A DNP Project Through Literature Review:
 Developing a Model for Screening and Intervention for Pediatric Oncology Open Access

Abstract

Background: Social determinants of health (SDoH) such as food insecurity, housing instability, and transportation barriers are increasingly recognized as critical factors influencing outcomes in pediatric oncology. Despite improved survival rates, material hardship remains prevalent and under-addressed during cancer care. Standardized SDoH screening and intervention strategies remain inconsistently applied across clinical settings. 

Objectives: This systematic review aimed to synthesize the current evidence regarding screening and intervention models addressing SDoH in pediatric oncology, specifically within the domains of housing, food, and transportation insecurity. 

Methods: The review was conducted following PRISMA guidelines. Articles published in English from the past 15 years were retrieved through PubMed, CINAHL, and other databases. Inclusion criteria required studies to focus on pediatric oncology populations and address at least one SDoH domain (housing, food, or transportation) through screening or intervention. Covidence software was used for review and data extraction. Quality appraisal was performed using the Johns Hopkins Nursing Evidence-Based Practice tool. 

Results: Fifteen studies were included. Screening studies consistently identified underreported hardship, particularly when assessments were repeated throughout treatment. Intervention studies, including programs involving meal kits, transportation vouchers, and patient navigation, demonstrated improved caregiver satisfaction, stress reduction, and quality of life. Multidomain interventions were most effective. 

Conclusions: SDoH screening and interventions can significantly reduce barriers to care and improve well-being among pediatric oncology families. Evidence supports embedding routine SDoH assessments and culturally responsive, policy-aligned interventions throughout the cancer care continuum. 

Table of Contents

Table of Contents

I. Introduction

II. Conceptual Framework

III. Methods

IV. Synthesis of Literature

V. Discussion

VI. Future Research Directions

VII. Limitations

VIII. Conclusion

IX. Tables and Figures

X. Evidence-Based Model- COCOON: Comprehensive Oncology Care Outreach and Ongoing

Navigation Model

XI. Stakeholder Engagement

XII. Project Timeline

XIII. References

About this Dissertation

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Nell Hodgson Woodruff School of Nursing
Specialty	Family Nursing Practice
Degree	D.N.P.
Submission	Dissertation
Language	English
Research Field	Health Sciences, Nursing
Keyword	social determinants of health intervention screening pediatric oncology
Committee Chair / Thesis Advisor	Jinbing Bai , Emory University

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