Caregiver Opinion of In-Hospital Screening for Unmet Social Needs by Pediatric Residents

Colvin, Jeffrey D.; Bettenhausen, Jessica L.; Anderson-Carpenter, Kaston D.; Collie‐Akers, Vicki; Chung, Paul J.

doi:10.1016/j.acap.2015.06.002

Cited by 49 publications

(36 citation statements)

References 37 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Families have self-reported increased satisfaction with providers, increased linkage to services, and better health care outcomes when their medical providers ask about SDH. 21,[34][35][36] On the provider side, barriers previously noted in the literature have included: lack of recognized benefit measurable outcome of screening, lack of time, lack of professional training, lack of familiarity with relevant tools, and lack of knowledge of community resources. 1521 Our study indicates that providers accept the evidence and indication for screening.…”

Section: Discussionmentioning

confidence: 99%

Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic

Morgenlander¹,

Tyrrell

Garfunkel

et al. 2019

Academic Pediatrics

View full text Add to dashboard Cite

BACKGROUND: The American Academy of Pediatrics and the Academic Pediatric Association have published guidelines supporting screening and referral for social determinants of health (SDH) in pediatric primary care. Despite this charge, little is known about the current prevalence of screening practices taking place in medical homes across the country.OBJECTIVE: The objective of this study is to describe current practices for systematically screening for social determinants of health in nationwide pediatric continuity clinics enrolled in the CORNET network. METHODS: We recruited 144 pediatric resident continuity clinics enrolled in the ContinuityResearch Network (CORNET) of the Academic Pediatric Association. Continuity clinic directors at 75 sites agreeing to participate received an electronic survey instrument requesting clinic demographics and information on screening and educational practices for fifteen social determinants of health. RESULTS:In the sixty-four clinic sites that responded to the survey, the range of SDH being screened for was 0-15 with a mean of 7. The most commonly screened SDH were maternal depression (86%), child education (84%), food insecurity (71%) and firearm exposure (65%).Most commonly, screening instruments are paper documents original to the clinic. Primary iii providers, nurses or medical assistants administer the majority of screens on rooming or during the encounter. Clinics not currently screening have plans to begin screening for nearly a quarter of those SDH not currently being screened within the next 3 years. Clinic directors most often cited lack of time (63%), lack of resources to address positive screen (50%) and inadequate training (46%) as barriers to SDH screening. Less than 10% of resident continuity clinic directors cited lack of indication or evidence for screening as barriers. CONCLUSIONS: Screening for SDH in pediatric resident continuity clinics has not yet been universally implemented. Screening practices are variable reflecting the complex nature of screening and the heterogeneity of the various SDH. Characteristics of commonly screened SDH include validated, concise screening tools, longstanding Bright Futures recommendations, literature suggesting benefit, and identifiable interventions. The major barriers to SDH screening are lack of time and lack of resources to address positive screens. A variety of measures including comprehensive, concise screening tools, up-to-date community resource guides, streamlined referral processes, embedded multidisciplinary teams, and strong community partnerships could mitigate these barriers.

show abstract

Section: Discussionmentioning

confidence: 99%

Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic

Morgenlander¹,

Tyrrell

Garfunkel

et al. 2019

Academic Pediatrics

View full text Add to dashboard Cite

show abstract

“…Another important reason to screen for psychosocial risk factors is that caregivers want their child's health care provider to screen for and assist with unmet social needs (Beck & Klein, 2016). Colvin et al (2016), in a cross-sectional study of caregivers of hospitalized children, found that greater than 70% of caregivers believed their child's health care provider should ask about concerns such as income, housing, food insecurity, educational needs, insurance, domestic violence, immigration, and guardianship. PNPs must feel comfortable asking sensitive questions across inpatient and outpatient care settings.…”

Section: Implications For Practicementioning

confidence: 99%

Trauma-Informed Care: Essential Elements for Pediatric Health Care

Hornor¹,

Davis²,

Sherfield³

et al. 2019

Journal of Pediatric Health Care

View full text Add to dashboard Cite

Childhood psychosocial trauma exposure is highly prevalent and associated with risk for poor physical and mental health outcomes extending throughout life. In a study of nearly 54,000 adult Americans (Gilbert et al., 2015), 60% reported experiencing at least one adverse childhood experience (ACE). According to the National Survey of Child Health, 48% of American children have suffered at least one ACE (Bethell, Newacheck, Hawkes, & Halfon, 2014). The U.S. Department of Health and Human Services (2017) states that more than 650,000 American children experienced child maltreatment in 2016 and up to 10 million children in the United States witness domestic violence each year (National Coalition Against Domestic Violence, 2015).

show abstract

“…49,62,70,74 Questions of the best workforce (physician, social worker, CHW, and volunteer advocate) remain unaddressed. There is also limited evidence regarding the most effective or efficient settings (inpatient, outpatient, and ED) 99 and the medium (paper, tablet, and electronic patient portal) 92 for screening. Other critical process and implementation questionssuch as what populations to target, how often to screen, what frequency of follow-up, and how best to document and communicate social needs in the health record are similarly important and underexplored.…”

Section: Opportunities For Further Researchmentioning

confidence: 99%

Perspectives from the Society for Pediatric Research: interventions targeting social needs in pediatric clinical care

et al. 2018

Self Cite

View full text Add to dashboard Cite

The social determinants of health (SDoH) are defined by the World Health Organization as the "conditions in which people are born, grow, live, work, and age." Within pediatrics, studies have highlighted links between these underlying social, economic, and environmental conditions, and a range of health outcomes related to both acute and chronic disease. Additionally, within the adult literature, multiple studies have shown significant links between social problems experienced during childhood and "adult diseases" such as diabetes mellitus and hypertension. A variety of potential mechanisms for such links have been explored including differential access to care, exposure to carcinogens and pathogens, health-affecting behaviors, and physiologic responses to allostatic load (i.e., toxic stress). This robust literature supports the importance of the SDoH and the development and evaluation of social needs interventions. These interventions are also driven by evolving economic realities, most importantly, the shift from fee-for-service to value-based payment models. This article reviews existing evidence regarding pediatric-focused clinical interventions that address the SDoH, those that target basic needs such as food insecurity, housing insecurity, and diminished access to care. The paper summarizes common challenges encountered in the evaluation of such interventions. Finally, the paper concludes by introducing key opportunities for future inquiry.

show abstract

Caregiver Opinion of In-Hospital Screening for Unmet Social Needs by Pediatric Residents

Cited by 49 publications

References 37 publications

Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic

Screening for Social Determinants of Health in Pediatric Resident Continuity Clinic

Trauma-Informed Care: Essential Elements for Pediatric Health Care

Perspectives from the Society for Pediatric Research: interventions targeting social needs in pediatric clinical care

Contact Info

Product

Resources

About