Community Health Worker Intervention to Address Social Determinants of Health for Children Hospitalized With Asthma

Schechter, Sarah; Lakhaney, Divya; Peretz, Patricia; Matiz, Luz Adriana

doi:10.1542/hpeds.2021-005903

Cited by 17 publications

(10 citation statements)

References 27 publications

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“…Electronic communications can be used or built into the electronic health record (EHR) to augment traditional methods [10 ▪ ]. Personnel such as care navigators, social workers, community health workers [58 ▪ ,59], and case managers are trained to provide more in-depth assistance.…”

Section: Connection To Community Resources and Closed-loop Communicationmentioning

confidence: 99%

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: Connection To Community Resources and Closed-loop Communicationmentioning

confidence: 99%

Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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“…The CHW intervention content addressed education, health knowledge, and self-efficacy; the delivery was informed by social cognitive theory, which emphasized behavior change. Other CHW interventions have been designed to more heavily address psychosocial stress or prioritize social determinants of health over disease states [ 16 , 36 , 37 ]. Our CHWs addressed psychosocial stressors relative to oral health behaviors.…”

Section: Discussionmentioning

confidence: 99%

Oral community health worker-led interventions in households with average levels of psychosocial factors

Lee

Avenetti

Edomwande

et al. 2022

Front. Oral. Health

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IntroductionHousehold-level psychosocial stress levels have been linked to child tooth brushing behaviors. Community health worker (CHW) interventions that target psychosocial factors in high-risk communities have been associated with changes in health behaviors.AimObserve changes in psychosocial factors over time and an association between psychosocial factors and CHW intervention dose amongst urban Chicago families.Patients and methodsParticipants (N = 420 families) were recruited from 10 community clinics and 10 Women, Infants, or Children (WIC) centers in Cook County, Illinois to participate in a clinical trial. Research staff collected participant-reported psychosocial factors (family functioning and caregiver reports of depression, anxiety, support, and social functioning) and characteristics of CHW-led oral health intervention visits (number, content, child engagement) at 0, 6, and 12 months. CHWs recorded field observations after home visits on household environment, social circumstances, stressors, and supports.ResultsParticipants across the cohort reported levels of psychosocial factors consistent with average levels for the general population for nearly all measures. Psychosocial factors did not vary over time. Social functioning was the only measure reported at low levels [32.0 (6.9); 32.1 (6.7); 32.7 (6.9); mean = 50 (standard deviation)] at 0, 6, and 12 months. We did not observe a meaningful difference in social functioning scores over time by exposure to CHW-led intervention visits (control arm, 0, 1, 2, 3, and 4 visits). Field observations made by CHWs described a range of psychosocial stress related to poverty, language barriers, and immigration status.ConclusionThe unexpectedly average and unchanging psychosocial factors over time, in the context of field observations of stress related to poverty, lack of support, immigration status, and language barriers, suggests that our study did not adequately capture the social determinants of health related to oral health behaviors or that measurement biases precluded accurate assessment. Future studies will assess psychosocial factors using a variety of instruments in an attempt to better measure psychosocial factors including social support, depression, anxiety, functioning, trauma and resilience within our urban population. We will also look at neighborhood-level factors of community distress and resilience to better apply the social ecologic model to child oral health behaviors.

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“…Schechter et al [47 ▪ ] implemented the use of Community Health Workers (CHW) to perform SDOH screening after discharge for hospitalized pediatric patients. They found very high rates of food and housing insecurity (50% reporting either one), 63% reporting poor housing conditions, 94% of the families had at least one social risk factor present, and 99% received assistance from the CHW with social resource navigation.…”

Section: Social Disparity and Care Deliverymentioning

confidence: 99%

Socioeconomic determinants of asthma health

Simoneau

Gaffin

2023

Current Opinion in Pediatrics

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Purpose of reviewThe current review provides an assessment of the recent pediatric literature evaluating socioeconomic drivers of asthma incidence and morbidity. The review addresses the specific social determinants of health related to housing, indoor and outdoor environmental exposures, healthcare access and quality, and the impact of systematic racism.Recent findingsMany social risk factors are associated with adverse asthma outcomes. Children living in low-income, urban neighborhoods have greater exposure to both indoor and outdoor hazards, including molds, mice, second-hand smoke, chemicals, and air pollutants, all of which are associated with adverse asthma outcomes. Providing asthma education in the community – via telehealth, school-based health centers, or peer mentors – are all effective methods for improving medication adherence and asthma outcomes. The racially segregated neighborhoods created by the racist ‘redlining’ policies implemented decades ago, persist today as hotspots of poverty, poor housing conditions, and adverse asthma outcomes.SummaryRoutine screening for social determinants of health in clinical settings is important to identify the social risk factors of pediatric patients with asthma. Interventions targeting social risk factors can improve pediatric asthma outcomes, but more studies are needed related to social risk interventions.

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Community Health Worker Intervention to Address Social Determinants of Health for Children Hospitalized With Asthma

Cited by 17 publications

References 27 publications

Social determinants of health screening in pediatric healthcare settings

Social determinants of health screening in pediatric healthcare settings

Oral community health worker-led interventions in households with average levels of psychosocial factors

Socioeconomic determinants of asthma health

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