Interventions Addressing Social Needs in Perinatal Care: A Systematic Review

被引:26
|
作者
Reyes, Ana M. [1 ]
Akanyirige, Precious W. [1 ]
Wishart, Danielle [2 ]
Dahdouh, Rabih [2 ]
Young, Maria R. [3 ]
Estrada, Araceli [2 ]
Ward, Carmenisha [2 ]
Cruz Alvarez, Cindy [3 ]
Beestrum, Molly [4 ,5 ]
Simon, Melissa A. [2 ]
机构
[1] Northwestern Univ, Feinberg Sch Med, 633 N St Clair St,Suite 1800, Chicago, IL 60611 USA
[2] Northwestern Univ, Feinberg Sch Med, Ctr Hlth Equ Transformat, Chicago, IL 60611 USA
[3] Loyola Univ, Chicago Stritch Sch Med, Maywood, IL 60153 USA
[4] Northwestern Univ, Feinberg Sch Med, Galter Hlth Sci Lib, Chicago, IL 60611 USA
[5] Northwestern Univ, Feinberg Sch Med, Learning Ctr, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
perinatal care; screening; social determinants; underserved populations; referral; INTIMATE PARTNER VIOLENCE; RANDOMIZED CONTROLLED-TRIAL; AFRICAN-AMERICAN WOMEN; PREGNANT-WOMEN; PSYCHOSOCIAL RISK; BEHAVIORAL RISK; PRENATAL-CARE; BIRTH; OUTCOMES; PROGRAM;
D O I
10.1089/heq.2020.0051
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: Health is impacted by a wide range of nonmedical factors, collectively termed the social determinants of health (SDoH). As the mechanisms by which these factors influence wellness and disease continue to be uncovered, health systems are beginning to assess their roles in addressing patient's social needs. This study seeks to identify and analyze clinic-based interventions aimed at addressing patients' social needs in perinatal care, including prenatal, antepartum, and postpartum care. Methods: We conducted a search of six databases through May 2020 for articles describing screening or intervention activities addressing social needs in at least one SDoH domain as defined by Healthy People 2020. We required that studies include pregnant or postpartum women and be based in a clinical setting. Results: Thirty-one publications describing 26 unique studies were identified. Most studies were either randomized-controlled trials (n=10) or observational studies (n=7) and study settings were both public and private. The mean age of women ranged from 17.4 to 34.1 years. Most studies addressed intimate partner violence (n=19). The next most common need addressed was social support (n=5), followed by food insecurity (n=3), and housing (n=2). Types of interventions varied from simple screening to ongoing counseling and case management. There was wide heterogeneity in outcomes investigated. Most IPV interventions that included counseling or ongoing support resulted in reduced IPV recurrence and severity. No intervention with only screening showed a reduction in rate of IPV. Conclusion: This systematic review shines light on several avenues to support pregnant and postpartum women through interventions that embed acknowledgment of social needs and actions addressing these needs into the clinical environment. The results of this review suggest that interventions with counseling or ongoing support may show promise in alleviating social risk factors and improving some clinical outcomes. However, the strength of this evidence is limited by the paucity of studies. More rigorous research is imperative to augment the knowledge of social needs interventions, especially in domains outside of IPV.
引用
收藏
页码:100 / 118
页数:19
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