Screening for social determinants of health in limited English proficiency families in pediatric primary care

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ESPR167
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Abstract: :

Background: Pediatricians are caring for an increasing number of families who have limited English proficiency (LEP) or speak a language other than English in their home. LEP and social determinants of health (SDH), have both been shown to impact medical care and worsen health disparities in pediatric patients. However, little is known about screening for and addressing SDH in families with LEP.  

Objective: Evaluate for differences in SDH and referrals to the clinic's community resource desk based on LEP status.

Methods: A convenience sample of parents presenting for a well child or follow-up visit at an urban academic pediatric primary care practice completed a brief, anonymous, self-administered survey. It was completed in English or Spanish and included 5 social need items adapted from the WE-CARE instrument, as well as items regarding English proficiency, whether families were referred to our community resource desk, and the effects of COVID on social needs. LEP status was defined as parents who reported not speaking English "very well" when asked: "How well do you speak English?"  Fisher's exact test and chi-square test were used to evaluate the relationship between LEP status and SDH items.

Results: 199 participants completed the survey. 25% identified as LEP. 77% of participants had at least a high school degree. There were no differences in SDH between language groups (Table 1). 45% reported having at least 1 social need. No differences in the number of reported social needs were found by LEP status. 48% of participants reported a referral to the community resource desk, and of those referred, 87% found the referral helpful. There were no differences in referrals by LEP status. Approximately half of both language groups had social needs that were negatively impacted by the COVID pandemic. 

Conclusions: Nearly half of all participants reported having 1 or more social needs. Similarly, about half of participants were referred to the clinic's community resource desk and most found referral helpful.  No differences were found by LEP status.  The lack of differences in social needs reported by LEP status might reflect shared characteristics across the population or practices such as universal SDH screening and robust interpreter services.  Thus, it may be possible to mitigate LEP-associated barriers to addressing SDH.  Further research in other settings and languages is needed to better understand how LEP contributes to identifying and addressing SDH.



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Alpert Medical School of Brown University/Hasbro Children's Hospital
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University
Department of Pediatrics of Rhode Island Hospital/Hasbro Children's Hospital and Alpert Medical School of Brown University

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