AdvocacyRotation – Have you already completed your advocacy rotation this year?

• Yes (1)
• No (0)

Display This Question: If Have you already completed your advocacy rotation this year? = Yes

AdvocacyTime – In what block was your advocacy rotation?

• Block 1 (6/24/2018 – 7/24/2018) (1)
• Block 2 (7/25/2018 – 8/21/2018) (2)
• Block 3 (8/22/2018 – 9/18/2018) (3)
• Block 4 (9/19/2018 – 10/16/2018) (4)
• Block 5 (10/17/2018 – 11/13/2018) (5)

Impact – Are you on IMPACT Track?

• Yes (1)
• No (0)

Display This Question: If Are you on IMPACT Track? = Yes

ImpactTrack – Which of the following most accurately describes your current track?

• Quality Improvement (1)
• Global Health (2)
• Community Pediatrics (3)

PrevAdvEd – Prior to beginning residency, did you receive any formal advocacy education?

• Yes (1)
• No (0)

Display This Question: If Prior to beginning residency, did you receive any formal advocacy education? = Yes

PrevAdvEd_FreeTxt – Please describe your previous advocacy education.

Pronoun – What is your preferred pronoun?

Children – Do you have children?

• Yes (1)
• No (0)
• Prefer not to answer (3)

Hispanic – Are you of Hispanic, Latino, or Spanish origin?

• Yes (1)
• No (0)
• Prefer not to answer (3)
• Unavailable/Unknown (4)

Race – Which category best describes your race? (One or more categories may be marked)

• American Indian/Alaska Native (1)
• Asian (2)
• Black or African American (3)
• Native Hawaiian/Other Pacific Islander (4)
• White (5)
• Some other race (6)
• ⊗Prefer not to answer (7)
• ⊗Unavailable/Unknown (8)

PersonalEx – Which of the following statements accurately describe your personal experiences? Please select any/all that apply

• One or more of my parents were born outside of the United States (1)
• I am the first in my family to go to college (2)
• In the household I grew up in, English was not the primary language (3)
• At the high school I attended, less than half of graduates go to college (4)
• ⊗None of the above (5)

ChildhoodHardship –  Which of the following CHILDHOOD social hardships have you personally experienced? Please select all that apply.

• Food insecurity (1)
• Poor housing conditions (2)
• Homelessness (3)
• Receipt of public benefits (4)
• Domestic violence (5)
• Child abuse (6)
• Parental mental illness (7)
• ⊗None of the above (8)
• ⊗Prefer not to answer (9)

Interest1 – Which of the following most accurately describes your interest in the topic of child poverty?

• Not at all interested (1)
• Slightly interested (2)
• Somewhat interested (3)
• Very interested (4)
• Extremely interested (5)

ScreeningToolsAware1 –  Are you aware of any screening tools that exist to assess for social determinants of health?

• Yes (1)
• No (0)

Display This Question: If Are you aware of any screening tools that exist to assess for social determinants of health? = Yes

ScreeningToolsAwareList1 –  Please list any screening tools that you are aware of that can be used to screen for social determinants of health. 

Q67 In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity during your last 4-week inpatient block. For those categories that you did not screen, please enter zero.

Display This Question: If If In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity duri… Other (Specify) – # of Times Screened –   Is Greater Than  0

Other1Specify – Please specify what other category you screened for:

Screen_Pre: Sum of all screening

CompKnowPre: Composite Pre-Intervention Knowledge Score

Interest2 – Which of the following most accurately describes your interest in the topic of child poverty? (re-coded to match for GroupB Post)

• Not at all interested (1)
• Slightly interested (2)
• Somewhat interested (3)
• Very interested (4)
• Extremely interested (5)

RetroComfort – Thinking back to the time before you began this curriculum, which of the following most accurately described your comfort with concepts related to the topic of child poverty?

• Not at all comfortable (1)
• Slightly comfortable (2)
• Somewhat comfortable (3)
• Very comfortable (4)
• Extremely comfortable (5)

Comfort2 – Now that you have completed this curriculum, which of the following most accurately currently describes your comfort with concepts related to the topic of child poverty?

• Not at all comfortable (1)
• Slightly comfortable (2)
• Somewhat comfortable (3)
• Very comfortable (4)
• Extremely comfortable (5)

ContentEnjoyment – On a scale of 1-10, with 10 being the most positive, please describe how much you enjoyed the content you received via text message?

ScreeningToolsAware2 – Are you aware of any screening tools that exist to assess for social determinants of health?

• Yes (1)
• No (0)

Display This Question: If Are you aware of any screening tools that exist to assess for social determinants of health? = Yes

ScreeningToolsAwareList2 Please list any screening tools that you are aware of that can be used to screen for social determinants of health. 

In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity during your last 4-week inpatient block. For those categories that you did not screen, please enter zero.

