Stakeholder Implementation Considerations for PATH (Plan for Appropriate Tailored Healthcare in Pregnancy) Social Needs Recommendations [ID 2683568

Abstract

INTRODUCTION: Unmet social needs negatively affect health care access and outcomes, and are disproportionately experienced by groups marginalized by racism, socioeconomic status, and geography. The Plan for Appropriate Tailored Healthcare in Pregnancy (PATH), a consensus-based prenatal care recommendation developed by a multidisciplinary panel of prenatal care experts, includes two recommendations regarding social needs: 1) early screening for medical and social determinants of health; and 2) management of social needs in prenatal care. A national listening tour was conducted to capture stakeholder feedback for implementing social needs recommendations into practice. METHODS: We conducted nine, 120-minute virtual focus groups with more than 25 organizations including professional (8), patient advocacy (8), public health (5), and payer groups (4). Focus groups were transcribed, coded by recommendation, and analyzed with matrix coding across patient, clinic, and policy level implementation considerations. RESULTS: Focus groups included 110 participants. Patient-level considerations for implementation included the importance of relationship building, shared decision-making, resources-first screening, and delivery of trauma-informed, culturally concordant care. On the clinic level, participants stressed robust clinic-level processes for providing effective social needs care, including multidisciplinary care navigation, social needs toolkit utilization, dynamic patient needs assessments, and provision of closed-loop referrals. Policy-level considerations included the need for improved provider incentives, interprofessional group collaboration, evidence-based research, and social needs infrastructure. CONCLUSION: Key considerations for implementing social needs care at the individual, clinic, and policy levels must be operationalized for successful integration into routine prenatal care. Further evidence is needed to identify and test the best approaches to addressing unmet social needs across practice settings.