Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

Tsui, Jennifer; Yang, Annie; Anuforo, Bianca; Chou, Jonathan; Brogden, Ruth; Xu, Binghong; Cantor, Joel C.; Wang, Su

doi:10.3389/fpubh.2021.674035

Cited by 6 publications

(3 citation statements)

References 72 publications

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“…Participants completed the survey on a computer tablet before, during, or after their clinic visit. The survey consisted of the 10-item Accountable Health Communities (AHC) health-related social needs screening tool, which is widely used and includes questions on housing, food, transportation, utilities, and interpersonal violence; 2 outcome measures of acceptability; and 20 questions on social risk factors associated with patient acceptability (eAppendix in Supplement 1). We modified questions from an earlier study evaluating acceptability of social risk screening in primary care clinics and EDs for use in a dermatology clinic setting.…”

Section: Methodsmentioning

confidence: 99%

Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

Wilkerson,

De Marchis,

Rudd

et al. 2023

JAMA Dermatol

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ImportanceProviding person-centered dermatologic care includes consideration of social risk factors, such as housing instability and unreliable transportation, that may affect clinical management. Patients’ perspectives on social risk screening and documentation in dermatology clinics have not yet been evaluated.ObjectiveTo understand patients’ perspectives on social risk screening and documentation in a dermatology clinic.Design, Setting, and ParticipantsThis mixed-methods study used a survey and semistructured interviews and was conducted in a general dermatology clinic at a large urban public hospital. Patients at the clinic were eligible to complete the survey if they were 18 years or older; able to speak and read English, Spanish, or Cantonese; and comfortable using a computer tablet. Survey participants who preferred to use English were eligible for interviews. The survey included social risk screening questions, measures of acceptability, and questions on social risk factors associated with patient acceptability. Semistructured interviews were conducted to explore attitudes and beliefs about social risk screening and documentation. Survey and interview findings were integrated during data analysis through development of themes and joint display. Data were analyzed from December 2021 to April 2023.Main Outcomes and MeasuresThere were 2 outcome measures of acceptability: appropriateness of screening in a dermatology clinic and comfort with documentation of social risk in the electronic health record (EHR).ResultsA total of 135 participants (including 73 males [54.1%]) answered both measures of acceptability in the survey. Of these participants, 116 (85.9%) reported that social risk screening in their dermatology clinic was very or somewhat appropriate and 85 (63.0%) reported being completely or somewhat comfortable with having their social risks documented in the EHR. Themes that were developed from surveys and interviews were the (1) role of interpersonal factors in willingness to disclose social risks, (2) implications of institutional trust for willingness to disclose and comfort with documentation, and (3) relevance of screening in a dermatology clinic.Conclusions and RelevanceResults of this study showed that most participants found social risk screening to be appropriate in a dermatology clinic, although a smaller proportion of participants were comfortable with EHR documentation of their social risks. Optimizing patients’ trust in their physicians and the medical system, while addressing privacy and discrimination concerns, may help facilitate disclosure of social risks.

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Section: Methodsmentioning

confidence: 99%

Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

Wilkerson,

De Marchis,

Rudd

et al. 2023

JAMA Dermatol

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“…Health The entire AHC tool has also applied to studies of diverse communities including English and Chinese versions which were self-administered to Asian Americans during COVID-19 to inform cancer screening and primary care (Tsui et al, 2021). However, initial validation of the tool has not been tested as a whole, but questions come from a range of expert domain-specific sources with supporting psychometric properties (Centers for Medicare and Medicaid Services et al, 2017).…”

Section: Protocol For Responding To and Assessing Patient Assets Risk...mentioning

confidence: 99%

An Examination of Stakeholder-Driven Health-Related Social Needs Screening Tools in Medical Care Delivery

Cammy

2024

Illness, Crisis & Loss

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The growing recognition that social risk factors influence individual and population health has generated stakeholder support in the promotion of health equity, bridging partnerships across health care, public health, and social service sectors. The integration of social care into health care delivery requires routine screening to identify and address health-related social needs (HRSN). Screening tools must be short, accessible, and inclusive and accurately reflect potential risks to prioritize tailored interventions. However, HRSNs are also sensitive and can prompt additional ethical concerns when integrated with clinical practice in medical care. This paper examines the psychometric properties of three stakeholder-driven HRSN screening tools to identify adverse, unmet risks among oncology patients. Further research is needed to ensure social needs initiatives protect sensitive social data in electronic health records and that patients with complex medical and social needs receive comprehensive resources through targeted service connections.

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“…It is unclear whether access to HPV vaccine information and limited knowledge about HPV vaccines persists as a key barrier to vaccine uptake among immigrant parents living in surburban, higher socioeconomic areas. Prior studies in suburban communities have shown that while these areas have higher unadjusted access to health care overall, a large proportion of surburban residents lack access to health care and remain medically vulnerable [ 13 , 14 ]. Studying this population may provide a better understanding of why HPV vaccine knowledge and HPV vaccine uptake remain lower in New Jersey compared to neighboring metropolitan areas such as Philadelphia and New York City [ 15 ] despite having higher education and socioeconomic status at the population level.…”

Section: Introductionmentioning

confidence: 99%

Disparities in HPV vaccine knowledge and adolescent HPV vaccine uptake by parental nativity among diverse multiethnic parents in New Jersey

et al. 2022

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Background Suboptimal human papillomavirus (HPV) vaccination rates persist among adolescents in the United States (U.S.). New Jersey (NJ), among the top, most racially/ethnically diverse states in the U.S., had among the lowest HPV vaccine initiation rates, prior to 2018. This study examined parental HPV vaccine knowledge and adolescent HPV vaccine initiation among multiethnic parents in NJ, where access to language concordant HPV vaccine information and vaccination services may differ, for immigrant parents. Methods We surveyed parents of adolescents (ages 11–18) at community events in NJ to examine parental HPV vaccine knowledge and adolescent HPV vaccine uptake. Vaccine knowledge was assessed using an 11-item question stem that covered vaccine efficacy, gender recommendation, vaccine protection, and myths. Multivariable models assessed the association of parent nativity on HPV vaccine knowledge scores and adolescent HPV vaccine initiation, controlling for sociodemographic factors. Results Of the 77 parents, most parents (84%) were aware of the HPV vaccine. However, knowledge scores were low and differed by parent nativity. Non-U.S. born parents had significantly lower knowledge scores − 1.7 [− 3.1, − 0.4] and lower odds of adolescent children initiating the HPV vaccine 0.3 [0.1, 0.9] compared to U.S.-born parents after adjusting demographic characteristics. Conclusions Our findings reveal that parental HPV vaccine knowledge remains low among suburban dwelling, immigrant parents, even though they have higher education and access to health care. Multilevel strategies to reduce missed opportunities for HPV vaccine education among parents and HPV vaccination for adolescents are needed, including for suburban, immigrant communities.

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Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

Cited by 6 publications

References 72 publications

Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

Patient Perspectives on Social Risk Screening and Documentation in a Dermatology Clinic

An Examination of Stakeholder-Driven Health-Related Social Needs Screening Tools in Medical Care Delivery

Disparities in HPV vaccine knowledge and adolescent HPV vaccine uptake by parental nativity among diverse multiethnic parents in New Jersey

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