Screening for Toxic Stress Risk Factors at Well-Child Visits: The Addressing Social Key Questions for Health Study

Selvaraj, Kavitha; Ruiz, Melissa; Aschkenasy, Jean; Chang, Jan; Heard, Anthony; Minier, Mark; Osta, Amanda; Pavelack, Melissa; Samelson, Monica; Schwartz, Alan; Scotellaro, Margaret; Seo-Lee, Alisa; Sonu, Stan; Stillerman, Audrey; Bayldon, Barbara

doi:10.1016/j.jpeds.2018.09.004

Cited by 50 publications

(94 citation statements)

References 25 publications

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“…Among the 13 studies in which the races and/or ethnicities of screened individuals were reported, 10 study samples contained a majority nonwhite sample. 11,12,17,18,[20][21][22][23][24][25] Screener Characteristics Table 2 depicts SDOH screener characteristics from the 11 unique screeners included in this review. Screening was conducted in a doctor's or pediatrician's office for the majority of screeners (ie, 8 screeners), with a parent or caregiver being the primary informant for all screeners.…”

Section: Study Selectionmentioning

confidence: 99%

“…Two screeners included additional information reported by a social worker 16 or physician. 20 Screeners were completed via a variety of methods, including paper and pencil, 11,[17][18][19][20][23][24][25][26]30 computer or tablet, [17][18][19]22,26,27 faceto-face interview, 12,16,21,[27][28][29] and phone interview. 12,27 All screeners were available in English, with 7 screeners also available in Spanish.…”

Section: Study Selectionmentioning

confidence: 99%

“…12,27 All screeners were available in English, with 7 screeners also available in Spanish. 11,12,[17][18][19][20][22][23][24][25][26][27]30 Three screeners had validity and/or reliability assessed in $1 study. 18,24,29 With respect to the time frame that respondents were asked to reflect on when answering questions about SDOHs, the majority of screeners (ie, 6 screeners) did not have a clearly defined referent period (eg, past 30 days, past year, or lifetime); the referent periods for other screeners varied by question, 18,22,28 and only 2 screeners had a single, clearly defined referent period for all included questions.…”

Section: Study Selectionmentioning

confidence: 99%

“…16,24 Regarding how the SDOH screeners were developed, only 4 screeners reported being informed by practice 18,21,24 and/or expert opinion. 18,21,23,24 Remaining screeners were solely adaptations of previous tools or did not report how they were developed. Table 3 reveals the specific SDOH domains assessed in each screener.…”

Section: Study Selectionmentioning

confidence: 99%

“…Common areas examined under the economic stability domain included food insufficiency, 11,12,[16][17][18][19][21][22][23][24][25][26][27][28][29][30] housing instability, 11,12,16,[22][23][24][25][27][28][29][30] and difficulty paying bills, making ends meet, or meeting basic needs. 11,12,[21][22][23][24][25]27,28,30 Seven screeners assessed the education domain, which included questions assessing parental education 11,20,[23][24][25]28,30 and access to child care. 11,12,[23][24][25]…”

Section: Famneedsmentioning

confidence: 99%

See 4 more Smart Citations

Screening Children for Social Determinants of Health: A Systematic Review

Sokol

Austin²,

Chandler³

et al. 2019

Pediatrics

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118

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show abstract

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Famneedsmentioning

confidence: 99%

See 3 more Smart Citations

Screening Children for Social Determinants of Health: A Systematic Review

Sokol

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Chandler³

et al. 2019

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187

118

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show abstract

Screening and Interventions for Social Risk Factors

Eder

Henninger

Durbin

et al. 2021

JAMA

108

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Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

Wilkerson,

De Marchis,

Rudd

et al. 2023

JAMA Dermatol

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ImportanceProviding person-centered dermatologic care includes consideration of social risk factors, such as housing instability and unreliable transportation, that may affect clinical management. Patients’ perspectives on social risk screening and documentation in dermatology clinics have not yet been evaluated.ObjectiveTo understand patients’ perspectives on social risk screening and documentation in a dermatology clinic.Design, Setting, and ParticipantsThis mixed-methods study used a survey and semistructured interviews and was conducted in a general dermatology clinic at a large urban public hospital. Patients at the clinic were eligible to complete the survey if they were 18 years or older; able to speak and read English, Spanish, or Cantonese; and comfortable using a computer tablet. Survey participants who preferred to use English were eligible for interviews. The survey included social risk screening questions, measures of acceptability, and questions on social risk factors associated with patient acceptability. Semistructured interviews were conducted to explore attitudes and beliefs about social risk screening and documentation. Survey and interview findings were integrated during data analysis through development of themes and joint display. Data were analyzed from December 2021 to April 2023.Main Outcomes and MeasuresThere were 2 outcome measures of acceptability: appropriateness of screening in a dermatology clinic and comfort with documentation of social risk in the electronic health record (EHR).ResultsA total of 135 participants (including 73 males [54.1%]) answered both measures of acceptability in the survey. Of these participants, 116 (85.9%) reported that social risk screening in their dermatology clinic was very or somewhat appropriate and 85 (63.0%) reported being completely or somewhat comfortable with having their social risks documented in the EHR. Themes that were developed from surveys and interviews were the (1) role of interpersonal factors in willingness to disclose social risks, (2) implications of institutional trust for willingness to disclose and comfort with documentation, and (3) relevance of screening in a dermatology clinic.Conclusions and RelevanceResults of this study showed that most participants found social risk screening to be appropriate in a dermatology clinic, although a smaller proportion of participants were comfortable with EHR documentation of their social risks. Optimizing patients’ trust in their physicians and the medical system, while addressing privacy and discrimination concerns, may help facilitate disclosure of social risks.

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Screening for Toxic Stress Risk Factors at Well-Child Visits: The Addressing Social Key Questions for Health Study

Cited by 50 publications

References 25 publications

Screening Children for Social Determinants of Health: A Systematic Review

Screening Children for Social Determinants of Health: A Systematic Review

Screening and Interventions for Social Risk Factors

Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

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