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Lax Y, Keller K, Silver M, Safadi BM, Hwang EK, Avner JR. The Use of Telemedicine for Screening and Addressing Social Needs in a Primary Care Pediatric Population in Brooklyn, New York. J Community Health 2024; 49:46-51. [PMID: 37405613 DOI: 10.1007/s10900-023-01254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
The objective of this study was to analyze temporal changes in social needs (SN), comparing those who received routine annual in-person care to those receiving SN screenings through a combination of tele-social care and in-person care biannually. Our prospective cohort study used a convenience sample of patients from primary care practices. Baseline data were collected from April 2019 to March 2020. The intervention group (n = 336) received SN screening and referral telephone outreach from June 2020 to August 2021. The control group (n = 2890) was screened, in person, during routine visits at baseline and summer 2021. We used a repeated-measures logistic regression with general estimating equations to assess incremental change in individual SN for the intervention group. Food, housing, legal and benefit needs increased and peaked at the beginning of the pandemic and decreased after interventions (P < 0.001). There was a 32% decrease in the odds of food insecurity for those in the intervention group compared to the control group (adjusted OR 0.668, 95% confidence interval 0.444-1.004, P = 0.052), and a 75% decrease in the odds of housing insecurity (adjusted OR 0.247, 95% confidence interval 0.150-0.505, P < 0.001). During COVID-19, there was an increase in SN followed by a decrease after interventions were offered. Those who completed tele-social care showed greater improvements in social needs than those in routine care, with the greatest improvements in food and housing needs.
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Affiliation(s)
- Yonit Lax
- Department of Pediatrics, Maimonides Medical Center, 1301 57th Street, Brooklyn, NY, 11219, USA.
- SUNY Downstate Health Sciences University Brooklyn, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
| | - Kim Keller
- Department of Pediatrics, Maimonides Medical Center, 1301 57th Street, Brooklyn, NY, 11219, USA
| | - Michael Silver
- Biostatistics, Maimonides Medical Center, 1301 57th Street, Brooklyn, NY, 11219, USA
| | - Bryant Muniz Safadi
- SUNY Downstate Health Sciences University Brooklyn, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Eun Kyeong Hwang
- SUNY Downstate Health Sciences University Brooklyn, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Jeffrey R Avner
- Department of Pediatrics, Maimonides Medical Center, 1301 57th Street, Brooklyn, NY, 11219, USA
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