Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.

<h4>Background</h4>The District of Columbia (DC) has striking disparities in maternal and infant outcomes comparing Black to White women and babies. Social determinants of health (SDoH) are widely recognized as a significant contributor to these disparities in health outcomes. Screening...

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Main Authors: Jason Brown, Naheed Ahmed, Matthew Biel, Loral Patchen, Janine Rethy, Angela Thomas, Hannah Arem
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0283815
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author Jason Brown
Naheed Ahmed
Matthew Biel
Loral Patchen
Janine Rethy
Angela Thomas
Hannah Arem
author_facet Jason Brown
Naheed Ahmed
Matthew Biel
Loral Patchen
Janine Rethy
Angela Thomas
Hannah Arem
author_sort Jason Brown
collection DOAJ
description <h4>Background</h4>The District of Columbia (DC) has striking disparities in maternal and infant outcomes comparing Black to White women and babies. Social determinants of health (SDoH) are widely recognized as a significant contributor to these disparities in health outcomes. Screening for social risk factors and referral for appropriate services is a critical step in addressing social needs and reducing outcome disparities.<h4>Methods</h4>We conducted interviews among employees (n = 18) and patients (n = 9) across three diverse, urban clinics within a healthcare system and one community-based organization involved in a five-year initiative to reduce maternal and infant disparities in DC. Interviews were guided by the Consolidated Framework for Implementation Research to understand current processes and organizational factors that contributed to or impeded delivery of social risk factor screening and referral for indicated needs.<h4>Results</h4>We found that current processes for social risk factor screening and referral differed between and within clinics depending on the patient population. Key facilitators of successful screening included a supportive organizational culture and adaptability of more patient-centered screening processes. Key barriers to delivery included high patient volume and limited electronic health record capabilities to record results and track the status of internal and community referrals. Areas identified for improvement included additional social risk factor assessment training for new providers, patient-centered approaches to screening, improved tracking processes, and facilitation of connections to social services within clinical settings.<h4>Conclusion</h4>Despite proliferation of social risk factor screeners and recognition of their importance within health care settings, few studies detail implementation processes for social risk factor screening and referrals. Future studies should test implementation strategies for screening and referral services to address identified barriers to implementation.
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spelling doaj.art-4d46f6e6f17b4970bde69daeebef837b2023-04-21T05:32:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184e028381510.1371/journal.pone.0283815Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.Jason BrownNaheed AhmedMatthew BielLoral PatchenJanine RethyAngela ThomasHannah Arem<h4>Background</h4>The District of Columbia (DC) has striking disparities in maternal and infant outcomes comparing Black to White women and babies. Social determinants of health (SDoH) are widely recognized as a significant contributor to these disparities in health outcomes. Screening for social risk factors and referral for appropriate services is a critical step in addressing social needs and reducing outcome disparities.<h4>Methods</h4>We conducted interviews among employees (n = 18) and patients (n = 9) across three diverse, urban clinics within a healthcare system and one community-based organization involved in a five-year initiative to reduce maternal and infant disparities in DC. Interviews were guided by the Consolidated Framework for Implementation Research to understand current processes and organizational factors that contributed to or impeded delivery of social risk factor screening and referral for indicated needs.<h4>Results</h4>We found that current processes for social risk factor screening and referral differed between and within clinics depending on the patient population. Key facilitators of successful screening included a supportive organizational culture and adaptability of more patient-centered screening processes. Key barriers to delivery included high patient volume and limited electronic health record capabilities to record results and track the status of internal and community referrals. Areas identified for improvement included additional social risk factor assessment training for new providers, patient-centered approaches to screening, improved tracking processes, and facilitation of connections to social services within clinical settings.<h4>Conclusion</h4>Despite proliferation of social risk factor screeners and recognition of their importance within health care settings, few studies detail implementation processes for social risk factor screening and referrals. Future studies should test implementation strategies for screening and referral services to address identified barriers to implementation.https://doi.org/10.1371/journal.pone.0283815
spellingShingle Jason Brown
Naheed Ahmed
Matthew Biel
Loral Patchen
Janine Rethy
Angela Thomas
Hannah Arem
Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
PLoS ONE
title Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
title_full Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
title_fullStr Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
title_full_unstemmed Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
title_short Considerations in implementation of social risk factor screening and referral in maternal and infant care in Washington, DC: A qualitative study.
title_sort considerations in implementation of social risk factor screening and referral in maternal and infant care in washington dc a qualitative study
url https://doi.org/10.1371/journal.pone.0283815
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