Parents in underserved communities want quality child care, adult education classes, and housing and food supports, but they often have reservations about talking to doctors and nurses about such critical social needs. When they do open up about their personal lives, clinicians need to listen—really listen.
These are some of the key lessons that more than 30 members of hospital-based pediatric primary care practices and their partner community-based organizations shared at a learning collaborative held at UHF on February 7. They were marking almost two years of participation in the Partnerships for Early Childhood Development (PECD) initiative, launched by UHF in March 2017. PECD is helping pediatric practices affiliated with eight New York City hospitals routinely screen young children and their families for the social and environmental risks that can interfere with healthy physical, cognitive, and emotional development, and connect them with social services that can address those risks.
The work is groundbreaking—most of the pediatric practices and community organizations had never partnered before—and challenging. UHF has held several learning collaboratives since the project began, both in-person and virtual, to support the teams and help them share their experiences. But perhaps more significantly, the learning collaboratives give the participants the time and the space to meet and talk face-to-face, interactions they rarely have the opportunity to arrange in their busy day-to-day worlds.
The February meeting, led by Suzanne Brundage, program director for UHF Children’s Health Initiative, Patricia S. Levinson Fellow and head of the PECD initiative, featured the presentation of a study by the non-profit research organization Public Agenda based on focus groups of parents participating in PECD. Dr. David Schleifer, Public Agenda vice-president and director of research, and Antonio Diep, research associate, discussed the parents’ perspectives on social and economic factors that impact their children’s overall health and how receptive they are to social needs screenings.
They reported that the clinicians need to earn the parents’ trust to be effective. Parents did not necessarily think of a pediatrician’s office as the place to go for help with non-medical issues, in part because of the worry that they would be reported to New York City’s Administration for Children’s Services (ACS). “The fear of ACS was huge,” Dr. Schleifer said. “Parents were afraid that if they shared information about their lives with their pediatrician they might be investigated or lose their kids.” An inviting office environment with a play area for kids, a warm reception, and non-judgmental questions went a long way toward alleviating those concerns.
Public Agenda plans to make the results of its study publicly available in the spring. Meanwhile, Dr. Benard Dreyer, PECD chair and director of pediatrics at NYC Health + Hospitals/Bellevue, told the attendees that “despite the difficulties, you should feel good knowing that you are making a real difference in how pediatric practices can help families with their social needs.”
PECD is also supported by Altman Foundation, The New York Community Trust, and the William J. and Dorothy K. O’Neill Foundation. The participating hospitals are BronxCare Health System, Cohen Children's Medical Center (part of Northwell Health), The Mount Sinai Hospital, NewYork-Presbyterian/Columbia University Irving Medical Center, NewYork-Presbyterian Queens, NYC Health + Hospitals/Gotham Health, Gouverneur, NYU School of Medicine/Family Health Centers at NYU Langone, and St. John's Episcopal Hospital.