Screening caregivers of patients with sickle cell disease (SCD) with the validated Psychosocial Assessment Tool (PAT) was able to identify families in need of resource support, according to a study presented at the 2023 ASPHO Annual Meeting.

However, the PAT alone was not sufficient to identify all families with financial challenges, highlighting the need to evaluate families using other approaches in addition to the PAT.

In the study, social workers administered the PAT to 240 caregivers of a patient with SCD. Results of the PAT were categorized into 3 different risk tiers of psychosocial concern, including universal, targeted, or clinical.

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The mean age of the child with SCD was 8.6 years and 95% of patients were Black. There were 86% of patients on Medicaid insurance.

Within the cohort, the PAT screener identified 66.7% of families as of universal risk, 27.9% of targeted risk, and 5.4% of clinical risk. Families categorized as at targeted or clinical risk were more likely to report financial challenges (P <.05).

In the clinical risk category, 23% of families reported that it was hard to meet their basic needs and another 23% indicated that they had many financial problems. In the targeted risk category, 4% and 4% reported difficulty meeting their basic needs or many problems, respectively.

However, within the universal risk category, 6% of families reported difficulty meeting their basic needs or that they had many financial problems, and another 29% reported some financial problems. These challenges were not identified by the PAT screener as these families were in the universal category.

The most common types of financial difficulties included car costs, paying the rent or mortgage, utility bills, and buying food.

Results from the PAT also showed that many caregivers experienced mental health concerns, such as anxiety (24%) and depression (25%). Families categorized as clinical or targeted risk were more likely to have mental health concerns, experience family stressors, and have less family support (all P <.05).

“Implementation of an inexpensive psychosocial screener in SCD clinic identified financial challenges for almost half of families, as well as caregiver burden and mental health concerns, allowing for timely resource support,” the authors concluded.


Frey N, LaMotte J, Bouck J, et al. Assessing psychosocial risk factors in children with sickle cell disease. ASPHO 2023; May 10-13, 2023. Abstract 357.