Addressing Social Determinants of Health at Well Child Care Visits
A Cluster RCT
Bibliographic Data
| ID | 23318484 |
|---|---|
| Authors | Arvin Garg (0000-0003-4581-4430, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts), Sarah Toy (0000-0003-0090-9153, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts), Yorghos Tripodis (0000-0003-2190-7608, Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts; and), Michael Silverstein (0000-0001-5497-3578, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts), Elmer Freeman (Northeastern University) |
| Year | 2015 |
| Volume | 135 |
| Issue | 2 |
| Pages | e296-e304 |
| Publication date | 2015-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | PEDIATRICS (JOURNAL) |
| Journal identifiers | ISSN: 0031-4005 • E-ISSN: 1098-4275 |
| Publisher | American Academy of Pediatrics (AAP) (PUBLISHER) |
| DOI | 10.1542/peds.2014-2888 |
| PMID | 25560448 |
| PMCID | PMC4306802 |
| OpenAlex | W2033448635 |
| Language | EN |
| Citations received | 61 |
| References cited | 35 |
OBJECTIVE: To evaluate the effect of a clinic-based screening and referral system (Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education [WE CARE]) on families' receipt of community-based resources for unmet basic needs. METHODS: We conducted a cluster randomized controlled trial at 8 urban community health centers, recruiting mothers of healthy infants. In the 4 WE CARE clinics, mothers completed a self-report screening instrument that assessed needs for child care, education, employment, food security, household heat, and housing. Providers made referrals for families; staff provided requisite applications and telephoned referred mothers within 1 month. Families at the 4 control community health centers received the usual care. We analyzed the results with generalized mixed-effect models. RESULTS: Three hundred thirty-six mothers were enrolled in the study (168 per arm). The majority of families had household incomes <$20,000 (57%), and 68% had ≥ 2 unmet basic needs. More WE CARE mothers received ≥ 1 referral at the index visit (70% vs 8%; adjusted odds ratio [aOR] = 29.6; 95% confidence interval [CI], 14.7-59.6). At the 12-month visit, more WE CARE mothers had enrolled in a new community resource (39% vs 24%; aOR = 2.1; 95% CI, 1.2-3.7). WE CARE mothers had greater odds of being employed (aOR = 44.4; 95% CI, 9.8-201.4). WE CARE children had greater odds of being in child care (aOR = 6.3; 95% CI, 1.5-26.0). WE CARE families had greater odds of receiving fuel assistance (aOR = 11.9; 95% CI, 1.7-82.9) and lower odds of being in a homeless shelter (aOR = 0.2; 95% CI, 0.1-0.9). CONCLUSIONS: Systematically screening and referring for social determinants during well child care can lead to the receipt of more community resources for families.
Cluster (spacecraft) · Cluster randomised controlled trial · Confidence interval · Family medicine · Health care · Logistic regression · Odds · Odds ratio · Randomized controlled trial · Receipt · Referral · Breastfeeding Practices and Influences · Food Security and Health in Diverse Populations · Medicine · Pediatric health and respiratory diseases
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| Unique citing works | 61 |
|---|---|
| Citations per year | 6,1 |
| Citation span | 2016 - 2026 (11) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 58 |