BRIEF REPORT
Alison Aronstam, MD, MS; Denisse Velazquez, BA; Holly Wing, MA; Danielle Hessler, PhD; Victoria F. Keeton, PhD, RN, CPNP; Karen Sokal-Gutierrez, MD, MPH; Laura M. Gottlieb, MD, MPH
Corresponding Author: Alison Aronstam, MD, MS; Department of Medicine, University of California, San Francisco
Email: alison.aronstam@ucsf.edu
DOI: 10.3122/jabfm.2023.230232R2
Keywords: Caregivers, Delivery of Health Care, Family Health, Health Disparities, Patient Navigators, Pediatrics, Public Health, Qualitative Research, Social Determinants of Health, Social Service, Vulnerable Populations
Dates: Submitted: 06-14-2023; Revised: 08-31-2023; 12-05-2023; Accepted: 01-02-2024
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INTRODUCTION: Interest is growing in clinic-based programs that screen for and intervene on patients’ social risk factors, including housing, food, and transportation. Though several studies suggest these programs can positively impact health, few examine the mechanisms underlying these effects. This study explores pathways through which identifying and intervening on social risks can impact families’ health.
METHODS: This qualitative study was embedded in a randomized clinical trial that examined the health impacts of participation in a social services navigation program. We conducted semi-structured interviews with 27 English or Spanish-speaking caregivers of pediatric patients who had participated in the navigation program. Interviews were analyzed using thematic analysis.
RESULTS: Caregivers described three pathways through which the navigation program affected overall child and/or caregiver health: 1) increasing families’ knowledge of and access to social services; 2) helping families connect with healthcare services; and 3) providing emotional support that reduced caregiver isolation and anxiety. Participants suggested that navigation programs can influence health even when they do not directly impact resource access.
DISCUSSION: Social care programs may impact health through multiple potential pathways. Program impacts appear to be mediated by the extent to which programs increase knowledge of and access to social and healthcare services and support positive relationships between families and program personnel.