Abstract
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. Supplement information: 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | S38-S46 |
| Journal | American journal of preventive medicine |
| Volume | 57 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 2019 |
ASJC Scopus subject areas
- Epidemiology
- Public Health, Environmental and Occupational Health
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Part II : A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers. / Byhoff, Elena; De Marchis, Emilia H.; Hessler, Danielle et al.
In: American journal of preventive medicine, Vol. 57, No. 6, 12.2019, p. S38-S46.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Part II
T2 - A Qualitative Study of Social Risk Screening Acceptability in Patients and Caregivers
AU - Byhoff, Elena
AU - De Marchis, Emilia H.
AU - Hessler, Danielle
AU - Fichtenberg, Caroline
AU - Adler, Nancy
AU - Cohen, Alicia J.
AU - Doran, Kelly M.
AU - Ettinger de Cuba, Stephanie
AU - Fleegler, Eric W.
AU - Gavin, Nicholas
AU - Huebschmann, Amy G.
AU - Lindau, Stacy Tessler
AU - Tung, Elizabeth L.
AU - Raven, Maria
AU - Jepson, Susan
AU - Johnson, Wendy
AU - Olson, Ardis L.
AU - Sandel, Megan
AU - Sheward, Richard S.
AU - Gottlieb, Laura M.
N1 - Funding Information: Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ), under HHS contract [1R13HS026664], Kaiser Permanente [CRN5374-7544-15320], and the Robert Wood Johnson Foundation [75922]. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of any of the sponsors. We thank the research staff at each of our 10 study sites for their assistance with data collection. We thank José Parra and Catherine Arevalo of the University of California, San Francisco (UCSF) for their assistance with study launch and organization of study sites. We thank Remi Frazier and Glenda Sharp of the UCSF Academic Research Systems for their assistance with inputting the study survey into REDCap. We would like to acknowledge Emily Abramsohn, Megan DePumpo, and Kelsey Paradise from the University of Chicago for their assistance with training, safety protocols, and data collection efforts. We thank Dr. Cara Lewis of Kaiser Permanente Washington Health Research Institute and Dr. Aric A. Prather of UCSF for their assistance with study development. We thank Dr. Eduardo Ochoa Jr. of the University of Arkansas for Medical Sciences for his assistance with study site supervision and data collection. This work was supported by The Commonwealth Fund (CWF), a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve healthcare practice and policy. The views presented here are those of the author and not necessarily those of CWF, its directors, officers, or staff. CWF had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. EB was additionally supported by funding from the NIH Office of Research on Women's Health award K12HD092535 . EHD was additionally supported by a fellowship training grant, National Research Service Award (NRSA) T32HP19025 . The research presented in this paper is that of the authors and does not reflect the official policy of the Commonwealth Fund , NIH, National Institute of Dental and Craniofacial Research, or NRSA. The study was approved by the UCSF IRB (17–23,110); per their own institutional requirements, 7 of the study sites also obtained site-specific IRB approvals (University of Arkansas, 217767; Boston Medical Center, H-37489; University of Chicago, 18-0139; University of Colorado, 17–2,434; Dartmouth College, STUDY00031049; Hennepin Health, 18–4,482; New York University, i18-00004). Author contributions: 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. EWF is a consultant for Veta Health, which is a company that develops software for chronic disease management. Veta Health also supports HelpSteps, a system for connecting families to social services developed by EWF. In the future, it is possible that this technology will be sold commercially. If this were to occur, EWF and Boston Children's Hospital might receive financial benefits in the form of compensation. As in all research studies, the Boston Children's Hospital has taken steps designed to ensure that this potential for financial gain does not endanger research subjects or undercut the validity and integrity of the information learned by this research. The research published in this paper is not related to any of the above consulting work and was conducted before EWF working with Veta Health. STL directed a Center for Medicare and Medicaid Innovation Health Care Innovation Award (1C1CMS330997-03) called CommunityRx. This award required development of a sustainable business model to support the model test after award funding ended. To this end, STL is founder and co-owner of “NowPow, LLC.” Neither the University of Chicago nor the University of Chicago Medicine is endorsing or promoting any “NowPow, LLC.” entity or its business, products, or services. No other financial disclosures were reported by the authors of this paper. Funding Information: 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. Funding Information: Publication of this article was supported by the Agency for Healthcare Research and Quality (AHRQ), under HHS contract [1R13HS026664], Kaiser Permanente [CRN5374-7544-15320], and the Robert Wood Johnson Foundation [75922]. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of any of the sponsors. We thank the research staff at each of our 10 study sites for their assistance with data collection. We thank Jos? Parra and Catherine Arevalo of the University of California, San Francisco (UCSF) for their assistance with study launch and organization of study sites. We thank Remi Frazier and Glenda Sharp of the UCSF Academic Research Systems for their assistance with inputting the study survey into REDCap. We would like to acknowledge Emily Abramsohn, Megan DePumpo, and Kelsey Paradise from the University of Chicago for their assistance with training, safety protocols, and data collection efforts. We thank Dr. Cara Lewis of Kaiser Permanente Washington Health Research Institute and Dr. Aric A. Prather of UCSF for their assistance with study development. We thank Dr. Eduardo Ochoa Jr. of the University of Arkansas for Medical Sciences for his assistance with study site supervision and data collection. This work was supported by The Commonwealth Fund (CWF), a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve healthcare practice and policy. The views presented here are those of the author and not necessarily those of CWF, its directors, officers, or staff. CWF had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. EB was additionally supported by funding from the NIH Office of Research on Women's Health award K12HD092535. EHD was additionally supported by a fellowship training grant, National Research Service Award (NRSA) T32HP19025. The research presented in this paper is that of the authors and does not reflect the official policy of the Commonwealth Fund, NIH, National Institute of Dental and Craniofacial Research, or NRSA. The study was approved by the UCSF IRB (17?23,110); per their own institutional requirements, 7 of the study sites also obtained site-specific IRB approvals (University of Arkansas, 217767; Boston Medical Center, H-37489; University of Chicago, 18-0139; University of Colorado, 17?2,434; Dartmouth College, STUDY00031049; Hennepin Health, 18?4,482; New York University, i18-00004). Author contributions: 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. EWF is a consultant for Veta Health, which is a company that develops software for chronic disease management. Veta Health also supports HelpSteps, a system for connecting families to social services developed by EWF. In the future, it is possible that this technology will be sold commercially. If this were to occur, EWF and Boston Children's Hospital might receive financial benefits in the form of compensation. As in all research studies, the Boston Children's Hospital has taken steps designed to ensure that this potential for financial gain does not endanger research subjects or undercut the validity and integrity of the information learned by this research. The research published in this paper is not related to any of the above consulting work and was conducted before EWF working with Veta Health. STL directed a Center for Medicare and Medicaid Innovation Health Care Innovation Award (1C1CMS330997-03) called CommunityRx. This award required development of a sustainable business model to support the model test after award funding ended. To this end, STL is founder and co-owner of ?NowPow, LLC.? Neither the University of Chicago nor the University of Chicago Medicine is endorsing or promoting any ?NowPow, LLC.? entity or its business, products, or services. No other financial disclosures were reported by the authors of this paper. Publisher Copyright: © 2019 American Journal of Preventive Medicine
PY - 2019/12
Y1 - 2019/12
N2 - 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. Supplement information: 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.
AB - 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. Supplement information: 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.
UR - http://www.scopus.com/inward/record.url?scp=85075023453&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075023453&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2019.07.016
DO - 10.1016/j.amepre.2019.07.016
M3 - Article
C2 - 31753278
AN - SCOPUS:85075023453
VL - 57
SP - S38-S46
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 6
ER -