P3B147: Integration of a Social Determinants of Health Curriculum into a Core Pediatric Residency Program

Background: An informed understanding of social determinants of health (SDH) and their impact on health is fundamental to mitigating child health disparities. The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric trainees to gain competency in population and community health; however, curricula for SDH education during residency training often needs to be more robust and defined.
We describe a longitudinal SDH curriculum integrated into our general pediatric residency program to 1) improve residents’ knowledge of SDH, 2) equip residents with resources and skills needed to perform social risk assessments in the clinical setting, and 3) train residents on how to address local social needs through targeted interventions, in partnership with community-based programs.

Methods: Delivered across 12 months, the curriculum included seven didactic sessions (video and oral presentations, case scenarios, and group discussions) and five community-based modules. The learner audience was all pediatric residents (PGY1-PGY3) divided into four cohorts, each led by two faculty mentors. Each cohort identified a specific SDH impacting child health within our local community, then designed and implemented interventions in collaboration with local community partners. The curriculum was evaluated using electronic pre- and post-curriculum surveys, consisting of 5-point Likert Scale questions to measure knowledge of and assess skill level in screening for SDH in the clinical setting. Data were analyzed using the Bowkers symmetry test for correlated proportions between pre- and post-curriculum survey respondents.

Results: All residents (n=58) responded to the pre-curriculum survey, and 45 (78%) responded to the post-curriculum survey. Statistically significant (p < 0.05) improvements were noted in residents’ knowledge of SDH, ability to perform social risk assessments, and identify specific community-based resources to address different social needs. Each cohort successfully partnered with local programs on projects to address food insecurity, vaccination awareness within the Latino community, housing insecurity, and early literacy.

Conclusion: Our study shows that a longitudinal curriculum comprised of didactic sessions and practice modules is effective and feasible for improving pediatric residents’ knowledge and skill in identifying and addressing social determinants that impact child health. This curriculum meets the priorities set forth by ACGME and is easily reproducible for other residency and training programs seeking to implement similar education and skill development.