P3.O282: “TEACH”ing: Evaluation of a 3-Year Multimodal Child Poverty Curriculum

Background: Recognizing and addressing child poverty is critical for equitable care. Few curricula discussing poverty exist, and even fewer include multimodal teaching coupled with robust evaluation and monitoring for change in resident behavior. Objective is to evaluate the effect of Years 1 through 3 of a child poverty curriculum on resident knowledge, attitudes, and clinical care.

Methods: The objective of the Trainee Education in Advocacy and Community Health (TEACH) curriculum is to train pediatric residents to recognize and address the effects of child poverty. Components include Epidemiology of Poverty (Year 1) and Population Health & Social Determinants of Health (Year 2), with interactive modules with case simulations, multiple choice pre/post case-based knowledge questions, reflection questions, and experiential learning. In Years 1 and 2, residents also complete pre/post questions assessing attitudes on a 5-point Likert scale regarding screening for poverty and social determinants of health. The statistical analysis of knowledge and attitudes paired resident pre- and post-responses. In Taking Action in Primary Care (Year 3), residents complete an interactive module and create a patient care plan to address a social need and then reflect on the experience.

Results: All residents participated but not all responses were captured. Residents demonstrated improved knowledge comparing pre- and post-test responses in each set of modules (Figure). Post-participation in Year 1 and in Year 2, residents reported they felt more prepared to address social needs (p < 0.001) and more effective in assisting families (p < 0.001). In the creation of a care plan, most residents (31/47) referred to onsite social work team members and one-third (17/47) discussed the care plan directly with the family. Themes from the reflection question showed increased understanding of patients’ experiences and prioritization of shared decision-making when addressing social needs (Table).

Conclusion: This analysis is evidence that resident knowledge and attitudes on poverty improve within each year of the TEACH curriculum. Residents demonstrated new insights into the patient experience and indicated behavior changes in clinical practice, though future studies will need to evaluate if changes are sustained beyond the curriculum. Next steps include further analysis of Year 3 data.