Health Equity最新文献

{"title":"The PERI Model of Radical Healing as a Framework for Advancing Perinatal Mental Health.","authors":"Christin A Mujica, B Andi Lee, Amber M Jarnecke","doi":"10.1177/24731242261448661","DOIUrl":"10.1177/24731242261448661","url":null,"abstract":"<p><p>Perinatal mental health disorders are among the most common complications of pregnancy and childbirth and represent a leading cause of maternal mortality in the United States. Black, Indigenous, and other People of Color (BIPOC) are disproportionately affected, reflecting the impact of structural racism, inequitable care, and broader social determinants of health. While medical and public health frameworks have advanced important strategies to address these inequities, psychological perspectives accounting for sociopolitical and cultural contexts remain underutilized, limiting responsive and effective mental health care for BIPOC individuals. We introduce the PERI Model of Radical Healing to reframe perinatal mental health equity as a liberatory and intergenerational process. This model emphasizes four interconnected domains: Practice, Emancipation, Resistance, and Intergenerational Hope. It positions perinatal mental health not only as the reduction of pathology but as a source of justice, dignity, and collective flourishing.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261448661"},"PeriodicalIF":2.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decolonization and Health Systems: A Scoping Review.","authors":"Karen Wright, Nikita-Moana Turoa","doi":"10.1177/24731242261435337","DOIUrl":"10.1177/24731242261435337","url":null,"abstract":"<p><strong>Introduction: </strong>Coloniality continues to define knowledge, culture, relationships and health outcomes for Indigenous peoples around the world. Health systems are shaped by coloniality, influencing access to health care and the quality of care. Decolonization, although pluralistic in understanding, provides a theoretical foundation for health system transformation. The aim of this scoping review was to explore what is known about decolonization, Indigenous health, and equity in publicly funded health systems, and to identify gaps in existing literature.</p><p><strong>Methods: </strong>This research is grounded in an Indigenous methodology and positioning, providing a critical structural analytical framework. Scoping review methods developed by the Joanna Briggs Institute and PRISMA-ScR were situated within a Kaupapa Māori framework to identify decolonization approaches and characteristics in publicly funded health systems within Aotearoa New Zealand, Australia and Canada. Data sources included four databases and an Aotearoa New Zealand-focused gray literature search.</p><p><strong>Results: </strong>Sixteen texts were included with more than three-quarters published between 2019 and 2021. The majority of approaches were at the level of the system or health professional and exploratory in nature. Implementation and outcome measurement were scarce. Characteristics of decolonization in health systems were categorized as Addressing Coloniality, Transformation, Relationships and Indigeneity.</p><p><strong>Conclusions: </strong>This review provides a novel synthesis of decolonization in the context of publicly funded health systems, identifying an emergent research area, and disconnect between theory and practice. Decolonization provides a rights-based intersectional framework that is distinct from alternative approaches, unique in its ambition to address power imbalance and see structural transformation. Misalignment between ideological positioning of decolonial theory and governments may limit the opportunity for implementation within publicly funded health systems. Research, implementation and evaluation of decolonization approaches is needed to expand knowledge, influence future public policy and see structural transformation of health systems to support Indigenous well-being and health equity.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261435337"},"PeriodicalIF":2.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Correlates of Postpartum Depressive Symptoms Among a Sample of Urban, Predominantly African American Mothers.","authors":"Andrew Lu, Knashawn H Morales, Michelle Reece, Olivia Quartey, Ellie Marino, Rhonda C Boyd, James P Guevara","doi":"10.1177/24731242261430688","DOIUrl":"10.1177/24731242261430688","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined associations between maternal characteristics, mental health services use, and trajectories of postpartum depressive (PPD) symptoms.</p><p><strong>Methods: </strong>Secondary analysis of longitudinal data of mothers <8 months postpartum with PPD symptoms, collected as part of a larger randomized controlled trial. Mothers completed measures of demographic characteristics, parenting, and social support at baseline and monthly reports of Mental Health Services Use and Edinburgh Postnatal Depression Scale (EPDS) scores. Univariate and multivariable mixed-effects linear regression models assessed associations between maternal characteristics, psychosocial variables, and mental health services with changes in EPDS scores.