622 - Facilitating Housing Intervention Uptake in Pediatric Asthma: The Role of Screening Checklists and Medical Interviews

Publication Number: 3603.622

Kate Alperin, George Washington University School of Medicine and Health Sciences, Washington DC, DC, United States; Rachel Margolis, Children’s National, Washington, DC, United States; Shayla Stringfield, Children's National Health System, Washington, DC, United States; Shilpa J.. Patel, Children's National Hospital, Bethesda, MD, United States; Parisa Kaviany, Children's National Health System, Washington, DC, United States

Background: Unmet social needs are associated with worse asthma control, and addressing these needs through targeted interventions has been shown to improve asthma control and reduce emergency room visits. Screening for unmet social needs through checklists and validated screening for unmet needs is broadly conducted and accepted. Another approach contextualizes social needs as integral to improving a patients’ clinical concern. Research is needed to understand how these different approaches influence acceptance of assistance programs.

Objective: To examine how utilization of structured social needs checklists along with targeted medical interviews impacts the acceptance of healthy housing interventions during pediatric asthma visits.

Design/Methods: We conducted a retrospective review of children screened for social needs during a 16-month period in our community-based asthma clinic. Concordance was analyzed between the pre-visit social needs checklist and modifiable household asthma triggers elicited during the patient interview, with the acceptance of housing remediation interventions as the primary outcome. Differences in intervention acceptance by checklist–interview concordance were evaluated using logistic regression.

Results: Of the 541 patients screened for social needs, those reporting no housing needs on the checklist and no relevant home exposures during the interview were excluded, leaving 457 patients for analysis. A majority were publicly insured and spoke English, 42% were female, and the median age was 13 years (IQR: 11-16). Concordance between the checklist and interview was observed in 159 patients, while 9 identified needs only on the checklist, and 289 only on the interview. Patients with concordant responses were more likely to accept an intervention (67%) than those with needs only on the checklist (11%) or interview (24%) (OR 6.4, 95% CI 4.2-9.9, p< 0.001). Expressing need only on the checklist or only during the interview was not associated with accepting an intervention.

Conclusion(s): Concordance between the pre-visit checklist and patient interview was a statistically significant predictor of intervention acceptance, highlighting the benefit of providing both structured screening social needs checklists and targeted questions in medical interviews for relative exposures in the home related to asthma health. These findings suggest that a patient's recognition of social needs paired with interview questions positively influences intervention uptake, underscoring the importance of a supportive disclosure process.

Pediatric Asthma Social Needs Screening Checklist
OUTPATIENT Asthma Social Needs Screening Tool 1.13.2022.pdfPre-visit checklist administered prior to pediatric asthma visits to identify housing-related and other modifiable social needs.