Mobile-based Social Services Screening and Referral Tool in an Pediatric Emergency Department

Not Applicable

Completed

• Conditions: Mobile Applications; Poverty; Social Determinants of Health; Pediatric ALL; Emergencies
• Interventions: Other: HelpSteps application

• Registration Number: NCT03562910
• Lead Sponsor: Boston Children's Hospital

Brief Summary

This study will determine the feasibility and effectiveness of using a mobile-based social services screening and referral tool in an urban pediatric Emergency Department (ED). Families will be offered the option to either download the tool, known as HelpSteps, as a mobile application ("app") on a personal cell phone or to use the app on a provided tablet. After leading the family through a brief social needs screening survey, HelpSteps will recommend local social service agencies based on identified needs and location. Families will then complete a brief survey on the ease of use of the tool as well as receive a follow-up call to ask about usefulness of the tool in solving social problems. The investigators will also ask physicians to fill out a brief survey about the use of the tool in the ED.

Detailed Description

Many families presenting in the ED may have unmet social needs. Prior studies have shown that families are receptive to screening for these needs in the ED setting. HelpSteps is a screening tool that not only identifies social needs but also connects individuals with local health and social services agencies. There have been no studies to date assessing the use of a new mobile-version of HelpSteps or the use of the tool in the ED setting. The objective of this study is (1) to assess the feasibility of using a patient-centered social services screening and referral mobile tool in the ED and (2) to determine if the tool is useful in helping patients identify social needs and link to appropriate referral services post-ED visit.

Data will be collected in a prospective, non-randomized fashion using a convenience sample of 330 adult subjects. All parents will be screened for enrollment. If a parent is not present, all unaccompanied patients 18 and older will be screened instead. If there are both parents present, investigators will ask families to self-identify the most appropriate research subject by asking which parent in their family is typically responsible for household resources or applications. Non-English speaking families and patients who present with a triage score of 1 or 2 (high acuity) will be excluded.

Once enrolled, research subjects will be offered the option to either download HelpSteps on a personal cell phone or to use the application on a provided tablet. The subject will then open the Help Steps tool and complete a brief social needs screening survey. Based on the results of the screening and on geographic proximity, HelpSteps will recommend referral agencies personalized to the subject. The subject will then choose agencies they are interested in and receive a personalized list of referrals.

While still in the ED, families will be asked to complete a brief survey regarding ease of use and recommending the tool to family and friends. After the ED visit, subjects will be sent two electronic reminders asking if they would like a referral list resent. All participants will receive a follow-up phone call approximately 2 weeks post-study enrollment to ask whether they have used HelpSteps at home, whether or not they contacted a referral agency, if their social need(s) were resolved, and if the application was helpful in finding a solution to their need(s). The investigators will also ask physicians to fill out a brief survey about the impact of the tool on clinical flow and usefulness in help supplementing care for the patient.

The investigators plan to use descriptive statistics to evaluate three categories of data: (1) social services needs, referrals and follow-up, (2) usefulness of the HelpSteps application, and (3) physician perspectives on use of the HelpSteps in the ED. The investigators will analyze the mobile-based group and the tablet-based group separately as they are likely two different populations (based on the lower socioeconomic status and thus higher social needs associated with not having a phone).

Study Timeline

• Study First Submitted: 2018-02-01
• Study First Submitted QC: 2018-06-08
• Study First Posted: 2018-06-20
• Study Start: 2019-05-13
• Primary Completion: 2020-11-11
• Study Completion: 2020-12-11
• Status Verified: 2021-03
• Last Update Submitted: 2021-03-01
• Last Update Posted: 2021-03-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 266

Inclusion Criteria

• All parents/caregivers or patients 18 and older presenting to a pediatric emergency department

Exclusion Criteria

• Non-English speaking
• Parents/caregivers or patients Families whose children are triaged to high acuity

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Intervention	HelpSteps application	All enrolled subjects will be given access to the HelpSteps application, either via their personal cell phone or to a provided tablet.

Primary Outcome Measures

Name	Time	Method
Prevalence of Social Needs	Day of enrollment	Number of social needs categories screened positive for or selected as a need

Secondary Outcome Measures

Name	Time	Method
Number of referral agencies selected/contacted	Day of enrollment and Two weeks post-enrollment	Participant selection and report of contacting social services organizations
ED physician attitudes towards social screening	Day of enrollment	ED physician report on usefulness of HelpSteps
Improvement in Social Needs	Two weeks post-enrollment	Participant report of social need improved
Impact on clinical flow	Day of enrollment	ED physician report of time added to encounter as a result of HelpSteps

Trial Locations

Locations (1)

Boston Children's Hospital; 🇺🇸 Boston, Massachusetts, United States