Assessing Social Drivers of Health Among Pediatric Solid Organ Transplant Patients Using Psychosocial Screening: Rates of Risk and What DO we <scp>DO</scp> ?

BACKGROUND: Disparities in pediatric solid organ transplantation (SOT) outcomes persist despite increasing awareness. Efforts to reduce such disparities may include increasing screening to identify and mitigate social drivers of health (SDOH); however, research is needed to understand current clinical screening efforts and their impacts on referral outcomes. METHODS: Caregivers (N = 302) of pediatric patients (0-20 years) completed the Psychosocial Assessment Tool (PAT 2.0) during annual multidisciplinary transplant clinic visits to identify SDOH and psychosocial risk. Total PAT scores were categorized into Universal, Targeted, or Clinical psychosocial risk ranges. Descriptive data from medical charts and PAT responses were analyzed to evaluate referral patterns, follow-up rates, and adverse SDOH prevalence. RESULTS: The majority of PAT scores were within the Universal risk range (65%), with heart transplant families reporting significantly higher psychosocial risk levels compared to liver and kidney (F(2, 298) = 5.22, p = 0.006). Most families (83%) identified at least one potentially adverse SDOH. Those screening Targeted or Clinical reported significantly greater average number of SDOH risk factors compared to Universal range (F(2, 299) = 38.75, p < 0.001). One year post-screening, the majority of families in the Targeted or Clinical risk range completed follow-up with at least one psychosocial service, including social work (86%), mental/behavioral health providers (41%), and educational specialist interventions (7%). CONCLUSIONS: Elevated rates of psychosocial risk in pediatric SOT continue to persist; therefore, standardized clinical assessments to identify potentially adverse SDOH or healthcare barriers are necessary to provide individualized support. Implementing routine screening with appropriate referrals is a crucial step in addressing SDOH disparities throughout the transplant process.