Part II: A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers
This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings. As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patien...
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| Veröffentlicht in: | American journal of preventive medicine Jg. 57; H. 6; S. S38 - S46 |
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Netherlands
Elsevier Inc
01.12.2019
Elsevier Science Ltd |
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| ISSN: | 0749-3797, 1873-2607, 1873-2607 |
| Online-Zugang: | Volltext |
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| Abstract | This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.
As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.
Fifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.
Despite gaps in the availability of social risk–related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.
This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation. |
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| AbstractList | Introduction This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings. Methods As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes. Results Fifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks. Conclusions Despite gaps in the availability of social risk–related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams. This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.INTRODUCTIONThis study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.METHODSAs part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.Fifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.RESULTSFifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.Despite gaps in the availability of social risk-related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.CONCLUSIONSDespite gaps in the availability of social risk-related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.SUPPLEMENT INFORMATIONThis article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation. This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings. As part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes. Fifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks. Despite gaps in the availability of social risk–related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams. This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation. |
| Author | Fichtenberg, Caroline Olson, Ardis L. Doran, Kelly M. Sandel, Megan Jepson, Susan Ettinger de Cuba, Stephanie Lindau, Stacy Tessler Cohen, Alicia J. Raven, Maria Huebschmann, Amy G. Sheward, Richard S. De Marchis, Emilia H. Johnson, Wendy Hessler, Danielle Byhoff, Elena Gottlieb, Laura M. Gavin, Nicholas Fleegler, Eric W. Adler, Nancy Tung, Elizabeth L. |
| AuthorAffiliation | 24 Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire 14 Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York 23 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire 8 Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island 12 Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts 1 Department of Medicine, Tufts Medical Center, Boston, Massachusetts 2 Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts 9 Ronald O. Perelman Department of Emergency Medicine, New York University, New York, New York 5 Lisa and John Pritzker Professor of Medical Psychology, Center for Health and Community, University of California, San Francisco, San Francisco, California 22 La Familia Medical Center, Santa Fe, |
| AuthorAffiliation_xml | – name: 4 Social Interventions Research and Evaluation Network, Center for Health and Community, University of California, San Francisco, San Francisco, California – name: 21 Upstream Health Innovations, Hennepin County Medical Center, Minneapolis, Minnesota – name: 16 Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, Colorado – name: 17 Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois – name: 7 Department of Family Medicine, Brown University, Providence, Rhode Island – name: 22 La Familia Medical Center, Santa Fe, New Mexico – name: 6 Providence VA Medical Center, Providence, Rhode Island – name: 20 Department of Emergency Medicine, University of San Francisco, California, San Francisco, California – name: 13 Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts – name: 18 Department of Medicine-Geriatrics, University of Chicago, Chicago, Illinois – name: 24 Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire – name: 1 Department of Medicine, Tufts Medical Center, Boston, Massachusetts – name: 2 Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts – name: 11 Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts – name: 15 Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado – name: 25 Children’s HealthWatch, Boston, Massachusetts – name: 14 Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York – name: 10 Department of Population Health, New York University, New York, New York – name: 19 Section of General Internal Medicine, University of Chicago, Chicago, Illinois – name: 5 Lisa and John Pritzker Professor of Medical Psychology, Center for Health and Community, University of California, San Francisco, San Francisco, California – name: 8 Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island – name: 3 Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California – name: 9 Ronald O. Perelman Department of Emergency Medicine, New York University, New York, New York – name: 23 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire – name: 12 Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts |
