372 - Screening for Interpersonal Violence--just scratching the surface

Publication Number: 372.6250

Katherine Poehling, Wake Forest School of Medicine, Winston-Salem, NC, United States; Waleska Soto-Velasquez, Atrium Health Wake Forest Baptist, Winston Salem, NC, United States; Jennifer D. Dixon, Atrium Health Wake Forest Baptist, Winston Salem, NC, United States; Jennifer B. Ingle, Atrium Health Wake Forest Baptist, King, NC, United States; Emma Carraway, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Shannon G. Hanson, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Elizabeth T.. Jensen, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States

Background: Intimate partner violence (IPV) is a leading cause of maternal mortality. Universal screening for interpersonal violence is included among new CMS guidelines for screening for social determinants of health (SDoH). The approach to screening necessitates care and consideration of how best to elicit valid information and protect confidentiality of those responses.

Objective: To describe a health system’s experience with implementing universal screening for SDoH during birth hospitalization, including IPV screening (4-item HITS inventory), and utilization of self-administered assessments built into the EPIC-based Welcome Platform.

Design/Methods: Using data obtained from all birth hospitalizations at a single academic hospital in NC from March 1, 2024 through October 7, 2024, we assessed the proportion of birthing persons who were screened and examined whether the screening was performed verbally or through the Welcome Platform. We electronically abstracted maternal age, preferred language, race, ethnicity, and insurance status, SDOH screening results, and approach to assessing SDoH. We analyzed data for each HITS questions as never, any affirmative response, and missing/unable to answer/decline as well as response to requesting assistance for SDoH using Chi-square analysis and Fisher’s exact tests.

Results: Among 1791 deliveries from March 1, 2024 through October 7, 2024, 1751 (97.8%) had SDoH screening completed. A total of 156 birthing persons (8.7%) completed the SDOH screening by the self-administered Welcome Platform, and 1595 (91.3%) were completed verbally. Among the four HITS questions, the most frequently reported as positive were being insulted (0.7%) or being recipient of screaming or cursing (1.5%). For the questions about being insulted, being threatened, or being recipient of screaming or cursing, fewer respondents skipped the question and more had any affirmative response when responding using the Welcome Platform (p < 0.001, 0.04, and 0.006, respectively). There was no difference in physical harm (p=0.28). The proportion requesting assistance for any SDoH was higher using the Welcome platform than being asked verbally (19% v 11%, p=0.003); the frequency of missing responses was similar for both approaches (10% v 13%, p=0.2).

Conclusion(s): While screening for SDoH is being completed during birth hospitalization, uptake of self-administered tool was low. We are actively working to understand and effectively address barriers to self-administered approaches to SDoH so that we can address the needs of birthing persons and their families and share updated results.