Academic pediatrics · 2025
Potential Pediatric Health Care Consequences of Not Getting Help for Disclosed Social Needs.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Garg Arvin, Brochier Annelise, Tripodis Yorghos, BarahonaPaz Katherine, Drainoni Mari-Lynn
Аннотация
OBJECTIVE: To assess the association between double loss (disclosure of social needs without receiving assistance) with low-income children's health care utilization outcomes.
METHODS: Data were from a hybrid effectiveness-implementation trial evaluating a social needs screening and referral intervention (WE CARE) implemented in 3 community health centers. WE CARE included 3 components: 1) social risk/need screener assessing parental desire for assistance with unmet social needs, 2) resource information referrals, and 3) patient navigator. A family was defined as experiencing double loss if, at their child's well-child visits (WCVs) from birth to age 3, there was at least 1 scanned screener with a request for help without a referral documented in the electronic health record. Multiple logistic regression was used to compare rates of double loss with adherence to WCV and immunization schedules.
RESULTS: Among the cohort of children (n = 403), 43.4% were Black, 21.1% Latino/a/e, and 13.9% Asian. Overall, 40.5% of parents experienced double loss. Families who experienced double loss had fewer reported social needs (0.3 vs 1.5, P < 0.001). Children whose families' experienced double loss had significantly lower WCV adherence ratios in the first 3 years of life (0.40 vs 0.43, P < 0.0001). Similarly, the immunization adherence ratio for children was significantly lower for families who experienced double loss than for families who did not experience double loss (0.79 vs 0.92, P < 0.0001).
CONCLUSIONS: Families experienced double loss had significantly lower WCV and immunization adherence. These exploratory findings carry significant implications for pediatric practice, guidelines, and health policy.
METHODS: Data were from a hybrid effectiveness-implementation trial evaluating a social needs screening and referral intervention (WE CARE) implemented in 3 community health centers. WE CARE included 3 components: 1) social risk/need screener assessing parental desire for assistance with unmet social needs, 2) resource information referrals, and 3) patient navigator. A family was defined as experiencing double loss if, at their child's well-child visits (WCVs) from birth to age 3, there was at least 1 scanned screener with a request for help without a referral documented in the electronic health record. Multiple logistic regression was used to compare rates of double loss with adherence to WCV and immunization schedules.
RESULTS: Among the cohort of children (n = 403), 43.4% were Black, 21.1% Latino/a/e, and 13.9% Asian. Overall, 40.5% of parents experienced double loss. Families who experienced double loss had fewer reported social needs (0.3 vs 1.5, P < 0.001). Children whose families' experienced double loss had significantly lower WCV adherence ratios in the first 3 years of life (0.40 vs 0.43, P < 0.0001). Similarly, the immunization adherence ratio for children was significantly lower for families who experienced double loss than for families who did not experience double loss (0.79 vs 0.92, P < 0.0001).
CONCLUSIONS: Families experienced double loss had significantly lower WCV and immunization adherence. These exploratory findings carry significant implications for pediatric practice, guidelines, and health policy.