Acceptability and usability of 'One Key Question'® in Australian primary health care.

Background: Around one-third of pregnancies in women attending antenatal care are unintended. This means a substantial number of women enter pregnancy without optimising their health prior to conception. Primary care practitioners are uniquely placed to counsel women about how to plan for pregnancy and about how to avoid unintended conception. The One Key Question® (OKQ®) tool facilitates a discussion of pregnancy intention and opens up subsequent discussions regarding preconception or contraception care. This study aimed to assess the acceptability and usability of the OKQ® tool in the Australian primary care setting. Methods: We undertook a pilot study consisting of quantitative and qualitative components across two general practice settings in Sydney, New South Wales, Australia. We documented women's responses to being asked the OKQ® as part of their consultation. We collected data on the characteristics of the participating GPs and their experience of using the OKQ® tool and conducted semi-structured interviews with all participating GPs. Results: Fifty-six patients were asked the OKQ®, with the majority stating they were happy to be asked about their reproductive choices and felt it was relevant to their general health. The 10 participating GPs felt the OKQ® was easy to use and although 62.5% reported it extended the consultation time, the medium time taken was 2 min. GPs felt framing the OKQ® helped introduce pregnancy intention discussions into a consultation. Conclusions: The OKQ® is acceptable to patients and easy for GPs to use. This tool facilitates a proactive and routine discussion to enhance the delivery of preconception care and contraceptive counselling. Around one-third of Australian women presenting to antenatal care report their pregnancies are unintended. Primary care is uniquely placed to prevent unplanned pregnancies and optimise preconception care, and the One Key Question® (OKQ®) is a tool that has been developed to facilitate this. General practitioners felt the OKQ® was easy to use and were comfortable using it, and patients generally found the screening tool to be acceptable and that it was applicable to their general health. [ABSTRACT FROM AUTHOR]