Objectives To better understand how social pediatric initiatives (SPIs) enact equitable, integrated, embedded approaches with high-needs children and families while facilitating proportionate distribution of health resources. Methods The realist review method incorporated the following steps: (1) identifying the review question, (2) formulating the initial theory, (3) searching for primary studies, (4) selecting and appraising study quality, (5) synthesizing relevant data and (6) refining the theory. Results Our analysis identified four consistent patterns of care that may be effective in social pediatrics: (1) horizontal partnerships based on willingness to share status and power; (2) bridged trust initiated through previously established third party relationships; (3) knowledge support increasing providers’ confidence and skills for engaging community; and (4) increasing vulnerable families’ self-reliance through empowerment strategies. Conclusions This research is unique because it focused on “how” outcomes are achieved and offers insight into the knowledge, skills and philosophical orientation clinicians need to effectively deliver care in SPIs. Research insights offer guidance for organizational leaders with a mandate to address child and youth health inequities and may be applicable to other health initiatives.

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In the Reconstruction period, Black religion and politics intersected and fostered ideas about black interdependent independence in predominantly white churches. We see this form of black religious politics exemplified in the experiences and ideas of the Reverend George Freeman Bragg Jr., a Black Episcopal priest who was educated at the Branch Theological School (BTS) in Petersburg, Virginia. It was upon the foundation of Bragg's experiences at the BTS, established as a racially segregated alternative to the Protestant Episcopal Theological Seminary (in Alexandria, Virginia), and in the Readjuster Movement (a biracial political coalition that controlled Virginia's legislature from 1879–1885), that he wrote histories of Black people in the Episcopal Church, histories that extolled black leadership, the need for (white) economic support for but also autonomous action of black churches and black leaders, and the efficacy of the Episcopal Church as a political training ground for black church members. Bragg's case both demonstrates how broadening the definitions of black religion reconfigures studies of religion, reconstruction, and Blackness, and expands our notions of Black political critique as deriving from more than the familiar binaries of protest and accommodation.

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