458 - Social Determinants of Health Screening and Resource Referral in a Level III NICU

Poster Number: 458
Publication Number: 458.3230

Background: Social determinants of health (SDoH), defined as non-medical factors such as housing, food and transportation, greatly affect quality-of -life and health outcomes. Despite AAP recommendation to screen for SDoH in all clinical settings, this has rarely been accomplished in neonatal intensive care units (NICU). Given the long duration of stay and high prevalence of low-income, at-risk families, the NICU is an ideal setting to screen SDoH and address needs.

Objective: To evaluate the feasibility of implementing a standardized SDoH screening tool in a level III NICU in order to identify and address needs and relay these results to the primary care provider (PCP).

Design/Methods: Our level III NICU serves as one of the five safety net NICUs within the state selected to implement a standardized SDoH screening tool. A multidisciplinary team, including physicians, nurses, unit managers, advanced practitioners, social workers, and family representatives assembled to begin screening in March of 2023. Inclusion criteria are patients ≤35 weeks gestation, born after January 1, 2023 and > 7 day length of admission. A NICU-based social worker uses an SDoH screening tool, currently used in our outpatient setting, to screen parents at bedside for access to housing, food, utilities, transportation, education, employment, childcare, and healthcare. Families are offered resources for any identified need(s) using a comprehensive local community resource guide we created. The primary outcome is percent of eligible families approached for screening. Secondary outcomes are percent of families with at least one identified SDoH need, percent requesting resources, and percent of screening results included in the discharge summaries.

Results: Between Jan 1 to Oct 1 2023, of 590 admissions to the NICU, 273 met inclusion criteria. Beginning in March of 2023, 168 families were approached and 100% consented to screening. Since May of 2023, ≈ 90% of eligible families have been approached for screening (Fig 1). In this time frame, ≈80-90% of screening results have been included in discharge summaries (Fig 2). Of 168 families screened, 14% screened positive for at least one SDoH. An additional 7% of families answered negative but still requested resources.

Conclusion(s): Implementation of a standardized SDoH screening tool and resource guide in a level III NICU was feasible, successful in identifying families with SDoH needs, connecting them to local resources, and relaying these needs to the PCP. It is unclear, based on families denying SDoH needs yet requesting resources, if families under report.