P0670 - Behind the Screen: Caregiver Preferences for Social Determinants of Health Screening and Resource Delivery

Background: The American Academy of Pediatrics recommends social determinants of health (SDOH) screening of all families and providing resources in the clinical setting. However, preferences for both SDOH screening and resource delivery vary greatly. In particular, patients’ comfort with screening and resource delivery, specifically where, how, and by whom, is unclear.

Objective: To determine where, how and by whom caregivers would like to be screened for SDOH and receive resources.

Methods: The study was conducted at 3 pediatric clinics that care for underserved children across greater Houston. Two are free standing clinics and the third is a mobile clinic that travels to different locations daily. Adult caregivers (18 years or older) of children accessing care at the clinics were approached by a trained research assistant to participate in the study by completing a survey on their attitudes and preferences towards SDOH screening and resource delivery. The 17-item survey, developed through cognitive interviewing and expert consultation, was completed by caregivers in either English or Spanish. The survey included questions on comfort with SDOH screening, who should conduct screening, how resources should be provided and demographic information of the family. Descriptive statistics, t-tests and chi-square analysis were conducted.

Results: A total of 382 surveys were collected across the sites (response rate=86.2%). Sixty-eight percent of caregivers felt comfortable/very comfortable with SDOH screening in the clinical setting. Caregivers preferred SDOH screening by doctors (50.4%), via paper (61.4%), and to receive resources from doctors (41.6%) by having assistance in clinic (44.5%). Caregivers who completed the survey in Spanish had 2.6 greater odds (±0.7, p=0.001) of preferring verbal SDOH screening to paper screening when compared to those completing the survey in English. Furthermore, caregivers completing the survey in Spanish had 0.4 odds (p<0.0001) of preferring resource handouts from clinical staff when compared to those completing the survey in English.

Conclusion: Caregivers feel comfortable with SDOH screening in clinic. Spanish speaking caregivers were more likely to prefer verbal screening and less likely to prefer paper resource handouts. Clinics serving patients who are primarily Spanish speaking should consider verbal screening and resources other than paper handouts to address preferences of the patients.