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Universal Psychosocial Screening in Hospitalized Pediatric Patients: A Randomized Control Trial
Rebecca Liu1,2, Alyssa Chong2,3, Jeffrey N Bone4
1Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Insights
The MyHEARTSMAP screening tool identified children with high psychosocial burden. While overall intervention rates were similar, children with positive MyHEARTSMAP screens received more psychosocial interventions, showing its promise for pediatric mental health.
Area of Science:
- Pediatric Psychology
- Child Mental Health
- Healthcare Screening Tools
Background:
- Hospitalized children face significant psychosocial challenges.
- Existing screening methods may not adequately address these needs.
- The MyHEARTSMAP tool was developed for psychosocial self-screening.
Purpose of the Study:
- To compare psychosocial intervention rates between children screened with MyHEARTSMAP during hospitalization and those screened post-discharge.
- To explore resource utilization 3 months after hospital discharge.
Main Methods:
- A randomized controlled trial in an emergency department involving 289 admitted children.
- Intervention group: MyHEARTSMAP screening during admission, results shared with clinicians.
- Control group: Standard care, MyHEARTSMAP screening post-discharge. Health records reviewed for management and follow-up.
Main Results:
- Overall psychosocial intervention rates were 40.4% (intervention) vs. 32.9% (control), not statistically significant (p=.109).
- Among children with positive screens, intervention rates were significantly higher in the intervention group (41.3%) vs. control (25.1%) (p=.0318).
- Post-discharge service engagement at 3 months was modest.
Conclusions:
- Universal screening using MyHEARTSMAP can identify children at higher risk for psychosocial burden.
- MyHEARTSMAP demonstrates potential as an accessible tool for addressing pediatric psychosocial needs.
- Targeted screening may improve intervention uptake for at-risk youth.
Abstract:
IntroductionA validated psychosocial self-screening tool, MyHEARTSMAP, was used to screen hospitalized children, who often experience disproportionate mental health burdens. The primary objective compared the proportion of participants receiving psychosocial intervention between those with and without MyHEARTSMAP screening. Secondarily, we explored the utilization of resources at 3 months post-discharge.MethodsThis randomized control trial was conducted in an emergency department, enrolling 289 children being admitted. The intervention group completed MyHEARTSMAP, and results were shared with clinicians. The control group received standard care and completed MyHEARTSMAP following discharge. Health records were reviewed to document in-hospital management. Descriptive statistics and logistic regression modeling were used to evaluate the association between screening and intervention.ResultsPsychosocial intervention rates were higher in the intervention group (40.4%) than the control (32.9%), though this was not significant (RR = 1.28, 95% CI [0.95, 1.73], p = .109). Among those with positive screening results, the intervention group had a statistically significant higher proportion of psychosocial intervention (41.3%) than the control (25.1%) (RR = 1.60, 95% CI [1.04, 2.46], p = .0318). At 3 months post-discharge, engagement with recommended services was overall modest.ConclusionsUniversal screening can identify youth at higher risk of psychosocial burden, and MyHEARTSMAP shows promise as a low-barrier tool for addressing the psychosocial needs of children.
