Are Sociodemographic and Economic Disparities Associated with the Impact of the COVID-19 Crisis on Parents, Families, and Children Born Extremely Preterm in California?

The aim of this project is to answer questions related to the broad and growing impact of the COVID-19 pandemic on children born preterm, their parents, and families, and to explore associations of post-discharge child healthcare access challenges, adverse child health effects, and parent stress and anxiety with sociodemographic disparities, and with NICU and HRIF clinic factors. To meet these objectives, we will launch a multilevel, serial survey to determine how parents and families of children born < 30 weeks estimated gestational age in California are impacted by the COVID-19 pandemic crisis - including parental stress and anxiety, access to medical and special health care services, financial and resource stability - through 3 years of age. For this project, we will focus on a 6-month birth cohort of children and families who were in a CPQCC NICU during the COVID-19 pandemic and referred CPQCC CCS HRIF at discharge, with surveys at 4-8 months of age and 12-16 months of age corrected for prematurity.

Improving Outreach to and Telehealth Access for Spanish-Speaking Community Members who Have Tested Positive for COVID-19 at the Roots Community Health Center

The coronavirus is a public health crisis impacting every facet of society with available data suggesting that it may be particularly devastating to African American and Latinx communities, bringing overdue attention to already well documented broader health disparities faced by these communities. In parallel to the pandemic magnifying existing health disparities, we have seen a tectonic shift in health care delivery to telehealth – telephonic, video, patient portal, text messaging, asynchronous communication, and remote monitoring modalities. We know that the current wide-spread implementation may further exacerbate existing health disparities by providing inequitable access to historically vulnerable populations. Community-responsive telehealth programs are critical to ensure gaps in health access are closed and not widened.

The two aims of this project are to (1) increase outreach to Spanish-speaking patients who have tested positive for COVID-19 and connect them with the health system for follow-up care and essential services, and (2) create a sustainable, community-responsive telehealth program that is developed based on the expressed needs and capabilities of this same patient population.

Zooming Out: Disparities in Pediatric Telehealth Utilization Associated with COVID-19

The aim of this project is to evaluate the uptake of telehealth and its impact on healthcare utilization; analyze the impact of sociodemographic factors on telehealth adoption; and explore how this varies by pediatric subspecialties/disease types.

Healthcare systems have rapidly adopted telehealth modalities to maintain routine patient care in response to COVID-19 and precautions on in-person interaction. Previous research has illustrated adult and pediatric patients of vulnerable sociodemographic groups such as race, ethnicity, and income level—as well as those with medical complexity—face disproportionate barriers to uptake of telehealth. The culmination of these factors implies that, even as new virtual technologies may improve the overall outcomes in some pediatric populations, they may serve to exacerbate outcome disparities for minority populations.

Cardinal Free Clinics’ Telehealth Initiative to Address Health Disparities and Social Needs in the South Bay During the COVID-19 Pandemic

The Cardinal Free Clinics are Stanford Medicine’s two student-run free clinics serving uninsured and underinsured individuals in the South Bay Area. Due to the ongoing COVID-19 crisis, the clinics are operating in a telehealth format. Through patient interviews, community partner interviews, and analysis of electronic medical record data, a team of faculty and students seeks to understand (1) how the pandemic has affected the clinics’ patients’ access to health and social care, including COVID-19 care, (2) how the patients’ social needs have changed from March 2020 to the present, and (3) how the pandemic has affected the community organizations that provide social and health support to the patients. In addition to providing more information on health disparities in South Bay Area communities, this project will be used to improve the social needs screening conducted in telehealth visits, enhance referral offerings and help the clinics be better community partners to other South Bay organizations.