Screening Children for Social Determinants of Health: A Systematic Review

Abstract

CONTEXT Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science. OBJECTIVE To systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of risk and inform care. DATA SOURCES Comprehensive electronic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. STUDY SELECTION Studies in which a tool that screened children for multiple SDOHs (defined according to Healthy People 2020) was developed, tested, and/or employed. DATA EXTRACTION Extraction domains included study characteristics, screening tool characteristics, SDOHs screened, and follow-up procedures. RESULTS The search returned 6274 studies. We retained 17 studies encompassing 11 screeners. Study samples were diverse with respect to biological sex and race and/or ethnicity. Screening was primarily conducted in clinical settings with a parent or caregiver being the primary informant for all screeners. Psychometric properties were assessed for only 3 screeners. The most common SDOH domains screened included the family context and economic stability. Authors of the majority of studies described referrals and/or interventions that followed screening to address identified SDOHs. LIMITATIONS Following the Healthy People 2020 SDOH definition may have excluded articles that other definitions would have captured. CONCLUSIONS The extent to which SDOH screening accurately assessed a child’s SDOHs was largely unevaluated. Authors of future research should also evaluate if referrals and interventions after the screening effectively address SDOHs and improve child well-being.

A feasibility and acceptability study of screening the parents/guardians of pediatric dental patients for the social determinants of health

“…This is the rst study reported in the scienti c literature to assess the feasibility and acceptability of SDOH screening and referral in a pediatric dental clinic of an FQHC network. Most research conducted to date on the topic of SDOH screening and referral has been in primary care, including reports related to SDOH screening tools, domains, processes, and guides for clinicians [21,[30][31][32][33].…”

Financing Approaches to Social Prescribing Programs in England and the United States

“…The available evidence shows that the scope of services offered to patients in social prescribing schemes in the two countries have some similarities but also some notable differences (Figure 1). 14,25‐27 Programs in the United States typically concentrate on connecting patients to resources that help meet basic material needs, such as food insecurity and housing instability 28 . Services in England also help address patients’ basic social needs, as well as enabling social prescribing practitioners to refer patients to other types of services, such as arts and crafts and volunteering programs, whose purpose is to improve the patient's overall well‐being and quality of life.…”

From zero to thrive: A model of cross‐system and cross‐sector relational health to promote early childhood development across the child‐serving ecosystem

“…For example, despite growing interest in trauma‐informed care, which considers how trauma affects development, trauma‐informed approaches are primarily implemented by persons within direct child‐serving systems (e.g., teachers, pediatricians, social workers (Herrenkohl et al., 2019)). Recently, efforts within health care and public health sectors have highlighted the need to address child trauma exposure and SDOH's, yet not all providers have such training (Garg et al., 2020; Garner et al., 2015; Herrenkohl et al., 2020; Sokol et al., 2019). Although not all members of the child‐serving ecosystem can become trauma‐informed care providers or IMH specialists, knowledge regarding the science of early development may be important in informing decision‐making across sectors that directly or indirectly impact children and families.…”

“…WE CARE is a clinic‐based SDOH screening and referral system developed for pediatric settings, and it has been implemented with parents of children ages 0–5 years (Garg et al., 2015). SDOH screening and referral could occur in a variety of settings (e.g., daycares, workplaces) but pediatric settings are the most common to date (Sokol et al., 2019). WE CARE includes three core activities.…”