The Sunset Park Family Health Center at NYU Langone–Second Avenue is located on Second Avenue in Brooklyn and is part of the Family Health Centers at NYU Langone’s network of eight community health centers and school-based clinics. The Family Health Centers network also includes its own Family Support Center to provide social, educational, and emotional support programs for families, children, and older adults. The Family Support Center is about a 15-minute walk from the Sunset Park Family Health Center–Second Avenue.

The majority of Center patients—more than 80%—are Latino; the rest are either Black or Asian, predominantly from mainland China or Hong Kong. Many are recent immigrants and have limited English proficiency. Ninety percent of the 4,000 children seen annually at the Center are insured by Medicaid.

Sunset Park Family Health Center: Key Elements

The Center’s leadership started its socioeconomic needs screening program in 2017. They decided that the screen would be administered by clinic staff rather than volunteers, believing reliance on staff administration would ensure the long-term sustainability of the program. To make the process as efficient as possible, Center staff hoped to move from using a paper-based screen to one conducted via tablet, which would facilitate uploading the information to the patient record. As of the end of 2019, clinic staff conducting the screening had become standard practice at the Center; migration to tablet screening and linking results to the EMR system was still in the pilot stage.

The Center refers most of its families with socioeconomic needs to the Family Support Center. Families initially did not follow up on referrals to the Family Support Center, despite it being located nearby, so in 2019 the Center added a bilingual family support counselor to its staff to serve as a personal link to the Family Support Center. The counselor meets with families at the end of their Center visit and explains the referral process. She also follows up with families by phone. Adding the counselor to the clinical team has materially improved the rate at which families follow through on referrals.

Center leadership is also keenly interested in learning whether the screen-and-refer program is making a difference in the health and daily lives of the children it serves and their families. Early in the program’s history they conducted family satisfaction surveys. Did families like the program? Was it helpful? The general response to both questions was yes— the families appreciated the Center’s interest and help. 

In late 2019, the Center undertook a more ambitious study with 200 families. The study, still underway, explores the links between family characteristics and specific social needs and how these affect the success of referrals. It also seeks to evaluate the effect of the program on parent stress and short-term measures of both the parent’s and child’s health. “The results of this study,” observed project director Dr. Suzy Tomopoulos, “will provide evidence on how to optimize community support networks to promote resilience in high-risk families who live in Sunset Park.”