719 - Social Influencers of Health Screening in Oncology Clinic: A Needs Assessment Study

Publication Number: 719.6623

Erin McCune, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Jennifer Reichek, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, United States

Background: Numerous studies show that disparities in social influencers of health (SIoH) contribute to adverse pediatric health outcomes. Families with children receiving cancer treatment often face increased financial needs, yet data is more limited when studying unmet SIoH in pediatric cancer patients. Currently, there is no standardized SIoH screening process at outpatient oncology visits at Ann & Robert H. Lurie Children's Hospital.

Objective: To identify the prevalence of unmet needs and stressors in families with children receiving outpatient oncologic care at an academic children's hospital, and to inform a targeted approach for standardized SIoH screening in this population.

Design/Methods: This needs assessment utilized an optional, anonymous survey, distributed at appointment check-in to caregivers of children receiving oncology care at Lurie Children’s Center for Cancer and Blood Disorders. If respondents requested social work referral, they provided contact information which was given to the social work team for follow-up. Survey responses were analyzed to compare cited needs among respondents.

Results: Among 75 survey participants (92% English, 8% Spanish), the most commonly reported needs were financial strain and transportation insecurity (see Tables 1 and 2). When asked if there was a time in the last year that they were unable to pay mortgage/rent on time, 29% responded “yes.” Food insecurity was reported by 6.7% of respondents. Nearly 20% of respondents endorsed difficulty reading hospital materials (5 of 14 were Spanish-speaking, 9 were English-speaking). Social work referral was requested in 20% of responses. The social work team met with families prior to survey completion in the majority of cases. Provided resources included rent/utility bill assistance, and transportation assistance with gas/parking reimbursements. Resources were available through pediatric oncology foundations and pediatric oncology funds.

Conclusion(s): These findings illustrate unmet needs identified with SIoH screening. The oncology social work team often interviews families at appointments, and they provided resources prior to the completion of this survey in many cases. However, survey results show ongoing financial and transportation needs, highlighting a potential area of improvement. Standardized SIoH screening at all visits could efficiently identify needs and initiate social work referral, which may capture SIoH not identified by interview alone. Further research is needed on the relationship between standardized SIoH screening and increased social work intervention, as well as its impact on pediatric health outcomes.

Image 1: Social Influencers of Health Survey - English
This is the survey that was offered to families attending pediatric oncology appointments at Lurie Children's Hospital. The survey was available in English and Spanish.

Table 1: Survey Question 6 and Question 10 Responses
Responses to the questions "In the past 12 months, was there a time when you were not able to pay the mortgage or rent on time?" and "How hard is it for you to pay for the very basics like food, housing, medical care, and heating?"

Table 2: Survey Question 4 and Question 5 Responses
Responses to the questions "In the past 12 months, has lack of transportation kept you from medical appointments or from getting medications?" and "In the past 12 months, has lack of transportation kept you from meetings, work, or getting things needed for daily living?"

Image 1: Social Influencers of Health Survey - English
This is the survey that was offered to families attending pediatric oncology appointments at Lurie Children's Hospital. The survey was available in English and Spanish.

Table 1: Survey Question 6 and Question 10 Responses
Responses to the questions "In the past 12 months, was there a time when you were not able to pay the mortgage or rent on time?" and "How hard is it for you to pay for the very basics like food, housing, medical care, and heating?"

Table 2: Survey Question 4 and Question 5 Responses
Responses to the questions "In the past 12 months, has lack of transportation kept you from medical appointments or from getting medications?" and "In the past 12 months, has lack of transportation kept you from meetings, work, or getting things needed for daily living?"