Facilitating Access to Care for Children With Complex Health Needs Through Low-Barrier Place-Based Intake Processes:...

Area of Science:

• Pediatric Health
• Social Determinants of Health
• Community-Based Interventions

Background:

• Adverse social determinants of health (SDoH) in childhood are linked to long-term health issues.
• Structurally marginalized populations have high rates of developmentally vulnerable children.
• The RICHER social pediatric model aims to improve healthcare access in underserved neighborhoods.

Purpose of the Study:

• To describe children and youth engaged with the RICHER service model.
• To characterize the health and social needs of this population.

Main Methods:

• Retrospective chart review of children and youth accessing RICHER primary care services (Jan 2018 - Apr 2021).
• Descriptive data analysis using Stata v15.1.

Main Results:

• 210 charts reviewed; mean age 6.32 years.
• 33% identified as Indigenous, 15% as recent newcomers.
• 41% experienced adverse SDoH (poverty, food insecurity, child welfare involvement).
• Median 4 diagnoses per patient; 50% had neurodevelopmental disorders (developmental delay, ADHD, learning disability).
• 72% referred to specialists; 34% for neuropsychological assessments, 35% for mental health services.

Conclusions:

• The RICHER model successfully engages a medically, developmentally, and socially complex population.
• High rates of neurodevelopmental (50%) and mental health (33%) concerns were observed, exceeding general population estimates.
• This underscores the impact of SDoH and the importance of place-based programs in identifying and supporting vulnerable children.