568 - Staff Attitudes about Screening for and Addressing Social Drivers of Health among Hospitalized Children and Their Families

Publication Number: 568.6700

Matthew S. Pantell, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Nathan Tran, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Laura M. Gottlieb, UCSF, San Francisco, CA, United States; Emilia De Marchis, University of California, San Francisco, School of Medicine, San Francisco, CA, United States

Background: Social risk factors - adverse social drivers (or determinants) of health (SDOH) – are associated with a variety of negative health outcomes among children. Consequently, standards setting organizations including the Joint Commission and National Committee for Quality Assurance have recommended screening hospitalized children for SDOH and providing resources to address social needs. Despite these recommendations, little is known about clinician attitudes about SDOH screening and referral workflows in the pediatric hospital setting.

Objective: To understand healthcare staff perspectives of screening for and providing resources to address patient and family SDOH in the pediatric hospital setting.

Design/Methods: We conducted a multi-site survey study of pediatric healthcare staff working at 3 pediatric inpatient units at two tertiary children’s hospitals in Northern California. Staff surveys explored comfort with screening for SDOH based on SDOH domain, attitudes about screening for and addressing SDOH, and attitudes about implications for health equity. We emailed surveys to all nurses, case managers, social workers, residents, fellows, and attendings on the 3 units. We calculated descriptive statistics summarizing staff attitudes.

Results: Our sample consisted of 51 healthcare staff members (10.5% response rate): 2 advance practice providers, 7 nurses, 1 social worker, 27 residents, 1 fellow, and 13 attendings. Most staff endorsed that SDOH screening should be a standard part of care, supporting efforts to assess and address SDOH, and believing that screening could improve communication, trust, and health equity with patients. However, roughly 20% of staff endorsed that SDOH screening contributes to their feelings of burnout (Figure 1). The most cited barriers to both SDOH screening and referrals were time needed to complete the task and availability of resources to respond to social needs (Figure 2). The highest proportion of staff endorsed intimate partner violence and food insecurity as being important to screen for, whereas the lowest proportion of staff endorsed food quality and employment as being important to screen for (Figure 3). Staff were most commonly comfortable asking families about transportation and employment, and least commonly comfortable asking about discrimination and adverse childhood experiences (Figure 3).

Conclusion(s): Healthcare staff working in pediatric hospital settings generally support SDOH screening and referral efforts, although attitudes about and comfort with screening vary by SDOH domain.

FIGURE 1. Pediatric Hospital Staff Attitudes about Screening for SDOH among Patients and Their Families


FIGURE 2. Pediatric Hospital Staff Perscpectives on Barriers and Facilitators of Screening for SDOH and Providing Referrals to Address Social Needs


FIGURE 3. Pediatric Hospital Staff Perspectives on Importance of and Comfort with Screening for SDOH