438 - To Screen or Not to Screen? The Impact of Social Determinants of Health Screening in a Pediatric Primary Care Clinic

Poster Number: 438
Publication Number: 438.463

Background: The AAP recommends surveillance for risk factors related to social determinants of health (SDOH) during all patient encounters; however, there is limited understanding of its impact from a family perspective.

Objective: To evaluate the family perspective regarding 1) the process of filling out an SDOH screening form and discussing next steps with a provider and 2) the effectiveness of connecting families with usable resources to support SDOH needs using community health workers.

Design/Methods: A subsample of parents of children who screened positive for SDOH needs and received outreach from a community health worker at a pediatric primary care clinic participated in semi-structured qualitative interviews. Interview topics included discussion of the process of screening, resource support, and perception of SDOH screening at a pediatric clinic, as well as a demographic survey. Qualitative analysis of the data was conducted using modified grounded theory with coding of all interviews reviewed by at least 3 authors to ensure consensus of themes elicited.

Results: Fourteen parents participated in interviews. 50% self-identified as black, 35% identified as Hispanic, and 15% identified as white. Of SDOH needs requested, 71% requested housing assistance, 43% requested utilities assistance, 14% requested food assistance, and 21% requested other support such as health insurance, car seats, childcare, and clothing. Four themes emerged from the interviews: First, a physician’s office is a safe space to disclose vulnerable needs. Second, structured follow up after screening is important to families. Third, setting expectations of available resources and support, especially with resource-limited needs such as housing is valued by families. Finally, working families present with additional difficulties associated with following up on available resources . 71% thought the process of screening and outreach was “great” or “easy”. 93% think that clinics should screen for SDOH needs.

Conclusion(s): SDOH screening and subsequent resource connection is an important part of providing holistic care for patients. Families appreciate screening at a physician’s office as it is perceived as a safe space to disclose vulnerable information. Disclosure of needs should be followed up with conversation and resources as available, with sensitivity to setting expectations for scarce resources and addressing barriers for working families.