Understanding social needs in pregnancy: Prospective validation of a digital short-form screening tool and patient survey.
Understanding social needs in pregnancy: Prospective validation of a digital short-form screening tool and patient survey.
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DOI：
10.1016/j.xagr.2022.100158
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发表时间：
2023-02
期刊：
影响因子：
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通讯作者：
Shah, Neel
中科院分区：
文献类型：
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作者：
Peahl, Alex F;Rubin-Miller, Lily;Paterson, Victoria;Jahnke, Hannah R;Plough, Avery;Henrich, Natalie;Moss, Christa;Shah, Neel
健康的社会决定因素显着影响健康结果，但在产前护理中却很少得到解决。本研究旨在通过以下方式提高解决妊娠期社会需求的效率和体验：（1）测试数字简短筛查工具； (2) 描述孕妇对社会需求筛查和管理的偏好。我们根据 PRAPARE（应对和评估患者资产、风险和经历的协议）开发了一种数字简短的健康筛查社会决定因素工具，并进行了一项调查来询问患者对满足社会需求的偏好。仪器在网上向围产期参与者进行管理，其中公共和私人保险患者的代表性相同。我们计算了简短工具与 PRAPARE 的敏感性和特异性。使用描述性统计来表征定量反应。使用矩阵和主题编码对自由文本响应进行分析。调查数据按历史上边缘化人群的亚组进行分析。共有 215 人完成了调查。参与者主要是白人（167 名；77.7%）和经产妇（145 名；67.4%）。简短工具 (77.7%) 和 PRAPARE (96.7%) 都普遍存在未满足的社会需求。简短筛选器对于检测任何社会需求的敏感性（79.3％）和特异性（71.4％）都很高。大多数参与者认为，怀孕护理团队了解自己的社交需求非常重要（材料：173 人，80.5%；支持：200 人，93.0%），如果有或没有援助，超过一半的人愿意通过面对面或数字方式分享自己的需求（材料：117 人，54.4%；支持：122 人，56.7%）。自由文本主题反映了将社会需求纳入常规产前护理的考虑。所有群体对解决怀孕期社会需求的接受度都很高。与黄金标准相比，数字简短的健康筛查社会决定因素工具表现良好。孕妇接受社会需求作为常规怀孕护理的一部分。未来的工作需要实施高效、有效、以患者为中心的方法来满足妊娠期的社会需求。
Social determinants of health significantly affect health outcomes, yet are infrequently addressed in prenatal care. This study aimed to improve the efficiency and experience of addressing social needs in pregnancy through: (1) testing a digital short-form screening tool; and (2) characterizing pregnant people's preferences for social needs screening and management. We developed a digital short-form social determinants of health screening tool from PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences), and a survey to query patients’ preferences for addressing social needs. Instruments were administered online to peripartum participants, with equal representation of patients with public and private insurance. We calculated the sensitivity and specificity of the short-form tool vs PRAPARE. Quantitative responses were characterized using descriptive statistics. Free-text responses were analyzed with matrix and thematic coding. Survey data were analyzed by subgroups of historically marginalized populations. A total of 215 people completed the survey. Participants were predominantly White (167; 77.7%) and multiparous (145; 67.4%). Unmet social needs were prevalent with both the short-form tool (77.7%) and PRAPARE (96.7%). The sensitivity (79.3%) and specificity (71.4%) of the short-form screener were high for detecting any social need. Most participants believed that it was important for their pregnancy care team to know their social needs (material: 173, 80.5%; support: 200, 93.0%), and over half felt comfortable sharing their needs through in-person or digital modalities if assistance was or was not available (material: 117, 54.4%; support: 122, 56.7%). Free-text themes reflected considerations for integrating social needs in routine prenatal care. Acceptability of addressing social needs in pregnancy was high among all groups. A digital short-form social determinants of health screening tool performs well when compared with the gold standard. Pregnant people accept social needs as a part of routine pregnancy care. Future work is needed to operationalize efficient, effective, patient-centered approaches to addressing social needs in pregnancy.