190 - “Keep on Fighting ‘Til the End”: The Vital Role of Provider Champions in Screening for Social Determinants of Health Before and During the COVID-19 Pandemic

Poster Number: 190
Publication Number: 190.413

Hong-An T. Nguyen, The Children's Hospital at Montefiore, Bronx, NY, United States; Rachel Berman, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, NY, United States; Samantha R. Levano, Albert Einstein College of Medicine, Bronx, NY, United States; Kevin Fiori, Albert Einstein College of Medicine, Bronx, NY, United States

Background: Routine screening for social determinants of health (SDoH) is recommended by the American Academy of Pediatrics; however, clinicians and health systems face many barriers in integrating such screening into practice. The COVID-19 pandemic has not only increased social needs among families but also contributed additional challenges to screening due to declines in pediatric primary care visits. The role of clinician champions has been critical to implementation change in health care settings and has been proposed as a solution to better integrate SDoH screening into routine care.

Objective: To assess the impact of "provider champions” on social needs screening and its role in sustaining screening during a global pandemic.

Design/Methods: Social needs screening data from April 2018-August 2021 were assessed at 11 pediatric primary care practices in the Bronx, NY. 3 intervention practices had provider champions while 8 control practices did not. The primary outcome was the number of administered social needs screens. The primary predictor was the time period when screening was conducted, dichotomized as before or after introduction of provider champions. Offset time for intervention practices were assigned based on the introduction of provider champions and, for control practices, reflected the total time, in months, that the practice contributed data. Wald Chi-Square tests and Poisson regressions evaluated the association between social needs screening and the introduction of provider champions.

Results: 32,183 social needs screens were administered (Table 1). The introduction of a provider champion was a significant predictor of social needs screening (p < 0.001). Between intervention and control practices, the rate of social needs screening for practices with a provider champion was 2.8 times higher per month than for practices without a provider champion (p < 0.001). Descriptive statistics demonstrate that practices experienced an initial decline in screening with the onset of the COVID-19 pandemic. Practices with provider champions, however, had even higher rates of social needs screening as the pandemic has continued (Figure 1).Conclusion(s): Provider champions increased social needs screening rates in pediatric primary care practices. Practices with provider champions continued to demonstrate increased screening rates even after the onset of the COVID-19 pandemic.
Table 1: Demographic Characteristics of Intervention and Control Ambulatory Pediatric Practices, April 2018-August 2021
Table 2: Practice Characteristics and Screens Administered Before and After Intervention, April 2018-August 2021