Pasadena-Pediatric and Adolescent Health Center (PA-PAHC) Patient Social Needs as Identified by Caregivers, Pediatric Residents, and Staff/Faculty

Padma Swamy, The University of Texas School of Public Health


Background: Toxic stress can have a lasting impact upon a child’s health. The American Academy of Pediatrics recommends, in several policy statements, that pediatricians address the social determinants of health (SDOH) through research, community partnership and policy development. ^ Objective: The aim of this study was to identify the unmet social needs of the patients served by the Pasadena-Pediatric and Adolescent Health Center (PA-PAHC) for development of a SDOH screening process. ^ Methods: The PA-PAHC serves a predominately underserved population in the Southeast Houston and Pasadena area. A cross-sectional survey was administered to caregivers of children presenting for their well check-up, pediatric residents, and staff/faculty at the PA-PAHC. In addition, the clinic staff/faculty and pediatric residents were also given a set of Likert based questions on their perceptions of the impact of SDOH on patient health. ^ Statistical analysis involved frequencies for categorical data, and mean/median for continuous variables. Secondary data analysis consisted of chi-square, Wilcoxon ranksum test, and logistic regression. Inter-rater reliability was measured using a weighted kappa. ^ Results: Results showed that healthcare was of the most concern to caregivers (14%). 47% of the caregivers did not identify any needs. The Wilcoxon ranksum showed that this 47% tended to have children younger in age (p=0.097). Pediatric residents and staff/faculty had high levels of agreement (70.2%). Staff/faculty had better agreement with caregivers than residents (62.9% vs. 66.0%). Pediatric residents had greater agreement with Spanish speaking caregivers than English speaking caregivers. ^ Discussion: This study shows that there is a need to expand knowledge on older children to better understand their social needs. This study showed that there are differences in needs based upon language. Limitations include that there was variation between the caregiver, pediatric resident and staff/faculty surveys. ^ Conclusion: Staff/faculty and pediatric residents view social determinants as impacting child health. A majority of caregivers identified at least one need (54%). Recommendations based upon this data show that a focus on health insurance needs should be prioritized given that all three groups identified this need. Further data needs to be collected on the children who present for urgent care visits, and a qualitative approach to elucidate more information on barriers and benefits of screening.^

Subject Area

Social research|Public health

Recommended Citation

Swamy, Padma, "Pasadena-Pediatric and Adolescent Health Center (PA-PAHC) Patient Social Needs as Identified by Caregivers, Pediatric Residents, and Staff/Faculty" (2017). Texas Medical Center Dissertations (via ProQuest). AAI10277827.