P3.C045: Frequencies and Types of Unmet Needs of Families with Children and Youth with Special Health Care Needs Undergoing a Preparedness Intervention

Background: Families with children and youth with special health care needs (CYSHCN) have unique and enhanced considerations for staying safe in emergencies. When these families also have social determinants of health (SDOH) hardships, achieving household preparedness may be particularly difficult.
Objective are to identify and address the unmet SDOH and preparedness needs in a diverse sample of families of CYSHCN recruited from medical homes across Pennsylvania as part of a comprehensive, virtual home preparedness intervention (VHPI).

Methods: The VHPI included (1) CYSHCN-centered pre/post interviews addressing medical needs, household preparedness, and SDOH; (2) information and support for emergency planning (eg, go-bag supply list, gift card) and local resources (eg, for housing assistance); and (3) individualized, as-needed referrals to professionals in the medical home or community partners (eg, American Red Cross, family-to-family health information centers, medical-legal partners). Interviews were conducted from April 2020 to June 2022 during which needs were identified and referrals were made and tracked. Needs then were coded and counted by type sample-wide, per-participant, and within sociodemographic subgroups.

Results: The CYSHCN of focus had reliance on medical equipment (68%), physical mobility needs (48%), communication or intellectual challenges (79%), and/or vision or hearing loss (36%). Among participants who completed the pre-VHPI (n = 170) and the post-VHPI (n = 148) interviews, SDOH hardships were prevalent and included food insecurity (20%) and housing insecurity (8%) (Table 1). A total of 1072 needs were identified and addressed through referrals; 279 of these pertained to emergency preparedness tasks. SDOH-coded needs fell into each of the Healthy People 2030 domains, especially Healthcare Access and Quality (558 needs) (Table 2). On average, 6 needs were noted per participant (range, 0 – 27 needs), with more needs associated with participants who primarily spoke a language other than English (additional median needs, +4), rented their home (+2), or lived in a household with another individual (other than the CYSHCN) with a disability or functional need (+1.5)

Conclusion: Families with CYSHCN have many unmet SDOH and preparedness needs. The VHPI, coupling preparing for emergencies with addressing SDOH hardships, may be an opportunity to address both in a routine care visit for CYSHCN.