Evidence map›Paper›PMID 34802465›Full record

ArticleImplementation science communications2021

Feasibility of implementing systematic social needs assessment for children with medical complexity.

David Y Ming, Kelley A Jones, Elizabeth Sainz, Heidie Tkach, Amy Stewart, Ashley Cram, Madlyn C Morreale, Samantha Dizon, Neal A deJong

Open access · goldAbstract read
In one paragraph

Article in Implementation science communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Rural-urban disparities in health care delivery for children with medical complexity and moderating effects of payer, disability, and community poverty.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

David Y MingDepartment of Pediatrics, DUMC, Duke University School of Medicine, Box 3352, Durham, NC, 27710, USA. david.ming@duke.edu.ORCID http://orcid.org/0000-0003-2836-6656
Kelley A JonesDepartment of Population Health Sciences, Duke University School of Medicine, 215 Morris St, Durham, NC, 27701, USA.
Elizabeth SainzDepartment of Pediatrics, DUMC, Duke University School of Medicine, Box 3352, Durham, NC, 27710, USA.
Heidie TkachDepartment of Pediatrics, University of North Carolina School of Medicine, 260 MacNider Building, CB#7220, Chapel Hill, NC, 27599, USA.
Amy StewartDepartment of Pediatrics, University of North Carolina School of Medicine, 260 MacNider Building, CB#7220, Chapel Hill, NC, 27599, USA.
Ashley CramUniversity of North Carolina School of Public Health, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
Madlyn C MorrealeDepartment of Pediatrics, University of North Carolina School of Medicine, 260 MacNider Building, CB#7220, Chapel Hill, NC, 27599, USA.
Samantha DizonDepartment of Pediatrics, DUMC, Duke University School of Medicine, Box 3352, Durham, NC, 27710, USA.
Neal A deJongDepartment of Pediatrics, University of North Carolina School of Medicine, 260 MacNider Building, CB#7220, Chapel Hill, NC, 27599, USA.
University of North Carolina at Chapel Hill · USDuke University · US

Funding

North Carolina Translational and Clinical Science Institute (NC TraCS) KL2KL2TR002490 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WEINBERGER, MORRIS · 2018 to 2022
$11.0M
NCATS NIH HHS KL2 TR002490NCATS NIH HHS KL2TR002490NHLBI NIH HHS K12HL13830
6 · The paper itself

Abstract

backgroundChildren with medical complexity (CMC) have inter-related health and social needs; however, interventions to identify and respond to social needs have not been adapted for CMC. The objective of this study was to evaluate the feasibility of implementing social needs screening and assessment within pediatric complex care programs.

methodsWe implemented systematic social needs assessment for CMC (SSNAC) at two tertiary care centers in three phases: (1) pre-implementation, (2) implementation, and (3) implementation monitoring. We utilized a multifaceted implementation package consisting of discrete implementation strategies within each phase. In phase 1, we adapted questions from evidence-informed screening tools into a 21-item SSNAC questionnaire, and we used published frameworks to inform implementation readiness and process. In phases 2-3, clinical staff deployed the SSNAC questionnaire to parents of CMC in-person or by phone as part of usual care and adapted to local clinical workflows. Staff used shared decision-making with parents and addressed identified needs by providing information about available resources, offering direct assistance, and making referrals to community agencies. Implementation outcomes included fidelity, feasibility, acceptability, and appropriateness.

resultsObservations from clinical staff characterized fidelity to use of the SSNAC questionnaire, assessment template, and shared decision-making for follow-up on unmet social needs. Levels of agreement (5-point Likert scale; 1 = completely disagree; 5 = completely agree) rated by staff for key implementation outcomes were moderate to high for acceptability (mean = 4.7; range = 3-5), feasibility (mean = 4.2; range = 3-5), and appropriateness (mean = 4.6; range = 4-5). 49 SSNAC questionnaires were completed with a 91% response rate. Among participating parents, 37 (76%) reported ≥ 1 social need, including food/nutrition benefits (41%), housing (18%), and caregiver needs (29%). Staff responses included information provision (41%), direct assistance (30%), and agency referral (30%).

conclusionsIt was feasible for tertiary care center-based pediatric complex care programs to implement a standardized social needs assessment for CMC to identify and address parent-reported unmet social needs.

Indexed as

Children with medical complexityComplex careImplementation strategySocial determinants of health

Identifiers

PMID34802465
PMCPMC8606226
OpenAlexW3216447651

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.