Housing Need Among Children With Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations

Esser, Kayla; Moore, Clara; Hounsell, Kara Grace; Davis, Adrienne L.; Sunderji, Alia; Shulman, Rayzel; Maguire, Bryan; Cohen, Eyal; Orkin, Julia

doi:10.1016/j.acap.2021.09.018

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…Healthy People 2030 groups SDOH into five domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context [1]. Over the past 2 years, pediatric literature has primarily focused on the domains of food insecurity/nutrition [10 ▪ ,22] and housing insecurity/housing conditions [23 ▪ ,24 ▪ ]. This is likely because of concrete social outcomes associated with community referrals (i.e., improving housing conditions/stability, and access to benefits like the Supplemental Nutrition Assistance Program), and prevalence within the pediatric population [22].…”

Section: Current and Emerging Social Determinants Of Health Domainsmentioning

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: Current and Emerging Social Determinants Of Health Domainsmentioning

confidence: 99%

Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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“…As would be expected, given the breadth of the clinical population, the funded projects also reflect a breadth of research questions, disciplines, and methods. Table 1 highlights a selection of projects funded through the NSCCI grants competition whose results have subsequently been published in high-quality, peer-reviewed clinical journals [7][8][9][10][11][12][13][14][15][16][17]. Orkin [10] Toward an understanding of advance care planning in children with medical complexity.…”

Section: Impact Of the Nscci On Researchmentioning

confidence: 99%

“…Esser [15] Housing need among children with medical complexity: a cross-sectional descriptive study of three populations.…”

Section: Process Evaluation Of Complex Care Modelmentioning

confidence: 99%

“…Social determinants of health in the context of CMC and their families were addressed in 5/41 studies. For example, two projects focused on housing, evaluating residential movement patterns and the housing needs of families of CMC [15,16]. Last, as an example of innovation funded through the NSCCI grants competition, an engineering-based study examined the impact of music generated from physiological signals ("biosongs") on caregiver perceptions of their interactions with individuals with communication challenges because of multiple profound disabilities [17].…”

Section: Population-based Cohort (Administrative Health Data)mentioning

confidence: 99%

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From Philanthropy to Clinical Care through Research: Impact of the Norman Saunders Complex Care Initiative

et al. 2022

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Norman Saunders was a respected academic community paediatrician who was passionate about the care of children with medical complexity. Following his untimely death at age 60, patients, friends, and colleagues raised funds to create the Norman Saunders Complex Care Initiative (NSCCI). Dr. Saunders’s vision was a comprehensive, coordinated, and integrated clinical program for children with medical complexity that was informed by research evidence. The objective of this review was to evaluate the impact of targeted philanthropic funding on research, clinical care, and policy. Since 2006, NSCCI funds have been used to support interdisciplinary and innovative research. Funded projects have reflected a breadth of research questions (clinical care, training, health system delivery, social determinants), disciplines, and methods, and the research results have informed and helped build an internationally renowned clinical program in complex care. Philanthropic funding was the foundation for the NSCCI, which over the last 15 years has built research and clinical capacity, catalysed clinical and research networks, helped train paediatric residents, influenced policy, and improved the health and well-being of children with medical complexity and their families across Canada, and beyond.

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“…As a result of these pressures, families with CMC are at an increased risk for housing needs (Esser et al, 2022). Prior work has demonstrated a high prevalence of both unstable (i.e.…”

Section: Introductionmentioning

confidence: 99%

Family perspectives on provider conversations about housing needs for children with medical complexity

Smith,

Donohue,

Seltzer

2024

Child

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BackgroundChildren with medical complexity (CMC) have unique, and often unmet, housing needs that place them at risk for housing insecurity and poor health outcomes. Yet, little is known about how families with CMC discuss their housing needs with healthcare providers. We sought to understand: (1) how housing is currently discussed between CMC caregivers and healthcare providers, and (2) how CMC caregivers want such conversations to occur.MethodsFrom August to November 2020, we conducted semi‐structured interviews with parents/guardians of CMC (<26 years old) in Maryland as part of a larger study to understand their housing experience. Four questions on communication with providers about housing were developed a priori and included in this analysis. Qualitative content analysis was applied to interview transcripts.ResultsAmong 31 completed interviews, most participants were female (90%), lived in single‐family homes (68%) and were from a mix of neighbourhood types (urban 19%, suburban 58%, rural 22%). Their children ranged in age from 6 months to 22 years, had a mix of insurance types (public 65%, private 29%, both 6%) and nearly all required medical equipment or technology. Four themes emerged: (1) Current housing conversations are rare and superficial, (2) Ideal housing conversations would result in thoughtful care plans and concrete supports, (3) Frequency and initiation of housing conversations are best tailored to family preferences and (4) Value of housing conversations are limited by lack of provider knowledge and time.ConclusionsConversations about housing needs for CMC happen in limited ways with healthcare providers, despite a desire on the part of their caregivers. Such conversations can give meaningful insights into the family's specific housing challenges, allowing providers to appropriately tailor care plans and referrals. Future work is needed to capture provider perspectives, design CMC‐specific housing screeners and develop interdisciplinary referral strategies.

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Housing Need Among Children With Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations

Cited by 8 publications

References 31 publications

Social determinants of health screening in pediatric healthcare settings

Social determinants of health screening in pediatric healthcare settings

From Philanthropy to Clinical Care through Research: Impact of the Norman Saunders Complex Care Initiative

Family perspectives on provider conversations about housing needs for children with medical complexity

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