Abstract

Supporting adolescent patients through near-peer education and social determinants of health screening: A screening, intervention, and resource referral program to improve health equity in a pediatric emergency department

Tomeka Frieson, MPH1, Lilin Tong, BS2, Sanil Gandhi, BA2, Nishita Sunkara, BA2, Haley Urbach, BA, MS2, Cyrah Finley, BS1, Rachel Thompson, MD2 and Edward Bernstein, MD2
(1)Boston University School of Public Health, Boston, MA, (2)Boston University Chobanian & Avedisian School of Medicine, Boston, MA

APHA 2023 Annual Meeting and Expo

Background: Adolescence is a critical period where sociocultural and economic factors shape current and future health. Despite this, many adolescents cannot or do not access routine healthcare, instead visiting emergency departments (EDs) that are ill-equipped to provide holistic, preventative care. Partners in Equity and Empowerment through Resources and Support (PEERS) bridges the capacity gap between what is and can be provided in a pediatric ED by employing near-peer public health and medical student volunteers to screen adolescents and provide resources for unmet social determinants of health (SDoH) needs.

Methods: Volunteers screen patients ages 13-24 using validated screening questions to assess health and SDoH needs, including mental health, substance use, experiences with violence and/or discrimination, housing, food insecurity, education, and employment. Volunteers conduct brief negotiated interviews to help adolescents identify intrinsic motivations for healthful behaviors, provide customized resources addressing SDoH needs, and conduct one-week and one-month follow-ups to understand patient utilization of SDoH resources.

Results: Over the past two years of the program’s pilot, 180 patients were screened. Patients’ mean age was 19.1 years old, 88.6% were non-white, and 48.3% were Hispanic/Latinx. 97.2% of patients reported having at least one unmet SDoH need, and 88.3% were provided with resources and/or referrals. For some SDoH, more patients requested resources than reported acute need for them through screening.

Conclusion: PEERS is a promising program to implement public health education and address adolescents’ SDoH in an emergency setting, highlighting how discussions about SDoH can empower adolescents and bridge healthcare capacity gaps.

Administer health education strategies, interventions and programs Advocacy for health and health education Assessment of individual and community needs for health education Clinical medicine applied in public health Implementation of health education strategies, interventions and programs