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Recording available 2/16-5/2

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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(432) Perspectives on Implementing Social Screenings in Maternal Substance Use Disorder Clinics: A Multicenter Qualitative Study

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

April Y. Lewis, MD (she/her/hers)

Resident Physician
Washington University School of Medicine
St. Louis, Missouri, United States

Coauthor(s)

AB

Ana Baumann, PhD

Washington University School of Medicine
Washington University in St. Louis, Missouri, United States
NR

Nandini Raghuraman, MD, MSCI

Associate Professor
Washington University School of Medicine
St. Louis, Missouri, United States
Rachel Paul, MPH (she/her/hers)

Clinical Research Specialist
Washington University School of Medicine
Washinton University in St. Louis School of Medicine, Missouri, United States
AB

Abigail R. Barker, PhD

Research Associate Professor
Washington University School of Medicine
St. Louis, Missouri, United States
Candice L. Woolfolk, PhD, MPH

Assistant Professor
Washington University School of Medicine
Washington University School of Medicine, Missouri, United States
MM

Melissa Mills, BS

Research Coordinator
Washington University School of Medicine
Saint Louis, Missouri, United States
BV

Brittaney Vaughn, MSN

Nurse Navigator
Washington University School of Medicine
Barnes Jewish Hospital/Saint Louis, Missouri, United States
Courtney Townsel, MD, MSc

Assistant Professor
University of Maryland School of Medicine
University of Maryland School of Medicine, Maryland, United States
TO

Tomi Ogungbenle, MA

Research Assistant
Washington University School of Medicine
St. Louis, Missouri, United States
AM

Abygail Martinez, BS

Washington University School of Medicine
Washington University School of Medicine, Missouri, United States
Jeannie C. Kelly, MD, MS (she/her/hers)

Associate Professor
Washington University School of Medicine
Washington University School of Medicine, Missouri, United States

Objective:
Screening for social drivers of health (SDoH) is mandated by managed care organizations, however implementation in obstetric settings, particularly for patients with substance use disorders (SUD), remains inconsistent due to a lack of standardized protocols and guidance. This study aims to explore clinician, clinical leader, and payer perspectives on effectively integrating SDoH screening and referral into a maternal SUD clinic.

Study Design:
Qualitative focus groups were held with 13 participants involved in perinatal SUD care at two urban tertiary care centers. Participants included clinicians and clinical leaders (n=8), social workers (n=2), and managed care payer informants (n=3). Individuals provided consent before participating. We analyzed transcripts using inductive thematic analysis. Thematic saturation guided sample sufficiency, and themes are reported with representative quotes (Table 1).

Results:

Three primary themes emerged: (1) Time and Workflow Constraints: Clinicians reported that competing priorities between complex patient needs and limited appointment time challenge their ability to complete SDoH screening, highlighting the need for dedicated personnel to assist. (2) Role Clarity and Training Needs: Participants expressed uncertainty about who was responsible for SDoH screening. Nurses, social workers, and community health workers were identified as key team members, but their training in standardized screening varied. (3) Psychological Safety and Patient Trust: Participants noted that patients with SUD may fear disclosing social needs due to stigma or child protective services involvement, emphasizing the need for trauma-informed training and trust-based therapeutic relationships.

Conclusion:
Despite being mandated, SDoH screening in maternal SUD care remains poorly defined in practice. Successful implementation will require clearly delineated clinical roles, adaptable workflows, and efforts to prioritize psychological safety.