Caregivers' Views of a Pediatric Inpatient Intervention to Address Health-Related Social Risks

To understand the experiences of parents and caregivers of hospitalized children with CommunityRx-Hunger, a social care intervention designed to address food insecurity and other health-related social risks (HRSRs). Perspectives on how clinicians can sensitively deliver information about HRSRs in the pediatric inpatient setting were also elicited.

In-depth, semistructured qualitative interviews were conducted (April 2022 through April 2023) with caregivers of children hospitalized at an urban academic medical center. Caregivers (N = 23) were purposefully sampled from the intervention arm of the double-blind CommunityRx-Hunger randomized controlled trial (NCT4171999). Initiated during hospital discharge, CommunityRx-Hunger includes 3 evidence-based components: education about HRSRs, delivery of HRSR-related resource information, and ongoing support to boost the intervention over 12 months. Data were analyzed using directed content analysis.

Most caregivers identified as the child's mother (n = 20) and as African American or Black (n = 19) and were partnered (n = 14). Three main themes emerged: (1) positive experiences with CommunityRx-Hunger, including the sentiment that caregivers were unaware of the amount of community resources available to address HRSRs and perceptions that caregivers "were set up for success once we left the hospital"; (2) barriers to integrating social care with medical care, including concern that clinicians "are gonna use [disclosure of HRSRs] against me"; and (3) recommendations for optimizing social care delivery, including a prevalent suggestion to "just give the information" to caregivers, without asking about risks or needs.

CommunityRx-Hunger was mostly well received by caregivers. Routinely providing resource information to all caregivers of hospitalized children, regardless of need, could help alleviate concerns about disclosing HRSRs.