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Smith M, Tepe KA, Sauers-Ford H, Atarama D, Gilliam M, Unaka N, Beck AF, Shah AN, Schondelmeyer AC, Auger KA. Addressing food insecurity in the inpatient setting: Results of a postdischarge pilot study. J Hosp Med 2024. [PMID: 38837594 DOI: 10.1002/jhm.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND AND OBJECTIVES With a growing interest in screening for food insecurity (FI) during pediatric hospitalization, there is a parallel need to develop interventions. With input from caregivers experiencing FI, we sought to identify interventions to assist with short-term FI after discharge and evaluate their feasibility, acceptability, and appropriateness. METHODS We first employed qualitative methods to identify potential interventions. Next, we conducted a pilot study of selected interventions for families experiencing FI. Seven days postdischarge, caregivers rated the intervention's feasibility, acceptability, and appropriateness. We also assessed for ongoing FI. We summarized the median and proportion of "completely agree" responses to feasibility, acceptability, and appropriateness questions, and we compared in-hospital and postdischarge FI using McNemar's test. RESULTS In the qualitative stage, 14 caregivers prioritized three interventions: grocery store gift cards, grocery delivery/pick-up, and frozen meals. In the pilot study, 53 caregivers (25% of those screened) endorsed FI during their child's hospitalization and received one or more of the interventions. Every caregiver selected the grocery gift card option; 37 families (69.8%) also received frozen meals. Seven days after discharge, most caregivers rated the intervention as "completely" feasible (76%), acceptable (90%), and appropriate (88%). There was a significant decrease in caregivers who reported FI after discharge compared to during the hospitalization (p < .001). CONCLUSIONS This study demonstrates the feasibility, acceptability, and appropriateness of inpatient interventions to address FI, particularly at the time of pediatric hospital discharge and transition home. Randomized trials are needed to further evaluate the efficacy of interventions employed during hospitalization.
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Affiliation(s)
- Megan Smith
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kerry A Tepe
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Hadley Sauers-Ford
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Denise Atarama
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Monique Gilliam
- Division of Hospital Medicine, Parent Partner Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ndidi Unaka
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew F Beck
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Anita N Shah
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amanda C Schondelmeyer
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Katherine A Auger
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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2
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Sheak K, Shah A, Unaka NI. Forging a Path to Effective Inpatient Health-Related Social Needs Screening and Response. Hosp Pediatr 2024; 14:e209-e211. [PMID: 38463006 DOI: 10.1542/hpeds.2023-007668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Kenna Sheak
- Division of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anita Shah
- Division of Hospital Medicine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ndidi I Unaka
- Division of Hospital Medicine
- Fischer Child Health Equity Center
- Office of Population Health, Cincinnati Children's Hospital, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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3
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Bouchelle Z, G. Menko S, Yazdani M, Vasan A, Scribano P, Shea JA, Kenyon CC. Parent Perspectives on Documentation and Sharing of Health-Related Social Needs Data. Hosp Pediatr 2024; 14:308-316. [PMID: 38477053 PMCID: PMC10965757 DOI: 10.1542/hpeds.2023-007478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Parents of pediatric patients are key stakeholders in the design and implementation of health-related social needs (HRSN) screening programs. Yet, there is little research exploring their perspectives on the documentation and sharing of HRSN data. We aimed to examine parents' preferences regarding how HRSN data are documented and shared. METHODS We conducted semi-structured interviews with parents of hospitalized children participating in an HRSN screening program at a quaternary care children's hospital. Interviews were coded using an inductive and deductive approach to identify emergent themes. RESULTS The 20 interviewed parents were uniformly female with 55% identifying as Black or African American and 20% identifying as Hispanic or Latino. Parents expressed comfort with electronic health record documentation of HRSN data and the use of International Classification of Diseases, 10th Revision Z codes as long as this information was used to provide families with meaningful support. Most parents viewed social workers and medical teams as the most appropriate recipients of HRSN data. Few parents felt comfortable with HRSN data being shared with payors. Parents desired transparency around HRSN data sharing. Many expressed concerns that documentation and sharing of HRSN data could lead to unwanted or unsafe disclosures or result in child welfare referrals. CONCLUSIONS Parents expressed comfort with HRSN documentation and sharing with health care providers, but requested that providers be transparent and respect parental preferences regarding data sharing to mitigate potential harms. When implementing HRSN support programs, health systems and payors should prioritize transparency around documentation and data sharing with families.