| Author_xml | – sequence: 1 givenname: Elena surname: Byhoff fullname: Byhoff, Elena email: ebyhoff@tuftsmedicalcenter.org organization: Department of Medicine, Tufts Medical Center, Boston, Massachusetts – sequence: 2 givenname: Emilia H. surname: De Marchis fullname: De Marchis, Emilia H. organization: Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California – sequence: 3 givenname: Danielle surname: Hessler fullname: Hessler, Danielle organization: Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California – sequence: 4 givenname: Caroline surname: Fichtenberg fullname: Fichtenberg, Caroline organization: Social Interventions Research and Evaluation Network, Center for Health and Community, University of California, San Francisco, San Francisco, California – sequence: 5 givenname: Nancy surname: Adler fullname: Adler, Nancy organization: Lisa and John Pritzker Professor of Medical Psychology, Center for Health and Community, University of California, San Francisco, San Francisco, California – sequence: 6 givenname: Alicia J. surname: Cohen fullname: Cohen, Alicia J. organization: Providence VA Medical Center, Providence, Rhode Island – sequence: 7 givenname: Kelly M. surname: Doran fullname: Doran, Kelly M. organization: Ronald O. Perelman Department of Emergency Medicine, New York University, New York, New York – sequence: 8 givenname: Stephanie surname: Ettinger de Cuba fullname: Ettinger de Cuba, Stephanie organization: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts – sequence: 9 givenname: Eric W. surname: Fleegler fullname: Fleegler, Eric W. organization: Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts – sequence: 10 givenname: Nicholas surname: Gavin fullname: Gavin, Nicholas organization: Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York – sequence: 11 givenname: Amy G. surname: Huebschmann fullname: Huebschmann, Amy G. organization: Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado – sequence: 12 givenname: Stacy Tessler surname: Lindau fullname: Lindau, Stacy Tessler organization: Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois – sequence: 13 givenname: Elizabeth L. surname: Tung fullname: Tung, Elizabeth L. organization: Section of General Internal Medicine, University of Chicago, Chicago, Illinois – sequence: 14 givenname: Maria surname: Raven fullname: Raven, Maria organization: Department of Emergency Medicine, University of San Francisco, San Francisco, California – sequence: 15 givenname: Susan surname: Jepson fullname: Jepson, Susan organization: Upstream Health Innovations, Hennepin County Medical Center, Minneapolis, Minnesota – sequence: 16 givenname: Wendy surname: Johnson fullname: Johnson, Wendy organization: La Familia Medical Center, Santa Fe, New Mexico – sequence: 17 givenname: Ardis L. surname: Olson fullname: Olson, Ardis L. organization: Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire – sequence: 18 givenname: Megan surname: Sandel fullname: Sandel, Megan organization: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts – sequence: 19 givenname: Richard S. surname: Sheward fullname: Sheward, Richard S. organization: Children's HealthWatch, Boston, Massachusetts – sequence: 20 givenname: Laura M. orcidid: 0000-0003-2669-4066 surname: Gottlieb fullname: Gottlieb, Laura M. organization: Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31753278$$D View this record in MEDLINE/PubMed |
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| Copyright | 2019 American Journal of Preventive Medicine Copyright © 2019 American Journal of Preventive Medicine. All rights reserved. Copyright Elsevier Science Ltd. Dec 2019 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Author contributions are as follows: Study concept and design: EHD, DH, CF, NA, AC, SE, EF, STL, MS, RSS, and LMG. Acquisition of data: EHD, KD, SE, NG, AGH, STL, MR, ET, SJ, WJ, ALO, MS, RSS, and LMG. Analysis and interpretation of data: EB, EHD, and LMG. Drafting of the manuscript: EB, EHD, DH, NA, and LMG. Critical revision of the manuscript for important intellectual content: all authors. Obtaining funding: NA, CF, and LMG. Administrative, technical, or material support and supervision: LMG. Final approval of the version to be published: all authors. |
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As part of a... Introduction This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings. Methods As... This study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.INTRODUCTIONThis study... |
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| SubjectTerms | Acceptability Adult Automobile industry Caregivers Caregivers - psychology Caregivers - statistics & numerical data Child Clinics Cross-Sectional Studies Delivery of Health Care Emergency Service, Hospital Emergency services Empathy Female Health care Health services Humans Innovations Interviews Interviews as Topic Male Mass Screening Medicaid Medical screening Medicare Middle Aged Patient-centered care Patients Patients - psychology Pediatrics Practitioner patient relationship Preventive medicine Primary care Primary Health Care Privacy Qualitative research Risk Social Determinants of Health - statistics & numerical data Social Welfare Surveys and Questionnaires Teams Tests United States Welfare benefits |
| Title | Part II: A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers |
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