</p><p><strong>Results: </strong>Most mothers were Black (72.5%), single (68.1%), and with a high school education or less (50.6%). Average EPDS scores were moderate at baseline, declined over 9 months, but were still high by study end. Univariate analysis showed parenting competence (β = -0.073, 95% confidence interval [95% CI] [-0.14, 0.00]) and perceived social support (β = -0.051, 95% CI [-0.09, 0.00]) were negatively associated with overall EPDS, while parenting stress was positively associated (β = 0.063, 95% CI [0.03, 0.10]). Psychosocial variables were not significantly associated with EPDS in the multivariate model. EPDS scores were higher at baseline among those who reported mental health treatment than those who did not, but score declines were similar in both groups.</p><p><strong>Conclusions: </strong>EPDS scores declined but remained elevated over the postpartum period among the cohort. Those who reported mental health treatment had higher but similar declines than those who did not. These findings support policy initiatives to provide 12 months of postpartum coverage for new mothers.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261430688"},"PeriodicalIF":2.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making Myana (\"Mothers, You Are Not Alone\"): An Equity-Focused Process for Developing a Postpartum Support App.","authors":"Sarah K Burns, Ashley Deal, Raelynn O'Leary, Kristin N Ray, Hyagriv Simhan, Anna Binstock, Tamar Krishnamurti","doi":"10.1177/24731242261435334","DOIUrl":"10.1177/24731242261435334","url":null,"abstract":"<p><strong>Introduction: </strong>Many digital tools are available to support healthy pregnancies. Far fewer focus on the postpartum period or have the explicit goal of reducing poor or inequitable maternal health outcomes. Yet, many pregnancy-related complications occur up to a year after labor and delivery. Here, we outline a healthequity-centered process, using multiple phases of data collection, which informed our design decisions when developing a comprehensive postpartum support app, Myana (\"Mothers, you are not alone\").</p><p><strong>Methods: </strong>Drawing on a behavioral decision research approach and grounded in principles for developing equity-focused digital reproductive health tools, we iteratively designed and tested the Myana app. Our data collection included qualitative interviews, focus groups, and evaluations of an interactive experience prototype and app wireframes.</p><p><strong>Results: </strong>To illustrate our process, we highlight two unique features of Myana intended to address health inequities: a symptom triaging feature (\"The Healing Check-in\") and a tailored educational hub (\"The Learning Center\"). Results from our iterative development process shaped how we asked about and responded to symptoms reported in the Healing Check-in, the topics and framing of curated content in the Learning Center, the cadence of expected interaction with features in the app, as well as the app's overall tone and visual design.</p><p><strong>Discussion: </strong>We created a postpartum support app to help birthing parents make informed decisions about their health and well-being in the year postpartum, with the larger goal of improving health outcomes. The iterative design and development process integrated clinical and community perspectives while intentionally centering health disparities. This approach represents a new model for developing digital supports to supplement the formal healthcare system.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261435334"},"PeriodicalIF":2.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Blurred Boundaries of Care: A Qualitative Analysis of Nurse-Doula Role Conflict.","authors":"Curisa Tucker, Maria McClam, Kelly Russin, Nansi Boghossian, Rachel Gulczinski, Lauren Workman","doi":"10.1177/24731242261436557","DOIUrl":"10.1177/24731242261436557","url":null,"abstract":"<p><strong>Introduction: </strong>Conflict between nurses and doulas can contribute to miscommunication, delays in treatment, and decreased patient satisfaction, especially among marginalized populations. Nurses and doulas both play essential roles in supporting birthing individuals, yet their interactions are often strained by unclear role boundaries, differing philosophies of care, and institutional policies that fail to integrate doulas into clinical teams. The purpose of this study is to examine the underlying sources of tension between nurses and doulas and identify facilitators that support more effective collaboration within maternity care teams.