Recently for Et Al.: The NCSD Journal Club, Dawne DiOrio and Amara Ross from Indiana spoke about their article in the July issue of Sexually Transmitted Diseases regarding social vulnerability in congenital syphilis case mothers. Here is a Q & A with Dawne.
Click here for the Et Al. resource page for Congenital Syphilis and Social Vulnerability
The article makes several recommendations for best practices including such things as:
An STD program could conduct a review of their congenital syphilis cases following the same process that was done in the paper to understand what factors drive their morbidity. Even higher morbidity areas could review a sample of cases to gain insight to commonalities locally. If the disease intervention specialists, at present, do not collect specific enough information pertaining to social characteristics and structural barriers experienced by the case mother, the STD program should amend their interview tools to include information not traditionally gleaned in an original interview, such as maternal insurance status. Interventions could then be formulated based on results of each state’s unique barriers. STD programs could identify prenatal care providers locally who may see women at high risk of syphilis and create partnerships for those women who have interrupted prenatal care.
Additional qualitative research, including focus groups with case mothers, could be of value in helping gain a greater understanding about the mother’s risk. This could include specifically identifying what factors the mothers perceive as influencing their prenatal care attendance or what would have helped them prevent the outcome of the congenital case. Such analysis could also help generate ideas of how the public health and the health care systems could adapt to ensure future cases are prevented.
If a screening criteria tool could be developed for prenatal care providers to help them identify which women are at increased risk for discontinuing prenatal care, missing testing or treatment appointments, and experiencing a high degree of social vulnerability as defined in the article, this would allow them to prioritize the women for supportive services. This model of a brief screening instrument for clinician use is already in place for alcohol, drugs, and depression/suicide and could be incorporated into early prenatal care visits to improve retention.