Kanak Mia M, Fleegler Eric W, Chang Lawrence, Curt Alexa M, Burdick Kendall J, Monuteaux Michael C, Deane Melissa, Warrington Peter, Stewart Amanda M
Children's Hospital Los Angeles (MM Kanak), Division of Emergency Medicine and Transport Medicine, Los Angeles, Calif.
Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass; Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass.
Acad Pediatr. 2023 Jan-Feb;23(1):93-101. doi: 10.1016/j.acap.2022.08.011. Epub 2022 Sep 6.
Many families in pediatric emergency departments (PED) have unmet social needs, which may be detected and addressed with the use of a digital social needs intervention. Our objective was to characterize the feasibility and effectiveness of utilizing personal phones or a PED tablet for screening and referral to social services.
We conducted a prospective single-arm intervention study using a convenience sample of caregivers and adult patients in an urban PED between May 2019 and October 2020. Participants chose either their personal phone or a PED-provided tablet to use an app, "HelpSteps." Participants self-selected need(s) then referrals to service agencies. Participants completed a 1-month follow-up. Clinicians were surveyed about screening and impact on visit.
Of 266 participants enrolled, 55% of participants elected to use their personal phone. Of all participants, 67% self-selected at least 1 health-related social need; 34% selected 3 or more. The top 3 "most important" needs were housing (14%), education (12%), and fitness (12%). At one month follow-up, 44% of participants reported their top need was "completely" or "somewhat" solved. For 95% of encounters, clinicians reported the intervention did not increase length of stay.
A mobile social needs intervention was feasible and effective at identifying and referring participants in the PED setting. While more than half of participants used their personal phones, several smartphone owners cited barriers and elected to use a tablet. Overall, participants found the app easy to use, appropriate for the PED, and the intervention had minimal impact on clinical flow.
许多儿科急诊科（PED）的家庭存在未得到满足的社会需求，使用数字社会需求干预措施可能会发现并解决这些需求。我们的目的是描述利用个人手机或PED平板电脑进行社会服务筛查和转诊的可行性和有效性。
我们在2019年5月至2020年10月期间，对城市PED中的照顾者和成年患者进行了一项前瞻性单臂干预研究，采用便利抽样。参与者选择使用他们的个人手机或PED提供的平板电脑来使用一款名为“HelpSteps”的应用程序。参与者自行选择需求，然后转介到服务机构。参与者完成了为期1个月的随访。对临床医生进行了关于筛查和对就诊影响的调查。
在266名登记的参与者中，55%的参与者选择使用他们的个人手机。在所有参与者中，67%自行选择了至少一项与健康相关的社会需求；34%选择了三项或更多。排名前三的“最重要”需求是住房（14%）、教育（12%）和健身（12%）。在1个月的随访中，44%的参与者报告他们的首要需求“完全”或“部分”得到了解决。在95%的就诊中，临床医生报告该干预措施没有增加住院时间。
移动社会需求干预措施在PED环境中识别和转介参与者方面是可行且有效的。虽然超过一半的参与者使用他们的个人手机，但一些智能手机用户提到了障碍并选择使用平板电脑。总体而言，参与者发现该应用程序易于使用，适用于PED，并且该干预措施对临床流程的影响最小。
