634 - Identifying Parent Preferences for Health-Related Social Needs Survey Administration in the Adolescent Population

Publication Number: 3614.634

Grace Bailey, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Olivia Migliori, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Neha Shastri, UPMC Childrens Hospital of Pittsburgh, Wexford, PA, United States; Kristin Ray, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Maya Ragavan, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

Background: Health-related social needs (HRSN) are linked to adverse child health outcomes. There has been momentum towards integrated HRSN screening in pediatric primary care. However, most HRSN screenings focus on caregivers of young children. Less is known about how best to implement HRSN programs for adolescents and their caregivers.

Objective: The goal of the study was to explore the perspectives of adolescents' caregivers regarding: 1) current HRSN screening practices; 2) how adolescents should be included in HRSN screening; and 3) recommendations for implementing HRSN screening for adolescents in primary care.

Design/Methods: We conducted semi-structured interviews with caregivers of children ages 13-17 who attended a well-child visit within the last year and who experienced or knew somebody experiencing insecurity in food, housing, transportation or utilities. Caregivers were recruited using an online recruitment repository or during their child's annual visit. Interviews were conducted via Zoom, were audio recorded, and lasted 45 minutes. Recordings were transcribed and analyzed using thematic analysis. Two coders individually coded the first 10 interviews and met to resolve discrepancy. After finalizing the codebook, every 3rd interview was dual coded. We completed interviews until reaching thematic saturation.

Results: 20 caregivers participated; the majority identified as cisgender female and African American. Participants described generally not being asked about HRSN during adolescent well-visits. They were supportive of teen inclusion in HRSN screening, noting the increased potential of identifying family needs and the opportunity to improve teen autonomy. They also described concerns that teens might be uninformed about their family's needs or intentionally mislead providers. Many participants therefore supported a screening model involving input from both caregiver and teen. Participants also expressed deep concern that their responses could lead to Child Protective Services involvement. They emphasized the importance of clear provider-parent communication to set expectations about teen participation and potential follow-up actions. They additionally recommended a self-administered survey modality to minimize discomfort and urged screening and potential resource provision, to all families, not only to those deemed high-risk.

Conclusion(s): Parents support utilizing teen input as part of HRSN screening but note the importance of communication about the intent of the process. Future studies should co-create and rigorously test HRSN screening and intervention programs with caregiver-adolescent dyads.

Table 1: Key themes and representative participant quotes