92. PERSPECTIVES ON THE PEDIATRICIAN'S ROLE IN SOCIAL DETERMINANTS OF HEALTH: A NATIONAL SURVEY OF CHIEF RESIDENTS

Abstract

Background Pediatric resident physicians often care for underserved populations and are expected to address social determinants of health (SDH); however, training varies in the identification of and referral to appropriate local resources. Pediatric physicians have reported insufficient knowledge and confidence as reasons for not addressing SDH, but report higher satisfaction when they do address SDH factors in the care of their patients. We aimed to assess chief resident perspectives of the pediatrician's role in, knowledge of, and referral to community resources which mitigate SDH. Methods We performed a national web-based survey of pediatric chief residents in Fall 2019 on their perspectives of SDH referrals, specifically regarding their knowledge of resources, their responsibility to refer, how often they refer, and confidence level in referring. Social determinant resources included: Development & Early Childhood Services, Education Resources, Dental Services, Mental Health, Housing, Parental Employment & Financial Support, Food Insecurity Support, Recreational/Physical Activity Needs, Legal Aid, Transportation Access, Domestic Violence, Parental Substance Use, and Parental Literacy Support. Results 28% (42/150) of programs responded. Chief residents agreed they must have knowledge of and hold responsibility to refer to many social determinant factors; however, practices and confidence levels in referring to resources were often low. For instance, 90% agreed that general pediatricians must have knowledge of housing resources, yet only 45% reported always or often referring, while 36% felt confident in their ability to refer. Chief residents reported lack of knowledge of resources and time constraints as the top factors influencing referring to social needs resources. Conclusions Understanding the specific resources pediatricians lack knowledge of and confidence in referring to can help develop and tailor residency curriculum in SDH screening, referral, and community resources.