Toward optimizing social drivers of health screenings in prenatal care: Healthcare professional perspectives.

Introduction: There is increased drive, including government-based mandates, to perform social drivers of health (SDoH) screenings across healthcare settings, without robust evidence to inform the process. Here, we aimed to understand perspectives of healthcare professionals (HCPs) around conducting SDoH screenings in a unique healthcare interaction, the prenatal care setting. Methods: We conducted a qualitative study with HCPs from February 20, 2023 to May 31, 2023 until thematic saturation was reached. Semi-structured interview guides were developed using the Consolidated Framework for Implementation Research (CFIR 2.0). Interview domains included (1) HCPs' willingness to conduct screenings, (2) preferences on how to conduct screenings, (3) current and preferred referral processes based on screening results, and (4) hopes for the future. Results: A total of 15 HCPs were included. We found that most HCPs were willing to conduct SDoH screenings and understood their importance in patient care. HCPs also expressed concerns around the lack of resources to effectively conduct the screenings, noting lack of time, training, reimbursement, and a robust knowledge of the resource landscape to support patients who screened positive. It often fell on HCPs to take on additional work and emotional burden to support their patients. Conclusion: While HCPs feel positive about SDoH screenings in the prenatal care setting, it is important that they receive adequate support to conduct the screenings effectively. Emerging recommendations from this work include: maintain an up-to-date database of local resources and designate an individual who is well-versed in the resource landscape to support patients who screen positive, train all HCPs on SDoH and screening best practices, and implement incentives to support and acknowledge HCPs for their work.