Low-Intensity Interventions Addressing Social Needs In Pediatric Settings Can Improve Child Health

MedicalResearch.com Interview with:
Laura M. Gottlieb, MD, MPH
Department of Family and Community Medicine,
2Center for Health and Community
University of California, San Francisco

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks.

In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation.

To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health.

The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13).

MedicalResearch.com: What should readers take away from your report?

Response: Even low-intensity interventions addressing social needs in pediatric clinical care settings have the ability to significantly decrease families’ social needs and significantly improving parent-reported child global health. More studies on the impacts of intervening on social determinants in clinical settings are needed to determine the best ways to improve patient health.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research in this area could examine additional health outcome measures in both children and their caregivers, the impacts of interventions of varying size and intensity, and/or the costs and returns on investment associated with the implementation of these kinds of interventions.

MedicalResearch.com: Is there anything else you would like to add?

Response: To better understand the impacts of addressing patients’ social determinants in health care settings, I work with a diverse group of thought leaders in this research field from around the US and Canada. If you are interested in learning more about the Social Interventions Research and Evaluation Network (SIREN), please email us at siren@ucsf.edu.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Gottlieb LM, Hessler D, Long D, et al. Effects of Social Needs Screening and In-Person Service Navigation on Child Health: A Randomized Clinical Trial. JAMA Pediatr.Published online September 06, 2016. doi:10.1001/jamapediatrics.2016.2521.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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