A Mixed-Method Evaluation of the Impact of Social Risk Screening on Uptake of Social Assistance

Study Overview
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Brief Summary
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Children are disproportionately affected by the rise in poverty rates in the United States. Economic hardships can compromise child development, overall health, and the ability to succeed in school and in life. The current economic recession and racial disparities underscored by COVID19 have magnified this impact on children and hastened the already rapid growth of screening protocols for social risk factors- such as food and housing insecurity, financial strain, and unsafe environments-within pediatric health care. However, it remains unclear what effect standardized screening has on family perception of and engagement with resources. Current implementation momentum for screening protocols is outpacing research, and is raising concern among patient advocates for unintended harm-alienating families for fear of stigma or worse, and overpromising services that may not exist. Through a rigorous mixed-method approach, the proposed study will explore the impact of screening on acceptance, perception, and engagement with social resources among families with children. Furthermore, by leveraging the new technology of resource mapping as the method of resource referral, this study will provide insight regarding its effectiveness as a social needs assistance strategy. The knowledge gained will provide guidance for policymakers and other healthcare systems on how to integrate social risk interventions into healthcare delivery in order to maximize the benefit to children and families.

Official Title
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A Mixed-Method Evaluation of the Impact of Social Risk Screening on Uptake of Social Assistance

Conditions
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Low-income Populations, Social Determinants of Health

Intervention / Treatment
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* Behavioral: Social Risk Screening Tool
* Other: Electronic Resource Map


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Caregivers presenting with a child to the pediatric clinical setting Child age 0-25 Exclusion Criteria: Engaged in complex care management services Child in critical condition Presenting to clinical setting specifically for social work intervention

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Social Risk Screening + Resource Map<br>Participants randomized to the experimental arm will receive a social risk assessment tool followed by an electronic resource map | Behavioral: Social Risk Screening Tool<br>* Investigators will use an adapted version of the evidence-based WE CARE screening tool, which assesses need in the 5 domains most frequently requested by our patient population: housing, transportation, child care, food security, and household heat and electricity. This tool was selected as it is evidence-based, takes fewer than 5 minutes to complete, is written at a 3rd grade reading level, and allows for differentiation between social risk and caregiver desire for assistance, as well as areas of emergency need.<br>Other: Electronic Resource Map<br>* All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha<br>|
| Active Comparator: Resource Map<br>Participants randomized to the active comparator group will receive only an electronic resource map | Other: Electronic Resource Map<br>* All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resource Uptake By Search | total number of searches | 30 days | 
| Resource Uptake By Domain | number of searches by domain | 30 days | 
| Resource Engagement By Time | time spent on site | 30 days | 
| Resource Engagement By Saves | number of resources saved | 30 days | 
| Resource Engagement By Domain | number of resources saved by domain | 30 days | 
| Resource Utilization | rates of resource utilization | 30 days | 
| Resource Impact | perceived impact of resource use on social need measured by using a modified version of the WE CARE screening tool | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived impact of screening on resource acceptance | Qualitative semi-structured interviews | up to 45 days | 
| Perceived impact of screening on resource perception | Qualitative semi-structured interviews | up to 45 days |