An Integrative Review of Social Determinants of Health Assessment and Screening Tools Used in Pediatrics

Morone, Jennifer

doi:10.1016/j.pedn.2017.08.022

Cited by 57 publications

(56 citation statements)

References 34 publications

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“…The activities include the completion of a structured social needs assessment, which is begun at the start of cancer treatment and is updated with each transition of care, such as the initiation of chemotherapy, surgery, or radiation therapy, or according to a patient's need. There are now standardized screening tools for social determinants . In addition to screening tools, there are local and national online tools that provide linkages between social needs and free or low‐cost community resources that navigators and patients can access to address identified needs .…”

Section: Resultsmentioning

confidence: 99%

“…There are now standardized screening tools for social determinants. [28][29][30][31][32][33] In addition to screening tools, there are local and national online tools that provide linkages between social needs and free or low-cost community resources that navigators and patients can access to address identified needs. [34][35][36][37] Several of the activities are focused beyond direct interactions with specific patients.…”

Section: Resultsmentioning

confidence: 99%

“…Our metrics do not include all the potential complexity of this workload; as with our other recommendations, this is intended to be a necessary minimal requirement. Prior work has shown that systematic screening for social determinants of health with short questionnaires similar to the one that we are using with referral to local resources can improve health outcomes and behaviors . Addressing social needs has often required that each navigator develop a list of community resources and connections to support his or her own patients.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence within primary care has documented positive health impacts from screening for social needs and providing resource referrals within the community to mitigate these needs. 29,52 A number of screening tools have been published [28][29][30][31][32][33] ; the supporting information provides the screening tool that we adapted from the literature and tailored to our community needs.…”

Section: Continuedmentioning

confidence: 99%

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Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

Freund

Haas

Lemon

et al. 2019

Cancer

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Background There is a need for guidelines on patient navigation activities to promote both the quality of patient navigation and the standards of reimbursement for these services because a lack of reimbursement is a major barrier to the implementation, maintenance, and sustainability of these programs. Methods A broad community‐based participatory research process was used to identify the needs of patients for navigation. A panel of stakeholders of clinical providers was convened to identify specific activities for navigators to address the needs of patients and providers with the explicit goal of reducing delays in the initiation of cancer treatment and improving adherence to the care plan. Results Specific activities were identified that could be generalized to all patient navigation programs for care during active cancer management to address the needs of vulnerable communities. Conclusions Oncology programs that seek to implement lay patient navigation may benefit from the adoption of these activities for quality monitoring. Such activities are necessary as we consider reimbursement strategies for navigators without clinical training or licensure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Continuedmentioning

confidence: 99%

See 2 more Smart Citations

Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

Freund

Haas

Lemon

et al. 2019

Cancer

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“…An alternative approach relies on self‐reported information about housing status collected through the use of screening tools administered to patients in clinical settings . The U.S. Department of Veterans Affairs’ (VA) Homelessness Screening Clinical Reminder (HSCR) is one such screening instrument that has been deployed on a wide scale.…”

Section: Introductionmentioning

confidence: 99%

Predictive modeling of housing instability and homelessness in the Veterans Health Administration

Byrne

Montgomery

Fargo

2018

Health Services Research

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Objective To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA). Data Sources/Study Setting Electronic medical record data from 5.8 million Veterans who responded to the VHA's Homelessness Screening Clinical Reminder (HSCR) between October 2012 and September 2015. Study Design We randomly selected 80% of Veterans in our sample to develop predictive models. We evaluated the performance of both logistic regression and random forests—a machine learning algorithm—using the remaining 20% of cases. Data Collection/Extraction Methods Data were extracted from two sources: VHA's Corporate Data Warehouse and National Homeless Registry. Principal Findings Performance for all models was acceptable or better. Random forests models were more sensitive in predicting housing instability and homelessness than logistic regression, but less specific in predicting housing instability. Rates of positive screens for both outcomes were highest among Veterans in the top strata of model‐predicted risk. Conclusions Predictive models based on medical record data can identify Veterans likely to report housing instability and homelessness, making the HSCR screening process more efficient and informing new engagement strategies. Our findings have implications for similar instruments in other health care systems.

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Performance of 2 Single-Item Screening Questions to Identify Future Homelessness Among Emergency Department Patients

et al. 2022

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ImportanceDespite increasing interest in assessing patient social needs in health care settings, there has been little research examining the performance of housing-related screening questions.ObjectiveTo examine the performance of 2 single-item screening questions assessing emergency department (ED) patients’ self-perceived risk of future homelessness.Design, Setting, and ParticipantsThis prospective cohort study was conducted among a randomly selected sample of adult ED patients from 2016 to 2017 in a public hospital ED in New York City. Data were analyzed from September 2019 through October 2021.ExposuresResponses on patient surveys conducted at the baseline ED visit for 2 single-item screening questions on self-perceived risk for future housing instability and homelessness were collected. One question asked patients if they were worried about having stable housing in the next 2 months, and the other question asked them to rate the likelihood that they would enter a homeless shelter in the next 6 months.OutcomesHomeless shelter entry 2, 6, and 12 months after an ED visit, assessed using shelter administrative data in the study city, which was linked with participant baseline survey responses.ResultsThere were 1919 study participants (976 [51.0%] men and 931 [48.6%] women among 1915 individuals with gender data; 700 individuals aged 31-50 years [36.5%] among 1918 individuals with age data; 1126 Hispanic or Latinx individuals [59.0%], 368 non-Hispanic Black individuals [19.3%], and 225 non-Hispanic White individuals [11.8%] among 1908 individuals with race and ethnicity data). Within 2, 6, and 12 months of the ED visit, 45 patients (2.3%), 66 patients (3.4%), and 95 patients (5.0%) had entered shelter, respectively. For both single-item screening questions, participants who answered affirmatively had significantly higher likelihood of future shelter entry at each time point examined (eg, at 2 months: 31 participants responding yes [6.5%] vs 14 participants responding no [1.0%] to the question concerning being worried about having stable housing in the next 2 months). Sensitivity of the screening questions ranged from 0.27 to 0.69, specificity from 0.76 to 0.97, positive predictive value from 0.07 to 0.27, and area under the receiver operating characteristic curve from 0.62 to 0.72.Conclusions and RelevanceThis study found that 2 single-item screening questions assessing ED patient self-perceived risk of future housing instability and homelessness had adequate to good performance in identifying risk for future shelter entry. Such single-item screening questions should be further tested before broad adoption.

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An Integrative Review of Social Determinants of Health Assessment and Screening Tools Used in Pediatrics

Cited by 57 publications

References 34 publications

Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

Predictive modeling of housing instability and homelessness in the Veterans Health Administration

Performance of 2 Single-Item Screening Questions to Identify Future Homelessness Among Emergency Department Patients

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