Factors affecting willingness of sexually transmitted disease (STD) counselors to integrate preconception counseling into sexually transmitted disease clinics

The high rate of unintended pregnancy is an immediate barrier to providing preconception care (PCC). Failure to provide PCC in STD clinics may represent a major missed opportunity to target women at high-risk. This study examined factors associated with STD provider attitudes that either positively or negatively impact their willingness to integrate preconception counseling services into STD clinics. This study was cross-sectional in design and utilized a self-reported questionnaire. One hundred and forty-two qualified respondents participated in the study. Study findings did not support what had been hypothesized but confirm that counselors perceive PCC as feasible to integrate into STD clinics. The employee's level of responsibility was shown to be a statistically significant predictor of whether or not the respondent thought PCC was important (-3,832, p<.01), whether the respondent would be willing to integrate it into the STD clinic (-0.587, p<.05) and whether the respondent thought high risk women should receive PCC service through the STD clinic (-0.468, p<.05). Study findings may confirm policy makers might play an important roll in making services integrated into STD clinics available to all women. Policy makers should consider granting states desiring to do so Medicaid waivers to increase access to PCC counseling. These waivers should be contingent upon the development of uniform policies for comprehensive care programs and the explicit identification of what components of PCC are amenable to integration.