Kavitha Selvaraj1, Melissa J Ruiz2, Jean Aschkenasy3, Jan D Chang4, Anthony Heard4, Mark Minier4, Amanda D Osta5, Melissa Pavelack6, Monica Samelson7, Alan Schwartz8, Margaret A Scotellaro9, Alisa Seo-Lee10, Stan Sonu10, Audrey Stillerman11, Barbara W Bayldon12. 1. Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: kavitha.selvaraj@gmail.com. 2. Pediatrics, Ventura County Medical Center, Ventura, CA. 3. Pediatrics, Rush University Children's Hospital, Chicago, IL; Behavioral Sciences, Rush University Children's Hospital, Chicago, IL; Pediatrics, John H. Stroger Jr Hospital of Cook County, Chicago, IL. 4. Pediatrics, University of Illinois at Chicago, Chicago, IL. 5. Pediatrics, University of Illinois at Chicago, Chicago, IL; Medicine, University of Illinois at Chicago, Chicago, IL. 6. Pediatrics, Advocate Children's Hospital, Park Ridge, IL. 7. Psychiatry, University of Washington Medical Center, Seattle, WA. 8. Pediatrics, University of Illinois at Chicago, Chicago, IL; Medical Education, University of Illinois at Chicago, Chicago, IL. 9. Pediatrics, Rush University Children's Hospital, Chicago, IL. 10. Pediatrics, John H. Stroger Jr Hospital of Cook County, Chicago, IL; Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL. 11. Family Medicine, University of Illinois at Chicago, Chicago, IL. 12. Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Abstract
OBJECTIVES: To determine the prevalence of and demographic characteristics associated with toxic stress risk factors by universal screening, the impact of screening on referral rates to community resources, and the feasibility and acceptability of screening in a medical home setting. STUDY DESIGN: We developed the Addressing Social Key Questions for Health Questionnaire, a 13-question screen of adverse childhood experiences (ACEs) and unmet social needs. Parents/guardians of children 0-17 years of age received this questionnaire at well-child visits at 4 academic clinics from August 1, 2016 to February 28, 2017. Providers reviewed the tool and referred to community resources as needed. A subset of families completed demographic and satisfaction surveys. Prevalence of ACEs and unmet social needs, community referral rates at 1 site with available data, and family acceptability data were collected. Analyses included frequency distributions, χ2 tests, and Poisson regression. RESULTS: Of 2569 families completing an Addressing Social Key Questions for Health Questionnaire, 49% reported ≥1 stressor; 6% had ≥1 ACE; 47% had ≥1 unmet social need. At 1 site, community referral rates increased from 2.0% to 13.3% (P < .0001) after screening implementation. Risk factors for having a stressor include male sex and African American or Hispanic race. 86% of 446 families want clinics to continue screening. CONCLUSIONS: Universal screening for toxic stress risk factors in pediatric primary care improved identification and management of family needs. Screening was feasible and acceptable to families. Prevalence of unmet social needs but not ACEs was comparable with prior studies. Further evaluation and modification of the screening protocol is needed to increase screening and identification.
OBJECTIVES: To determine the prevalence of and demographic characteristics associated with toxic stress risk factors by universal screening, the impact of screening on referral rates to community resources, and the feasibility and acceptability of screening in a medical home setting. STUDY DESIGN: We developed the Addressing Social Key Questions for Health Questionnaire, a 13-question screen of adverse childhood experiences (ACEs) and unmet social needs. Parents/guardians of children 0-17 years of age received this questionnaire at well-child visits at 4 academic clinics from August 1, 2016 to February 28, 2017. Providers reviewed the tool and referred to community resources as needed. A subset of families completed demographic and satisfaction surveys. Prevalence of ACEs and unmet social needs, community referral rates at 1 site with available data, and family acceptability data were collected. Analyses included frequency distributions, χ2 tests, and Poisson regression. RESULTS: Of 2569 families completing an Addressing Social Key Questions for Health Questionnaire, 49% reported ≥1 stressor; 6% had ≥1 ACE; 47% had ≥1 unmet social need. At 1 site, community referral rates increased from 2.0% to 13.3% (P < .0001) after screening implementation. Risk factors for having a stressor include male sex and African American or Hispanic race. 86% of 446 families want clinics to continue screening. CONCLUSIONS: Universal screening for toxic stress risk factors in pediatric primary care improved identification and management of family needs. Screening was feasible and acceptable to families. Prevalence of unmet social needs but not ACEs was comparable with prior studies. Further evaluation and modification of the screening protocol is needed to increase screening and identification.
Authors: Erin McCune; Jennifer Wojtowicz; William Adams; Garry Sigman; Collette Williams; Pauline Ahn; Ashley Ciliberti; Lena Hatchett; Julie O'Keefe Journal: J Prim Care Community Health Date: 2021 Jan-Dec
Authors: Emilia H De Marchis; Danielle Hessler; Caroline Fichtenberg; Nancy Adler; Elena Byhoff; Alicia J Cohen; Kelly M Doran; Stephanie Ettinger de Cuba; Eric W Fleegler; Cara C Lewis; Stacy Tessler Lindau; Elizabeth L Tung; Amy G Huebschmann; Aric A Prather; Maria Raven; Nicholas Gavin; Susan Jepson; Wendy Johnson; Eduardo Ochoa; Ardis L Olson; Megan Sandel; Richard S Sheward; Laura M Gottlieb Journal: Am J Prev Med Date: 2019-12 Impact factor: 5.043