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Adaptation of Screening Tools for Social Determinants of Health in Pregnancy: A Pilot Project

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Abstract

Objectives

Social determinants of health (SDOH) and stress during pregnancy may contribute to adverse pregnancy outcomes. The objective of this in the field pilot project was to develop a comprehensive screening tool by combining existing validated screeners. Additionally, implement use of this tool within routine prenatal visits and assess feasibility.

Methods

Pregnant patients accessing prenatal care at a single site of an urban Federally Qualified Health Center were recruited during prenatal visits to complete a Social Determinants of Health in Pregnancy Tool (SIPT). SIPT combines a series of questions from existing and well-validated tools and consists of five domains: (1) perceived stress, (2) relationship and family stress, (3) domestic violence, (4) substance abuse, and (5) financial stress.

Results

Between April 2018 and March 2019, 135 pregnant participants completed SIPT. Ninety-one percent of patients scored positive on at least one screener, 54% to three or more screeners.

Conclusions

Despite guidelines to screen for SDOH during pregnancy there is no universal tool. Our pilot project demonstrated the concurrent use of adapted screening tools where participants reported at least one area of potential stress, and that linking to resources at the time of a visit is plausible. Future work should examine if screening and point of care linkages of services improves maternal child outcomes.

Significance

What is already known about this subject? The American College of Obstetrics and Gynecology acknowledges to improve care and decrease inequalities prenatal providers should routinely screen for SDOH within prenatal visits.

What does this study add? Our study aimed to implement a comprehensive stress and SDOH tool that could be used quickly within a prenatal visit by the provider to enable timely linkage of services. While national recommendations emphasize screening and need for possible referrals this study demonstrates the feasibility of screening, implementation, and follow up.

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Author notes

  1. Lauren E. Harriett and Rebecca L. Lynne have contributed equally to this work.

Authors and Affiliations

  1. PCC Community Wellness Center, 115 North Parkside Avenue, Chicago, IL, 60644, USA

    Lauren E. Harriett

  2. Department of Family and Community Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., K Building, 2nd Floor, Suite 400F, Dallas, TX, 75390, USA

    Rebecca L. Eary & Sarah A. Prickett

  3. Department of Obstetrics and Gynecology, NorthShore University Health System, Chicago, IL, USA

    Janedelie Romero

  4. A.L. Burdick Family Medicine Center, 3 Erie Court Suite 6160, Oak Park, IL, 60302, USA

    Rebecca G. Maddrell

  5. Department of Obstetrics and Gynecology, NorthShore University Health System and Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Lauren S. Keenan-Devlin & Ann E. B. Borders

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  1. Lauren E. Harriett
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  2. Rebecca L. Eary
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Correspondence to Rebecca L. Eary.

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Harriett, L.E., Eary, R.L., Prickett, S.A. et al. Adaptation of Screening Tools for Social Determinants of Health in Pregnancy: A Pilot Project. Matern Child Health J 27, 1472–1480 (2023). https://doi.org/10.1007/s10995-023-03732-2

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  • DOI: https://doi.org/10.1007/s10995-023-03732-2

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