Families' Perspectives on Social Services Navigation After Pediatric Urgent Care.

Background: Interest is growing in clinic-based programs that screen for and intervene on patients' social risk factors, including housing, food, and transportation. Though several studies suggest these programs can positively impact health, few examine the mechanisms underlying these effects. This study explores pathways through which identifying and intervening on social risks can impact families' health.

Revising the Logic Model Behind Health Care's Social Care Investments.

Policy Points This article summarizes recent evidence on how increased awareness of patients' social conditions in the health care sector may influence health and health care utilization outcomes. Using this evidence, we propose a more expansive logic model to explain the impacts of social care programs and inform future social care program investments and evaluations.

Associations between Social Adversity and Biomarkers of Inflammation, Stress, and Aging in Children.

Background: Prior work has found relationships between childhood social adversity and biomarkers of stress, but knowledge gaps remain. To help address these gaps, we explored associations between social adversity and biomarkers of inflammation (interleukin-1β [IL-1β], IL-6, IL-8, tumor necrosis factor-alpha [TNF-α], and salivary cytokine hierarchical "clusters" based on the three interleukins), neuroendocrine function (cortisol, cortisone, dehydroepiandrosterone, testosterone, and progesterone), neuromodulation (N-arachidonoylethanolamine, stearoylethanolamine, oleoylethanolamide, and palmitoylethanolamide), and epigenetic aging (Pediatric-Buccal-Epigenetic clock).

Methods: We collected biomarker samples of children ages 0-17 recruited from an acute care pediatrics clinic and examined their associations with caregiver-endorsed education, income, social risk factors, and cumulative adversity.

Community Health Center Staff Perspectives on Financial Payments for Social Care.

Unlabelled: Policy Points State and federal payers are actively considering strategies to increase the adoption of social risk screening and interventions in health care settings, including through the use of financial incentives. Activities related to social care in Oregon community health centers (CHCs) provided a unique opportunity to explore whether and how fee-for-service payments for social risk screening and navigation influence CHC activities. CHC staff, clinicians, and administrative leaders were often unaware of existing financial payments for social risk screening and navigation services.

Unmet Social Needs and Patterns of Hair Cortisol Concentration in Mother-Child Dyads.

Background: Mothers and their children demonstrate dyadic synchrony of hypothalamic-pituitary-adrenal (HPA) axis function, likely influenced by shared genetic or environmental factors. Although evidence has shown that chronic stress exposure has physiologic consequences for individuals-including on the HPA axis-minimal research has explored how unmet social needs such as food and housing instability may be associated with chronic stress and HPA axis synchrony in mother-child dyads.

Methods: We conducted a secondary analysis of data from 364 mother-child dyads with low-income recruited during a randomized trial conducted in an urban pediatric clinic.

Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers.

Latinx families may be particularly vulnerable to emotional dysfunction, due to higher rates of economic hardship and complex social influences in this population. Little is known about the impact of environmental stressors such as unmet social needs and maternal stress on the emotional health of Latinx children from low-income families. We conducted secondary analyses using survey and biomarker data from 432 Latinx children and mothers collected in a separate study.

Social Needs and Acculturation as Predictors of Emotional Problems and Perceived Stress Among Latinx Mothers with Low Income.

Associations between household social needs, acculturation, and emotional health remain understudied, particularly among Latinx mothers. We analyzed baseline survey data from 455 Latinx mothers in a previous study. Using multinomial regression, we examined whether emotional problems and perceived stress were associated with household social needs and acculturation.

Association of 2 Social Needs Interventions With Child Emergency Department Use and Hospitalizations: A Secondary Analysis of a Randomized Clinical Trial.

This secondary analysis of a randomized clinical trial compares the use of a social resources handout alone vs a handout plus guidance for children’s health and health services use.

Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review.

METHODS: RESULTS: CONCLUSIONS:

Salivary cytokine cluster moderates the association between caregivers perceived stress and emotional functioning in youth.

