Journal
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
Volume 57, Issue 6, Pages S25-S37Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amepre.2019.07.010
Keywords
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Funding
- Agency for Healthcare Research and Quality (AHRQ), under HHS contract [1R13HS026664]
- Kaiser Permanente [CRN5374-754415320]
- Robert Wood Johnson Foundation [75922]
- Commonwealth Fund (CWF), a national, private foundation based in New York City
- National Research Service Award (NRSA) [T32HP19025]
- Social Needs Network for Evaluation and Translation (SONNET)
- Kaiser Permanente National Community Health
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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. (C) 2019 American Journal of Preventive Medicine. Published by Elsevier Inc.
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