PMCID: PMC4712125; DOI: 10.1016/j.acap.2015.06.001
OBJECTIVE: It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting.
METHODS: During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use.
RESULTS: A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months).
CONCLUSIONS: A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs.
Adult; Behavior Therapy; Domestic Violence; Emigration and Immigration; Female; Food Supply; Health Status Disparities; Housing; Humans; Insurance, Health; Internship and Residency; Legal Guardians; Male; Mass Screening; Needs Assessment; Pediatrics; Poverty; Referral and Consultation; Social Determinants of Health; Socioeconomic Factors
Social determinants of health; Family Characteristics
Colvin, J. D., Bettenhausen, J. L., Anderson-Carpenter, K. D., Collie-Akers, V., Plencner, L., Krager, M., Nelson, B., Donnelly, S., Simmons, J., Higinio, V., Chung, P. J. Multiple Behavior Change Intervention to Improve Detection of Unmet Social Needs and Resulting Resource Referrals. Acad Pediatr 16, 168-174 (2016).