Nurse versus community health worker identification of psychosocial risks in pregnancy through a structured interview

A structured psychosocial risk screening interview, the Prenatal Risk Overview, was administered to 733 women in prenatal care. Either a community health worker (CHW) or a registered nurse (RN) conducted the interview based on day of the week. A comparison of identified risk factors found no significant differences between study samples for six of 13 domains. For CHW interviews, significantly more participants were classified as Moderate/ High Risk for Depression, Lack of Telephone Access, Food Insecurity, and Housing Instability, and as High Risk for Lack of Social Support, Lack of Transportation Access, and Housing Instability. For RN interviews, significantly more participants were classified as High Risk for Alcohol Use. Community health workers successfully conducted psychosocial screening and elicited more self-reported risk than RNs, especially lack of basic needs. Comparing the hourly salary/ wage, the cost for CHWs was 56% lower than for RNs. Preliminary findings support use of paraprofessionals for structured screening interviews.