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 20 participants (9 nurses and 11 doulas) recruited from both clinical and community settings in South Carolina. Interviews were analyzed using thematic analysis to identify barriers and facilitators to nurse-doula collaboration in maternity care.</p><p><strong>Results: </strong>Three key themes emerged: (1) lack of institutional recognition and role legitimacy (structural conditions), (2) territorialism and perceived competition in shared care spaces (interpersonal dynamics), and (3) blurred boundaries between advocacy and scope of practice (role-level influences). Participants also identified strategies to enhance collaboration, including clearer role definitions, institutional support, and mutual respect.</p><p><strong>Discussion: </strong>Findings underscore structural, interpersonal, and role-level barriers to nurse-doula collaboration. Integrating doulas into maternity care teams through inclusive hospital policies, joint training, and explicit role clarification may improve teamwork and advance equitable, patient-centered care.</p><p><strong>Health equity implications: </strong>Strengthening nurse-doula collaboration is a critical step toward addressing the U.S. maternal health crisis, particularly for marginalized communities. Integrating doulas more fully into maternity care teams can promote equitable, patient-centered care and reduce avoidable disparities.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261436557"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purpose, Privilege, and Pathways: Advancing Socioeconomic Diversity in a Pathway Program to Medical School.","authors":"Mahesh S Gupta, Brandon Lu, Amanda Young, Jonathan F Finks, Gurjit Sandhu","doi":"10.1177/24731242261435335","DOIUrl":"10.1177/24731242261435335","url":null,"abstract":"<p><strong>Introduction: </strong>Diversity in the physician workforce is associated with improved patient outcomes, yet individuals from lower socioeconomic status (SES) backgrounds remain underrepresented in medicine. Doctors of Tomorrow (DoT) is a pathway program at the University of Michigan Medical School that provides mentorship and interactive learning experiences to expand health care career access for students from resource-limited backgrounds. DoT recruits students from two Detroit high schools that require entrance exams, raising concerns that the program may disproportionately enroll students from higher SES households with greater social capital. This study aims to evaluate the SES of DoT participants to assess whether the pathway program is reaching students from resource-limited backgrounds and those who are underrepresented in medicine.</p><p><strong>Methods: </strong>A cross-sectional, web-based survey was conducted among 122 parents of DoT students to assess socioeconomic markers. Findings were compared with Detroit population data from the American Community Survey and with national medical school applicant and matriculant data from the AAMC.</p><p><strong>Results: </strong>The survey response rate was 62%. Only 7% of DoT parents reported working in health care. Compared with Detroit census data, DoT households reported higher parental college education and home ownership, while household income was similar. Racial composition was predominantly Black in both the DoT cohort and Detroit overall. Compared with national medical school applicants and matriculants, DoT parents were less likely to have a college degree and had a distinct racial distribution.</p><p><strong>Conclusion: </strong>DoT recruits students without pre-existing access to health care mentors, with household income comparable to Detroit overall, but who significantly differ from national medical school applicants. Ensuring socioeconomic diversity in pathway programs to medical school is essential for diversification of the physician workforce and better outcomes for historically marginalized patients.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261435335"},"PeriodicalIF":2.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Health Worker-Delivered Interventions for Perinatal Mental Health in the United States: A Scoping Review.","authors":"Anna Paden McCormick, Marie E Thoma, Lindsay M Mallick, Nedelina Tchangalova, Gabriel Dogbanya, Rebecca A Gourevitch, Mona Mittal","doi":"10.1177/24731242261434365","DOIUrl":"10.1177/24731242261434365","url":null,"abstract":"<p><strong>Background: </strong>Maternal health in the United States is in crisis, and perinatal mental health conditions are emerging as a critical contributor to maternal morbidity and mortality. Perinatal mood and anxiety disorders (PMADs) encompass a range of mental health disorders experienced during pregnancy and 1 year after delivery. Expanding the perinatal mental health workforce to include paraprofessionals could help address a national shortage of mental health professionals.</p><p><strong>Objective: </strong>This scoping review aims to investigate the literature on perinatal mental health interventions delivered by community health workers (CHWs) or paraprofessionals in the United States.