A community-based participatory approach to develop a social risk screening protocol, tailored to the needs of pregnant and postpartum people in Metro Atlanta

Introduction: Our goal was to co-create a locally tailored social risk screening protocol for use in obstetric care settings in Metro Atlanta.

Methods: We conducted a community-based participatory study consisting of key informant interviews and a year-long working group. Interviews were conducted with representatives of community organizations (n = 7) and people who were currently or recently pregnant (n = 8). Select interview participants and care providers were then invited to participate in a working group. Over six meetings, the group collaboratively reviewed interview data, current literature, published screening tools, and local resource information for eight domains: education/employment, health literacy, housing, food insecurity, financial strain, childcare, safety, and transportation. A final set of questions and recommended processes for social needs screening during pregnancy and postpartum were iteratively derived via group consensus.

Results: Key interview themes included the need for a central and reliable source of information, challenges of enrollment, limited availability of resources for some domains of needs (e.g., housing), and the inability of passive navigation strategies (e.g., written resource lists) to effectively meet needs. The working group created a final screening tool consisting of a combination of an initial question regarding any urgent needs and 36 multiple-choice and open-ended questions. The tool included recommendations for timing of screening during pregnancy and processes for resource provision within each domain.

Conclusions: The community-informed social needs screening tool and protocol provides a framework for targeted social support during and after pregnancy that could be integrated in routine obstetric care in Metro Atlanta and other practice settings.