Approaches to addressing social determinants of health in the NICU: a mixed methods study

Objective Examine current approaches to addressing social determinants of health (SDOH) in the NICU and perceived appropriateness of a standardized screening and referral process. Study design We performed a mixed methods study in two Massachusetts safety-net NICUs. We examined rates that unmet basic needs were assessed and identified among 601 families. We conducted focus groups with NICU staff to understand current methods to assess unmet basic needs and perceived appropriateness of a standardized SDOH screening and referral process. Result Except employment (89%), other unmet basic needs were infrequently assessed (housing 38%, food/hunger 7%, childcare 3%, transportation 3%, utilities 0.2%). Staff believed: (1) processes to assess SDOH were not standardized and inconsistently performed/documented; (2) addressing SDOH was important; and (3) using a standardized screening and referral process would be feasible. Conclusions Current NICU assessment of SDOH is limited and use of a standardized screening and referral process could be useful.