Background:
Evaluating the impact of interventions targeting psychosocial risks among pregnant and postpartum women is hampered by the lack of clear and consistent definitions of risk and the lack of universal screening. Twin Cities Healthy Start developed the Prenatal Risk Overview (PRO) and Postpartum Risk Overview (PPRO) screening interviews to address this gap. These interviews are part of a web-based system that screens for 13 psychosocial risk factors prenatally and 8 psychosocial risk factors postpartum. Automated scoring classifications of low, moderate and high are generated for each risk factor. Prenatal and postpartum case management protocols are defined based on risk designations.

Objectives:
Demonstrate the utility of a postpartum psychosocial risk screening and case management protocol.

Methods:
The PRO and PPRO have been successfully incorporated into standard clinical practice at 4 clinics and 1 social service site providing services for Twin Cities Healthy Start.

Results:
: Presenters will discuss strategies to ensure systematic postpartum screening and provide postpartum screening results from the first 18 months of implementation documenting risk levels of housing instability, lack of social support, domestic violence, depression, second hand smoke exposure of the infant, alcohol and drug use. Analysis will also compare postpartum risks with those identified prenatally.

Conclusion and implications for practice:
A comprehensive structured screening interview to address interconceptional psychosocial risk factors can be successfully implemented into clinical settings and can be used to assist in the provision of case management services at an individual level as well as provide data essential for documenting the level of risk in the population served.