Pediatricians believe it is important to screen for social needs. However, many do not screen and lack staffing and preparation to routinely incorporate screening into their practice, according to findings from a recently published AAP Periodic Survey of Fellows (Garg A, et al. Acad Pediatr. May 23, 2019, https://doi.org/10.1016/j.acap.2019.05.125).
The Academy’s 2016 policy Poverty and Child Health in the United States (http://bit.ly/2OzC9ty) calls for screening children for risk factors and connecting them with resources, including public health insurance, food supplementation and affordable housing.
The Periodic Survey collected data in 2014-’15, prior to release of the policy statement, and screening levels may now be higher.
The majority of pediatricians reported that it is important to screen for family financial and related social needs routinely at health visits (62%). Fewer reported that it is feasible to screen (40%) or that they are well-prepared to address families’ financial and related social needs (20%).
About half of pediatricians (47%) reported there is someone in their practice to connect low-income families to community services. Pediatricians with such staff available were more likely to screen for social needs, including child care, transportation, housing insecurity, food insecurity and utilities (see figure). Still, routine screening was under half for all areas of potential need.
“Despite a history in the field of pediatrics that encourages clinicians to address patients’ adverse social circumstances, only a minority of pediatricians routinely screen for social needs,” the study authors concluded.
As a next step in the AAP’s research on addressing social needs, the AAP Pediatric Research in Office Settings (PROS) primary care research network is launching a practice-based study, “WE CARE: Well Child Care Evaluation, Community Resources, Advocacy, Referral, Education.” Funded by the National Institutes of Child Health and Human Development, the study will evaluate an intervention to help practices develop and utilize local resources to increase screening and referral for unmet material needs.
Periodic Survey #90 was conducted from October 2014 to March 2015. The survey was mailed to 1,570 non-retired AAP members in the U.S., with a response rate of 47%. Analyses were limited to post-training pediatricians who provide direct patient care.
