The program has also provided social determinants of health screenings for 8,400 children and their families.
A New York City program for addressing the social determinants of health in pediatric care settings has helped to connect over 1,500 families with social and community health services, according to the United Health Fund.
The Partnership for Early Childhood Development (PECD) initiative, managed by UHF and in its second year of operation, charges pediatricians at eight New York hospital organizations to screen children and their families for key social determinants of health. Leaning on a network of community health partners, these providers help connect families to different resources that fill unmet basic needs, like nutritious food or home heating.
This past year, which UHF said was the program’s Phase 2, was successful.
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“We started PECD to address those factors outside the clinic walls that can adversely affect a child’s health and educational attainment,” Suzanne Brundage, director of UHF’s Children’s Health Initiative and author of the Phase 2 report, said in a statement. “Over the first two years of the project, the primary care teams and their community partners have learned much about how to create and sustain a system of care for families that can truly make a meaningful, long-term positive impact on the lives of children.”
This past year, PECD clinicians screened 8,400 children and families helped meet the needs of 1,500, identifying housing and utilities, food insecurity, adult education, transportation, and childcare as top challenges.
This is on top of the 12,000 children and families PECD clinicians have screened since program inception in 2017.
Of the 8,400 families who received SDOH screenings in the 2019 program, 46 percent presented with at least one social need. Clinicians were able to refer 2,000 of these families to some sort of social support within their networks, with 1,500 of them accessing that support. The other 500 said they received help through other networks.
With that success, UHF has announced the Phase 3 of the PECD initiative, which aims to build on prior progress in Phases 1 and 2.
During the first two phases, program participants work to build out the community health partnerships that are essential for addressing social determinants of health in children and families. During this final stage of the program, participants will work to assess the effectiveness of those community partnerships and interventions.
“This project is significant because it not only screens children for social needs but ensures that they and their families get the services to address those needs, thanks to the robust partnerships that have been built between health systems and community organizations” Brundage said ahead of this next step in the program. “An evaluation of PECD will contribute significantly to understanding how health care providers can effectively address non-medical factors that influence health.”
Work to address the social determinants of health in pediatrics have come to the forefront in healthcare. In 2016, the American College of Pediatrics recommended all children and their families be screened for the social determinants of health.
And while these latest results from UHF show that an SDOH screening can result in a community health intervention, challenges remain for pediatric providers.
Actually carrying out the screening serves as one main issue. A 2019 report from UHF and Public Agenda revealed that trust between patients and providers can considerably hinder pediatric SDOH screenings because parents do not always feel comfortable disclosing their social needs.
A series of focus groups with 88 parents living in low-income areas of New York City revealed that although most parents agree the social determinants of health have an impact on wellness, they don’t always want to discuss these points with providers.
Parents are wary of disclosing issues about parental custody, neighborhood safety, school bullying, and environmental hazards. Additionally, parents are fearful of discussing their own mental health with the pediatrician.
By and large, this is because parents are nervous any issues might tip off a call to social services and custody over their children may be put in jeopardy. Parents have also voiced concerns that providers cannot actually connect them with resources to address social needs.
Providers need to approach screenings with empathy, using their communication skills to engender trust with parents. Being up front about the resources available to the provider and the issues that would require a report from the provider is also helpful, the report authors said.
“Parents bring their young children to the pediatrician up to 11 times within the first two years of life, and each of these visits offers an opportunity to identify unmet social needs and coordinate care with community-based services,” Brundage said of the report. “As screening for social determinants of health becomes more common in pediatric practices, qualitative and quantitative research can help us understand and improve how parents experience these screenings.”
Source: PatientEngagement HIT