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Pediatrics. 2015 Oct;136(4):e993-1001. doi: 10.1542/peds.2015-0549. Epub 2015 Sep 21.

A Road Map to Address the Social Determinants of Health Through Community Collaboration.

Pediatrics

Adrienne W Henize, Andrew F Beck, Melissa D Klein, Monica Adams, Robert S Kahn

Affiliations

  1. Divisions of General and Community Pediatrics, and [email protected].
  2. Divisions of General and Community Pediatrics, and Hospital Medicine, Department of Pediatrics, and.
  3. Social Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  4. Divisions of General and Community Pediatrics, and.

PMID: 26391941 DOI: 10.1542/peds.2015-0549

Abstract

Economic, environmental, and psychosocial needs are common and wide-ranging among families cared for in primary care settings. Still, pediatric care delivery models are not set up to systematically address these fundamental risks to health. We offer a roadmap to help structure primary care approaches to these needs through the development of comprehensive and effective collaborations between the primary care setting and community partners. We use Maslow's Hierarchy of Needs as a well-recognized conceptual model to organize, prioritize, and determine appropriate interventions that can be adapted to both small and large practices. Specifically, collaborations with community organizations expert in addressing issues commonly encountered in primary care centers can be designed and executed in a phased manner: (1) build the case for action through a family-centered risk assessment, (2) organize and prioritize risks and interventions, (3) develop and sustain interventions, and (4) operationalize interventions in the clinical setting. This phased approach to collaboration also includes shared vision, codeveloped plans for implementation and evaluation, resource alignment, joint reflection and adaptation, and shared decisions regarding next steps. Training, electronic health record integration, refinement by using quality improvement methods, and innovative use of clinical space are important components that may be useful in a variety of clinical settings. Successful examples highlight how clinical-community partnerships can help to systematically address a hierarchy of needs for children and families. Pediatricians and community partners can collaborate to improve the well-being of at-risk children by leveraging their respective strengths and shared vision for healthy families.

Copyright © 2015 by the American Academy of Pediatrics.

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