Clinical Fellow Cincinnati Children's Hospital Medical Center Cincinnati, Ohio, United States
Background: Inequities based on race, ethnicity, insurance, household income, and zip code contribute to profound, complex, and persistent disparities for critically ill children. Further, disparities influence illness severity, access to care, risk of hospitalization, mortality, and long-term outcomes. Screening for and addressing unmet social needs is often championed but rarely implemented. The merits of social needs screening are described in many contexts but there is a paucity of data on screening in the PICU. To address this need, we have developed and validated a screening tool to assess critically ill children and their families for unmet social needs. Objective: To develop and test a strengths-based, trauma-informed, community-supported screening tool to assess for unmet social needs in the PICU Design/Methods: We aimed to develop a validated social needs screening tool with a PICU-sensitive approach, recognizing the unique context and challenges of a critical care hospitalization. Community and family stakeholders were engaged in a series of interviews and focus groups to elicit perspectives, suggestions, and priorities for screening. The screening tool was then constructed after an extensive literature review of published social needs screens and in collaboration with content experts to identify priority domains. Content validity was completed by engaging content experts in a series of modified-Delphi panels to review and refine the screen. Face validity is being assessed through cognitive interviews with parents of children with recent PICU admissions. This phase will conclude in January 2024. Finally, criterion validity will be assessed by comparing the sensitivity and specificity of the screening tool to a complete evaluation by a licensed and experienced PICU social worker. This phase will be completed by April 2024. The tool will then be assessed for feasibility and acceptability in a multi-site pilot in PICUs across the country. This study has been approved by Lurie Children’s IRB (IRB 2021-4781).
