111 - Screening for Social Determinants of Health in CenteringParenting

Poster Number: 111
Publication Number: 111.212

Iris Navarro, Einstein Medical Center Philadelphia, Philadelphia, PA, United States; Susan Leib, Einstein Medical Center Philadelphia, Philadelphia, PA, United States; Katrina Blankenhorn, Ross University School of Medicine, Philadelphia, PA, United States; Caitlin Waggoner, Einstein Medical Center Philadelphia, Philadelphia, PA, United States; Andrew Paoletti, Einstein Healthcare Network, Audubon, PA, United States

Background: Screening for social determinants of health is an important part of well child care. CenteringParenting is a model of group well child visits that emphasizes family centered care and community building.

Objective: To examine rates of screening for social determinants of health and maternal postpartum depression during Centering visits compared to traditional well child visits.

Design/Methods: In Centering cohorts of 6-8 same age infant/parent dyads meet with pediatric providers for shared well child visits and facilitated group discussions for the first 2 years of life. Our clinic sees children in Centering and traditional well child visits.

This case control study included randomly selected infants born 10/1/2014 - 02/18/19 with 5 or more well visits, either in Centering or traditional visits, by 2 years of age at an academic center serving an urban, minority, publicly insured population. Infants in Centering were matched 1:2 with infants in traditional visits (controls). Using electronic records, we examined rates of screenings for social determinants of health using the Safe Environment for Every Kid Parent Questionnaire (SEEK) at 2, 6, 24 months and for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) at birth, 4, 6 months.

Results: The study population included 115 infants in Centering and 220 infants in traditional visits. There were no significant demographic differences between infants in Centering and controls for maternal mean age (26.5 years), race/ethnicity (71% African American, 19% Hispanic, 3% White, 3% Asian), and Medicaid (87%). Centering mothers were more likely to be primiparous than mothers in traditional visits (54% vs 37%, p < 0.01) and to have behavioral health diagnoses at delivery (17% vs 5%, p < 0.001).

At 2 months of age, Centering infants were more likely to be screened for social determinants of health than infants in traditional visits (90% vs 59%, p < 0.001). At 4 months of age, Centering mothers were more likely to be screened for postpartum depression (59% vs 31%, p < 0.001). SEEK screening rates at the 24-month visit were comparable (56% vs 51%, p=NS). Infants in Centering completed more SEEK screenings than infants in traditional care throughout their well child care (p < 0.01).Conclusion(s): Infants seen in Centering visits were more likely to be screened for social determinants of health and maternal depression than infants seen in traditional visits. Improved screening rates may allow for greater opportunities to provide resources and address social determinants of health that directly impact the health and wellbeing of children and families.