Phone versus in-person navigation of social needs and caregivers' desire for resources in the pediatric emergency department

OBJECTIVE: To determine the association between in-person versus telephone-based contact by a resource navigator and caregivers' expressed desire for community-based resources to meet social needs in a pediatric emergency department (PED).

METHODS: This retrospective observational study used data from the PED in a large, metropolitan, academic children's hospital. Families were approached by resource navigators and offered community-based resources either in-person or by phone during waiting periods in the PED exam room. We used descriptive statistics and chi-squared analysis to summarize demographics and mode of contact, and simple and multivariable logistic regression to estimate the association between desire for resources and mode of contact.

RESULTS: Contact was attempted among 4902 caregivers, with 2918 (59.5%) caregivers approached in-person, 1913 (39.0%) approached by phone, and 71 (1.5%) with no mode of contact recorded. Resource navigators successfully reached 2738 (93.8%) caregivers approached in-person and 1432 (74.9%) caregivers approached by phone. Of caregivers successfully reached, 782 (18.8%) desired resources; 526 (19.2%) in-person, and 256 (17.9%) by phone. Caregivers contacted by phone were no more or less likely to desire resources than caregivers contacted in-person in unadjusted (OR=0.92, 95% CI=0.78-1.08) and adjusted analyses (OR=0.92, 95% CI= 0.77-1.09).

CONCLUSIONS: Within a large, urban PED, caregivers' expressed desire for community-based resources was no different whether a caregiver was engaged in-person or by phone. This suggests caregivers may be equally receptive to discussing social needs and community-based resources remotely versus in-person. More work is needed to examine if rates of resource connection differ by mode of contact.

WHAT'S NEW: This paper reports no difference in caregivers expressing a desire for community-based resources in the pediatric emergency department when offered in-person versus by phone. This has encouraging implications for remote models of social care delivery in pediatric healthcare settings.