(PS8-A18) Keeping Babies Clean and Dry: The Role of Early Intervention Providers in Identifying Diaper Need in Under-resourced Families

Diaper need – when families cannot afford sufficient diapers to keep their infant or toddler clean, dry, and healthy - is a significant public health issue. In Connecticut (CT) alone, 7,991 children received diaper assistance in the past fiscal year from the Diaper Bank of CT  - an agency that connects families in need with community resources. However, the estimated need far exceeds those receiving services, and diaper need is particularly challenging as federal nutrition programs targeting under-resourced families (e.g., WIC, SNAP) do not cover diapers.  An inadequate diaper supply predicts children’s health (e.g., urinary tract infections, diaper rash; Sobowale et al., 2021), can keep them out of daycare, and limits parents’ access to education and employment (Raver et al., 2010).  Research has also linked diaper need with maternal mental health problems such as increased depressive symptoms (Austin & Smith, 2017). Connecting families to diapers may improve physical and mental well-being for under-resourced families and reduce a significant public health burden. However, it is unclear who screens for diaper need, or how common it is.  Thus, we explored diaper need screening practices in early intervention providers in CT, as they regularly work with families with young children. We explored if and how they screen for diaper need, willingness to screen in the future, and concerns about screening.

Participants in the single-time point online study were 72 early intervention providers in CT. We conducted a series of frequency analyses on all available responses. When asked about social risk factors, 43 respondents indicated they screen for factors such as food or housing insecurity, and 43 reported they screen for diaper need specifically. For both items, 28 indicated either no one in their agency screens or they do not know if anyone screens; one participant did not respond. In terms of their willingness to screen for diaper need in the future, most who responded (54 out of 69) reported they would be somewhat or very willing to screen if a free tool were available. Further, when shown two diaper need screening questions recently added to patient medical records in some hospitals in CT, 66 out of the 69 said they would be somewhat or very willing to ask those questions in the future; only 3 were unwilling.  When asked about concerns about diaper need screening, respondents noted concerns about the sufficiency of available resources and a lack of knowledge of such resources as the most common barriers.  

Results suggest that while many early intervention providers do screen for diaper need, many still do not. However, the vast majority were willing to screen in the future if a tool were provided, despite having concerns about their knowledge of diaper resources and the sufficiency of those resources. Future research could could develop and assess a brief diaper need screening tool, and disseminate information to providers about local diaper resources.  These research efforts paired with lobbying to increase funding for diaper resources in our communities (e.g., making diapers covered for all children ages 0-3 receiving Medicaid) has the potential to improve the physical and mental wellbeing of families and reduce the public health burden of diaper need.