How, when, and who should ask about pregnancy intentions in primary care? A qualitative study of women's preferences.

BACKGROUND: For health services to help people plan for or prevent pregnancy, health professionals need an acceptable way to identify individuals' preferences. OBJECTIVE: To assess women's views on the acceptability of specific questions about pregnancy preferences when asked by health professionals in a variety of primary care contexts. METHODS: One-to-one in-depth interviews with 13 women aged 18-48 from across the UK, involving role-play scenarios and ranking exercises. Interviews covered a range of settings and health professionals, different question wording, and ways of asking (in person or digitally). We conducted a thematic Framework Analysis, focussing on themes relating to feelings and preferences. RESULTS: Women were generally open to being asked about pregnancy preferences if they understood the rationale, it was asked in a relevant context, such as in women's health-related consultations, and there was follow-up. After signposting, an open question, such as 'How would you feel about having a baby in the next year?' was preferred in a face-to-face context as it enabled discussion. While some women valued a face-to-face discussion with a health professional, for others the privacy and convenience of a digital option was preferred; methods should be tailored to the target population. CONCLUSION: Discussion of pregnancy preferences via a range of formats is acceptable to, and valued by, women in the UK across a range of primary care settings. Acceptability to health professionals and feasibility of implementation needs further exploration and would benefit from greater public awareness of the benefits of pregnancy planning.

How are your berries? Perspectives of Alaska's environmental managers on trends in wild berry abundance.

BACKGROUND: Wild berries are a valued traditional food in Alaska. Phytochemicals in wild berries may contribute to the prevention of vascular disease, cancer and cognitive decline, making berry consumption important to community health in rural areas. Little was known regarding which species of berries were important to Alaskan communities, the number of species typically picked in communities and whether recent environmental change has affected berry abundance or quality. OBJECTIVE: To identify species of wild berries that were consumed by people in different ecological regions of Alaska and to determine if perceived berry abundance was changing for some species or in some regions. DESIGN: We asked tribal environmental managers throughout Alaska for their views on which among 12 types of wild berries were important to their communities and whether berry harvests over the past decade were different than in previous years. We received responses from 96 individuals in 73 communities. RESULTS: Berries that were considered very important to communities differed among ecological regions of Alaska. Low-bush blueberry (Vaccinium uliginosum and V. caespitosum), cloudberry (Rubus chamaemorus) and salmonberry (Rubus spectabilis) were most frequently identified as very important berries for communities in the boreal, polar and maritime ecoregions, respectively. For 7 of the 12 berries on the survey, a majority of respondents indicated that in the past decade abundance had either declined or become more variable. CONCLUSIONS: Our study is an example of how environmental managers and participants in local observer networks can report on the status of wild resources in rural Alaska. Their observations suggest that there have been changes in the productivity of some wild berries in the past decade, resulting in greater uncertainty among communities regarding the security of berry harvests. Monitoring and experimental studies are needed to determine how environmental change may affect berry abundance.