739 - The First 1000 Days: Preferences of Postpartum Mothers on Health-Related Social Needs Screening and Resource Referrals

Publication Number: 1716.739

Yonit Lax, Maimonides Medical Center, Brooklyn, NY, United States; Jeremy Silverstein, Maimonides Infants and Children's Hospital of Brooklyn, New York, NY, United States; Cassidy Psihos, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States; Dana Seag, State University of New York Downstate Medical Center College of Medicine, Brooklyn, NY, United States; Maria Andrea Reinberg Palmar, Maimonides Medical Center, Brooklyn, NY, United States; Melisa Perez Navarrete, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Zoe Bouchelle, University of Colorado School of Medicine, Denver, CO, United States

Background: Unmet health-related social needs (HRSN) are associated with poor health outcomes in children. The first 1000 days is a critical time to identify and address needs, yet many families experience barriers to engaging with HRSN screening and referral programs in this period.

Objective: In this qualitative study we examined barriers and facilitators for postpartum mothers to screening and resource connection.

Design/Methods: We conducted semi-structured interviews with 34 mothers who completed HRSN screening prenatally, perinatally, and/or in primary care within the prior 4 months. Using purposive sampling, we interviewed English- (74%) and Spanish-speaking (26%) mothers (See Table 1) regarding barriers and facilitators to engagement. Transcripts were analyzed by 3 coders using Dedoose and reflexive thematic analysis.

Results: Families identified several barriers and facilitators to screening and resource connection. Barriers to engaging in HRSN screening included (1) screening in the first day postpartum, and (2) lack of clarity on purpose of screening. Facilitators to engaging in HRSN included (1) non-judgmental communication with privacy and brevity, and (2) written and verbal screening options, with Spanish-speaking mothers largely preferring verbal screening. Barriers to resource connection included (1) lack of a verbal explanation (i.e. printed resource list only) and follow up regarding resource connection, and (2) limited domains of provided resources (e.g. expanding postpartum needs like home visits, childcare, and parent groups). Facilitators to resource connection included (1) receipt of both paper and electronic resources, and (2) reduced provider hand offs (Tables 2+3)

Conclusion(s): In this qualitative study, postpartum mothers with infants identified several barriers and facilitators to engaging in HRSN screening and resource connection across the prenatal, perinatal, and primary care continuum. HRSN programs targeting the first 1000 days may consider screening at 3 touchpoints prenatally, postpartum and pediatrics, avoiding the immediate postpartum period and deploying brief screeners with verbal and written options that cover not only basic HRSN but also common postpartum resource needs, like childcare. HRSN programs should also consider verbal counseling and follow-up navigation for resources offered, as well as minimizing the number of hand offs. This study underscores that tailored HRSN screening to the site of care and stage of child development may facilitate engagement.

Demographics Table


Facilitators and Barriers to Engaging in HRSN Screening
Themes and Sample Quotes

Facilitators and Barriers to Engaging in HRSN Referrals
Themes and Sample Quotes