IMAGINE: A Trial of Messaging Strategies for Social Needs Screening and Referral

Understanding Patients’ Interest in Healthcare-Based Social Assistance Programs

“…A total of 4 studies examined clinicbased, multineed screening and assistance activities 40−43 ; 1 examined the use of a clinic-based produce distribution/ market 44 ; and 1 compared the use of online with in-person resource navigation not linked to any specific health setting. 39 A total of 4 studies analyzed quantitative data about interest in assistance or uptake of a program 39,40,42,44 ; 2 of these compared different approaches to either introducing screening 42 or the type of assistance offered. 39 Two of these also analyzed qualitative data.…”

“…If patients are declining assistance because they are confused about why they are being screened and what is being offered, more information about the goals of screening may help. The study by Nederveld et al, 42 1 of the 2 intervention studies in this supplement, asked this very question. Their multisite, 3-stage intervention study found that using medical assistants to introduce and explain the goals of screening during rooming was associated with higher rates of interest in assistance and higher perceived helpfulness of screening than when screening forms were handed out during check-in without verbal introduction.…”

“…First, a verbal explanation of the goals of screening and what assistance the healthcare team can provide might help to reduce the number of patients who decline assistance because of uncertainty about what is being offered. The study of Nederveld et al 42 also suggests that who introduces the program and when it is introduced can influence uptake.…”

“…Finally, a major gap in the literature that is not addressed by these studies relates to how racism and systemic racialized disadvantage impact interest in social assistance programs. Although several studies in the supplement indicate some differences in interest or uptake between racial groups, 39,42,44 none was powered to examine this question. Given the persistence of racism at the individual, institutional, and systemic levels as well as the racialization of poverty and social needs in U.S. society, ensuring that social care programs equitably and effectively serve individuals from all racial/ethnic groups is crucial.…”