Perinatal Outcomes among Women Identified by a Community Health Needs Assessment

Objective The aim of the study is to compare perinatal outcomes for women with greater social needs, as identified by the Community Health Needs Assessment, to those of women living in other areas of the county. Study Design This was a retrospective cohort study of pregnant women delivering at a large inner-city county hospital. Perinatal outcomes were analyzed for women living within a target area with substantial health disparities and social needs, and compared with those women living outside the target area. Statistical analysis included student's t-test, Chi square, and logistic regression. Results Between January 2015 and July 2020, 66,936 women delivered at Parkland hospital. Of these, 7,585 (11%) resided within the target area. These women were younger (26.8 ± 6.5 vs. 27.9 ± 6.4 years, p < 0.001), more likely to be black (37 vs. 13%, p < 0.001), and had a higher body mass index or BMI (33.3 ± 7.0 vs. 32.6 ± 6.4 kg/m2, p < 0.001). All women were likely to access prenatal care, with 7,320 (96.5%) in the target area and 57,677 (97.2%) outside the area attending at least one visit. Adverse perinatal outcomes were increased for women living within the target area, which persisted after adjustment for age, race, and BMI. This included an increased risk of preeclampsia (adjusted risk ratio [aRR] 1.1, 95% confidence interval or CI [1.03, 1.2]) and abruption (aRR 1.3, 95% CI [1.1, 1.7]), as well as preterm birth before both 34 weeks (aRR 1.3, 95% CI [1.2, 1.5]) and 28 weeks (aRR 1.3, 95% CI [1.02,1.7]). It follows that neonatal ICU admission (aRR 2.1, 95% CI [1.3, 3.4]) and neonatal death (aRR 1.2, 95% CI [1.1, 1.3]) were increased within the target area. Interestingly, rate of postpartum visit attendance was higher in the target area (57 vs. 48%), p < 0.001. Conclusion Even among vulnerable populations, women in areas with worse health disparities and social needs are at greater risk of adverse perinatal outcomes. Efforts to achieve health equity will need to address social disparities. Key Points

SWK-06. ANSWERING 900 VOICES: A NATIONAL NONPROFIT ORGANIZATION RESPONDS TO A NATIONWIDE COMMUNITY HEALTH NEEDS ASSESSMENT THAT ELUCIDATED KEY CHALLENGES FACED BY PEDIATRIC BRAIN TUMOR FAMILIES

The five-year relative survival rate for childhood primary brain and other central nervous system tumors is nearly 75 percent (Central Brain Tumor Registry of the United States, 2017). Nevertheless, childhood brain tumor survivors often suffer from lifelong side effects caused by their illness or treatments such as surgery, radiation and chemotherapy. To define the nature and extent of problems survivors and their families face, the Pediatric Brain Tumor Foundation (PBTF), the world’s largest nonprofit solely dedicated to children and teens with brain tumors, conducted a 2017 national community health needs assessment in collaboration with the Sol Price Center for Social Innovation at the University of Southern California. The assessment found that pediatric brain tumor patients and their families face key challenges in four general areas: 1) interpersonal and emotional support, 2) logistical and financial support, 3) information and medical education gathering, and 4) educational and vocational anxieties. In 2020, the PBTF’s response to the 900 assessment participants who represent the thousands living with the effects of this disease includes the launch of a national Peer to Peer Mentoring program to meet the ongoing challenges families face; the disbursement of emergency financial assistance to hundreds of families in the throes of treatment; and the distribution of a resource notebook for newly diagnosed families and a comprehensive guidebook for survivors and their families. The results of the needs assessment suggest additional clear, actionable areas for impact not only by the PBTF but by medical professionals, other nonprofit organizations and governmental agencies.

Abstract 14085: Population Health Delivery: A Community Health Needs Assessment Related to Physical Activity and Exercise

Introduction: A community health needs assessment asks members to measure the health of their community by prioritizing problems and identifying the needs. Methods: There are 10 counties in the Cedar Valley Area of Northeast Iowa, USA. Healthcare providers and allied service organizations came together as partners to write online survey to identify the community health needs of Cedar Valley residents. The online survey for residents was posted from March 1-May 15, 2019 and drew 1,554 unique responses. The online Survey Monkey for residents was supplemented by paper surveys distributed to and collected from members of minority church congregations. Responses were tabulated and analyzed. Once the initial responses arrived, the partners reached out to gather additional responses from minority populations to help match the overall return to the market profile. The resident survey was extended 45 days past its original deadline to ensure additional returns. This report focuses on physical inactivity and exercise part of the multi question survey. Results: For the question of risky adult behavior, 45% of the residents identified physical inactivity. For question of what healthy behaviors would you like to start or do more often to improve your health, 77% of the residents identified more exercise. For the question of what prevents you from doing the healthy behavior, 63% identified lack of motivation, 61% identified not enough time. But only 5% said that they were not aware of the healthy options. For the question of what would help you or your family members to start or maintain a healthier lifestyle, 58% identified more affordable facilities, 36% identified employee wellness programs, 32% identified community exercise programs and 17% identified school wellness programs. Conclusion: These results indicate that there is clear awareness in this community that physical inactivity is a risky adult behavior and 95% of the population was aware of exercise as a healthy option. The results also identified specific perceived needs. To achieve high degree of physical activity and exercise and to maintain population health, more efforts need to be focused on wellness programs to improve the motivation and make available affordable facilities.