Journal of racial and ethnic health disparities

2196-88372024Jun27Journal of racial and ethnic health disparitiesJ Racial Ethn Health DisparitiesBeyond the First Trimester: Social Determinants of Delayed Prenatal Care at a Community Health Center Using the PRAPARE Tool.10.1007/s40615-024-02052-7Social determinants of health have been used to explore associations with pregnancy outcomes and the birth weight of infants; however, research employing individually based social risk measures has not examined associations among underserved populations, including pregnant persons at community health centers. Data were collected from a sample (n = 345) of pregnant persons who sought care at a community health center between January 2019 and December 2020. Social risks of pregnant patients were measured using the PRAPARE tool. First, associations between patients' social risks and trimester in which they initiated care were assessed using ANOVAs, grouping social risk by PRAPARE social determinant domains (persona characteristics, family and home, money and resources, and social and emotional health). ANOVAs were stratified by ethnicity. Next, a multivariate logistic regression examined associations between social measures and seeking care after the first trimester. Patients who sought care in the first trimester reported more financial needs than those who sought care in the second (p = .02) or the third (p = .049). Hispanic patients who sought care in the first trimester reported more monetary needs than those who sought care in the second trimester (p = .048), and non-Hispanic patients who sought care in the first trimester reported greater family and home needs than those who sought care in the second trimester (p = .47). Those who experienced stress were 3.07 times as likely to seek care after the first trimester as those who reported no stress. CHC may reduce social risk among poor and underserved communities by reducing barriers to access to care.© 2024. The Author(s).PageAbbieADepartment of Health, Human Performance and Recreation, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA.St. Francis House NWA Inc. dba. Community Clinic, Springdale, AR, 72764, USA.Center for Public Health and Technology, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA.McCannRebeccaRDepartment of Health, Human Performance and Recreation, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA.Center for Public Health and Technology, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA.Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, 72701, AR, USA.ManessSarahSDepartment of Health Education and Promotion, East Carolina University, Greensville, NC, 27858-4353, USA.MerriweatherMayaMFay W. Boozman College of Public Health, University of Arkansas for Medical Science, Little Rock, AR, 72205, USA.Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.DobbsPage DPD0000-0003-1913-6488Department of Health, Human Performance and Recreation, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA. pdobbs@uark.edu.Center for Public Health and Technology, University of Arkansas, 346 West Ave. Suite 317, Fayetteville, AR, 72701, USA. pdobbs@uark.edu.engJournal Article20240627