Social Determinants of Health: Assessment of Mia and Her Family

Social determinants of health, which include social and physical environments, have a tremendous effect on an individual’s health (Healthy People 2020). Nurses are well positioned to consider the social determinants of health during each client/patient interaction. Understanding key protective and risks factors enables nurses to provide education, links to community resources, and/or advocate for changes in policy and resource allocation.

The focus of this teaching strategy is on Mia and her family, one of the ACE.P unfolding cases. It is recommended that students complete this teaching strategy prior to engaging in the simulation of Mia. Students will have the opportunity to identify key social determinant risks and protective factors that influence Mia’s health and well-being.

Social Determinants of Health: Assessment of Mia and Her Family

Learning Objectives

Students will: 

  • Assess Mia and her family while focusing on the social determinants of health.   
  • Identify the key social determinant risks and protective factors for Mia and her family. 
  • Describe important social determinants of health education topics for families with young children.

Learner Pre-Work

Complete the Social Determinants of Health: Identifying Risks and Protective Factors for Children and Families teaching strategy exercise one and two.

Create a series of assessment questions you would want to ask a four-year-old child and her family to assess for the social determinants of health risk and protective factors. [Hint: you may want to use the Bright Futures assessment tool as a guide. Remember this is just a social determinants of health assessment not a physical assessment.]

Consider potential teaching points for a four-year-old child’s family. Use the Parent Handout found at the end of the Bright Futures assessment tool as your guide.

Suggested Learning Activities

Completing a holistic developmental and family assessment while considering the social determinants of health is an important part of pediatric nursing.

  • Have students listen to the monologue of Mia's mother, Katrina Roberts, and answer the following questions.
    • What are the social determinant risks and protective factors applicable to Mia and her family?
    • What additional information would you want to know?
  • Have students complete an assessment of Mia and her family using the tool they created in their pre-work activity. Divide students into groups of two or three. Assign each student to one of the following roles: (1) Mia’s mother; (2) health care provider; (3) Mia (if group of three). The student(s) assigned to be Mia and/or her mother should be given the family script document and some time to read the document and get into character. The health care provider should have the assessment questions they developed earlier and some time to organize their thoughts.
    • Questions to ask students following the assessment activity:
      • What additional information did you discover about the family with regard to the social determinants of health? What were the risk factors? What were the protective factors?
      • What other concerns did Mia and or her Mother have? How would you address these concerns?
      • Were there any additional questions you would have liked to ask?
      • What were the key areas for potential educational support that you identified for Mia and her family? What educational material would you give Mia and her mother? Students should consider the knowledge of the family prior to giving any education or educational material.
      • How did the use of your assessment tool enhance or impede ability to gather data and your relationship with Katrina and Mia?
      • What did you learn during this exercise that you will use in your nursing practice?

Author Information

Lee-Anne Stephen, MN, RN 
University of the Fraser Valley
Chilliwack, British Columbia