@article{umstead_gill_pearsall_stuebe_tully_2023, title={Human-centered design in the context of social determinants of health in maternity care: methods for meaningful stakeholder engagement}, volume={18}, ISSN={["1748-2631"]}, url={https://doi.org/10.1080/17482631.2023.2205282}, DOI={10.1080/17482631.2023.2205282}, abstractNote={ABSTRACT Purpose The screening process for social determinants of health (SDoH) includes questions regarding life circumstances and barriers to accessing health care. For patients, these questions may be intrusive, biased, and potentially risky. This article describes human-centered design methods to engage birthing parents and health care team members around SDoH screening and referral in maternity care. Methods Three phases of qualitative research with birthing parents, health care teams, and hospital administrators were conducted in the United States. Shadowing, interviews, focus groups, and participatory workshops addressed the explicit and tacit concerns of the stakeholders regarding SDoH during maternity care. Results Birthing parents wanted to be informed of the purpose of the clinic collecting SDoH information and how this information is used. Health care teams want to feel they are providing reliable and quality resources to their patients. They would like greater transparency that administrators are acting on SDoH data and the information is reaching people that can assist patients. Conclusion As clinics implement patient-centered strategies for addressing SDoH in maternity care, it is important to include patients’ perspectives. This human-centered design approach advances understanding of knowledge and emotional needs around SDoH and offers insights to meaningful engagement around sensitive health data.}, number={1}, journal={INTERNATIONAL JOURNAL OF QUALITATIVE STUDIES ON HEALTH AND WELL-BEING}, author={Umstead, Kelly A. and Gill, Carolina and Pearsall, Marina S. and Stuebe, Alison M. and Tully, Kristin P.}, year={2023}, month={Dec} }
 @article{tully_gibson_pearsall_umstead_gill_stuebe_2022, title={Screening and Referral for Social Determinants of Health: Maternity Patient and Health Care Team Perspectives}, volume={6}, ISSN={["2473-1242"]}, DOI={10.1089/heq.2022.0020}, abstractNote={Objective: To identify patient and health care team perspectives on screening and referral for Social Determinants of Health (SDoH) in maternity care. Methods: This human-centered design study was conducted in a prenatal clinic and in the surrounding community of a university teaching hospital in the Southeastern United States. Qualitative data were collected through semistructured interviews and focus groups between March 2019 and February 2020, with findings shared in-person with participants for feedback. Results: A total of 19 English- and Spanish-speaking patients and 11 health care team members participated. Participants suggested that all patients should be screened as part of integrated health assessments, early in care and periodically, but only when protocols are in place for addressing needs—immediate or ongoing. They expressed concerns that disclosure of SDoH screening data might exacerbate already existing biases, negatively impact care, or be used to harm them. Patients wanted proactive transparency about the purpose of SDoH screening, and to know who would have access to their data, when and how it would be used, and how long it would be stored. Patients expressed concern about confidentiality and stigma, and wanted their health care team to normalize seeking help, and acknowledge that birthing people's circumstances change over time. Patients and health care team responded that patient-provider communication should be respectful, be antiracist, and demonstrate respect for patient autonomy. Conclusion: Patients and health care team members recommended that SDoH resource information be accessible to all patients regardless of endorsed needs.}, number={1}, journal={HEALTH EQUITY}, author={Tully, Kristin P. and Gibson, Amelia N. and Pearsall, Marina S. and Umstead, Kelly and Gill, Carolina and Stuebe, Alison M.}, year={2022}, month={Dec}, pages={887–897} }