656 - Caregiver preference for resource-based versus validated screening for social drivers of health in an outpatient clinical setting

Poster Number: 656
Publication Number: 656.317

Hans B. Kersten, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Hope Vega, Drexel University College of Medicine, Philadelphia, PA, United States; Kelly A.. Courts, Drexel University, Philadelphia, PA, United States; Ann Cushwa, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Emily A. Spengler, Drexel University College of Medicine, Swarthmore, PA, United States

Background: Social drivers of health (SDH), such as poverty, food insecurity, unsafe environments, and housing instability have been linked to adverse health outcomes for children and their families. The American Academy of Pediatrics (AAP) recommends screening for health drivers during all patient encounters to protect children’s health. Many providers use validated screening questionnaires to assess families’ needs, but there is little known about caregiver perspectives on screening and how to best screen in a patient centered care model.

Objective: To assess caregiver attitudes about screening for SDH and the resources they receive. 

Design/Methods: A resource-based screener was developed to allow caregivers to select what resources are desired rather than reporting their needs. This screener replaced a validated screener. A 13-question caregiver survey was created to assess caregiver attitudes about screening and screening preferences in a variety of outpatient clinical settings. The survey was adapted from a larger survey to assess clinical services of a specialized clinic that cares for families with social complexity (e.g., foster care placement, parent with substance use disorder). Questions domains included provider understanding of caregiver SDH, caregiver preference for the way they would like to discuss SDH, if providers assess for resilience factors, and open-ended questions addressing SDH. A research associate approached families in four clinical settings to complete the survey. Families were surveyed, the results were recorded, compiled, de-identified, and analyzed.

Results: There were 40 families who completed the survey in several outpatient clinics. A large majority of caregivers (78.9%) remembered providers asking them about SDH, 77.5% of caregivers agreed the medical team understood the stressors in their life, 67.5% of families want providers to ask about SDH, 67.5% want resources from the provider, and 80% of caregivers felt the medical team helped them with SDH in their life. Caregivers reported that 70% of providers asked about their strengths. When families were asked about how they would like to be asked about health determinants 51% always wanted resources, 31% preferred a resource-based screener, and 10% preferred a validated screener.

Conclusion(s): These findings underscore the perceived value of SDH screening and resource referral among caregivers in outpatient clinics. The results may indicate a need to streamline the way caregivers are screened for and provided with resources to mitigate SDH and promote health equity.