Material economic hardship is associated with adverse 1-year outcomes after pediatric liver transplantation: Prospective cohort results from the multi-center SOCIAL-Tx study.

Pediatric liver transplant outcomes exhibit disparities, necessitating identification of modifiable risk factors to develop targeted interventions. We characterized associations between household material economic hardship (e.g.

Social risk factors and cancer prevention care among patients in community health-care settings.

Background: Social risks are negatively associated with receipt of cancer preventive care. As knowledge is lacking on the pathways underlying these associations, we investigated associations between patient-reported social risks and colorectal cancer (CRC), cervical cancer, and breast cancer screening order provision and screening completion.

Methods: This study included patients eligible for CRC, cervical cancer, or breast cancer screening at 186 community-based clinics between July 1, 2015, and February 29, 2020.

Do new quality measures for social risk screening 'measure up'?

Purpose Of Review: New social risk screening standards and quality metrics reward or penalize healthcare delivery organizations for social risk screening. After summarizing the recent literature on social risk screening in pediatric healthcare settings we consider how this evidence - and persistent evidence gaps - might inform future standards development.

Recent Findings: Reported social risk screening rates, measures, and modality differ greatly across recent work.

Associations Between Patient/Caregiver Trust in Clinicians and Experiences of Healthcare-Based Discrimination.

Background: Higher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination.

Objective: Examine associations between experiences of healthcare discrimination and patients' and caregivers of pediatric patients' trust in providers, and identify factors associated with high trust, including prior experience of healthcare-based social screening.

Addressing Mental Health and Social Needs in Tandem to Promote Health Equity.

Compelling evidence shows that social risks and mental health are intertwined. Pediatric clinicians can maximize the effectiveness of interventions that address mental health concerns by incorporating social risks and social needs screening and interventions. Approaches that elevate the interconnectedness of social risks and mental health require (a) an understanding of the multi-level contextual factors that contribute to patient and family functioning; and (b) a culturally responsive and multidisciplinary clinical practice that targets contextual factors.

"We Need to Know These Things": Use Cases for Combined Social and Clinical Data Among Primary Care-Based Clinical and Social Care Providers.

Introduction/objectives: Primary care organizations are increasingly collecting data on patients' social risks, bringing forth an unprecedented opportunity to present combined health and social data that clinical and social care providers could leverage to improve patient care and outcomes. Little is known, however, about how these data could be used and what combinations of specific data elements are most helpful. We explored how primary care staff who provide clinical or social care services view potential benefits of and use cases for combined patient-level clinical and social data.

Provision of digital devices and internet connectivity to improve synchronous telemedicine access in the U.S.: a systematic scoping review.

Introduction: The COVID-19 pandemic led to a dramatic increase in telemedicine use for direct patient care. Inequities in device/internet access can limit the extent to which patients can engage with telemedicine care and exacerbate health disparities. In this review, we examined existing literature on interventions designed to improve patient telemedicine access by providing digital devices including tablets, smartphones, and computers and/or internet connectivity.

"I would love to see these big institutions… throwing their weight around": qualitative findings regarding health and social sector collaborations to address community-level socioeconomic adversity.

Background: Health and social sector organizations are increasingly working together to mitigate socioeconomic adversity within their communities. We sought to learn about the motivations, experiences, and perspectives of organizations engaged in these collaborations.

Methods: We conducted semi-structured, 60-minute interviews with 34 leaders from 25 health and social sector organizations between January-April 2021.

The impacts of supplemental benefits on Medicare Advantage plan composition.

Objectives: In 2019 and 2020, Medicare Advantage (MA) plans received historic flexibility to begin to address members' nonmedical and social needs through a set of primarily health-related benefits (PHRBs) and Special Supplemental Benefits for the Chronically Ill (SSBCIs). We aimed to evaluate the impact of adoption on the number and composition of new MA plan enrollees.

Study Design: A difference-in-differences design of retrospective Medicare enrollment data linked to publicly available plan and county-level data.

The Construction and Meaning of Race Within Hypertension Guidelines: A Systematic Scoping Review.

Background: Professional society guidelines are evidence-based recommendations intended to promote standardized care and improve health outcomes. Amid increased recognition of the role racism plays in shaping inequitable healthcare delivery, many researchers and practitioners have critiqued existing guidelines, particularly those that include race-based recommendations. Critiques highlight how racism influences the evidence that guidelines are based on and its interpretation.

Adjusting Clinical Plans Based on Social Context.

Background: Social risk data collection is expanding in community health centers (CHCs). We explored clinicians' practices of adjusting medical care based on their awareness of patients' social risk factors-that is, changes they make to care plans to mitigate the potential impacts of social risk factors on their patients' care and health outcomes-in a set of Texas CHCs.

Methods: Convergent mixed methods.

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.

New Supplemental Benefits and Plan Ratings Among Medicare Advantage Enrollees.

Importance: In 2018, the US Congress gave Medicare Advantage (MA) historic flexibility to address members' social needs with a set of Special Supplemental Benefits for the Chronically Ill (SSBCIs). In response, the Centers for Medicare & Medicaid Services expanded the definition of primarily health-related benefits (PHRBs) to include nonmedical services in 2019. Uptake has been modest; MA plans cited a lack of evidence as a limiting factor.

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.

Structured and unstructured social risk factor documentation in the electronic health record underestimates patients' self-reported risks.

Objectives: National attention has focused on increasing clinicians' responsiveness to the social determinants of health, for example, food security. A key step toward designing responsive interventions includes ensuring that information about patients' social circumstances is captured in the electronic health record (EHR). While prior work has assessed levels of EHR "social risk" documentation, the extent to which documentation represents the true prevalence of social risk is unknown.

Caregivers' and providers' perspectives of social and medical care after pediatric liver transplant: Results from the multicenter SOCIAL-Tx study.

Disparities exist in pediatric liver transplant (LT). We characterized barriers and facilitators to providing transplant and social care within pediatric LT clinics. This was a multicenter qualitative study.

Implementation and Impacts of California Senate Bill 1152 on Homeless Discharge Protocols.

Introduction: In recent decades, there has been a growing focus on addressing social needs in healthcare settings. California has been at the forefront of making state-level investments to improve care for patients with complex social and medical needs, including patients experiencing homelessness (PEH). Examples include Medicaid 1115 waivers such as the Whole Person Care pilot program and California Advancing and Innovating Medi-Cal (CalAIM).

Advancing health equity through social care interventions.

Objective: To use evidence on addressing racism in social care intervention research to create a framework for advancing health equity for all populations with marginalized social identities (e.g., race, gender, and sexual orientation).

Caregiver Perceptions of Social Risk Screening in Pediatric Liver Transplantation: From the Multicenter SOCIAL-Tx Study.

Background: The social determinants of health contribute to adverse post-liver transplant outcomes. Identifying unmet social risks may enable transplant teams to improve long-term outcomes for at-risk children. However, providers may feel uncomfortable asking about household-level social risks in the posttransplant period because they might make their patients/families uncomfortable.

"Wanting the Best for Our Folks"-A Mixed Methods Analysis of Community Health Center Social Risk Screening Initiatives.

Background: Many community health centers (CHC) are scaling social risk screening in response to growing awareness of the influence of social adversity on health outcomes and concurrent incentives for social risk data collection. We studied the implementation of social risk screening in Texas CHCs to inform best practices and understand equity implications.

Methods: Convergent mixed methods of 3 data sources.