Clinical Approaches to Reducing Material Hardship Due to Poverty: Social Risks/Needs Identification and Interventions

Garg, Arvin; Brochier, Annelise; Messmer, Emily; Fiori, Kevin P.

doi:10.1016/j.acap.2021.02.007

Cited by 32 publications

(13 citation statements)

References 28 publications

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“…SDOH were identified as the overarching theme of Healthy People 2030, which sets data-driven national objectives to improve health and well being over the next decade. The American Academy of Pediatrics recommends screening for SDOH in clinical encounters [2,3 ▪ ,4] to improve patient-centered health outcomes. Screening practices also rely on implementation of interventions, such as connections to community resources, to address positive screens [5].…”

Section: Introductionmentioning

confidence: 99%

“…This article will: provide an update on current SDOH screening practices; discuss how the COVID-19 pandemic has impacted SDOH screening; summarize recent studies on provider and patient perspectives surrounding screening; and discuss the clinical and public health implications of recent studies on SDOH screening and interventions as they relate to value-based care and return on investment (ROI), with a focus on research gaps and future needs. Whereas the authors recognize the distinction between SDOH, social risk, and social needs, we will use SDOH screening as a general term, highlighting discussions that describe community-focused social risk or patient-centered social needs [3 ▪ ,8]…”

Section: Introductionmentioning

confidence: 99%

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Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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Purpose of reviewThis article outlines updates in social determinants of health (SDOH) screening practices in pediatric healthcare and community settings. The transition to value-based care and the COVID-19 pandemic have both had significant impacts on screening practices, with implications for providers, communities, and policymakers.Recent findingsThe COVID-19 pandemic has exacerbated social needs for vulnerable patients and families, resulting in increased recognition by healthcare teams through screening. Policy frameworks like value-based care that aim to deliver whole-child care in the community are reorienting the logistics of screening, including screening in acute-care settings and community settings. Recent studies on family and provider perspectives should be integrated into screening practices.SummaryDespite significant advances in and expansion of SDOH screening in the pediatric healthcare setting, there remain limitations and future research needs. More data is needed to evaluate social need screeners and interventions, and determine how healthcare systems, communities, and states can spread and scale such interventions based on outcomes and value measurements. Population-based social indices have the potential to augment individual patient screening, but this remains a future research need.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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“…Although PPC is often posited as a panacea, we observe in this study that poverty‐related differences in care may persist, even when access to palliative care is sustained. A critical area of inquiry for future research and quality improvement initiatives is whether poverty‐targeted PPC interventions for children with cancer may mitigate observed disparities in end‐of‐life care 47,48 …”

Section: Discussionmentioning

confidence: 99%

“…A critical area of inquiry for future research and quality improvement initiatives is whether poverty-targeted PPC interventions for children with cancer may mitigate observed disparities in end-of-life care. 47,48 Among the key limitations of this study was a small sample size, despite data from seven quaternary institutions. We were therefore unable to conduct multivariable analyses to identify factors associated with higher quality end-of-life care.…”

Section: F I G U R Ementioning

confidence: 96%

End‐of‐life care quality for children with cancer who receive palliative care

Ananth

Lindsay

Nye

et al. 2022

Pediatric Blood & Cancer

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Background:We previously developed stakeholder-informed quality measures to assess end-of-life care quality for children with cancer. We sought to implement a subset of these quality measures in the multi-center pediatric palliative care (PPC) database. Procedures:We utilized the Shared Data and Research database to evaluate the proportion of childhood cancer decedents from 2017-2021 who, in the last 30 days of life, avoided chemotherapy, mechanical ventilation, intensive care unit admissions, and > 1 hospital admission; were enrolled in hospice services, and reported ≤ 2 highly distressing symptoms. We then explored patient factors associated with the attainment of quality benchmarks.Results: Across 79 decedents, 82% met ≥ 4 quality benchmarks. Most (76%)

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“…The National Academies of Sciences, Engineering, and Medicine, Centers for Medicare & Medicaid Services, and other professional organizations and payers have all called for improved integration of social care into medical care (5-9). While systematic screening for social risks and interventions to address social needs are increasingly being implemented in health care settings, there is limited evidence regarding best practices (10)(11)(12). As the nation's largest integrated healthcare system with a robust network of embedded social services, the Department of Veterans Affairs health system (VA) is uniquely positioned to address social needs.…”

Section: Introductionmentioning

confidence: 99%

Adaptation of a social risk screening and referral initiative across clinical populations, settings, and contexts in the Department of Veterans Affairs Health System

Cohen

Russell

Elwy

et al. 2023

Front. Health Serv.

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Identifying and addressing social risks and social needs in healthcare settings is an important step towards achieving health equity. Assessing Circumstances and Offering Resources for Needs (ACORN) is a Department of Veterans Affairs (VA) social risk screening and referral model that aims to systematically identify and address social needs. Since initial piloting in 2018, our team has collaborated with clinical and operations partners to implement ACORN across multiple VA clinical settings while adapting and tailoring the initiative to meet the needs of different populations, specialties, and individuals administering screening. Given ACORN's complexity as a growing initiative with multiple partners and frequent real-time modifications within a large national healthcare system, we recognized a need to systematically document the rationale and process of adaptations over time. We looked to three implementation frameworks—RE-AIM, the Adaptome, and FRAME—to describe the rationale for adaptations, the nature of and context within which adaptations were made, and the details of each adaptation. In this manuscript, we uniquely interweave these three frameworks to document adaptations to ACORN across diverse VA clinical settings, with a focus on how adaptations support the promotion of heath equity in the Veteran population.

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Clinical Approaches to Reducing Material Hardship Due to Poverty: Social Risks/Needs Identification and Interventions

Cited by 32 publications

References 28 publications

Social determinants of health screening in pediatric healthcare settings

Social determinants of health screening in pediatric healthcare settings

End‐of‐life care quality for children with cancer who receive palliative care

Adaptation of a social risk screening and referral initiative across clinical populations, settings, and contexts in the Department of Veterans Affairs Health System

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