A Mixed-Method Evaluation of the Impact of Social Risk Screening on Uptake of Social Assistance

Does foregoing social risk screening during pediatric visits increase uptake of social services among low-income families?

Economic hardship can compromise child development and the ability to succeed in school and in other areas of life. Recently, social risk screening has emerged as a policy response to identify families in need of social services that can mitigate negative outcomes. The intent of risk screening is to link families and children living in poverty with the services they need, but there is concern that screening for risks such as food and housing insecurity or financial strain may deter those who need help the most from seeking it. Families may fear reporting their situations due to concerns about providers’ racial bias or child protective services involvement. Cullen and colleagues will use a multi-site randomized controlled trial of 2,064 caregivers of children who visit three Children’s Hospital of Philadelphia primary care clinics to test the impact of social risk screening on caregivers’ use of a resource map, a tool that provides personalized access to family support resources. The research team will also test the impact of screening on resource utilization and resulting changes in family needs. The team will interview caregivers from the intervention and comparison conditions to better understand how their comfort level and interest in services is affected by screening. Findings will inform state policy in Pennsylvania, where the team has requested the Department of Health and Medicaid postpone implementation of a statewide mandate for screening pending results of this study.

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