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Study Background: Despite the growing understanding of preconception care, numerous barriers to its delivery still exist, including a lack of evidence-based, accessible screening tools., Purpose: To validate a new digital Preconception Health Assessment Tool (PreCHAT) against the current best practice, physician-delivered tool in Ontario, Canada, and explore how PreCHAT's design impacts its risk identification abilities relative to the comparison tool., Methods: A criterion validation study was conducted with 53 female participants aged 18-44 years. Participants completed both tools in a controlled setting. PreCHAT was completed on a tablet individually by participants, while the comparison tool was administered by a physician. Three physicians administered the comparison tool. Measures of strength of agreement between PreCHAT and the comparison tool were calculated using percent agreement, Cohen's Kappa, and prevalence-adjusted and biased-adjusted kappa (PABAK)., Results: PreCHAT identified 135 individual risk factors, while the comparison tool identified 102. Both tools shared the same 14 domains of preconception care and 88 risk factors; of the 88 risk factors, PreCHAT identified an average of 3.42 (p < 0.0001) more risks per participant than the comparison tool. PABAK scores indicated almost perfect agreement between PreCHAT and the comparison tool., Conclusions: This study suggests that PreCHAT is valid against the current best practice tool and is broader in its risk identification among individuals of reproductive age. PreCHAT's patient-facing, digital, EMR-integrated design may offer unique benefits to providers and patients. PreCHAT offers providers an innovative approach to deliver preconception care and may positively impact reproductive, maternal, and child health.

Introduction: To improve reproductive, maternal, and child health, preconception health (PCH) care that is innovative and generationally relevant is essential. In response, Wellington-Dufferin-Guelph Public Health (WDGPH) developed and tested an evidence-based PCH electronic intervention delivered in a primary care setting. The purpose of this study was to: (1) identify the prevalence of PCH risks among women of reproductive age, (2) determine the impact of the PCH intervention on knowledge and behaviour, and (3) assess the implementation of the intervention., Methods: The PCH intervention was designed as a cohort study using a mixed method approach. 300 women aged 15-49 years participated across seven primary care sites. The intervention was implemented using a three-part model., Participants: (1) completed a Risk Assessment (RA) on tablet with results sent to their electronic medical record, (2) discussed results with primary care providers (PCPs), (3) received handout with results and key messages. Data were collected from participants (RA and two surveys), and PCPs (interviews)., Results: The RA screened for 34 PCH risk factors. The number of risks identified per participant ranged from 4 to 24, averaging 15. The majority reported a positive experience using the RA and would recommend the intervention. PCPs reported many practice benefits. The study highlights the positive influence that PCPs have around PCH., Discussion: The PCH intervention is the first of its kind in Canada. The intervention is an evidence-based population health approach that may help to improve reproductive, maternal and child health. Further research, evaluation and promotion is needed.