Marcia A Morgenlander1, Hollyce Tyrrell2, Lynn C Garfunkel3, Janet R Serwint4, Michael J Steiner5, Samantha Schilling5. 1. Department of Family Medicine (MA Morgenlander). Electronic address: Marcia_Morgenlander@med.unc.edu. 2. Academic Pediatric Association (H Tyrrell), McLean, Va. 3. Department of Pediatrics (LC Garfunkel), University of Rochester School of Medicine and Rochester Regional Health, Rochester, NY. 4. Department of Pediatrics (JR Serwint), The Johns Hopkins University School of Medicine, Baltimore, Md. 5. Department of Pediatrics (MJ Steiner and S Schilling), University of North Carolina at Chapel Hill.
Abstract
OBJECTIVE: Describe current practices in systematic screening for social determinants of health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET). METHODS: CORNET clinic directors were surveyed on demographics, barriers to screening, and screening practices for 15 SDH, including the screen source, timing of screening, process of administering the screen, and personnel involved in screening. Incidence rate ratios were tabulated to investigate relationships among screening practices and clinic staff composition. RESULTS: Clinic response rate was 41% (65/158). Clinics reported screening for between 0 and 15 SDH (median, 7). Maternal depression (86%), child educational problems (84%), and food insecurity (71%) were the items most commonly screened. Immigration status (17%), parental health literacy (19%), and parental incarceration (21%) were least commonly screened. Within 3 years, clinics plan to screen for 25% of SDH not currently being screened. Barriers to screening included lack of time (63%), resources (50%), and training (46%). CONCLUSIONS: Screening for SDH in our study population of CORNET clinics is common but has not been universally implemented. Screening practices are variable and reflect the complex nature of screening, including the heterogeneity of the patient populations, the clinic staff composition, and the SDH encountered.
OBJECTIVE: Describe current practices in systematic screening for social determinants of health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET). METHODS: CORNET clinic directors were surveyed on demographics, barriers to screening, and screening practices for 15 SDH, including the screen source, timing of screening, process of administering the screen, and personnel involved in screening. Incidence rate ratios were tabulated to investigate relationships among screening practices and clinic staff composition. RESULTS: Clinic response rate was 41% (65/158). Clinics reported screening for between 0 and 15 SDH (median, 7). Maternal depression (86%), child educational problems (84%), and food insecurity (71%) were the items most commonly screened. Immigration status (17%), parental health literacy (19%), and parental incarceration (21%) were least commonly screened. Within 3 years, clinics plan to screen for 25% of SDH not currently being screened. Barriers to screening included lack of time (63%), resources (50%), and training (46%). CONCLUSIONS: Screening for SDH in our study population of CORNET clinics is common but has not been universally implemented. Screening practices are variable and reflect the complex nature of screening, including the heterogeneity of the patient populations, the clinic staff composition, and the SDH encountered.
Authors: Jana C Leary; Leena Rijhwani; Natalie M Bettez; Amy M LeClair; Anays Murillo; Maria Rodriguez Berrios; Arvin Garg; Karen M Freund Journal: Acad Pediatr Date: 2021-09-30 Impact factor: 3.107
Authors: Andrew F Beck; Erika M Edwards; Jeffrey D Horbar; Elizabeth A Howell; Marie C McCormick; DeWayne M Pursley Journal: Pediatr Res Date: 2019-07-29 Impact factor: 3.756