Improving patient outcomes and generating sustainable funding through a technology–enabled social care referral network

Background: Children's hospitals are moving to implement social care interventions and policies, largely aimed at improving patient and family care experiences, in advance of evidence to support best practices.Evidence is needed to inform implementation of these interventions and policies, including the perspectives of families to ensure family-centered social care.Objective: To understand the experiences of parents and caregivers ("caregivers") of hospitalized children with CommunityRx-Hunger, a social care intervention designed to address food insecurity and other health-related social risks (HRSRs).Perspectives on how clinicians can sensitively deliver information about HRSRs in the pediatric inpatient setting were also elicited.Methods: In-depth, semi-structured qualitative interviews were conducted (04/2022-04/2023) with caregivers of children hospitalized at an urban academic medical center.Caregivers (N = 23) were purposefully sampled from the intervention arm of the double-blind CommunityRx-Hunger randomized controlled trial (NCT4171999).Initiated during hospital discharge, CommunityRx-Hunger includes three evidence-based components: education about HRSRs, delivery of HRSR-related resource information and ongoing support to boost the intervention over 12 months.Data were analyzed using directed content analysis.Results: Most caregivers identified as the child's mother (n = 20), African American or Black (n = 19) and were partnered (n = 14).Three main themes emerged: (1) positive experiences with CommunityRx-Hunger, including the sentiment that caregivers were unaware of the amount of community resources available to address HRSRs and perceptions that caregivers "were set up for success once we left the hospital"; (2) barriers to integrating social care with medical care, including concern that clinicians "are gonna use [disclosure of HRSRs] against me," and (3) recommendations for optimizing social care delivery, including a prevalent suggestion to "just give the information" to caregivers, without asking about risks or needs.Conclusion: CommunityRx-Hunger was mostly well-received by caregivers.Routinely providing resource information to all caregivers of hospitalized children, regardless of need, could help alleviate concerns about disclosing HRSRs.