Understanding Patients’ Interest in Healthcare-Based Social Assistance Programs

Fichtenberg, Caroline; Marchis, Emilia H. De; Gottlieb, Laura M.

doi:10.1016/j.amepre.2022.04.026

Cited by 17 publications

(9 citation statements)

References 39 publications

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“…There is a growing research base to document health care–based interventions to address food insecurity and related social needs, but additional evidence is needed to identify best practices to close the gap between patient food insecurity and community resource engagement. In the present study, only 1 in 5 adults with food insecurity had interest in assistance, and likely far fewer successfully connected with the social worker, reached out to the provided resources, and ultimately received assistance . Prior studies have shown that patients may not remember opting out of requesting assistance on a questionnaire, may no longer be experiencing food insecurity at the time of the encounter, were overwhelmed with more urgent health concerns or other social needs, or felt their social needs were beyond the scope of what their health care practitioner could address.…”

Section: Discussionmentioning

confidence: 63%

Food Insecurity Prevalence and Risk Factors at a Large Academic Medical Center in Michigan

Leung,

Patel,

Miller

et al. 2024

JAMA Netw Open

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ImportanceHealth care systems are increasingly adopting methods to screen for and integrate food insecurity and other social risk factors into electronic health records. However, there remain knowledge gaps regarding the cumulative burden of food insecurity in large clinical settings, which patients are most at risk, and the extent to which patients are interested in social assistance through their health care system.ObjectiveTo evaluate the 5-year prevalence and associated risk factors of food insecurity among adult primary care patients, and to examine factors associated with patients’ interest in social assistance among those with food insecurity.Design, Setting, and ParticipantsThis cross-sectional analysis of a retrospective cohort study took place at a tertiary care academic medical center (encompassing 20 primary care clinics) in Michigan. Participants included adult patients who completed screening for social risk factors between August 1, 2017, and August 1, 2022. Data analysis was performed from November 2022 to June 2023.ExposureFood insecurity was assessed using the Hunger Vital Sign.Main Outcomes and MeasuresThe primary outcome was patients’ interest in social assistance, and associated factors were examined using multivariate logistic regression models, adjusting for patients’ demographic and health characteristics.ResultsOver the 5-year period, 106 087 adult primary care patients (mean [SD] age, 52.9 [17.9] years; 61 343 women [57.8%]) completed the standardized social risk factors questionnaire and were included in the analysis. The overall prevalence of food insecurity was 4.2% (4498 patients), with monthly trends ranging from 1.5% (70 positive screens) in August 2018 to 5.0% (193 positive screens) in June 2022. Food insecurity was significantly higher among patients who were younger, female, non-Hispanic Black or Hispanic, unmarried or unpartnered, and with public health insurance. Food insecurity was significantly associated with a higher cumulative burden of social needs, including social isolation, medical care insecurity, medication nonadherence, housing instability, and lack of transportation. Only 20.6% of patients with food insecurity (927 patients) expressed interest in social assistance. Factors associated with interest in social assistance including being non-Hispanic Black, unmarried or unpartnered, a current smoker, and having a higher burden of other social needs.Conclusions and RelevanceIn this retrospective cohort study, the overall prevalence of food insecurity was 4.2%, of whom approximately 1 in 5 patients with food insecurity expressed interest in assistance. This study highlights ongoing challenges in ensuring all patients complete routine social determinants of health screening and gaps in patients’ interest in assistance for food insecurity and other social needs through their health care system.

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Section: Discussionmentioning

confidence: 63%

Food Insecurity Prevalence and Risk Factors at a Large Academic Medical Center in Michigan

Leung,

Patel,

Miller

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

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“…This has been referred to as a potential “road to nowhere problem” given the significant financial strain on social and community services in the US [ 72 ]. In addition to discrimination and shame, negative experiences accessing resources may contribute to the large gaps between patients’ identified unmet social needs and their interest in receiving assistance in healthcare settings [ 69 – 71 ]. In this study, most patients indicated that they wanted more support and assistance but did not expect it.…”

Section: Discussionmentioning

confidence: 99%

“Addressing the bigger picture”: A qualitative study of internal medicine patients’ perspectives on social needs data collection and use

et al. 2023

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Background There is increasing interest in collecting sociodemographic and social needs data in hospital settings to inform patient care and health equity. However, few studies have examined inpatients’ views on this data collection and what should be done to address social needs. This study describes internal medicine inpatients’ perspectives on the collection and use of sociodemographic and social needs information. Methods A qualitative interpretive description methodology was used. Semi-structured interviews were conducted with 18 patients admitted to a large academic hospital in Toronto, Canada. Participants were recruited using maximum variation sampling for diverse genders, races, and those with and without social needs. Interviews were coded using a predominantly inductive approach and a thematic analysis was conducted. Results Patients expressed that sociodemographic and social needs data collection is important to offer actionable solutions to address their needs. Patients described a gap between their ideal care which would attend to social needs, versus the reality that hospital-based teams are faced with competing priorities and pressures that make it unfeasible to provide such care. They also believed that this data collection could facilitate more holistic, integrated care. Patients conveyed a need to have a trusting and transparent relationship with their provider to alleviate concerns surrounding bias, discrimination, and confidentiality. Lastly, they indicated that sociodemographic and social needs data could be useful to inform care, support research to inspire social change, and assist them with navigating community resources or creating in-hospital programs to address unmet social needs. Conclusions While the collection of sociodemographic and social needs information in hospital settings is generally acceptable, there were varied views on whether hospital staff should intervene, as their priority is medical care. The results can inform the implementation of social data collection and interventions in hospital settings.

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“…A slate of recently published studies examine how different implementation strategies might increase patient interest in assistance. 19 Recent US efforts have also highlighted the need to more explicitly design and tailor social prescribing interventions that are anti-racist to ensure that social prescribing does not inadvertently worsen health inequities for people of colour and people living in poverty. A recent review demonstrated that only 29% of 152 social prescribing studies included race or ethnicity in their analysis of effectiveness, and only 14% examined differential treatment effects by race.…”

Section: Implementation Researchmentioning

confidence: 99%

Developing a research agenda for social prescribing in the UK using lessons from the US

et al. 2022

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Understanding Patients’ Interest in Healthcare-Based Social Assistance Programs

Cited by 17 publications

References 39 publications

Food Insecurity Prevalence and Risk Factors at a Large Academic Medical Center in Michigan

Food Insecurity Prevalence and Risk Factors at a Large Academic Medical Center in Michigan

“Addressing the bigger picture”: A qualitative study of internal medicine patients’ perspectives on social needs data collection and use

Developing a research agenda for social prescribing in the UK using lessons from the US

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