Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-7-2022

Graduate Advisor

Elise Schaller, DNP, MHA, APRN, CPNP-PC

Committee

Vanessa Loyd, DNP, PhD, RN

Allison King, MD, MPH, PhD

Abstract

Problem: Social determinants of health (SDOH) affect health outcomes across the lifespan. The American Academy of Pediatrics recommends routine screening for SDOH. Poverty is a SDOH affecting health outcomes in children, especially in children with a chronic disease such as sickle cell disease (SCD). Children with sickle cell disease have a high burden of SDOH. This project sought to describe the SDOH barriers experienced by pediatric patients with SCD.

Methods: A descriptive survey/observational design, using a convenience sample of pediatric patients ages 0-19 years old in a comprehensive SCD clinic at a large, urban, Midwestern academic medical center was utilized for this project. The validated, self-reported, WE CARE screener, assessing eight domains of SDOH, was given to patients/families to fill out during a routine clinic visit. Any patient that endorsed one or more SDOH was given a community resource sheet with their After Visit Summaries (AVS). Data taken directly from these screeners was analyzed.

Results: During the pilot period (February – April, 2022), 102 (75%) of 136 eligible unique patients/families were screened. A large majority of patients, 83% (68), endorsed at least one or more needs; 17% (34) patients/families did not endorse any needs. The most frequent needs endorsed were food at 21%, followed by the desire for more education at 17% and difficulty paying utilities at 16%.

Implications for Practice: Screening for SDOH should be universal/routine in comprehensive sub-specialty clinics that become medical homes for patients to allow for early referral and intervention to mitigate endorsed SDOH.

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