Display This Question: If If In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity duri… Other (Specify) – # of Times Screened –   Is Greater Than  0

Other2Specify – Please specify what other category you screened for:

Screen_Post: Sum of all screening

ComposKnowPost: Composite Post-Intervention Knowledge Score

Interest3 – Which of the following most accurately describes your interest in the topic of child poverty?

• Not at all interested (1)
• Slightly interested (2)
• Somewhat interested (3)
• Very interested (4)
• Extremely interested (5)

Comfort 3 – Which of the following most accurately describes your current comfort with concepts related to the topic of child poverty?

• Not at all comfortable (1)
• Slightly comfortable (2)
• Somewhat comfortable (3)
• Very comfortable (4)
• Extremely comfortable (5)

ScreeningToolsAware3 – Are you aware of any screening tools that exist to assess for social determinants of health?

• Yes (1)
• No (0)

Display This Question: If Are you aware of any screening tools that exist to assess for social determinants of health? = Yes

ScreeningToolsAwareList3 – Please list any screening tools that you are aware of that can be used to screen for social determinants of health. 

FoodInsecurity3 – In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity during your last 4-week inpatient block. For those categories that you did not screen, please enter zero.

Display This Question: If If In reflecting on your last month of inpatient service, how many times, if any, did you screen for social determinants of health? Please enter a whole number to describe your screening activity duri… Other (Specify) – # of Times Screened –   Is Greater Than  0

Other3Specify – Please specify what other category you screened for:

Screen_3mo_Post: Sum of all screening

ComposKnow3mo: Composite 3-month Follow-up Knowledge Score

Knowledge Test

1. Which of the following parameters is used in determining the threshold for poverty?

• Census data is used to establish a value that is less than the bottom 10% of income for the country
• Local governments assess the minimum income needed to meet basic needs and the threshold is adjusted for family size
• The federal government designates this value based on the population needs and utilization of current entitlement funds
• A value 3 times the cost of a minimum food diet in 1963 was assigned as the initial poverty threshold with adjustment for family composition, and each year this value is updated to account for inflation
• An annual income based on federal minimum wage is used to establish this threshold

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident. ____

2. A 7-year-old previously healthy girl is admitted to the inpatient unit at Children’s Hospital Los Angeles with a new diagnosis of asthma. The patient’s parents have no other children and a combined income of $27,000 per year, which is approximately 137% of the federal poverty level (FPL) for a family of 3. 
   
   To which of the following programs would this child most likely be eligible?

• Supplemental Nutrition Assistance Program (SNAP)
• Medicaid
• Supplemental Security Income (SSI)
• California Children’s Services (CCS)
• In-Home Support Services (IHSS)

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

3. Which of the following government-sponsored programs offers breastfeeding support to new mothers?

• Supplemental Nutrition Assistance Program (SNAP)
• California Children’s Services (CCS)
• Women, Infants, and Children (WIC)
• Coalition for Mothers (CFM)
• In-Home Support Services (IHSS)

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

4. Which of the following federal programs is referred to as CalFresh in the state of California?

• Women, Infants, and Children (WIC)
• Supplemental Nutrition Assistance Program (SNAP)
• Temporary Assistance for Needy Families (TANF)
• Supplemental Security Income (SSI)
• California Children’s Services (CCS)

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

5. Which of the following is a cash assistance program that provides support to very low-income families with children?

• Supplemental Nutrition Assistance Program (SNAP)
• Temporary Assistance for Needy Families (TANF)
• Supplemental Security Income (SSI)
• Women, Infants, and Children (WIC)
• California Children’s Services (CCS)

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

6. Which of the following does NOTrepresent one of the five key domains used to describe the social determinants of health?

• Education
• Health and healthcare
• Neighborhood and built environment
• Socioeconomic status
• Social and community context

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

7. Which of the following best reflect the three components that are considered when defining socioeconomic status?

• Home environment, income, education
• Home environment, education, occupation
• Education, Income, neighborhood
• Income, education, occupation
• Neighborhood, occupation, income

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

8. Which of the following screening tools can be used by a provider when they are obtaining an admission history to help assess the literacy needs of a parent?

• WECARE
• IHELLP
• CDC-Kaiser ACE Study Questionnaire
• ISCREEN-L

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

9. For which of the following reasons would you most likely use Hager’s validated 2-item screen?

• Failure to thrive
• Asthma
• Altered mental status
• Suicidal ideation
• Non-accidental trauma

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.

10. Which of the following changes to Medi-Cal resulted from the passage of California State Senate Bill SB 75?   

• Expansion of benefits to include coverage of children in foster and kinship care
• Expansion of benefits to include children with medical complexities previously excluded given enrollment in California Children’s Services (CCS)
• Expansion of benefits to include all eligible children under 19 years of age, regardless of immigration status
• Expansion of benefits to include childless adults

Please indicate your confidence in answering the above question, where 1 means not at all confident and 5 means extremely confident.