Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study
Abstract Background There is increasing interest in addressing adverse social determinants of health (SDoH) as a part of clinical care, yet there is limited understanding about the perspectives of patients, including pregnant and postpartum individuals from marginalized groups, that can be used to i...
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BMC
2025-05-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-025-12666-0 |
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| author | Ramona G. Olvera Halia Melnyk Sarah R. MacEwan Nikki Thomas Leah Roth Mireille Bitangacha Laura J. Rush Kaprea F. Johnson William A. Grobman Ann Scheck McAlearney |
| author_facet | Ramona G. Olvera Halia Melnyk Sarah R. MacEwan Nikki Thomas Leah Roth Mireille Bitangacha Laura J. Rush Kaprea F. Johnson William A. Grobman Ann Scheck McAlearney |
| author_sort | Ramona G. Olvera |
| collection | DOAJ |
| description | Abstract Background There is increasing interest in addressing adverse social determinants of health (SDoH) as a part of clinical care, yet there is limited understanding about the perspectives of patients, including pregnant and postpartum individuals from marginalized groups, that can be used to inform collection and use of information about patients’ social needs. This study examines the perceptions of patients regarding barriers to and facilitators of sharing information about social needs during pregnancy with their obstetric providers. Methods In this qualitative study, we conducted exploratory semi-structured telephone and in-person interviews with pregnant and postpartum patients of an ambulatory obstetrics and gynecology clinic serving a large and racially diverse population primarily covered by Medicaid. Researchers recruited English-speaking pregnant and postpartum individuals 18 years or older during their clinic visits. We asked about experiences of and preferences for sharing social needs information with healthcare providers and receiving support to address those needs. We used deductive and reflective thematic analysis to categorize verbatim transcripts of the patients’ interviews into codes and themes. Results Twenty-two pregnant (6 to 37 weeks of gestation) and 4 postpartum (1 to 1.5 months postpartum) patients participated in interviews. Their median age was 28 years (range: 18 to 38); 54% identified as Black, 19% White, 12% Latinx, 8% Asian, and 8% multiracial. We delineated two subthemes relating to perceived barriers to sharing information about social needs with providers: process barriers (never/inconsistently asked; limited time during appointments; inadequate ways to capture information about pregnancy-related social needs); and expectation discordancy barriers (skepticism about providers’ intentions to help; perceiving the clinician role as limited to physical health). Additionally, we defined two subthemes that facilitate patients’ sharing social needs information with providers: relational facilitators (good relationships with providers; providers demonstrate effective interpersonal skills; pregnancy as opportune time to build relationships with providers); and process facilitators (ensured privacy and confidentiality; receiving more than a list of resources). Conclusions Health systems should consider the perspectives of patients to inform processes around the collection and use of information about SDoH to increase equity, improve patient-centered care during pregnancy, and improve maternal and infant outcomes. |
| format | Article |
| id | doaj-art-761fb317d16147e7afcbda8371de0f34 |
| institution | OA Journals |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Health Services Research |
| spelling | doaj-art-761fb317d16147e7afcbda8371de0f342025-08-20T01:52:25ZengBMCBMC Health Services Research1472-69632025-05-0125111010.1186/s12913-025-12666-0Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative studyRamona G. Olvera0Halia Melnyk1Sarah R. MacEwan2Nikki Thomas3Leah Roth4Mireille Bitangacha5Laura J. Rush6Kaprea F. Johnson7William A. Grobman8Ann Scheck McAlearney9Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityDepartment of Educational Studies, College of Education and Human Ecology, The Ohio State UniversityBrown University Medical SchoolCenter for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST) in Health Services and Implementation Science Research, College of Medicine, The Ohio State UniversityAbstract Background There is increasing interest in addressing adverse social determinants of health (SDoH) as a part of clinical care, yet there is limited understanding about the perspectives of patients, including pregnant and postpartum individuals from marginalized groups, that can be used to inform collection and use of information about patients’ social needs. This study examines the perceptions of patients regarding barriers to and facilitators of sharing information about social needs during pregnancy with their obstetric providers. Methods In this qualitative study, we conducted exploratory semi-structured telephone and in-person interviews with pregnant and postpartum patients of an ambulatory obstetrics and gynecology clinic serving a large and racially diverse population primarily covered by Medicaid. Researchers recruited English-speaking pregnant and postpartum individuals 18 years or older during their clinic visits. We asked about experiences of and preferences for sharing social needs information with healthcare providers and receiving support to address those needs. We used deductive and reflective thematic analysis to categorize verbatim transcripts of the patients’ interviews into codes and themes. Results Twenty-two pregnant (6 to 37 weeks of gestation) and 4 postpartum (1 to 1.5 months postpartum) patients participated in interviews. Their median age was 28 years (range: 18 to 38); 54% identified as Black, 19% White, 12% Latinx, 8% Asian, and 8% multiracial. We delineated two subthemes relating to perceived barriers to sharing information about social needs with providers: process barriers (never/inconsistently asked; limited time during appointments; inadequate ways to capture information about pregnancy-related social needs); and expectation discordancy barriers (skepticism about providers’ intentions to help; perceiving the clinician role as limited to physical health). Additionally, we defined two subthemes that facilitate patients’ sharing social needs information with providers: relational facilitators (good relationships with providers; providers demonstrate effective interpersonal skills; pregnancy as opportune time to build relationships with providers); and process facilitators (ensured privacy and confidentiality; receiving more than a list of resources). Conclusions Health systems should consider the perspectives of patients to inform processes around the collection and use of information about SDoH to increase equity, improve patient-centered care during pregnancy, and improve maternal and infant outcomes.https://doi.org/10.1186/s12913-025-12666-0Social needsSocial determinants of healthPatient-provider interactionsPatient preferencesPregnancyHealth equity |
| spellingShingle | Ramona G. Olvera Halia Melnyk Sarah R. MacEwan Nikki Thomas Leah Roth Mireille Bitangacha Laura J. Rush Kaprea F. Johnson William A. Grobman Ann Scheck McAlearney Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study BMC Health Services Research Social needs Social determinants of health Patient-provider interactions Patient preferences Pregnancy Health equity |
| title | Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study |
| title_full | Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study |
| title_fullStr | Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study |
| title_full_unstemmed | Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study |
| title_short | Patients’ perspectives about sharing information with providers on social needs during pregnancy: a qualitative study |
| title_sort | patients perspectives about sharing information with providers on social needs during pregnancy a qualitative study |
| topic | Social needs Social determinants of health Patient-provider interactions Patient preferences Pregnancy Health equity |
| url | https://doi.org/10.1186/s12913-025-12666-0 |
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