Enhancing Behavioral Health Risk Screening and Referral for Pregnant and Postpartum Women: A Community Stakeholder Perspective

Background: The Behavioral Health Integrated Centralized Intake (BHCI) project is multi-site MIECHV funded CBPR initiative emphasizing coordinated systems of care and a consistent point of entry into home visiting for pregnant and postpartum women.  Four communities conceptualized and implemented a streamlined and centralized access point to maternal and child health home visiting services into which behavioral health risk screening was seamlessly integrated.

Methods: Participants from representative stakeholder groups were recruited across all four sites (N=30) for in depth interviews during both the formative and implementation stages of BHCI.  We utilized open coding and constant comparison to identify themes related to the development and sustenance of community partnerships; themes were compiled into an exhaustive case study of the investigated phenomena that was presented back to each community.

Findings: Seven primary themes emerged from the data, highlighting community strengths and barriers to the centralized intake process.  Themes included varying power dynamics in partnerships, community collaboration readiness, and the degree of emphasis on client experience either which hindered or strengthened the BHCI implementation in each community.

Implications: This formative evaluation utilizing participatory case study development opened dialogue among community partners regarding the complexity of community partnerships, and the impact of that complexity on addressing behavioral health risk of pregnant and postpartum women. Community barriers were brought into the collaborative conversation and shifts were made in services and partnership structures that significantly improved both outputs and client outcomes of the project.  This strategy may be an important tool for augmenting the collaborative potential of community partnerships.