on communities most at risk across four Southeastern states.
As part of its community-engaged research program, Project IMPACT (IMproving Preconception Actions and Choices for Tomorrow), the team used a rigorous implementation science model to study the factors behind delivering a preconception counseling intervention in 10 community sites in Georgia, North Carolina, South Carolina, and Tennessee. Centering community voices, the team established a Regional Accountability Board of local stakeholders to steer the work and provide insights. The research team distributed a survey to the partner sites and conducted a series of group interviews with staff and community members.
“Engaging community partners in the development of strategies and consistently incorporating their feedback at every stage of the study has not only highlighted the importance of the intervention but also ensured that it aligns with the needs and priorities of their communities.” Discover Health Systems, June 2025
Overall, the team found high levels of support for preconception heart health counseling from partner site staff and the community. Sites indicated that they were reasonably well-equipped to provide the counseling, but they also identified barriers, such as staffing and funding considerations. Trusting relationships between the sites and the community were identified as major strengths, as were the sites’ robust abilities to refer patients to local services to address pregnancy health care, smoking cessation, food and nutrition, and social service needs.
Moving forward, the research team plans to use these findings to support better implementation of preconception counseling, tailored to those who need it most. These efforts will help improve the health of women — before, during, and after pregnancy.
