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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study

Laura Gottlieb, Danielle Hessler, Dayna Long, Anais Amaya and Nancy Adler
Pediatrics December 2014, 134 (6) e1611-e1618; DOI: https://doi.org/10.1542/peds.2014-1439
Laura Gottlieb
aDepartment of Family and Community Medicine, and
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Danielle Hessler
aDepartment of Family and Community Medicine, and
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Dayna Long
dDepartment of Psychiatry, University of California, San Francisco, San Francisco, California; and
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Anais Amaya
dDepartment of Psychiatry, University of California, San Francisco, San Francisco, California; and
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Nancy Adler
aDepartment of Family and Community Medicine, and
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Abstract

BACKGROUND: There is growing interest in clinical screening for pediatric social determinants of health, but little evidence on formats that maximize disclosure rates on a wide range of potentially sensitive topics. We designed a study to examine disclosure rates and hypothesized that there would be no difference in disclosure rates on face-to-face versus electronic screening formats for items other than highly sensitive items.

METHODS: We conducted a randomized trial of electronic versus face-to-face social screening formats in a pediatric emergency department. Consenting English-speaking and Spanish-speaking adult caregivers familiar with the presenting child’s household were randomized to social screening via tablet computer (with option for audio assist) versus a face-to-face interview conducted by a fully bilingual/bicultural researcher.

RESULTS: Almost all caregivers (96.8%) reported at least 1 social need, but rates of reporting on the more sensitive issues (household violence and substance abuse) were significantly higher in electronic format, and disclosure was marginally higher in electronic format for financial insecurity and neighborhood and school safety. There was a significant difference in the proportion of social needs items with higher endorsement in the computer-based group (70%) than the face-to-face group (30%).

CONCLUSIONS: Pediatric clinical sites interested in incorporating caregiver-reported socioeconomic, environmental, and behavioral needs screening should consider electronic screening when feasible, particularly when assessing sensitive topics such as child safety and household member substance use.

  • psychosocial issues
  • emergency medicine
  • Accepted September 10, 2014.
  • Copyright © 2014 by the American Academy of Pediatrics

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Pediatrics
Vol. 134, Issue 6
1 Dec 2014
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A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study
Laura Gottlieb, Danielle Hessler, Dayna Long, Anais Amaya, Nancy Adler
Pediatrics Dec 2014, 134 (6) e1611-e1618; DOI: 10.1542/peds.2014-1439

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A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study
Laura Gottlieb, Danielle Hessler, Dayna Long, Anais Amaya, Nancy Adler
Pediatrics Dec 2014, 134 (6) e1611-e1618; DOI: 10.1542/peds.2014-1439
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  • Social Determinants of Health and Hospital Readmission
  • Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol
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  • Clinicians Perceptions of Screening for Food Insecurity in Suburban Pediatric Practice
  • Perspectives in Primary Care: A Conceptual Framework and Path for Integrating Social Determinants of Health Into Primary Care Practice
  • Theory vs Practice: Should Primary Care Practice Take on Social Determinants of Health Now? No.
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