Community to Clinic Linkage Program at SFGH

Study Overview
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Brief Summary
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It is increasingly clear that the environment in which a child lives, plays, and goes to school has a significant impact on their health. With the implementation of a Community to Clinic Linkage Program (CCLiP) in the SFGH Pediatrics Clinics, we will routinely address Social Determinants of Health when families present. We will randomize patients to receive either the CCLiP intervention or standard of care. We will evaluate programmatic outcome, health care utilization data and return on investment data. We hypothesize that by addressing the environmental and social factors that contribute to health within the setting of the medical home, we will be able to better connect families to community resources, enable more appropriate use of healthcare resources, improve health status, and enhance patient satisfaction.

Detailed Description
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We are proposing a 4-arm, 18 month randomized control clinical trial to address social determinants of health, improve health status and health care satisfaction, and change health care utilization patterns in the Pediatric Urgent Care and Primary Care Clinics at San Francisco General Hospital. We will compare our CCLiP protocol to standard of care in both the Pediatric Primary Care Clinic & Urgent Care. All arms (intervention and control) include a baseline survey including social needs assessment, health care status, health care satisfaction and health care utilization assessment; and two telephone-based follow up surveys at 3 and 6 months. Patients in the intervention arms (whether in urgent care or primary care) will receive a maximum of 3 months of intervention protocol which includes a 30 minute on-site intervention at time of enrollment in addition to twice monthly follow-up phone calls for up to 3 months to help address social needs. Patients in all arms will receive 3 and 6-month follow up surveys.

Official Title
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Community to Clinic Linkage Program at SFGH

Conditions
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Family's Connection to Community Resources and Public Benefits, Caregiver Satisfaction and Connectedness to Clinic, Child Health Care Status

Intervention / Treatment
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* Other: Pediatric Primary Care Intervention
* Other: Pediatric Urgent Care Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: English or Spanish Speaking Parent/caregiver accompanying an SFGH Primary Care or Urgent Care Clinic patient 0-17 years old Consenting adult over or equal to 18 years old Exclusion Criteria: Non-English or non-Spanish speaking caregiver Caregiver under age 18 Caregiver accompanying patient is not familiar with the child's living situation Family participated in study previously Non-San Francisco resident Foster child or child in clinic for a child protective clearance exam

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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Accepts Healthy Volunteers

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: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Pediatric Primary Care Control<br>Baseline survey with a social needs assessment, health care status, health care satisfaction and health care utilization assessment and two telephone-based follow up surveys at 3 and 6 months. | |
| No Intervention: Pediatric Urgent Care Control<br>Baseline survey with a social needs assessment, health care status, health care satisfaction and health care utilization assessment and two telephone-based follow up surveys at 3 and 6 months. | |
| Experimental: Pediatric Primary Care Intervention<br>Baseline survey that includes social needs assessment, health care status, health care satisfaction and health care utilization assessment; 30 minute on-site intervention, twice monthly follow-up phone calls for up to 3 months to help address social needs | Other: Pediatric Primary Care Intervention<br>* 30 minute on-site intervention with biweekly follow up phone calls to address social needs and health care status.<br>|
| Experimental: Pediatric Urgent Care Intervention<br>Baseline survey that includes social needs assessment, health care status, health care satisfaction and health care utilization assessment; 30 minute on-site intervention, twice monthly follow-up phone calls for up to 3 months to help address social needs | Other: Pediatric Urgent Care Intervention<br>* 3 months of intervention protocol, including a 30 minute on-site intervention and twice monthly phone calls to address social needs and health care status.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Family's connection to community resources and public benefits | This will be assessed at 3 months and 6 months post-enrollment by phone administered questionnaires. | up to 6 months post base-line | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child health care utilization | This will be assessed at 3 months and 6 months post-enrollment by phone administered questionnaires. | up to 6 months | 
| Child health status | This will be assessed at 3 months and 6 months post-enrollment by phone administered questionnaires. | up to 6 months |