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Affiliation(s)
- Zoe Bouchelle
- National Clinician Scholars Program
- Department of Pediatrics
- Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- PolicyLab
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Mishaal Yazdani
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Aditi Vasan
- Department of Pediatrics
- Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- PolicyLab
- Clinical Futures
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Philip Scribano
- Department of Pediatrics
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Judy A. Shea
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Chén C. Kenyon
- Department of Pediatrics
- Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- PolicyLab
- Clinical Futures
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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4
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Nadarajah A, Lazor T, Meserve A, Buchanan F, Birken C, van den Heuvel M. Experiences of Financial Stress and Supports in Caregivers During Pediatric Hospital Admission. Hosp Pediatr 2024; 14:233-241. [PMID: 38495016 DOI: 10.1542/hpeds.2023-007453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVE In Canada and the United States, ∼1 in 5 children live in poverty, contributing to poor health outcomes. Families with children with chronic illness may experience additional financial stress related to hospitalization. This study aimed to capture experiences of financial needs and supports among caregivers with a child admitted to a tertiary care pediatric hospital to inform hospital-based financial services to reduce financial stress in families. METHODS We recruited caregivers of children admitted to the general inpatient ward of an academic pediatric center using purposive sampling with no exclusion criteria. Individual, semistructured, in-depth interviews with participants were conducted. Data collected included socio-demographics, financial needs, and experiences with financial supports. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed on NVivo software using a modified-grounded theory approach and summative content analysis. RESULTS Fifteen caregivers of diverse backgrounds were interviewed, including non-English speakers (n = 4). Three themes and associated subthemes (in parentheses) were identified: (1) financial stress expressed by participants (acute admission-related and chronic financial stress), (2) challenges associated with accessing and utilizing financial supports (caregiver factors, systemic hospital factors, and systemic government factors), and (3) ideas for financial services at the pediatric hospital (services that will provide acute- and chronic financial assistance including education about financial supports and benefits). CONCLUSIONS Our study highlighted acute and chronic financial needs as well as challenges in accessing financial support. Participants were interested in the healthcare system gaining a comprehensive understanding of their financial circumstances and accessing financial services in a hospital setting.
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Affiliation(s)
| | - Tanya Lazor
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Department of Social Work
| | | | | | - Catherine Birken
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Division of Paediatrics
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Meta van den Heuvel
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Division of Paediatrics
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
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5
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Rosenberg J, Sude L. Financial Health Is Health: Addressing Acute and Chronic Financial Stress Across the Care Spectrum. Hosp Pediatr 2024; 14:e212-e214. [PMID: 38495027 PMCID: PMC10965755 DOI: 10.1542/hpeds.2023-007601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Julia Rosenberg
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Leslie Sude
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
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6
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Leary JC, Bagley H, Chan IT, Coates JL, Foote AM, Murzycki JE, Perkins TA, Landrigan CP, Freund KM, Garg A. Evaluating the Impact of a Pediatric Inpatient Social Care Program in a Community Hospital. Hosp Pediatr 2024; 14:225-232. [PMID: 38463007 PMCID: PMC10965758 DOI: 10.1542/hpeds.2023-007487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVES To evaluate the impact of implementing a stakeholder-informed social risk screening and social service referral system in a community hospital setting. METHODS We implemented a stakeholder-informed social care program at a community hospital in April 2022. The evaluation included patients aged 0 to 17 years admitted to the pediatric unit between April 2021 and March 2022 (1 year preimplementation) and between April 2022 and March 2023 (1 year postimplementation). For a random subset of 232 preimplementation and 218 postimplementation patients, we performed manual data extraction, documenting program process measures and preliminary effectiveness outcomes. We used χ square and Wilcoxon rank tests to compare outcomes between the preimplementation and postimplementation groups. Multivariable logistic regression was used to assess the preliminary effectiveness of the social care program in identifying social risks. RESULTS Screening rates were higher in the postimplementation group for nearly all social domains. Compared with preimplementation, the postimplementation group had higher rates of social risks identified (17.4% vs 7.8% [P < .01]: adjusted odds ratio 2.9 [95% confidence interval 1.5-5.5]) on multivariate testing. Social work consults were completed more frequently and earlier for the postimplementation group (13.8.% vs 5.6% [P < .01]) and median (19 hours vs 25 hours [P = .03]), respectively. Rates of communication of social risks in discharge summaries were higher in the postimplementation group (46.8% vs 8.2% [P < .001]). CONCLUSIONS The implementation of a stakeholder-informed social care program within a community hospital setting led to the increased identification of social risks and social work consultations and improved timeliness of social work consultations and written communication of social risks in discharge summaries for primary care providers.
