P3.D070: Promoting Young Child Wellness in the Pediatric Clinic within the Chickasaw Nation

Background: Hofanti Chokma is a collaborative, multi-department effort of the Chickasaw Nation to support young child wellness as a way to promote long term physical and mental health. This collaboration has adapted the Healthy Steps program to provide universal screening, developmental supports and positive parenting guidance using a team approach with children, families, medical providers, and behavioral health providers to meet this goal in a culturally relevant manner. The presentation includes annual data collection and significant changes found.

Methods: Hofanti Chokma selected the Healthy Steps model along with the Survey of Well-Being of Young Children (SWYC) to screen young children and their families for developmental delays, behavioral issues, and social determinants of health as a screening tool to use at well checks from the newborn period through 5 years of age. Follow-up with an Early Childhood Development therapist is determined by using a tiered approach based on results of the SWYC.

Results: 6,166 SWYCs were collected between October 2022 and September 2023. The highest percentage of concerning screening results include social-emotional development (46%) and family needs (28%). Other results showed that parents often did not express concern regarding social-emotional development, developmental milestones, or autism despite not passing these areas of the SWYC. Family needs that have been identified on the SWYC include, 26% tobacco use, 10% food insecurity, 6% caregiver mood concerns, 2% substance abuse, and 2% interpersonal violence. Substance abuse reported on the SWYC had a decrease from 19% to 2%. While this is a dramatic decrease, it is consistent with national post-covid trends. 51% of completed SWYCs have reported reading to their children 3 or fewer times in the past week with 9% of families reading to their children zero times in the past week.

Conclusion: Applying the Healthy Steps program to patient care within the Chickasaw Nation Pediatric Clinic, not only provides early identification of developmental, behavioral, and social concerns but has allowed patients, families, medical providers, and early childhood development therapists to build connections to improve the overall quality of life of the Chickasaw people. Families are provided with supportive services and early interventions to improve children’s outcomes, including development as well as physical and emotional well-being.