P3.L221: Caregivers’ willingness to address injury and social risks after targeted counseling at their pediatric primary care visit

Purpose/Objectives: Unintentional injury remains the leading cause of mortality in US children, and social determinants of health (SDH) have been shown to impact health outcomes. An Ohio AAP Quality Improvement (QI) Program has shown that standardized screening for unintentional injury and social risks at well child visits increases targeted anticipatory guidance and community resource distribution. Limited data exist assessing caregivers’ willingness to address injury and social risks following appropriate counseling by providers.

Design/Methods: Caregivers for children < 5 years of age who participated with QI program providers voluntarily participated in a follow-up survey immediately after their well-child visit between September 2023 and February 2024. In the QI program, providers used a tablet with a standardized screening tool (Injury Prevention plus Safe Environment for Every Kid) to screen caregivers for unintentional injury (car seat, home, and sleep safety) and SDH risks (family and social needs), then counsel, defined as targeted anticipatory guidance and/or resource provision, when applicable. The tablet-based follow-up survey assessed if a caregiver received the appropriate targeted counseling by the primary care provider and the caregiver’s willingness to address a risk or make a change.

Results: A total of 213 caregivers completed the injury prevention and SDH screening tool from a total of 8 practices (11 providers). 73% (155) screened positive for at least one injury risk and 30% (64) screened positive for at least one SDH risk. Lack of First Aid/CPR training (n=124, 58%) and child passenger safety concerns (n=80, 38%) were the most reported injury risks. The most common SDH risk was caregiver feeling under extreme stress (n=31, 15%). 94% (200) of caregivers were counseled about all risks assessed by the primary care provider. Of the 65% (138) of caregivers that completed the feedback survey, 100% (138) reported they were counseled by the primary care provider on an injury prevention or SDH topic, and 99% (137) of caregivers expressed willingness to address a risk or make a behavioral change. When asked how likely caregivers were to change or address a risk, the majority were ready to make a change (Figure 1).

Conclusion/Discussion: Targeted counseling following standardized screening tool usage for injury prevention and SDH risks in the pediatric primary care setting educates caregivers and increases their willingness to change future risky behaviors.