Piloting a diaper need screening tool for a community health needs assessment

Introduction: Diaper need is the lack of sufficient diapers to keep a child clean, dry, and healthy. It is an emerging social determinant of health linked to parental stress, adverse child outcomes, and economic hardship. Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to pilot a one-question diaper need screening tool in Middlesex County, NJ, with the goal of establishing a foundation for sustainable implementation in 2026 and subsequent integration into the 2028 Community Health Needs Assessment (CHNA). Methodology: This quality improvement project used a descriptive correlational design. A screening tool was administered to families participating in community health programs and events throughout Middlesex County. Demographic data collected included household income, age, and diaper need. Data were analyzed to identify prevalence of diaper need and its association with age and income level. Results: Results demonstrated that diaper need is prevalent in Middlesex County, with a statistically significant association between lower income levels and increased diaper need, consistent with national trends. These findings demonstrate that diaper need reflects underlying social determinants of health, including financial hardship, limited access to resources, and family vulnerability. Implications for Practice: The outcomes validated the need to expand diaper need screening across community partners and incorporate the measure into future CHNA data collection. Integrating diaper need screening into routine assessments provides a practical, efficient strategy to identify an unmet basic need affecting child, family, and community health.