Cognitive-Behavioral Therapy for Health Anxiety and Heart-Focused Anxiety in Adult Congenital Heart Disease-A Single Case Experiment.

Pregnancy-related mortality in the United States has risen over the past three decades, with racial and socioeconomic disparities playing a significant role in worsening maternal health outcomes. Black women experience maternal mortality rates nearly three times higher than their White counterparts, a disparity that can be largely attributed to social determinants of health (SDOH). Social needs reflect areas in which individuals have inadequate access to an opportunity-promoting SDOH or excess exposure to a harmful SDOH. These include limited access to quality health care, financial instability, and inadequate social support. Systemic racism underpins the unequal distribution of social needs between Black and White birthing people and drives maternal health disparities. Health plans and professional organizations increasingly recommend social needs screening and referral as part of routine care to promote health equity. Social needs screening has been increasingly integrated into a variety of health care settings, yet uptake in prenatal care is inconsistent and often focuses only on intimate partner violence. There is little published evidence on how social needs screening should be integrated into obstetric care settings. Research to date has shown inconsistent associations between screening for social needs and health outcomes, with some suggesting potential unintended negative consequences of screening. Despite the proliferation of screening tools, few are tailored to the perinatal context. Pregnancy represents a critical window, as medical, emotional, and social needs change, and unmet needs could harm the long-term health of mother and baby. Partnerships between health care institutions and local organizations can improve maternal outcomes among socially marginalized groups by integrating culturally responsive, community-centered care. Without a comprehensive, culturally appropriate assessment of social needs and community capacity to provide services integrating the perspectives of individuals with lived experience, efforts to improve referral systems and care linkages may fail to reach those at greatest risk. By engaging with community members and individuals with lived birthing experience, this study aims to advance maternal health equity by co-creating a locally tailored social needs screening protocol for use during routine obstetric care.