Gaps, Successes, and Opportunities Related to Social Drivers of Health from the Perspectives of Black Preterm Infant Caregivers: A Qualitative Study.

Abstract

To identify Black preterm infant caregiver experiences and institutional priorities regarding screening and addressing social drivers of health (SDH). In the Centering Black Preterm Infant Caregiver Priorities study, Black female researchers conducted semistructured interviews in 2024 with Black caregivers of preterm infants born in the San Francisco Bay Area of California. Transcripts were coded using a book generated from an interview guide, and the resulting data were analyzed using thematic analysis. Themes were generated and refined through discussion. Twenty sociodemographically diverse caregivers participated. Five themes were identified: (1) financial insecurity and inadequate access to resources for everyday social needs contribute negatively to caregiver and child health and well-being; (2) a trusted provider who takes a personal approach to screening and addressing SDH is needed in medical settings; (3) inequitably distributed, fragmented, and disorganized medical and social support systems in the transition to home period are burdensome and a source of stress; (4) community-based organizations centering Black families holistically address SDH and promote social well-being and connectedness; and (5) state and federal legislation, policies, and programs are critical opportunities to address SDH. SDH are a significant source of stress for caregivers after preterm birth, and there are opportunities across state and federal legislative policies, community-based organizations, medical systems, and connections across the systems to address them.