Related Experiment Video
Updated: Mar 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Effects of Social Needs Screening and In-Person Service Navigation on Child Health: A Randomized Clinical Trial
Laura M Gottlieb1, Danielle Hessler2, Dayna Long3
1Department of Family and Community Medicine, University of California, San Francisco2Center for Health and Community, University of California, San Francisco.
Insights
Pediatric social needs screening and navigation services significantly reduced social needs and improved child health. This study demonstrates the effectiveness of addressing social determinants of health in pediatric care.
Area of Science:
- Pediatric health services research
- Social determinants of health
- Health equity
Background:
- Social determinants of health significantly impact children's immediate health and long-term disease risk.
- Pediatric healthcare organizations are increasingly implementing interventions to address family social adversity.
- Evidence on the effectiveness of these social needs interventions in pediatric settings is limited.
Purpose of the Study:
- To evaluate the impact of social needs screening and in-person resource navigation services on reported social needs and child health outcomes.
- To assess the effectiveness of a pediatric social needs navigation program within safety-net hospital settings.
Main Methods:
- A randomized clinical trial was conducted in pediatric primary and urgent care clinics.
- Participants included caregivers of minor children receiving non-acute medical care.
- The intervention group received in-person resource navigation, while the control group received information on community services.
Main Results:
- The intervention group showed a significant decrease in reported social needs compared to the control group (P < .001).
- Caregivers in the intervention group reported significantly greater improvement in their child's overall health status (P < .001).
- The study enrolled 1809 patients, with outcomes assessed at 4 months post-enrollment.
Conclusions:
- This is the first randomized clinical trial to assess health outcomes of a pediatric social needs navigation program.
- The findings support the feasibility and effectiveness of addressing social needs within pediatric healthcare.
- Interventions targeting social determinants of health can improve child health outcomes in vulnerable populations.
Importance:
Social determinants of health shape both children's immediate health and their lifetime risk for disease. Increasingly, pediatric health care organizations are intervening to address family social adversity. However, little evidence is available on the effectiveness of related interventions.
Objective:
To evaluate the effects of social needs screening and in-person resource navigation services on social needs and child health.
Design, Setting, And Participants:
Patients were randomized to intervention or active control conditions by the day of the week. Primary outcomes observed at 4 months after enrollment included caregivers' reports of social needs and child health status. Recruitment occurred between October 13, 2013, and August 27, 2015, in pediatric primary and urgent care clinics in 2 safety-net hospitals. Participants were English-speaking or Spanish-speaking caregivers accompanying minor children to nonacute medical visits.
Interventions:
After standardized screening, caregivers either received written information on relevant community services (active control) or received in-person help to access services with follow-up telephone calls for further assistance if needed (navigation intervention).
Main Outcomes And Measures:
Change in reported social needs and in caregiver assessment of child's overall health reported 4 months later.
Results:
Among 1809 patients enrolled in the study, evenly split between the 2 sites, 31.6% (n = 572) were enrolled in a primary care clinic and 68.4% (n = 1237) were enrolled in an urgent care setting. The children were primarily Hispanic white individuals (50.9% [n = 921]) and non-Hispanic black individuals (26.2% [n = 473]) and had a mean (SD) age of 5.1 (4.8) years; 50.5% (n = 913) were female. The reported number of social needs at baseline ranged from 0 to 11 of 14 total possible items, with a mean (SD) of 2.7 (2.2). At 4 months after enrollment, the number of social needs reported by the intervention arm decreased more than that reported by the control arm, with a mean (SE) change of -0.39 (0.13) vs 0.22 (0.13) (P < .001). In addition, caregivers in the intervention arm reported significantly greater improvement in their child's health, with a mean (SE) change of -0.36 (0.05) vs -0.12 (0.05) (P < .001).
Conclusions And Relevance:
To our knowledge, this investigation is the first randomized clinical trial to evaluate health outcomes of a pediatric social needs navigation program. Compared with an active control at 4 months after enrollment, the intervention significantly decreased families' reports of social needs and significantly improved children's overall health status as reported by caregivers. These findings support the feasibility and potential effect of addressing social needs in pediatric health care settings.
Trial Registration:
clinicaltrials.gov Identifier: NCT01939704.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:30Preventive Healthcare Services
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...