Addressing Low-Income Families' Basic Social Needs at Pediatric Visits

Study Overview
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Brief Summary
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This research project is aimed to address low-income families' basic social needs (housing, food, employment, education, childcare, utilities) within the context of pediatric primary care. This project builds upon the PI's prior study at Hopkins which demonstrated a positive impact of a similar intervention on pediatric residents' screening and referral to community agencies. This study will specifically test whether a further strengthened intervention--Basic Needs Surveillance (BNS) protocol-- can lead to greater maternal enrollment in community resources and receipt of eligible benefits. In addition, we will measure the intervention's impact on maternal well-being, and compliance with well-child care (WCC) visits. The project will take place at eight community health centers in the Greater Boston Area. The centers will be randomized to either an intervention or control site. Mothers who bring their infant in for a WCC visit from birth to 6 months will be eligible. They will be followed until their child is one year of age. Study subjects will complete two self-administered surveys (baseline, follow-up), and one brief telephone interview (when their infant is 9 months old). Pediatric providers will also be subjects; and will fill out a demographic questionnaire at the time of enrollment. The BNS intervention will consist of 4 components: 1) WE CARE survey which mothers will fill out in the waiting room prior to their child's WCC visits; 2) Family Resource book containing 1-page information sheets on resources, that providers will have access to in exam rooms; 3) a Community Resource Coordinator who will assist families link to available resources, and update providers; 4) Training Session which will provide a 1 hr overview of the intervention to providers. Families attending the control health centers will receive standard of care. Enrolled mothers will be offered the intervention at the end of the 12-month follow-up interview. When follow-up data collection is complete, the PI will offer the control sites the opportunity to implement the BNS protocol.

Official Title
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Addressing Low-Income Families' Basic Social Needs at Pediatric Visits: the WE CARE Project

Conditions
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Low Income Families Basic Social Needs

Intervention / Treatment
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* Behavioral: Basic Needs Surveillance (BNS) protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mothers (18 yrs or older) who bring their infant between the ages of birth and 6 months for a well-child care visit Medical providers who provide care to pediatric patients at the participating community health centers Exclusion Criteria: Foster parent Mothers who anticipate changing their infant's site for care Mothers who are non-English or non-Spanish speaking Infants with hx of prematurity (born before 32 weeks) Infants with chronic cardiac or respiratory diseases Previously enrolled mother

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>Study subjects will receive the Basic Needs Surveillance (BNS) intervention. | Behavioral: Basic Needs Surveillance (BNS) protocol<br>* The BNS intervention will consist of 4 components: 1) WE CARE survey which mothers will fill out in the waiting room prior to their child's WCC visits; 2) Family Resource book containing 1-page information sheets on resources, that providers will have access to in exam rooms; 3) a Community Resource Coordinator who will assist families link to available resources, and update providers; 4) Training Session which will provide a 1 hr overview of the intervention to providers<br>|
| No Intervention: Control arm<br>Study subjects in the control arm will receive the standard of care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enrollment in new community-based resources and services |  | when index child is 1 yr of age | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Food insecurity |  | when index child is one yr of age | 
| Maternal depression |  | when index child is one yr of age | 
| preventative care adherence, child health, child maltreatment |  | when index child is one yr of age | 
| referrals received by mother at index well-child care visit | referrals received for any of the 6 following unmet needs (food, housing, employment, education, childcare, heat) | 1st well-child care visit | 
| contact of community resource | self-report of contact of a community resource for one of the 6 unmet needs (food, housing, employment, childcare, education, heat) | child is 9 months of age | 
| unmet basic needs | food, housing, employment, education, childcare, heat | 12 month follow-up | 
| parenting stress, maternal life satisfaction |  | 12 month follow-up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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community resource, well-child care visit, low-income