Addressing Social Needs in Underserved Parents Through Parents as Teachers 

Summary

Social determinants of health are conditions in the environment that affect health and well-being at the community level. Social needs refer to the downstream personal factors shaped by these conditions, which affect health at the individual or family level. Such needs may include money for necessities and unexpected expenses, stable housing, a safe physical environment, food security, reliable transportation, and dependable childcare. 

Social needs are an important driver of health during pregnancy, with unmet social needs associated with an increased risk of complications. Importantly, pregnancy complications increase the risk of future disease. For example, people who have gestational diabetes are up to 60% more likely to develop type 2 diabetes later in life, and individuals with preeclampsia during pregnancy experience a fourfold increase in the risk of future heart disease.  

People of color and low socioeconomic status experience disproportionately high rates of both pregnancy complications and unmet social needs. Unfortunately, current interventions to address social needs during pregnancy fail to meet the full range of needs in these populations. To improve health outcomes, it is important to understand the unique social needs experienced by vulnerable populations during pregnancy. 

Home visiting programs provide support and education to vulnerable people in the community. Parents as Teachers is an evidence-based home visiting model implemented in over 1,000 sites across all 50 states. The program serves more than 100,000 families annually, 80% of whom are defined as having a high level of unmet needs. 

This project partners with Parents as Teachers to better understand the social needs of pregnant people in vulnerable populations. Specifically, this study aims to determine the core components of a Pregnancy Social Needs Module, which could be incorporated into home visiting programs, and then to develop and pilot the module with Parents as Teachers.  

The research team conducted interviews with 15 pregnant people of color and low socioeconomic status, 15 Parents as Teachers educators, and 10 Parents as Teachers supervisors to get their feedback on what should be included in the Pregnancy Social Needs Module. These interviews were then analyzed to determine the module’s core components. Next, the team will collaborate with the Parents as Teachers National Center to develop a complete module. Once the module is constructed, a six-week pre-post feasibility study will be conducted with pregnant people of color and low socioeconomic status, parent educator pairs, and Parents as Teachers supervisors to inform training, recruitment, module implementation, and data collection methods. 

Significance

Once the Pregnancy Social Needs Module is developed, it will benefit parent educators and the people they serve by allowing them to better address their social needs. This will ultimately help to improve health outcomes and reduce pregnancy complications in underserved pregnant people. 

Importantly, this project was designed to improve the social needs of pregnant people of color and low socioeconomic status, which will result in improved health for this priority population. We are working directly with a trusted community organization and pregnant people of color and low socioeconomic status to help produce an intervention to promote health. 

Benefits

Demonstrated benefits are those that have been observed and are verifiable.

Potential benefits are those logically expected with moderate to high confidence.

Connects underserved pregnant people with resources in their community to meet social needs. potential.

Community

Community health services

Increases equitable access to health care by connecting pregnant people in vulnerable populations to health care services located in their community. potential.

Community

Health care accessibility

Helps parent educators better understand and address social needs in vulnerable populations, reducing the occurrence of unmet social needs and related pregnancy complications. potential.

Community

Disease prevention & reduction

Helps pregnant people of color and low socioeconomic status achieve a better quality of life by connecting them with resources that make it easier to access needed services such as housing, transportation, and health care. potential.

Community

Life expectancy & quality of life

Community

This project has the potential to improve health, well-being, and quality of life in the many communities served by Parents as Teachers. By helping pregnant people in vulnerable populations connect with resources and health care services in their community, this intervention could reduce the number of unmet social needs they experience and potentially reduce their risk of pregnancy complications. 

Lessons Learned

To develop a Pregnancy Social Needs Module that accurately represents the needs of the people and communities it aims to serve, it was important to establish a strong community partnership with Parents as Teachers and to collaborate with parent educators from the onset of the project.