</p><p><strong>Methods: </strong>Studies on interventions addressing perinatal mental health were included if delivered by CHWs or paraprofessionals in the United States. Seven databases were searched via EBSCO through August 29, 2025. No publication year limits were applied. Results were exported to Zotero for deduplication, Catchii for screening, and Excel for data extraction and analysis. Risk of bias was not assessed.</p><p><strong>Results: </strong>After removing 4148 duplicates from the 7524 records identified, 3376 records were screened, and 13 studies met the inclusion criteria. CHW-delivered interventions for PMADs in the United States varied in design, content, and implementation. Most were initiated during the antenatal period, extended postnatally, and targeted primary prevention of depression symptoms. Ten studies evaluated outcomes among predominantly low-income, Latina, or Black mothers in urban environments. Interventions enhanced social support, cognitive, emotional, behavioral, parenting, and practical skills. Intervention results varied. Most studies reported positive effects: all nonexperimental designs found statistically significant improvements in depressive symptoms, and many experimental designs demonstrated statistically significant improvements in depressive symptoms among women receiving adequate intervention dosage.</p><p><strong>Conclusions: </strong>This review expands knowledge of perinatal mental health interventions delivered by CHWs and health paraprofessionals in the United States, including information about populations served, CHWs, intervention characteristics, and outcomes. Gaps in evidence and recommendations for future research are presented.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261434365"},"PeriodicalIF":2.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Recommendations for Hospital-Based Maternity Care: Insights from Black and Pacific Islander Mothers in San Francisco.","authors":"Sarah B Garrett, Catthi Ly, Julie R Taylor, Lauleva Lua'iufi Aiono, Linda Jones, Breezy Powell, Brittany Chambers Butcher","doi":"10.1177/24731242261424791","DOIUrl":"10.1177/24731242261424791","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitals in the United States are increasingly working to advance maternal health (MH) equity. To succeed, these efforts must be community-driven, centering voices of those with experience of health inequities, suboptimal care, and the impacts of structural racism. However, robust hospital engagement with such guidance remains rare. We documented community-driven strategies for advancing MH equity.</p><p><strong>Methods: </strong>Using a community-based participatory research approach, we conducted longitudinal in-person strategy sessions with individuals from communities disproportionately burdened by MH inequities: Black and/or Pacific Islander individuals who had recently delivered or considered delivering in San Francisco hospitals. Two 2.5-h discussion-intensive meetings focused on generating and refining recommendations for improving hospital maternity care. Participants then selected their top 15 recommendations. Experienced community-based team members led recruitment and facilitated sessions. We independently reviewed data for accuracy and conducted thematic analysis to categorize recommendations into domains.</p><p><strong>Results: </strong>Participants developed and refined 48 unique recommendations to improve hospital maternity care for their communities, categorized into seven domains. Top-rated recommendations included: Respecting patient preferences/requests.Trainings to educate and un-bias clinicians.Engaging patients and clinical teams with the \"Black Birthing Bill of Rights.\"Racially-, culturally-, and/or community-concordant programs and care teams.Hospital-based community task forces.Collecting patient feedback at discharge using tablets with clinician photos.</p><p><strong>Discussion: </strong>The recommendations affirm guidance from other realms of reproductive care and reveal new strategies for hospitals to better serve affected communities.</p><p><strong>Health equity implications: </strong>Community-generated recommendations offer actionable and responsive ways for hospitals to improve maternal health care. These strategies are likely transferable across diverse hospital settings.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"10 ","pages":"24731242261424791"},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Stakeholder Engagement to Build Cancer Survivorship Care Coordination Capacity Between Primary and Oncology Care.","authors":"Julie S Armin, Sarah N Price, Elizabeth S Ver Hoeve, Yvonne Bueno, Leila Ali-Akbarian, Nancy Johnson, Elizabeth Calhoun, Lorena Verdugo, Heidi A Hamann","doi":"10.1177/24731242251385402","DOIUrl":"10.1177/24731242251385402","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer survivors experience gaps in access to timely and well-coordinated care. We describe stakeholder engagement activities across a university-based comprehensive cancer center and a primary care-focused federally qualified health center, which informed implementation and sustainability of community-focused cancer care coordination interventions to optimize care for underserved cancer patients in specialty and primary care.