Files
Download Full Text (892 KB)
DOI
https://doi.org/10.63853/HZAI3734
Description
QUALITY IMPROVEMENT
Background: Low parental health literacy is an under-screened social determinant of health (SDOH) that drives inequities in rural communities such as East Texas, where over 105,000 children lack access to a pediatrician, and families travel 80+ miles for care. Pediatric mortality in this region is 2.5 times the national average (UT Tyler SOM, 2023). National data indicate that one in three parents has limited health literacy (Tran et al., 2008), further exacerbating risks of missed appointments, medication errors, and poor outcomes.
Methodology: The initiative was conducted in a rural outpatient pediatric cardiology clinic within Children’s Health located in Tyler, Texas (PHS Tyler). Tyler is a small town with a population of approximately 108,000, 95 miles southeast of Dallas, Texas- the main hospital campus. After Children’s inpatient areas implemented SDOH screening in 2021, the project was expanded to the Outpatient areas. PHS Tyler was an early outpatient adopter motivated to deploy resources to patients and families. Strategies implemented included monthly compliance monitoring, staff training, and workflow reinforcement. With the deployment of an EHR-integrated SDOH screening tool, a resource page was developed with a list of local community resources like the food bank, housing resources, and WIC enrollment information. PHS Tyler utilized Tableau dashboards and tracked compliance from March-September 2025. Eligible patients (n=1,873) were included.
Outcomes: SDOH workflow integration consisted of the use of an iPad in the clinic and MyChart questionnaires prior to their appointment resulting in staff reported satisfaction, engagement, and ease. Consistent leadership follow-up with staff and social work involvement also contributed to improved engagement with the screening process. Screening compliance increased steadily, rising from 88% in March to 91% in September. Across the seven-month period, compliance averaged 91% (range 88–95%). Positive screens were identified in 35–42% of encounters, with the most common domains being transportation, food insecurity, and health literacy.
Publication Date
11-24-2025
Disciplines
Pediatric Nursing
Recommended Citation
Bien, Katie, "Improving SDOH Screening Compliance in Pediatric Settings: Addressing Health Literacy in East Texas" (2025). 2025. 30.
https://scholarlycollection.childrens.com/nursing-anf2025/30
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
