Borkowski Vera, Piano Mariann R, Maughan Erin D, Curry-Johnson Stacy, Jeffery Alvin D
Vanderbilt University School of Nursing, Nashville, Tennessee, USA.
School of Nursing, College of Public Health, George Mason University, Fairfax, Virginia, USA.
Pediatr Pulmonol. 2025 Apr;60(4):e71105. doi: 10.1002/ppul.71105.
Asthma has a high prevalence among children and is associated with negative outcomes and extreme costs. Asthma exacerbations, often preventable, have been associated with social determinants of health and social risk factors. It is unclear whether school-based health providers consider social information for asthma, possibly related to a lack of knowledge or data availability.
Describe the information-gathering behaviors and approaches for social risk screening for patients with asthma exacerbations performed by school-based health center providers.
We conducted a qualitative descriptive study with a purposive sample of school-based health center medical providers. We conducted four focus group sessions (total participants = 16 nurse practitioners) and employed thematic analysis to generate themes.
We identified four major themes: (1) Information-gathering tactics, (2) diligence, (3) challenges accessing and assessing social determinants of health information, and (4) uncertainty. Major findings include: (1) There is a variety of information-gathering tactics used; (2) there are missed opportunities for social risk screenings in schools; (3) social risk screening is feasibly challenging; and (4) there is continued need for resources and increased awareness of screening.
This study highlights the lived experiences of school-based health center providers in gathering information about social determinants of health and social risk factors. Challenges limit the ability to provide effective screening and referral to resources, particularly for school-age children with asthma. Our findings can be used for further research and development of informatics resources to promote effective social risk screening in school-based health centers.
哮喘在儿童中患病率很高，且与不良后果和高昂成本相关。哮喘发作往往是可预防的，与健康的社会决定因素和社会风险因素有关。尚不清楚学校的医疗服务提供者是否会考虑哮喘相关的社会信息，这可能与缺乏相关知识或数据有关。
描述学校健康中心的医疗服务提供者针对哮喘发作患者进行社会风险筛查时的信息收集行为和方法。
我们对学校健康中心的医疗服务提供者进行了一项定性描述性研究，采用目的抽样法。我们组织了四次焦点小组讨论（参与者共16名执业护士），并运用主题分析法生成主题。
我们确定了四个主要主题：（1）信息收集策略；（2）勤勉程度；（3）获取和评估健康信息的社会决定因素时面临的挑战；（4）不确定性。主要发现包括：（1）使用了多种信息收集策略；（2）学校存在社会风险筛查的机会缺失；（3）社会风险筛查在实际操作中具有挑战性；（4）持续需要资源并提高对筛查的认识。
本研究突出了学校健康中心医疗服务提供者在收集有关健康的社会决定因素和社会风险因素信息方面的实际经历。这些挑战限制了提供有效筛查和资源转诊的能力，尤其是对于患有哮喘的学龄儿童。我们的研究结果可用于进一步研究和开发信息学资源，以促进学校健康中心的有效社会风险筛查。
