Part I: A Quantitative Study of Social Risk Screening Acceptability in Patients and Caregivers

Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. This was a cross-sectional survey of 969 adult patients and adult caregivers of...

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Vydáno v:American journal of preventive medicine Ročník 57; číslo 6; s. S25 - S37
Hlavní autoři: De Marchis, Emilia H., Hessler, Danielle, Fichtenberg, Caroline, Adler, Nancy, Byhoff, Elena, Cohen, Alicia J., Doran, Kelly M., Ettinger de Cuba, Stephanie, Fleegler, Eric W., Lewis, Cara C., Lindau, Stacy Tessler, Tung, Elizabeth L., Huebschmann, Amy G., Prather, Aric A., Raven, Maria, Gavin, Nicholas, Jepson, Susan, Johnson, Wendy, Ochoa, Eduardo, Olson, Ardis L., Sandel, Megan, Sheward, Richard S., Gottlieb, Laura M.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier Inc 01.12.2019
Elsevier Science Ltd
Témata:
ISSN:0749-3797, 1873-2607, 1873-2607
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Abstract Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities’ social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019. Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07). A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier. 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.
AbstractList Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities’ social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019. Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07). A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier. 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.
Introduction Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. Methods This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019. Results Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07). Conclusions A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier.
Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening.INTRODUCTIONDespite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening.This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019.METHODSThis was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019.Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07).RESULTSScreening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07).A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier.CONCLUSIONSA strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier.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.
Author Fichtenberg, Caroline
Olson, Ardis L.
Doran, Kelly M.
Sandel, Megan
Prather, Aric A.
Ochoa, Eduardo
Jepson, Susan
Lewis, Cara C.
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 19 Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, Colorado
23 Upstream Health Innovations, Hennepin County Medical Center, Minneapolis, Minnesota
14 Kaiser Permanente Washington Health Research Institute, Seattle, Washington
18 Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
4 Department of Medicine, Tufts Medical Center, Boston, Massachusetts
16 Department of Medicine-Geriatrics, University of Chicago, Chicago, Illinois
20 Department of Psychiatry, University of San Francisco, San Francisco, California
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
9 Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York
17 Section of General Internal Medicine, University of Chicago, Chicago, Illinois
3 Center
AuthorAffiliation_xml – name: 23 Upstream Health Innovations, Hennepin County Medical Center, Minneapolis, Minnesota
– name: 15 Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
– name: 19 Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, Colorado
– name: 10 Department of Population Health, New York University School of Medicine, New York, New York
– name: 22 Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
– name: 2 Social Interventions Research and Evaluation Network, Center for Health and Community, University of California, San Francisco, San Francisco, California
– name: 6 Providence VA Medical Center, Providence, Rhode Island
– name: 13 Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts
– name: 9 Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York
– name: 24 La Familia Medical Center, Santa Fe, New Mexico
– name: 28 Children’s HealthWatch, Boston, Massachusetts
– name: 26 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
– name: 17 Section of General Internal Medicine, University of Chicago, Chicago, Illinois
– name: 4 Department of Medicine, Tufts Medical Center, Boston, Massachusetts
– name: 21 Department of Emergency Medicine, University of San Francisco, San Francisco, California
– name: 11 Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
– name: 25 Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
– name: 1 Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California
– name: 5 Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
– name: 18 Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
– name: 20 Department of Psychiatry, University of San Francisco, San Francisco, California
– name: 27 Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
– name: 8 Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island
– name: 14 Kaiser Permanente Washington Health Research Institute, Seattle, Washington
– name: 3 Center for Health and Community, University of California, San Francisco, San Francisco, California
– name: 12 Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts
– name: 16 Department of Medicine-Geriatrics, University of Chicago, Chicago, Illinois
– name: 7 Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
Author_xml – sequence: 1
  givenname: Emilia H.
  surname: De Marchis
  fullname: De Marchis, Emilia H.
