609 - Increasing Resource Dissemination for the Social Influencers of Health in Pediatric Resident Primary Care Clinics

Publication Number: 3590.609

Kathleen Kelly, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Nicole Hickman, Rady Children's Hospital San Diego, San Diego, CA, United States; Maheen Quadri, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Lucas Bruton, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Jacqueline Corboy, Northwestern Feinberg School of Medicine, Wilmette, IL, United States

Background: The presence of social influencers of health (SIoH) leads to increased acute care visits, hospitalizations, and adverse health outcomes. Given the prevalence of SIoH among children, our large, academic residency program launched a novel resident educational curriculum targeting competence in addressing SIoH. The curriculum was grounded in Kern's six stages of curriculum development and QI methodology.

Objective: To increase dissemination of community resource referrals for families who screen positive for SIoH needs in resident continuity clinic well child checks (WCC) by 10% in three months following the implementation of novel resident curriculum.

Design/Methods: A multi-day educational curriculum was launched in the pre-existing weekly clinic didactic schedule, including education on the SIoH screener given during WCC available both in English and Spanish. Electronic medical record data for WCC conducted by resident providers were assessed weekly for the 12 weeks preceding and following the intervention (July 2024 to January 2024). Data for the for number of SIoH screens documented, number of positive SIoH screens, and number of community resource referrals were evaluated. Data were stratified by language. Statistical process control (SPC) charts were used to evaluate intervention efficacy.

Results: A total of 1,729 WCC were conducted pre-intervention and 1,515 visits post intervention. There was no change in the number of positive screens (average 39%) during the study period. After the intervention, there was a run with an increased mean resource referral dissemination at WCC where SIoH screen was positive (28% pre intervention to 34% post intervention). While there was no change in the number of patients screened (average 77%) for SIoH during the entire study period, families who spoke Spanish were screened for SIoH less frequently (67%) compared to families who spoke English (78%).

Conclusion(s): With an education-based intervention, there was a significant shift toward increasing frequency of providing community resource referrals to resident continuity clinic patients. This study suggests an important role for educational interventions to increase resources dissemination for patients who are identified to have social needs. However, almost two thirds of patients who screen positive for a social need did not receive community resource referrals, suggesting education alone is insufficient to close this gap. Future work should continue to address barriers to screening, automatic resource dissemination with positive screens, and assess for continued improvement with spaced repetition of education.

SPC chart of the percentage of well child checks (WCC) where a community resource referral was sent from July 2024-January 2024.
The vertical dotted line represents when the educational intervention was conducted. The red data points indicate a run with increased shift from baseline.

SPC chart of the percentage of well child checks (WCC) where English-speaking patients were screened for SIoH from from July 2024-January 2024.
There was no observed change in the percentage of patients that were screened for SIoH during the study.

SPC chart of the percentage of well child checks (WCC) where Spanish speaking patients were screened for SIoH from from July 2024-January 2024.
There was large variation in the percentage of Spanish speaking families that were screened for SIoH during the study period.