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Affiliation(s)
- Jana C Leary
- Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital
| | - Hannah Bagley
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Iris T Chan
- Tufts University School of Medicine, Boston, Massachusetts
| | | | - Amy M Foote
- Department of Pediatrics, Lowell General Hospital, Lowell, Massachusetts
| | - Jennifer E Murzycki
- Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital
| | - Tiffany A Perkins
- Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital
| | - Christopher P Landrigan
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Karen M Freund
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Arvin Garg
- Department of Pediatrics, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts
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Wadhwani SI, Kruse G, Squires J, Ebel N, Gupta N, Campbell K, Hsu E, Zielsdorf S, Vittorio J, Desai DM, Bucuvalas JC, Gottlieb LM, Lai JC. Caregiver Perceptions of Social Risk Screening in Pediatric Liver Transplantation: From the Multicenter SOCIAL-Tx Study. Transplantation 2024; 108:940-946. [PMID: 37831642 PMCID: PMC10963151 DOI: 10.1097/tp.0000000000004835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
BACKGROUND The social determinants of health contribute to adverse post-liver transplant outcomes. Identifying unmet social risks may enable transplant teams to improve long-term outcomes for at-risk children. However, providers may feel uncomfortable asking about household-level social risks in the posttransplant period because they might make their patients/families uncomfortable. METHODS We conducted a mixed-methods analysis of caregiver participants (ie, parents/guardians of pediatric liver transplant recipients) in the Social and Contextual Impact on Children Undergoing Liver Transplantation study to assess their perceptions of provider-based social risk screening. Participants (N = 109) completed a 20-min social determinants of health questionnaire that included questions on the acceptability of being asked intimate social risk questions. A subset of participants (N = 37) engaged in an in-depth qualitative interview to share their perceptions of social risk screening. RESULTS Of 109 participants across 9 US transplant centers, 60% reported financial strain and 30% reported at least 1 material economic hardship (eg, food insecurity, housing instability). Overall, 65% of respondents reported it very or somewhat appropriate and 25% reported being neutral to being screened for social risks in a liver transplant setting. In qualitative analyses, participants reported trust in the providers and a clear understanding of the intention of the screening as prerequisites for liver transplant teams to perform social risk screening. CONCLUSIONS Only a small minority of caregivers found social risk screening unacceptable. Pediatric liver transplant programs should implement routine social risk screening and prioritize the patient and family voices when establishing a screening program to ensure successful implementation.
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Affiliation(s)
| | - Gina Kruse
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - James Squires
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | | | - Evelyn Hsu
- Seattle Children’s Hospital, Seattle, WA
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8
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Zanzoul S, Strickland PO, Mendelsohn AL, Malke K, Bator A, Hemler J, Jimenez ME. Stress and Infant Media Exposure During COVID-19: A Study Among Latino Families. J Dev Behav Pediatr 2024; 45:e14-e20. [PMID: 38127845 PMCID: PMC10922283 DOI: 10.1097/dbp.0000000000001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The COVID-19 pandemic disproportionately harmed Latino families; however, its effects on their stress and media routines remain understudied. We examined economic and parenting stress patterns during the COVID-19 pandemic and estimated associations between these forms of stress and nonadherence to American Academy of Pediatrics (AAP) infant media exposure recommendations among Latino families. We also explored how nonadherence with AAP recommendations varied with COVID-19 cases. METHODS We analyzed baseline data from an ongoing clinical trial recruiting low-income Latino parent-infant dyads. Nonadherence with AAP media exposure recommendations (ScreenQ) and economic and parent stress were measured using parent reports. Additional variables included epidemiological data on COVID-19 cases. Linear models examined associations between the pandemic and both stress variables as well as between stress and ScreenQ. Using locally weighted scatterplot smoothing curve fitting, the rise and fall of NJ COVID-19 cases were overlayed with ScreenQ scores over time to visualize and explore trends. RESULTS All parents identified as Latino (62.6% unemployed, 91.5% limited English proficiency). Mean infant age was 8.2 months. Parent stress increased over time during the COVID-19 pandemic (r = 0.13, p = 0.0369). After covariate adjustment, economic and parent stress were associated with increased nonadherence with AAP recommendations (standardized beta = 0.16, 95% confidence interval [CI], 0.03-0.29; standardized beta = 0.18, 95% CI, 0.04-0.31, respectively). Nonadherence to media exposure recommendations seemed to track with rises in the number of COVID-19 cases with a lag of 7 days. CONCLUSION Parent and economic stress were associated with nonadherence to infant media exposure recommendations among Latino families. These findings highlight the need for practitioners to support families from under-resourced communities and to promote healthy media routines.
