Improving Screening Rates for Social Determinants of Health in Pediatric Primary Care Practices.

The COVID-19 pandemic highlighted pediatric health care disparities and disrupted routine care, including social needs assessments. The American Academy of Pediatrics recommends universal screening for Social Determinants of Health (SDOH), yet implementation remains inconsistent in primary care sett...

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Publicado en:Population Health Management Vol. 29; no. 3; pp. 164 - 173
Autores principales: Rao, Vara S., Chamberlain, Celeste, Bernstein, Bruce, Williams, Na-Tasha, Cooper, Mary Reich
Formato: algorithm questionnaire/scale research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jun2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2026
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      pub: Mary Ann Liebert, Inc.
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        atl: Improving Screening Rates for Social Determinants of Health in Pediatric Primary Care Practices.
      aug:
        au:
          Rao, Vara S.
          Chamberlain, Celeste
          Bernstein, Bruce
          Williams, Na-Tasha
          Cooper, Mary Reich
        affil: Nemours Children Health, Pennsylvania, USA.
      sug:
        subj:
          Pediatric Care
          Primary Health Care
          Social Determinants of Health Evaluation
          Health Screening Standards
          Professional Practice
          Quality Improvement
          Program Implementation
          Referral and Consultation
          Human
          Sustainable Growth
          Conceptual Framework
          Implementation Science
          Healthcare Disparities
          Socioeconomic Disparities in Health
          Population Health
          Child Health
          United States
          Chi Square Test
          Odds Ratio
          Descriptive Statistics
          Data Analysis Software
      ab: The COVID-19 pandemic highlighted pediatric health care disparities and disrupted routine care, including social needs assessments. The American Academy of Pediatrics recommends universal screening for Social Determinants of Health (SDOH), yet implementation remains inconsistent in primary care settings. This quality improvement (QI) project aimed to implement a standardized, sustainable SDOH screening and referral process in pediatric primary care, hypothesizing that structured interventions would improve screening rates. This QI initiative was conducted from January to September 2023 across six practices within a large pediatric health system. Eligible patients (ages 0–19) included those attending their first well visit of the calendar year. The SMART aim targeted a 50% increase in SDOH screening compliance, from 28% at baseline to 42% over 9 months. Using the Consolidated Framework for Implementation Research and two Plan-Do-Study-Act cycles, the team addressed key implementation barriers and refined interventions. The primary measure was screening completion rate; the balancing measure was the number of refusals to screen. SDOH screening rates increased from 28% to 55%, with eligible patient volumes ranging from 2400 to 5500. All six practices demonstrated statistically significant improvements (P < 0.001). Positive screens ranged from 3.3% to 8% of patients screened. Screening refusals increased significantly (P < 0.001). Standardized SDOH screening, implemented through structured QI methods and stakeholder engagement, significantly improved screening rates in pediatric primary care. Future studies should assess referral effectiveness, clinical outcomes, cost-effectiveness, and strategies to mitigate patient discomfort and systemic barriers.
      pubtype: Academic Journal
      doctype:
        algorithm
        questionnaire/scale
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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