272 - Investigating the Efficacy of a Pediatric Primary Care Patient Navigator Program in Connecting Families to Public Benefit Programs

Poster Number: 272
Publication Number: 272.1480

Background: Families seeking to obtain public benefits face significant challenges, including complex eligibility criteria and language barriers. As such, only a portion of eligible families are actually enrolled. Patient navigators (PN) have been shown to have mixed effect in connecting families to benefit programs, and few investigations have determined their efficacy in the pediatric primary care setting.

Objective: To evaluate the impact of PNs on improving enrollment in public benefits among patients with this identified social need.

Design/Methods: Between December 2022 and June 2023, families at one large academic pediatric primary care clinic were screened for SDOH during their annual well child visit. In this IRB-approved stepped-wedge cluster randomized control trial, patients were randomized to control vs. intervention groups based on the day seen in clinic (Figure 1). All patients with a positive screen were provided a list of community resources; those in the intervention arm were also contacted by a PN. Families were enrolled in the study if they reported needing assistance with public benefits and consented to participation. Needs were reassessed 3 months after their initial screen. We used descriptive statistics to describe demographic data. The primary outcome measure was resolution of the public benefit need. Chi square test was used to determine the difference in proportion of resolution in the intervention and control groups at follow-up.

Results: A total of 392 families identified unmet social needs, with 161 and 231 families in the control and intervention groups, respectively. At baseline, 56.5% (n=91) of families identified a public benefit need in the control group, compared to 55.4% (n=128) in the intervention group. See Table 1 for demographic characteristics. Of families with a positive public benefit need, 58.2% (n=53) and 31.2% (n=40) in the control and intervention groups, respectively, completed the three-month follow-up assessment. Data revealed that a greater proportion of patients in the intervention arm (72.5%, n=29) continued to require assistance with public benefits, compared to 34.0% (n=18) of patients in the control group (p <.001).

Conclusion(s): PN services may not be effective in helping families obtain public benefits in the short-term. Findings may be attributed to study limitations, which include high dropout rate in the intervention group, small sample size, and PN workflows that typically connect families to third party organizations for enrollment in benefits.