RT Journal Article
SR Electronic
T1 A Randomized Trial on Screening for Social Determinants of Health: the iScreen Study
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP e1611
OP e1618
DO 10.1542/peds.2014-1439
VO 134
IS 6
A1 Gottlieb, Laura
A1 Hessler, Danielle
A1 Long, Dayna
A1 Amaya, Anais
A1 Adler, Nancy
YR 2014
UL http://pediatrics.aappublications.org/content/134/6/e1611.abstract
AB 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.