Integrating a Social Determinants of Health Screener at an Outpatient Pediatric Clinic in East Harlem, New York City

Rinehart, Rebecca; Zajac, Lauren; Acevedo, Jennifer; Mayer, Rebecca Kann Victoria; Mogilner, Leora

doi:10.1353/hpu.2021.0199

Cited by 2 publications

(9 citation statements)

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“…Target groups consisted of CYP and their families (39–41), or (young) mothers with infants (38, 42–45). They were identified via bespoke screening tools (43, 45), through their existing or previous use of social care or support (38), and an actual or proxy measure of low-income or deprivation (39–41). The interventions were typically delivered in community based care centres or clinics (38, 39, 43–45), or in two instances the CYP’s home (42, 44).…”

Section: Resultsmentioning

confidence: 99%

“…We identified three types of integrated health and social care services: Targeted support for CYP and their families, where specified groups with additional needs were identified and then receive a range of health and care interventions (38)(39)(40)(41)(42)(43)(44)(45); Collaborative health and social support, involving health and social care organisations work together to deliver shared and complementary services (46)(47)(48)(49); and School centred health and social care, in which health and social care services embedded or directly linked to educational facilities (50)(51)(52)(53). A summary of the key characteristics of each of the types of integrated care model can be found in Table 3 and below we summarise the results of the studies identified within each.…”

Section: Integrated Health and Social Care Modelsmentioning

confidence: 99%

“…Target groups consisted of CYP and their families (39)(40)(41), or (young) mothers with infants (38,(42)(43)(44)(45). They were identified via bespoke screening tools (43,45), through their existing or previous use of social care or support (38), and an actual or proxy measure of low-income or deprivation (39)(40)(41).…”

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

“…The interventions were typically delivered in community based care centres or clinics (38,39,(43)(44)(45),…”

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

“…At a single clinic in a deprived district in East Harlem just under 60% of participants had at least one unmet need relating to housing, tobacco exposure, or food insecurity with 80% successfully referred to the appropriate social support as a result (39) (38).…”

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

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Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

Bird,

Harper,

Muslim

et al. 2024

Preprint

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ObjectiveTo explore the evidence for interventions that integrate child health and social care and support programmes and the impact they have on child health and wellbeing.Data sourcesThe Cochrane Library, Ovid Medline, Ovid Embase, Ovid Emcare, Ovid Health Management Information Consortium (HMIC) database, and Ovid Social Policy and Practice, Proquest Psychinfo and Ebscohost Cinahl.EligibilityPeer-reviewed original research that described an intervention integrating health care and social support or care interventions for children and young people (CYP) up to the age of 18 years in high-income countries. All databases were searched from inception to August 2023.Data extraction and synthesis16 studies were identified: 4 RCTs, 5 quantitative studies, 5 qualitative studies and 2 mixed methods studies. A narrative review and quality check of included studies was performed. Study heterogeneity meant a meta-analysis could not be completed.ResultsFive qualitative, five quantitative, two mixed methods and four randomised controlled trials were included. We identified three main models of delivering integrated health and social care services: targeted support for vulnerable groups, where the provision of packages of interventions focussed on target populations showed potential for decreasing the need for social support in the long-term but with limited evidence for reducing referrals into other services. They were more successful in meeting specific objectives such as lower rates of smoking, and reducing repeat pregnancies; collaborative health and social support were typically collocated services which improved collaborative working but with little impact on workload, job satisfaction, or service delivery; and school centred health and social care, which improved some aspects of CYP wellbeing and physical health but with concerns they added to teacher workload.ConclusionsIntegrated health and social support programmes offer promising solutions to addressing health inequity in children and young people in underserved populations. However, more robust and consistent study designs are needed to guide researchers and policy makers in their implementation and evaluation.What is already known on this topic.Integrated care that is equipped to mitigate at least some of the social determinants of health is considered key to improving health inequalities in children and young people in underserved populations.Despite increasing investment in integrating health and social support there is little evidence of which models of delivery are most effective in which circumstances nor of the precise impact on target groups and the wider healthcare system.What this study addsWe identified three models of integrating health and social support: Packages of interventions targeted at specific groups; Collaborative (and collocated) health and social support; and School-centered health and social care interventions.Results across the three models offered promise of improved care and support for the underserved, referral rates into other services tended to be lower and packages interventions achieved positive results for specific objectives. However, findings were inconsistent, drop-out rates were high, and there are concerns over sustainability without sufficient resources.How this study might affect research, practice and policyEmbedding iterative co-production in future research and interventions could improve engagement and outcomes and it’s important that further works explores their cost effectiveness and implications for other elements of health and care services.Appropriate resources and a longer-term commitment to promoting integrated health and social support is needed to fully understand the strengths and weaknesses of the offer and maximise the potential benefits.

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Section: Resultsmentioning

confidence: 99%

Section: Integrated Health and Social Care Modelsmentioning

confidence: 99%

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

“…The interventions were typically delivered in community based care centres or clinics (38,39,(43)(44)(45),…”

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

Section: Targeted Support For Cyp and Their Familiesmentioning

confidence: 99%

See 3 more Smart Citations

Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

Bird,

Harper,

Muslim

et al. 2024

Preprint

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The ‘what’ and ‘how’ of screening for social needs in healthcare settings: a scoping review

Karran

Cashin

Barker

et al. 2023

PeerJ

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Background Adverse social determinants of health give rise to individual-level social needs that have the potential to negatively impact health. Screening patients to identify unmet social needs is becoming more widespread. A review of the content of currently available screening tools is warranted. The aim of this scoping review was to determine what social needs categories are included in published Social Needs Screening Tools that have been developed for use in primary care settings, and how these social needs are screened. Methods We pre-registered the study on the Open Science Framework (https://osf.io/dqan2/). We searched MEDLINE and Embase from 01/01/2010 to 3/05/2022 to identify eligible studies reporting tools designed for use in primary healthcare settings. Two reviewers independently screened studies, a single reviewer extracted data. We summarised the characteristics of included studies descriptively and calculated the number of studies that collected data relevant to specific social needs categories. We identified sub-categories to classify the types of questions relevant to each of the main categories. Results We identified 420 unique citations, and 27 were included. Nine additional studies were retrieved by searching for tools that were used or referred to in excluded studies. Questions relating to food insecurity and the physical environment in which a person lives were the most frequently included items (92–94% of tools), followed by questions relating to economic stability and aspects of social and community context (81%). Seventy-five percent of the screening tools included items that evaluated five or more social needs categories (mean 6.5; standard deviation 1.75). One study reported that the tool had been ‘validated’; 16 reported ‘partial’ validation; 12 reported that the tool was ‘not validated’ and seven studies did not report validation processes or outcomes.

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Integrating a Social Determinants of Health Screener at an Outpatient Pediatric Clinic in East Harlem, New York City

Cited by 2 publications

References 0 publications

Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

Exploring the impact of integrated health and social care services on child health and wellbeing in underserved populations: a systematic review

The ‘what’ and ‘how’ of screening for social needs in healthcare settings: a scoping review

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