Nonclient factors in the reporting of prenatal psychosocial risk assessments

Psychosocial and nutrition risk assessments at 27 randomly selected sites of a Medicaid-funded enhanced prenatal program were examined for completeness and uniformity of reporting. The recording of psychosocial data, but not of nutrition data, was found to be associated with a substantial number of nonclient factors, including geographical location and abstractor, assessor, and service provider characteristics. The variability in recording of psychosocial problems reflects the numerous ways that assessments are performed and the subsequent difficulty in interpreting the practice of psychosocial assessment. A uniform system of defining and classifying risks is needed to improve both service delivery and service evaluation.