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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(424) Implementation Challenges for Prenatal Genetic Screening (PGS) at Federally Qualified Health Centers

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To identify implementation challenges for prenatal genetic services (PGS) (aneuploidy and carrier) at federally qualified health centers (FQHCs).

Study Design: Qualitative interview study of maternity care providers (MCPs) at FQHCs in NC. Eligible participants were those that see pregnant patients, order and provide counseling for prenatal genetic screening, and follow up results. One-on-one semi-structured interviews were conducted by a single interviewer using an audio-video platform, were recorded, and transcribed. Interviews focused on the following domains based on the Consolidated Framework for Implementation Research (CFIR) constructs: (1) perceived value of genetic screening; (2) perceptions of advancing prenatal genetic technologies; (3) individuals and structural barriers to PGS in public health settings; and (4) recommendations for improved implementation. Interviews were completed after categorical saturation was reached. Interviews were immediately analyzed after interview using a rapid qualitative analytic process.

Results:

Twelve MCPs were interviewed across FQHCs in 12 counties in NC. 9 providers identified as maternal health program coordinators or managers (RN), and 3 providers identified as advanced practice providers (NP). Mean number of years in practice among the cohort was 6.6 (SD 2.4). In describing their patient populations,  all providers reported seeing patients who have Medicaid, presumptive Medicaid, or uninsured. Patient languages in all clinical settings were described as English and Spanish, with one clinic reporting a large Haitian Creole population. Several key themes were identified: (1) MCPs value PGS and describe inequities in access, informed consent, and  types of testing between public and private healthcare settings; (2) health literacy and cost are the most cited barriers to PGS implementation; (3) resources for education and expert consultation are needed in rural areas.

Conclusion:

Resources to address health literacy, cost, and access to genetics expertise are necessary to improve implementation of PGS at FQHCs.