A Health System-Wide Approach to Addressing Unmet Social Needs Among Children With Asthma

Area of Science:

• Pediatric Health
• Public Health
• Health Disparities

Background:

• Social determinants like housing and financial hardship significantly increase pediatric asthma morbidity and health disparities.
• While general social risk screening is common, asthma-specific models and social needs screening (focusing on preferences) are less described.
• Existing literature highlights social factors driving health inequities in pediatric asthma.

Purpose of the Study:

• To describe the implementation of a health system-wide, asthma-specific social needs checklist using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework.
• To evaluate the feasibility, acceptability, and sustainability of this screening in various settings within an urban pediatric medical center.
• To characterize the social needs of families with children diagnosed with asthma.

Main Methods:

• Utilized the EPIS framework to guide the implementation process.
• Expanded an existing community-based asthma program's social needs screening to multiple clinical settings.
• Assessed implementation outcomes including feasibility, acceptability, and sustainability, alongside documenting identified social needs.

Main Results:

• The asthma-specific social needs checklist was broadly acceptable to families.
• Implementation feasibility and sustainability were site-dependent, influenced by leadership support and dedicated staffing.
• A high prevalence of unmet social needs was identified among families of children with asthma.

Conclusions:

• Expanding asthma-specific social needs screening is feasible and acceptable, though site-specific factors impact success.
• Addressing the high burden of unmet social needs is critical for mitigating pediatric asthma disparities.
• Future efforts should focus on overcoming implementation barriers and evaluating the longitudinal impact on patient outcomes.