PMID- 37273312
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230606
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 5
DP  - 2023 May
TI  - Preliminary Pilot-Testing of Social Determinants of Health Screener for 
      Individuals With Intellectual and Developmental Disabilities in Med-Peds.
PG  - e38541
LID - 10.7759/cureus.38541 [doi]
LID - e38541
AB  - In the United States, one in six children has an intellectual and/or 
      developmental disability (I/DD), including attention deficit hyperactivity 
      disorder (ADHD), autism, cerebral palsy, learning disabilities, seizures, and 
      developmental delays, with or without intellectual impairment. Individuals with 
      I/DDs experience disproportionate rates of immune, metabolic, cardiovascular, and 
      neurological disorders, as well as anxiety, depression, functional somatic 
      symptoms, and other co-occurring physical and mental health conditions. During 
      the coronavirus disease 2019 (COVID-19) pandemic, having an I/DD emerged as one 
      of the strongest predictors of contracting and dying from COVID-19. These 
      findings spurred increased attention toward the myriad health inequities 
      affecting this population well before the pandemic. While inequities for 
      individuals with I/DD can be traced to many factors, social determinants of 
      health (SDOH) - the underlying social, economic, and environmental 
      conditions that lead to poor health outcomes and high healthcare costs - are key 
      contributors. Our interdisciplinary combined internal medicine and pediatrics 
      (Med-Peds) team of physicians, psychologists, and researchers within a large, 
      diverse, academic health system aimed to pilot-test the implementation of a 
      five-item SDOH screener within a Med-Peds specialty clinic focused on the 
      developmental needs of individuals with I/DD and their families (Leadership 
      Education in Neurodevelopmental Disabilities LEND) and a general primary care 
      practice (PCP). The SDOH screener tested in this initiative includes five items 
      from the Accountable Health Communities (AHC) Health-Related Social Needs 
      Screening Tool (HRSN) assessing social isolation, food insecurity, 
      transportation, and paying for basic needs, such as housing and medical care. In 
      this study, we describe the process of implementing this screener and collecting 
      initial pilot data from 747 patients between October 2022 and April 2023 across 
      the LEND and the primary care practice. We also highlight the challenges and 
      opportunities identified during the mid-way point of implementation and pilot 
      testing. The results of this pilot study revealed low response rates among SDOH 
      screeners, spurring several measures to increase uptake, including increasing the 
      accessibility of the screener and ensuring the screener results in effective 
      referrals. We call on additional Med-Peds healthcare teams without universal SDOH 
      screening protocols in place - particularly those serving the I/DD population - 
      to consider adopting these practices.
CI  - Copyright (c) 2023, Hotez et al.
FAU - Hotez, Emily
AU  - Hotez E
AD  - General Internal Medicine, University of California Los Angeles, David Geffen 
      School of Medicine, Los Angeles, USA.
FAU - Chua, Kristine J
AU  - Chua KJ
AD  - General Internal Medicine, University of California Los Angeles, David Geffen 
      School of Medicine, Los Angeles, USA.
FAU - Samras, Nathan
AU  - Samras N
AD  - General Internal Medicine, University of California Los Angeles, David Geffen 
      School of Medicine, Los Angeles, USA.
FAU - Smith, Andrew M
AU  - Smith AM
AD  - General Internal Medicine, University of California Los Angeles, David Geffen 
      School of Medicine, Los Angeles, USA.
FAU - Kuo, Alice
AU  - Kuo A
AD  - General Internal Medicine, University of California Los Angeles, David Geffen 
      School of Medicine, Los Angeles, USA.
LA  - eng
PT  - Journal Article
DEP - 20230504
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10239263
OTO - NOTNLM
OT  - intellectual and developmental disabilities
OT  - interdisciplinary health team
OT  - med peds
OT  - screening
OT  - social determinants of health (sdoh)
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/06/05 13:04
MHDA- 2023/06/05 13:05
PMCR- 2023/05/04
CRDT- 2023/06/05 11:45
PHST- 2023/03/21 00:00 [received]
PHST- 2023/05/03 00:00 [accepted]
PHST- 2023/06/05 13:05 [medline]
PHST- 2023/06/05 13:04 [pubmed]
PHST- 2023/06/05 11:45 [entrez]
PHST- 2023/05/04 00:00 [pmc-release]
AID - 10.7759/cureus.38541 [doi]
PST - epublish
SO  - Cureus. 2023 May 4;15(5):e38541. doi: 10.7759/cureus.38541. eCollection 2023 May.