Some individuals exposed to early life stress show evidence of enhanced systemic inflammation and are at greater risk for psychopathology. In the current study, caregivers and their offspring (0-17 years) were recruited at a pediatric clinic visit at the University of California, San Francisco (UCSF). Mothers and seven-year-old children from the Growing Up inSingaporeTowards healthy Outcomes (GUSTO) prospective birth cohort were used as a replication cohort.

Effects of In-Person Assistance vs Personalized Written Resources About Social Services on Household Social Risks and Child and Caregiver Health: A Randomized Clinical Trial.

Importance: Social and economic contexts shape children's short- and long-term health. Efforts to address contextual risk factors are increasingly incorporated into pediatric health care.

Objective: To compare the effectiveness of 2 social risk-related interventions.

Impact of Transportation Interventions on Health Care Outcomes: A Systematic Review.

Introduction: Lack of reliable transportation can be a barrier to keeping appointments or accessing other health care services. Increasingly, insurers and health care delivery systems subsidize transportation services for patients. This systematic review synthesizes existing research on nonemergency medical transportation interventions.

Evaluation Activities and Influences at the Intersection of Medical and Social Services.

Despite a growing national interest in health care-based strategies focused on patients' social determinants of health (SDH), little has been compiled about the impacts of SDH interventions undertaken in clinical settings. To understand better what is known in this area and incentives and barriers to related research, we conducted 30 semi-structured interviews with leaders and researchers in for-and non-profit organizations developing interventions to bridge health and social service delivery. Key informants described evaluation activities primarily concentrated on program design and implementation, and less commonly on impact evaluations and dissemination research.

A Systematic Review of Interventions on Patients' Social and Economic Needs.

Context: Healthcare systems are experimenting increasingly with interventions to address patients' social and economic needs. This systematic review examines how often and how rigorously interventions bridging social and medical care have been evaluated.

Evidence Acquisition: The review included literature from PubMed published between January 2000 and February 2017.

Understanding Medicaid Managed Care Investments in Members' Social Determinants of Health.

Despite widespread interest in addressing social determinants of health (SDH) as a means to improve health and to reduce health care spending, little information is available about how to develop, sustain, and scale nonmedical interventions in diverse payer environments, including Medicaid Managed Care. This study aimed to explore how Medicaid Managed Care Organization (MMCO) leaders interpret their roles and responsibilities around SDH, how they garner resources to develop and sustain interventions to address SDH, and how they perceive the influences of external organizations on related activities. Semistructured qualitative key informant interviews were conducted with a purposive sample of 26 Medicaid Managed Care corporate executives.

States' Influences on Medicaid Investments to Address Patients' Social Needs.

Introduction: Relationships between socioeconomic adversity and poor health have been well documented. Given these associations, Medicaid MCOs (MMCOs) have shown increasing interest in addressing social determinants of health (SDH) to improve health and decrease healthcare costs. The authors sought to better understand how contractual relationships with State Medicaid Agencies influence MMCO investments in addressing members' SDH.

Clinical interventions addressing nonmedical health determinants in Medicaid managed care.

Objectives: We aimed to examine how interventions addressing social determinants of health (SDH) have been adopted in the context of Medicaid managed care organizations (MMCOs), which serve a large proportion of patients with social and economic barriers to good health.

Study Design: We designed a systematic literature review to examine how SDH interventions have been adopted in MMCOs.

Methods: The review included published articles from PubMed, Scopus, and Business Source databases, as well as review articles published in the gray literature and articles recommended by the study's National Advisory Committee to identify interventions describing how MMCOs have invested in interventions that address patients' SDH.

Costs of infertility treatment: results from an 18-month prospective cohort study.

Objective: To examine resource use (costs) by women presenting for infertility evaluation and treatment over 18 months, regardless of treatment pursued.

Design: Prospective cohort study in which women were followed for 18 months.

Setting: Eight infertility practices.

The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States.

Objective: To determine the prevalence of complementary and alternative medicine (CAM) use among couples seeking fertility care and to identify the predictors of CAM use in this population.

Design: Prospective cohort study.

Setting: Eight community and academic infertility practices.

Sexual, marital, and social impact of a man's perceived infertility diagnosis.

Introduction: Male factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples.

Aim: To measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility.