Consensus Preconception Educational Domains for People With Mobility Disabilities: A Delphi Study

Abstract

Background: Preconception health education is critical to improve pregnancy and neonatal outcomes, but people with mobility disabilities have specific, often unique issues related to preparing for pregnancy. This study sought to develop consensus-based domains for a preconception education curriculum for people with mobility disabilities.

Methods: We used a mixed-methods approach, including a literature review and a Delphi method to develop consensus. Delphi panel members and domains were identified by a systematic review and purposive sampling and the panel included physicians, researchers, and individuals with lived experience of mobility disabilities. A Delphi method was used to reach consensus on domains for a preconception education curriculum for people with mobility disabilities.

Results: The systematic review identified 53 domains of preconception health education. Seventeen individuals participated in the Delphi panel process. After three rounds of quantitative and qualitative consensus feedback, 13 educational domains were selected for preconception education for people with mobility disabilities. The domains were 1) Pregnancy Interest; 2) Infertility and Obstetric History; 3) Genetic History and Screening; 4) Medical History; 5) Medication History; 6) Mental Health History; 7) Nutrition and Weight History; 8) Social Determinants of Health; 9) Intimate Partner Violence and Caregiver Abuse; 10) Functional Mobility and Physical Accommodations; 11) Musculoskeletal and Skin Health; 12) Bowel and Bladder Surgery; and 13) Neurological and Neurosurgical History.

Conclusions: A consensus preconception education curriculum for people with mobility disabilities includes standard domains plus additional domains focused on functional mobility and physical accommodations: musculoskeletal and skin health, bowel and bladder surgery, and neurological and neurosurgical history.