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Acad Pediatr ; 19(8): 868-874, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30862512

RESUMO

OBJECTIVE: Describe current practices in systematic screening for social determinants of health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET). METHODS: CORNET clinic directors were surveyed on demographics, barriers to screening, and screening practices for 15 SDH, including the screen source, timing of screening, process of administering the screen, and personnel involved in screening. Incidence rate ratios were tabulated to investigate relationships among screening practices and clinic staff composition. RESULTS: Clinic response rate was 41% (65/158). Clinics reported screening for between 0 and 15 SDH (median, 7). Maternal depression (86%), child educational problems (84%), and food insecurity (71%) were the items most commonly screened. Immigration status (17%), parental health literacy (19%), and parental incarceration (21%) were least commonly screened. Within 3 years, clinics plan to screen for 25% of SDH not currently being screened. Barriers to screening included lack of time (63%), resources (50%), and training (46%). CONCLUSIONS: Screening for SDH in our study population of CORNET clinics is common but has not been universally implemented. Screening practices are variable and reflect the complex nature of screening, including the heterogeneity of the patient populations, the clinic staff composition, and the SDH encountered.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Depressão/diagnóstico , Educação , Abastecimento de Alimentos , Internato e Residência , Programas de Rastreamento/estatística & dados numéricos , Pediatria/educação , Padrões de Prática Médica/estatística & dados numéricos , Determinantes Sociais da Saúde , Assistência Ambulatorial/organização & administração , Criança , Maus-Tratos Infantis/diagnóstico , Cuidado da Criança , Agentes Comunitários de Saúde , Direito Penal , Estudos Transversais , Emigração e Imigração , Armas de Fogo , Letramento em Saúde , Humanos , Violência por Parceiro Íntimo , Programas de Rastreamento/organização & administração , Mães/psicologia , Avaliação das Necessidades , Médicos de Atenção Primária , Características de Residência , Assistentes Sociais , Fatores de Tempo
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