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APHA Scientific Session and Event Listing

Recorded presentation

Cindy Engler, RN, MPH, Boston Public Health Commission, 1010 Massachusetts Avenue, Boston, MA 02118, 617 -534-4743, Cindy_Engler@bphc.org, Barbara R. Gottlieb, MD, MPH, Brookside Community Health Center, 3297 Washington Street, Jamaica Plain, MA 02130, and Ellen M. Hutchins, ScD, MSW, HRSA, Department of Health and Human Services, Boston Regional Division, Room 1826 - JFK Federal Building, Boston, MA 02203.

The Boston Fetal Infant Mortality Review, a comprehensive study of infant deaths in Boston, concluded that some of the largest gaps in women's health services occurred in the failure to identify and address women's life circumstances and behavioral risks in their ongoing health care. The Preconceptional Screening and Assessment Project (PSAP) funded by the HRSA Maternal Child Health Bureau is a collaboration between the Boston Public Health Commission, Massachusetts Department of Public Health, two Boston community health centers, and representatives of academic institutions designed to address these barriers to care and gaps in services. We have developed a brief screening tool for depression, substance use, and domestic violence for women of reproductive age in the preconception period. Throughout the project an ongoing feedback loop involving consumers, primary care providers, and behavioral health experts has been critical for success. Focus groups with health center consumers held in English, Spanish, Portuguese and Vietnamese confirm that women across cultures want their providers to screen for behavioral risks, while providers consistently identify barriers to screening. Over 1200 women have been screened using the PSAP tool, with rates for identification of women at risk for depression, substance/alcohol use and domestic violence increasing significantly after implementation of the project. We will present: our findings comparing baseline rates of behavioral risk screening compared to screening rates with the PSAP tool; qualitative findings comparing provider and patient perception of screening; and recommendations for addressing the barriers to screening for behavioral risks in primary care.

Learning Objectives: