Keywords: Anti-poverty programs, social determinants of health, obstetrics

Background: Medical-Financial Partnerships (MFPs) clinically integrate financial support and services to promote health and well-being. The MFP at Harbor-UCLA (HUMC) addresses financial and social drivers of health via 1-on-1 social work support for families in pediatric and prenatal care. Though the MFP has been shown to increase pediatric clinic visits and vaccinations, its impact in prenatal patients is unknown.

Objective: Assess MFP impact on prenatal care utilization and Health-Related Quality of Life (HRQoL).

Methods: The intervention was offered to expectant mothers in prenatal care planning to continue at the academic public medical center, HUMC, for their child’s pediatric care. We retrospectively compared participants who opted into MFP to demographically-matched mothers receiving usual care. Primary outcomes were prenatal care adequacy (collected via chart review) and HRQoL overall scores with mental and physical health sub-scales (surveyed biannually). We used descriptive statistics for participant characteristics and longitudinal linear regression with post-estimation for outcome analyses.

Results: Forty-four participants enrolled in MFP. Seventy-three percent identified as Latino, 73% spoke English as primary language, and 72% had high school education or less. Among intervention participants, 80% achieved prenatal care adequacy, versus 84% of control participants (p=0.45). At baseline compared to controls, intervention participants had lower HRQoL overall scores (34.2 vs. 38.6) and mental and physical sub-scale scores (46.1 vs. 52.4, 46.7 vs. 49.0). However, intervention participants’ overall HRQoL scores improved relative to baseline and to controls, whose scores decreased (overall scores 34.7 [intervention] vs. 34.5 [control] at 6-month, 37.1 vs. 35.9 at 12-month, 38.1 vs. 34.2 at 18-month follow-up, all p<0.05). Similar significant improvements were seen for mental and physical HRQoL subscale scores.

Conclusions: In this first study to examine prenatal MFP impacts, MFP enrollment was associated with improved HRQoL overall and mental and physical health scores over time and unchanged prenatal care adequacy.