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Mobile Social Screening and Referral Intervention in a Pediatric Emergency Department

Published:September 05, 2022DOI:https://doi.org/10.1016/j.acap.2022.08.011

      Abstract

      Objective

      Many families in pediatric emergency departments (PED) have unmet social needs, which may be detected and addressed with the use of a digital social needs intervention. Our objective was to characterize the feasibility and effectiveness of utilizing personal phones or a PED tablet for screening and referral to social services.

      Methods

      We conducted a prospective single-arm intervention study using a convenience sample of caregivers and adult patients in an urban PED between May 2019 and October 2020. Participants chose either their personal phone or a PED-provided tablet to use an app, “HelpSteps.” Participants self-selected need(s) then referrals to service agencies. Participants completed a 1-month follow-up. Clinicians were surveyed about screening and impact on visit.

      Results

      Of 266 participants enrolled, 55% of participants elected to use their personal phone. Of all participants, 67% self-selected at least 1 health-related social need; 34% selected 3 or more. The top 3 “most important” needs were housing (14%), education (12%), and fitness (12%). At one month follow-up, 44% of participants reported their top need was “completely” or “somewhat” solved. For 95% of encounters, clinicians reported the intervention did not increase length of stay.

      Conclusions

      A mobile social needs intervention was feasible and effective at identifying and referring participants in the PED setting. While more than half of participants used their personal phones, several smartphone owners cited barriers and elected to use a tablet. Overall, participants found the app easy to use, appropriate for the PED, and the intervention had minimal impact on clinical flow.

      Keywords

      Abbreviations:

      PED (Pediatric Emergency Department), EMR (Electronic Medical Record), CMMI (Center for Medicare and Medicaid Innovation), AHC (Accountable Health Communities), IPV (Interpersonal Violence), FPL (Federal Poverty Level), GED (General Educational Development)
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