Increase public awareness of the importance of preconception health behaviors and preconception care services by using information and tools appropriate across various ages; literacy, including health literacy; and cultural/linguistic contexts.

Consumers should be more involved in improving preconception care services. Knowledge and attitudes and behaviors related to reproductive health are influenced by childhood experiences and prevailing social norms among adults. Certain U.S. adults are not aware of the factors that influence reproductive health and childbearing. The preconception guidelines from Canada state that preconception care is 1) physical preparation for pregnancy and parenting and 2) the social, psychological, and spiritual components of pregnancy. The factors that influence attitudes regarding preconception care include a person's age and life stage, their childbearing history, and their life priorities.

Activities specifically designed to improve school general health education are an essential step in improving reproductive awareness. Efforts to inform adults regarding the risks and opportunities to improve their health are equally important. Several health promotion campaigns provide opportunities to change adult knowledge and attitudes and behaviors, including campaigns designed to reduce tobacco use, promote responsible use of alcohol, and encourage healthy diet and optimal weight. Campaigns can include messages concerning reproductive health and childbearing. Such campaigns typically focus on the effect of adverse behaviors on children and do not include parallel messages regarding the potential impact on childbearing. New social marketing and health promotion campaigns that focus on how to prepare for childbearing and parenting can influence the behavior of men and women. For example, folic acid intake has been promoted among women of childbearing age. Similar to efforts to reduce teenage childbearing or increase use of prenatal care, the media can play a vital role in promoting reproductive awareness.

Success in improving preconception health will require changes in public attitudes and has been achieved in other areas (e.g., attitudes changed during the previous 10 years regarding tobacco use, infant sleep position, or vaccinations for infants and toddlers instead of preschoolers) (158). A critical tool for stimulating these changes is social marketing, which is designed to influence the voluntary behavior of targeted audiences to improve their well-being (159,160).

Consumer-friendly tools can help women self-assess risks, make plans, and take actions that will improve their health and that of their children. More consumer-focused research is needed to determine which messages and tools might be effective to encourage reproductive life planning. The SPPC members have suggested that such research explore which terms the public best understands, what messages might increase demand for services, and how touch-screen kiosks or other technology might be used to promote knowledge of preconception health topics.