Through Communities & Health Professionals Together, UC Davis Pediatrics and the WellSpace Health, a Federally Qualified Health Center (FQHC), have partnered since February 2014 to implement its Resource Desk program for families in Oak Park, a relatively underserved neighborhood of Sacramento. Resource Desk volunteers work with families to identify goals that will enhance their total health, refer them to local resources that can address these goals, and support the families until each resource is accessed and each goal is achieved.
Research has shown that social factors have a strong influence on health, especially for children. Food insufficiency, for example, has been shown to have a negative impact on success in school and negative psychological effects such as difficulty concentrating, disruptive classroom behavior and difficulty getting along with peers. Housing insecurity, including crowded homes or frequent moves, is associated with poorer health and limited growth and development in young children. When basic needs like food and shelter are not met, children and their families experience poorer physical health and may experience negative short- and long-term psychological side effects from the stress of struggling to address these issues.
Research has shown that social factors have a strong influence on health, especially for children. Food insufficiency, for example, has been shown to have a negative impact on success in school and negative psychological effects such as difficulty concentrating, disruptive classroom behavior and difficulty getting along with peers. Housing insecurity, including crowded homes or frequent moves, is associated with poorer health and limited growth and development in young children. When basic needs like food and shelter are not met, children and their families experience poorer physical health and may experience negative short- and long-term psychological side effects from the stress of struggling to address these issues.
Common service areas addressed by Resource Desk advocates. Unfortunately, a typical clinical interaction does not give a physician enough time to ask about or address those non-medical needs. According to research conducted at UC Davis, 47.1% reported spending 11 to 20 minutes with a pediatrician during a visit. 33.6% of parents reported spending fewer than 10 minutes. In a study conducted at Johns Hopkins, families in an urban clinic reported a median of two social needs each. 91% of the pediatricians practicing in that clinic acknowledged the importance of resolving these needs, yet only 11-18% of them screened for them. The limited length of each visit and long list of required “well child check-up” items do not leave the pediatrician much time to ask about non-medical components of health. Fortunately, pediatricians in our Oak Park clinic have stated that they feel confident transferring families to Resource Desk advocates and appreciate feeling reduced pressure to “solve all patient issues” at each visit.
Our model is based on an approach pioneered by Health Leads. Health Leads, a national organization headquartered in Boston, has successfully replicated a similar model in 7 major US cities allowing them to serve over 11,000 families in 2013. In the first 17 months of our local project’s operation our advocates have interacted with 315 individual clinic families and made over 500 referrals to local organizations.
Our model is based on an approach pioneered by Health Leads. Health Leads, a national organization headquartered in Boston, has successfully replicated a similar model in 7 major US cities allowing them to serve over 11,000 families in 2013. In the first 17 months of our local project’s operation our advocates have interacted with 315 individual clinic families and made over 500 referrals to local organizations.
Working model for the life of a case at the Resource Desk. Our undergraduate volunteers (called “advocates”) approach families at the start of each clinic visit and briefly describe the program. Families who opt into the program then set between one and six non-medical goals. During the patient’s visit with the physician, the advocate finds an appropriate referral in our online resource database, calling that organization ensure that they are a good fit for the client. After delivering the referral at the end of the visit, the volunteer follows up by phone call, text message, or email each week. If the referral was unsuccessful, the volunteer engages the parent to discuss the barriers he/she encountered provides a better referral and/or strategies to avoid this barrier on the next attempt. This volunteer-patient relationship continues over the course of several weeks until each of the family’s goals are met, at which point the advocate closes the case and updates the patient’s physician.
Recently published research demonstrated that a patient’s perception of how much his or her medical providers “cares” about them and how connected he or she feels to a medical home will influence his or her decisions about when and where to seek care. By addressing a family’s medical and non-medical needs (“whole person health”), we aim to help foster a sense of caring that encourages our families to stay connected to our medical home and seek preventive care in addition to the acute primary care they already receive.
Furthermore, with detailed information and guidance from a Resource Desk advocate, families will feel more comfortable accessing resources already available within their communities (in accordance with the principles of Asset-Based Community Development). When we address underlying factors that may contribute to or even cause health complaints, a family will be more likely to achieve positive health outcomes. In turn, better health moves families closer towards escaping the cycle of poverty.
Recently published research demonstrated that a patient’s perception of how much his or her medical providers “cares” about them and how connected he or she feels to a medical home will influence his or her decisions about when and where to seek care. By addressing a family’s medical and non-medical needs (“whole person health”), we aim to help foster a sense of caring that encourages our families to stay connected to our medical home and seek preventive care in addition to the acute primary care they already receive.
Furthermore, with detailed information and guidance from a Resource Desk advocate, families will feel more comfortable accessing resources already available within their communities (in accordance with the principles of Asset-Based Community Development). When we address underlying factors that may contribute to or even cause health complaints, a family will be more likely to achieve positive health outcomes. In turn, better health moves families closer towards escaping the cycle of poverty.
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