Abramsohn Emily M, Mendoza Tania A, Bartlett Allison H, Glasser Nathaniel J, Grana Mellissa, Jerome Jessica, Miller Doriane C, Murphy Jeff, O'Malley Christine, Waxman Elaine, Tessler Lindau Stacy
Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.
Department of Pediatrics, Comer Children's Hospital, UChicago Medicine, Chicago, Illinois.
Hosp Pediatr. 2025 Jan 1;15(1):46-56. doi: 10.1542/hpeds.2024-008025.
To understand the experiences of parents and caregivers of hospitalized children with CommunityRx-Hunger, a social care intervention designed to address food insecurity and other health-related social risks (HRSRs). Perspectives on how clinicians can sensitively deliver information about HRSRs in the pediatric inpatient setting were also elicited.
In-depth, semistructured qualitative interviews were conducted (April 2022 through April 2023) with caregivers of children hospitalized at an urban academic medical center. Caregivers (N = 23) were purposefully sampled from the intervention arm of the double-blind CommunityRx-Hunger randomized controlled trial (NCT4171999). Initiated during hospital discharge, CommunityRx-Hunger includes 3 evidence-based components: education about HRSRs, delivery of HRSR-related resource information, and ongoing support to boost the intervention over 12 months. Data were analyzed using directed content analysis.
Most caregivers identified as the child's mother (n = 20) and as African American or Black (n = 19) and were partnered (n = 14). Three main themes emerged: (1) positive experiences with CommunityRx-Hunger, including the sentiment that caregivers were unaware of the amount of community resources available to address HRSRs and perceptions that caregivers "were set up for success once we left the hospital"; (2) barriers to integrating social care with medical care, including concern that clinicians "are gonna use [disclosure of HRSRs] against me"; and (3) recommendations for optimizing social care delivery, including a prevalent suggestion to "just give the information" to caregivers, without asking about risks or needs.
CommunityRx-Hunger was mostly well received by caregivers. Routinely providing resource information to all caregivers of hospitalized children, regardless of need, could help alleviate concerns about disclosing HRSRs.
了解住院儿童的父母及照料者参与“社区处方 - 饥饿”项目的体验,该项目是一项旨在解决粮食不安全及其他与健康相关的社会风险(HRSRs)的社会关怀干预措施。同时,还探讨了临床医生如何在儿科住院环境中敏感地提供有关HRSRs信息的观点。
于2022年4月至2023年4月对一家城市学术医疗中心住院儿童的照料者进行了深入的半结构化定性访谈。照料者(N = 23)是从双盲社区处方 - 饥饿随机对照试验(NCT4171999)的干预组中有目的地抽取的。社区处方 - 饥饿项目在出院时启动,包括三个基于证据的组成部分:关于HRSRs的教育、提供与HRSRs相关的资源信息以及在12个月内持续提供支持以加强干预。使用定向内容分析法对数据进行分析。
大多数照料者为孩子的母亲(n = 20),非裔美国人或黑人(n = 19),且处于伴侣关系(n = 14)。出现了三个主要主题:(1)对社区处方 - 饥饿项目的积极体验,包括照料者表示未意识到有多少社区资源可用于解决HRSRs,以及认为“一旦我们出院,就为成功做好了准备”;(2)社会关怀与医疗护理整合的障碍,包括担心临床医生“会利用(HRSRs的披露)来对付我”;(3)优化社会关怀提供的建议,包括普遍建议“直接向照料者提供信息”,而不询问风险或需求。
照料者对社区处方 - 饥饿项目大多表示认可。无论需求如何,定期向所有住院儿童的照料者提供资源信息有助于减轻对披露HRSRs的担忧。