One Key Question at JPS Health Network: Pregnancy Intention as a Predictor of Pregnancy and Birth Outcomes




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Purpose: One Key Question® (OKQ) is a patient-centered screening tool used in routine visits by asking, “Would you like to become pregnant within the next year?” with the goal of preventing unintended pregnancy. We aim to examine the effectiveness of the OKQ at a safety-net hospital by resulting pregnancy rates in the following year. Methods: We examined 5,318 OKQ responses from 8/1/2017 through 1/31/2021 and analyzed resulting pregnancies through 1/31/2022. We compared age category, race and ethnicity, and payor class on likelihood to answer “No” to OKQ, be on birth control, and become pregnant within a year (if answered no to OKQ), stratified by visit type (postpartum vs. well-woman). Chi squared tests assessed associations between these variables. Results: Almost all of the women responded “No” to the OKQ (96%), with 5.6% of those women becoming pregnant within the year. Most women responding were Hispanic (56%), ages 25-34 (51%) and at a postpartum visit (87%). Women at postpartum visits responding “No” to OKQ were less likely to be on birth control compared to women at well-woman visits (39% vs. 79%). Overall, being on birth control differed by race and ethnicity (p= <.0001) and age category (p= <.0001), but not by payor class. Conclusions: OKQ offers insight into continuing patient-centered education regarding pregnancy intention and birth control status to prevent unintended pregnancies and potential adverse pregnancy and birth outcomes.


Research Appreciation Day Award Winner - Texas College of Osteopathic Medicine, 2024 Honors Student Research Award