A randomized trial on screening for social determinants of health: the iScreen study
Abstract
Background There is growing interest in clinical screening for pediatric social determinants of health, but little evidence on formats that maximize disclosure rates on a wide range of potentially sensitive topics. We designed a study to examine disclosure rates and hypothesized that there would be no difference in disclosure rates on face-to-face versus electronic screening formats for items other than highly sensitive items. Methods We conducted a randomized trial of electronic versus face-to-face social screening formats in a pediatric emergency department. Consenting English-speaking and Spanish-speaking adult caregivers familiar with the presenting child's household were randomized to social screening via tablet computer (with option for audio assist) versus a face-to-face interview conducted by a fully bilingual/bicultural researcher. Results Almost all caregivers (96.8%) reported at least 1 social need, but rates of reporting on the more sensitive issues (household violence and substance abuse) were significantly higher in electronic format, and disclosure was marginally higher in electronic format for financial insecurity and neighborhood and school safety. There was a significant difference in the proportion of social needs items with higher endorsement in the computer-based group (70%) than the face-to-face group (30%). Conclusions Pediatric clinical sites interested in incorporating caregiver-reported socioeconomic, environmental, and behavioral needs screening sho…
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The social risk survey instrument used in this study was sourced from a previous social risk factor screening trial.
“The survey instrument was sourced from a previous social risk factor screening trial and is shown in Appen- dix SA. 11,12”
From Structured and unstructured social risk factor documentation in the electronic health record underestimates patients’ self-reported risks (2024) · cites this paper as [12]
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Development and Validation of Computable Social Phenotypes for Health‐Related Social Needs
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- Authors
- Gottlieb, L., Hessler, D., Long, D., Amaya, A., & Adler, N.
- Affiliations
- Department of Family and Community Medicine, and
- University of California, San Francisco (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2014-12-01
- Volume
- 134
- Issue
- 6
- Pages
- e1611-e1618
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2045160717
- Cited by
- 258
- References
- 9
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 35 · 2023: 45 · 2022: 30 · 2021: 27 · 2020: 27 · 2019: 25 · 2018: 11 · 2017: 14 · 2016: 10 · 2015: 3
- FWCI
- 16.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- social determinants of health, pediatric emergency department, electronic screening, tablet computers, face-to-face interviews, disclosure rates, sensitive topics, domestic violence, substance abuse, financial insecurity, neighborhood safety, school safety
- MeSH terms
- Adult, Child, Female, Health Surveys, Humans, Interview, Psychological, Male, Mass Screening, San Francisco, Self Disclosure, Domestic Violence, Substance-Related Disorders, Needs Assessment, Disclosure, Computers, Handheld, Social Determinants of Health
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