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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Veröffentlicht in:American journal of preventive medicine Jg. 57; H. 6; S. S25 - S37
Hauptverfasser: 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.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Netherlands Elsevier Inc 01.12.2019
Elsevier Science Ltd
Schlagworte:
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
United States
ISSN:0749-3797, 1873-2607, 1873-2607
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Zusammenfassung: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.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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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.
ISSN:0749-3797
1873-2607
1873-2607
DOI:10.1016/j.amepre.2019.07.010