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Affiliation(s)
| | - Pamela Ohman Strickland
- Rutgers School of Public Health, Piscataway
- Department of Family Medicine and Community Health, New Brunswick, NJ
| | - Alan L. Mendelsohn
- Department of Pediatrics, New York University School of Medicine/Bellevue Hospital Center, New York, New York
| | | | - Alicja Bator
- Department of Family Medicine and Community Health, New Brunswick, NJ
| | - Jennifer Hemler
- Department of Family Medicine and Community Health, New Brunswick, NJ
| | - Manuel E. Jimenez
- The Department of Pediatrics, New Brunswick, NJ
- Department of Family Medicine and Community Health, New Brunswick, NJ
- Child Health Institute of New Jersey, New Brunswick, NJ
- Boggs Center for Developmental Disabilities, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
- Children’s Specialized Hospital, New Brunswick, NJ
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9
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Shah AN, Goodman E, Lawler J, Bosse D, Rubeiz C, Beck AF, Parsons A. Inpatient Screening of Parental Adversity and Strengths. Hosp Pediatr 2023; 13:922-930. [PMID: 37724391 DOI: 10.1542/hpeds.2022-007111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Social adversities, including health-harming social risks and adverse childhood experiences, contribute to poor outcomes after hospital discharge. Screening for social adversities is increasingly pursued in outpatient settings. Identifying and addressing such adversities has been linked to improved child outcomes. Screening for social adversities and strengths in the inpatient setting may contribute to better transitions from hospital to home. Our goal was twofold: 1. to use qualitative methods to understand parent perspectives around screening tools for potential use in inpatient settings; and 2. to develop a family-friendly inpatient screening tool for social adversity. METHODS We used in-depth, cognitive qualitative interviews with parents to elicit their views on existing screening tools covering social adversities and strengths. We partnered with a local nonprofit to recruit parents who recently had a child hospitalized or visited the emergency department. There were 2 phases of the study. In the first phase, we used qualitative methods to develop a screening prototype. In the second phase, we obtained feedback on the prototype. RESULTS We interviewed 18 parents who identified 3 major themes around screening: 1. factors that promote parents to respond openly and honestly during screening; 2. feedback about screening tools and the prototype; and 3. screening should include resources. CONCLUSIONS Social adversity routinely affects children; hospitalization is an important time to screen families for adversity and potential coexisting strengths. Using qualitative parent feedback, we developed the family friendly Collaborate to Optimize Parent Experience screening tool.
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Affiliation(s)
- Anita N Shah
- Divisions of Hospital Medicine
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
| | | | - Julianne Lawler
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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10
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Luke MJ, Vasan A. From Incentives to Outcomes: A Framework for Implementing and Evaluating Social Needs Interventions. Hosp Pediatr 2023; 13:e295-e298. [PMID: 37718960 DOI: 10.1542/hpeds.2023-007375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
- Michael J Luke
- PolicyLab and Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aditi Vasan
- PolicyLab and Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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11
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Leary JC, Pantell M, Garg A. Elevating Parents' Voices in Designing and Implementing Pediatric Inpatient Social Care Systems. Hosp Pediatr 2023; 13:e213-e215. [PMID: 37483136 PMCID: PMC10375028 DOI: 10.1542/hpeds.2023-007326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Affiliation(s)
- Jana C. Leary
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
- Section of Hospital Medicine, Department of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Matthew Pantell
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
- Center for Health and Community, San Francisco, California
| | - Arvin Garg
- Child Health Equity Center, Department of Pediatrics, UMass Chan Medical School, UMass Memorial Children’s Medical Center, Worcester, Massachusetts
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12
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Abstract
PURPOSE OF REVIEW This article outlines updates in social determinants of health (SDOH) screening practices in pediatric healthcare and community settings. The transition to value-based care and the COVID-19 pandemic have both had significant impacts on screening practices, with implications for providers, communities, and policymakers. RECENT FINDINGS The COVID-19 pandemic has exacerbated social needs for vulnerable patients and families, resulting in increased recognition by healthcare teams through screening. Policy frameworks like value-based care that aim to deliver whole-child care in the community are reorienting the logistics of screening, including screening in acute-care settings and community settings. Recent studies on family and provider perspectives should be integrated into screening practices. SUMMARY Despite significant advances in and expansion of SDOH screening in the pediatric healthcare setting, there remain limitations and future research needs. More data is needed to evaluate social need screeners and interventions, and determine how healthcare systems, communities, and states can spread and scale such interventions based on outcomes and value measurements. Population-based social indices have the potential to augment individual patient screening, but this remains a future research need.
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Affiliation(s)
- Abby L Nerlinger
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
- Nemours Children's Hospital, Delaware, Wilmington, Delaware
| | - Gift Kopsombut
- University of Central Florida
- Nemours Children's Hospital, Florida, Orlando, Florida, USA
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13
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Bouchelle Z, Vasan A. Promoting Health Equity Through Family-Centered Social Needs Screening and Intervention in the Inpatient Setting. Hosp Pediatr 2022; 12:e275-e277. [PMID: 35843956 PMCID: PMC9390831 DOI: 10.1542/hpeds.2022-006725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Zoe Bouchelle
- National Clinician Scholars Program, Perelman School of Medicine.,Department of Pediatrics, Perelman School of Medicine.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.,PolicyLab and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Aditi Vasan
- Department of Pediatrics, Perelman School of Medicine.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.,PolicyLab and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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