  email: emilia.demarchis@ucsf.edu
  organization: Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California
– sequence: 2
  givenname: Danielle
  surname: Hessler
  fullname: Hessler, Danielle
  organization: Department of Family & Community Medicine, University of California, San Francisco, San Francisco, California
– sequence: 3
  givenname: Caroline
  surname: Fichtenberg
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  organization: Social Interventions Research and Evaluation Network, Center for Health and Community, University of California, San Francisco, San Francisco, California
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  organization: Center for Health and Community, University of California, San Francisco, San Francisco, California
– sequence: 5
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  organization: Department of Medicine, Tufts Medical Center, Boston, Massachusetts
– sequence: 6
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  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 School of Medicine, 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
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  surname: Lewis
  fullname: Lewis, Cara C.
  organization: Kaiser Permanente Washington Health Research Institute, Seattle, Washington
– sequence: 11
  givenname: Stacy Tessler
  surname: Lindau
  fullname: Lindau, Stacy Tessler
  organization: Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
– sequence: 12
  givenname: Elizabeth L.
  surname: Tung
  fullname: Tung, Elizabeth L.
  organization: Section of General Internal Medicine, University of Chicago, Chicago, Illinois
– sequence: 13
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  surname: Huebschmann
  fullname: Huebschmann, Amy G.
  organization: Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado
– sequence: 14
  givenname: Aric A.
  surname: Prather
  fullname: Prather, Aric A.
  organization: Department of Psychiatry, University of San Francisco, San Francisco, California
– sequence: 15
  givenname: Maria
  surname: Raven
  fullname: Raven, Maria
  organization: Department of Emergency Medicine, University of San Francisco, San Francisco, California
– sequence: 16
  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: 17
  givenname: Susan
  surname: Jepson
  fullname: Jepson, Susan
  organization: Upstream Health Innovations, Hennepin County Medical Center, Minneapolis, Minnesota
– sequence: 18
  givenname: Wendy
  surname: Johnson
  fullname: Johnson, Wendy
  organization: La Familia Medical Center, Santa Fe, New Mexico
– sequence: 19
  givenname: Eduardo
  surname: Ochoa
  fullname: Ochoa, Eduardo
  organization: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
– sequence: 20
  givenname: Ardis L.
  surname: Olson
  fullname: Olson, Ardis L.
  organization: Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
– sequence: 21
  givenname: Megan
  surname: Sandel
  fullname: Sandel, Megan
  organization: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
– sequence: 22
  givenname: Richard S.
  surname: Sheward
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  organization: Children's HealthWatch, Boston, Massachusetts
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  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/31753277$$D View this record in MEDLINE/PubMed
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Author contributions are as follows: Study concept and design: EHD, DH, CF, NA, AJC, SE, EWF, CCL, STL, AAP, MS, RSS, and LMG. Acquisition of data: EHD, KMD, SE, STL, ELT, AGH, MR, NG, SJ, WJ, ALO, EO, MS, RSS, and LMG. Analysis and interpretation of data: all authors. Drafting of the manuscript: EHD, DH, NA, and LMG. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: EHD, DH, and CF. Obtaining funding: CF, NA, and LMG. Administrative, technical, or material support and supervision: LMG. Final approval of the version to be published: all authors.
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Snippet Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates...
Introduction Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This...
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SourceType Open Access Repository
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SubjectTerms Acceptability
Adult
Adults
Appropriateness
Archives & records
Caregivers
Caregivers - psychology
Caregivers - statistics & numerical data
Child
Clinics
Comfort
Computerized medical records
Cross-Sectional Studies
Data collection
Delivery of Health Care
Discrimination
Documentation
Electronic Health Records
Emergency Service, Hospital
Emergency services
Female
Health care delivery
Health records
Health services
Humans
Innovations
Male
Mass Screening
Medicaid
Medical records
Medical screening
Medicare
Middle Aged
Patients
Patients - psychology
Pediatrics
Polls & surveys
Preventive medicine
Primary care
Primary Health Care
Quantitative analysis
Recruitment
Risk
Social Determinants of Health - statistics & numerical data
Surveys and Questionnaires
Tests
United States
Title Part I: A Quantitative Study of Social Risk Screening Acceptability in Patients and Caregivers
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https://dx.doi.org/10.1016/j.amepre.2019.07.010
https://www.ncbi.nlm.nih.gov/pubmed/31753277
https://www.proquest.com/docview/2325743048
https://www.proquest.com/docview/2317598035
https://pubmed.ncbi.nlm.nih.gov/PMC7336892
Volume 57
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