A Mixed-Method Evaluation of the Impact of Social Risk Screening on Uptake of Social Assistance

Sponsor

Children's Hospital of Philadelphia (Other)

Overall Status

Recruiting

CT.gov ID

NCT05251311

Collaborator

(none)

2,188

Enrollment

Location

Arms

38.4

Anticipated Duration (Months)

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Children are disproportionately affected by the rise in poverty rates in the United States. Economic hardships can compromise child development, overall health, and the ability to succeed in school and in life. The current economic recession and racial disparities underscored by COVID19 have magnified this impact on children and hastened the already rapid growth of screening protocols for social risk factors- such as food and housing insecurity, financial strain, and unsafe environments-within pediatric health care. However, it remains unclear what effect standardized screening has on family perception of and engagement with resources. Current implementation momentum for screening protocols is outpacing research, and is raising concern among patient advocates for unintended harm-alienating families for fear of stigma or worse, and overpromising services that may not exist. Through a rigorous mixed-method approach, the proposed study will explore the impact of screening on acceptance, perception, and engagement with social resources among families with children. Furthermore, by leveraging the new technology of resource mapping as the method of resource referral, this study will provide insight regarding its effectiveness as a social needs assistance strategy. The knowledge gained will provide guidance for policymakers and other healthcare systems on how to integrate social risk interventions into healthcare delivery in order to maximize the benefit to children and families.

Condition or Disease	Intervention/Treatment	Phase
Low-income Populations Social Determinants of Health	Behavioral: Social Risk Screening Tool Other: Electronic Resource Map	N/A

Study Design

Study Type:

Interventional

Anticipated Enrollment :

2188 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Care Provider)

Masking Description:

Social worker that follows up with each participant will be blinded to randomization arm

Primary Purpose:

Health Services Research

Official Title:

A Mixed-Method Evaluation of the Impact of Social Risk Screening on Uptake of Social Assistance

Actual Study Start Date :

Apr 19, 2022

Anticipated Primary Completion Date :

Apr 1, 2024

Anticipated Study Completion Date :

Jul 1, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Social Risk Screening + Resource Map Participants randomized to the experimental arm will receive a social risk assessment tool followed by an electronic resource map	Behavioral: Social Risk Screening Tool Investigators will use an adapted version of the evidence-based WE CARE screening tool, which assesses need in the 5 domains most frequently requested by our patient population: housing, transportation, child care, food security, and household heat and electricity. This tool was selected as it is evidence-based, takes fewer than 5 minutes to complete, is written at a 3rd grade reading level, and allows for differentiation between social risk and caregiver desire for assistance, as well as areas of "emergency" need. Other: Electronic Resource Map All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha
Active Comparator: Resource Map Participants randomized to the active comparator group will receive only an electronic resource map	Other: Electronic Resource Map All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha

Arm

Intervention/Treatment

Experimental: Social Risk Screening + Resource Map

Participants randomized to the experimental arm will receive a social risk assessment tool followed by an electronic resource map

Behavioral: Social Risk Screening Tool

Investigators will use an adapted version of the evidence-based WE CARE screening tool, which assesses need in the 5 domains most frequently requested by our patient population: housing, transportation, child care, food security, and household heat and electricity. This tool was selected as it is evidence-based, takes fewer than 5 minutes to complete, is written at a 3rd grade reading level, and allows for differentiation between social risk and caregiver desire for assistance, as well as areas of "emergency" need.

Other: Electronic Resource Map

All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha

Active Comparator: Resource Map

Participants randomized to the active comparator group will receive only an electronic resource map

Other: Electronic Resource Map

All participants will receive access to an electronic, geographically searchable resource map hosted on Aunt Bertha

Outcome Measures

Primary Outcome Measures

Resource Uptake By Search [30 days]
total number of searches
Resource Uptake By Domain [30 days]
number of searches by domain
Resource Engagement By Time [30 days]
time spent on site
Resource Engagement By Saves [30 days]
number of resources saved
Resource Engagement By Domain [30 days]
number of resources saved by domain
Resource Utilization [30 days]
rates of resource utilization
Resource Impact [30 days]
perceived impact of resource use on social need measured by using a modified version of the WE CARE screening tool

Secondary Outcome Measures

Perceived impact of screening on resource acceptance [up to 45 days]
Qualitative semi-structured interviews
Perceived impact of screening on resource perception [up to 45 days]
Qualitative semi-structured interviews

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 100 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Caregivers presenting with a child to the pediatric clinical setting
Child age 0-25

Exclusion Criteria:

Engaged in complex care management services
Child in critical condition
Presenting to clinical setting specifically for social work intervention

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Children's Hospital of Philadelphia	Philadelphia	Pennsylvania	United States	19146

Sponsors and Collaborators

Children's Hospital of Philadelphia

Investigators

Principal Investigator: Danielle Cullen, MD MPH MSHP, Children's Hospital of Philadelphia

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

Responsible Party:

Children's Hospital of Philadelphia

ClinicalTrials.gov Identifier:

NCT05251311

Other Study ID Numbers:

21-018785

First Posted:

Feb 22, 2022

Last Update Posted:

Jun 7, 2022

Last Verified:

Jun 1, 2022

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Study Results

No Results Posted as of Jun 7, 2022