Department of Pediatrics, Maimonides Medical Center, Brooklyn, New York, USA.
Popul Health Manag. 2022 Apr;25(2):186-191. doi: 10.1089/pop.2021.0277.
In March 2020, at the start of the COVID-19 pandemic, New York City instituted a shelter-in-place order, dramatically affecting the area's social and economic landscape. Pediatric primary care practices universally screen for social determinants of health (SDOH) and mental health (MH) needs, providing an opportunity to assess changes in the population's needs during COVID-19. To assess changes in SDOH and MH needs of pediatric families before and during COVID-19, the authors conducted a prospective cohort study of patients seen in the hospital's pediatric primary care practices. Baseline data were collected during well visits from March 1, 2019 to March 1, 2020, and included the following outcome measures: Patient Health Questionnaire (PHQ2) score >0, PHQ9 scores ≥5, pediatric symptom checklist (PSC17) scores ≥15, and SDOH needs. Follow-up pandemic data were collected from June to August 2020. A total of 423 patients (215 [51%] female, 279 [66%] Hispanic, and 248 [59%] primary English speakers) were enrolled in the study. The following SDOH needs significantly increased during COVID-19: food (17%-32%; < 0.001), legal (19%-30%; = 0.003), public benefits (4%-13.8%; < 0.001), and housing (17.2%-26%; = 0.002). There was no significant change in MH screening results during COVID-19 compared with baseline: positive PHQ2 depression screen (27.9% vs. 34.3%, = 0.39), positive PHQ9 depression screen (45.5% vs. 64.1%, = 0.32), or positive PSC17 measuring emotional and behavioral concerns (4.9% vs. 8.2%, = 0.13). During COVID-19, patients with food, housing, or legal needs had a significantly higher likelihood of having emotional or behavioral difficulties ( < 0.01). Further research is needed to evaluate outcomes in the following months.
2020 年 3 月，在 COVID-19 大流行开始时，纽约市实施了就地避难令，这极大地影响了该地区的社会和经济格局。儿科初级保健实践普遍筛查社会决定因素健康（SDOH）和心理健康（MH）需求，为评估 COVID-19 期间人群需求的变化提供了机会。为了评估 COVID-19 之前和期间儿科家庭的 SDOH 和 MH 需求的变化，作者对医院儿科初级保健实践中就诊的患者进行了前瞻性队列研究。基线数据于 2019 年 3 月 1 日至 2020 年 3 月 1 日期间在就诊时收集，包括以下结果指标：患者健康问卷（PHQ2）评分>0、PHQ9 评分≥5、儿科症状清单（PSC17）评分≥15 和 SDOH 需要。2020 年 6 月至 8 月收集了后续大流行数据。共有 423 名患者（215[51%]名女性、279[66%]名西班牙裔和 248[59%]名主要英语使用者）入组该研究。在 COVID-19 期间，以下 SDOH 需要显著增加：食物（17%-32%； < 0.001）、法律（19%-30%； = 0.003）、公共福利（4%-13.8%； < 0.001）和住房（17.2%-26%； = 0.002）。与基线相比，COVID-19 期间心理健康筛查结果没有显著变化：阳性 PHQ2 抑郁筛查（27.9%比 34.3%； = 0.39）、阳性 PHQ9 抑郁筛查（45.5%比 64.1%； = 0.32）或阳性 PSC17 测量情绪和行为问题（4.9%比 8.2%； = 0.13）。在 COVID-19 期间，有食物、住房或法律需求的患者出现情绪或行为困难的可能性显著更高（ < 0.01）。需要进一步研究来评估接下来几个月的结果。
