Preconception health and care policies, strategies and guidelines in the UK and Ireland: a scoping review.

BACKGROUND: Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland. METHODS: Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the "Healthy Reproductive Years" Patient and Public Involvement and Engagement advisory panel. RESULTS: The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women's, rather than men's, behaviours. CONCLUSIONS: This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health.

Preconception health and care policies, strategies and guidelines in the UK and Ireland: a scoping review protocol.

INTRODUCTION: Preconception care can significantly improve maternal and infant outcomes, and thus optimise intergenerational health. The aims of this scoping review are to (1) provide an up-to-date summary of preconception health and care strategies, policies, guidelines, frameworks and recommendations across the UK and Ireland and (2) explore preconception health and care services and interventions in Northern Ireland as a case study. METHODS AND ANALYSIS: This scoping review of grey literature will be conducted as per the Scoping Review Methods Manual by the Joanna Briggs Institute and the Arksey-O'Malley framework for scoping studies, and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted on Google Advanced Search, OpenAire, NICE, ProQuest and relevant public health websites in May 2022. Only results published, reviewed or updated between January 2011 and the time of the searches (May 2022) were considered for inclusion. In addition, searches on interventions and services provided in Northern Ireland will be supplemented by consultations and audits with key stakeholders to validate findings, identify other potentially eligible resources and ensure breadth of coverage. Data will be extracted into Excel and coded using NVivo, and ≥10% of the data will be double-coded. A narrative approach with content analysis highlighting key themes and concepts will be used to report findings.Throughout the research cycle, members of the wider public will be involved and engaged with to provide feedback. ETHICS AND DISSEMINATION: Ethical approval is not required as analyses will be conducted on data available in the public domain. Findings will be shared with relevant stakeholders with the aim to inform future research, practice and decision-making, and disseminated through a peer-reviewed publication, conference presentations and infographics. Dissemination plans will be informed by the 'Healthy Reproductive Years' patient and public involvement and engagement advisory panel.