Postpartum maternal preferences on health-related social needs programs in the first 1000 days

Objective: Our objective was to qualitatively assess maternal perspectives on health related social needs screening and referral programs in the first 1000 days (pregnancy through early childhood).

Methods: In this qualitative study, we conducted semi-structured interviews with 34 mothers who completed health-related social needs screening prenatally, perinataly, and/or in primary care within the prior 4 months. Using purposive sampling, we interviewed English- (74%) and Spanish-speaking (26%) mothers regarding barriers and facilitators to engagement.

Results: Barriers to engaging in screening included (1) screening on the first day postpartum, and (2) lack of clarity on the purpose of screening. Facilitators to engaging in screening included (1) communication style and (2) written and verbal screening options. Barriers to resource connection included (1) a lack of verbal explanations and follow-up with resource connection, and (2) narrow resource domains that do not align with needs in the first 1000 days. Facilitators to resource connection included (1) receipt of both paper and electronic resources, and (2) reduced hand-offs.

Conclusions: Mothers reported several barriers and facilitators to engaging in health-related social needs screening and resource connection across the first 1000 days. Health-related social needs programs targeting this period should consider screening at all 3 touchpoints (prenatally, perinatally, and postnatally in pediatric primary care). Programs should also consider verbal counseling and follow-up navigation for resources offered, and minimizing handoffs. This study underscores that tailored health-related social needs screening to the site of care and stage of child development may facilitate engagement.