</p><p><strong>Methods: </strong>Methods were systematic, iterative, and flexible to establish and maintain trust, honesty, and collaborative decision-making between academic, community, and clinical partners. First, we collaboratively identified clinical (<i>N</i> = 43) and patient (<i>N</i> = 16) stakeholders and their needs through in-depth interviews and focus groups. Then, we planned, implemented, evaluated, and modified strategies to improve cancer care coordination in response to challenges and new information.</p><p><strong>Results: </strong>Primary care providers reported needing more information about cancer survivorship care and wanting more complete information about their patients' cancer treatment. Patients described concerns about cancer recurrence, challenges managing comorbid conditions, and economic concerns. These findings influenced the focus and implementation of a community navigation program at the academic cancer center and informed bi-directional information-sharing interventions with primary and oncology care partners, which included face-to-face meetings, service-learning opportunities, and improving data transmission through the electronic health record.</p><p><strong>Health equity implications: </strong>Health systems' mutual learning and resource sharing enhance patient cancer care coordination to address social determinants of health. Engaging partners at different levels within health systems (e.g., administrative staff and clinical leadership) ensures sustainability of relationships, interventions, and advocacy for cancer patients with significant social needs.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"648-656"},"PeriodicalIF":2.5,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12758592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Patient Experience to Promote Health Equity: Development and Validation of the Patient Experience of Social Needs Screening Questionnaire.","authors":"Christopher K Rogers, Manisha Parulekar","doi":"10.1177/24731242251390227","DOIUrl":"10.1177/24731242251390227","url":null,"abstract":"<p><strong>Introduction: </strong>Screening for social determinants of health (SDOH) is a critical strategy to advance health equity among underserved and vulnerable populations. Despite growing adoption, few validated, quantitative tools exist to measure patients' experiences with screening tools and clinical workflows. The Patient Experience of Social Needs Screening (PESNS) questionnaire was developed to fill this gap.</p><p><strong>Objective: </strong>To develop and validate a 9-item PESNS questionnaire to measure patient perceptions of SDOH screening tools and workflows in ambulatory, inpatient, and emergency department settings, with a focus on supporting health equity and patient-centered care.</p><p><strong>Methods: </strong>A comprehensive literature review informed the development of 27 constructs. Using a modified Delphi process with eight experts, 29 preliminary items were refined across four rounds, resulting in a final 9-item questionnaire. Spanish translation followed best practices, including cognitive testing with six patients. The PESNS questionnaire was administered via telephone to 262 Medicare and Medicaid patients. Principal component analysis, exploratory factor analysis, and polychoric correlations assessed construct validity. Internal consistency was measured using Cronbach's α.</p><p><strong>Results: </strong>Two components emerged-Enhancing User Experience Essentials and Patient-Centered User Experience-accounting for 60% of variance. Cronbach's α was 0.841 overall, with factors 1 and 2 scoring 0.790 and 0.848, respectively. All items showed acceptable correlations (0.438-0.669), supporting scale reliability and construct validity. Component 1 captures the usability and effectiveness of the PESNS questionnaire, and Component 2 assesses privacy and environmental comfort. These dimensions align with health equity goals by highlighting patient-centered barriers and facilitators to SDOH screening.</p><p><p><b>Conclusion:</b> The PESNS questionnaire offers a reliable, valid, and equity-focused tool to assess patient experience with SDOH screening. Its adoption can inform quality improvement and support more inclusive and effective health care delivery.</p>","PeriodicalId":36602,"journal":{"name":"Health Equity","volume":"9 1","pages":"657-667"},"PeriodicalIF":2.5,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}