Universal social needs assessment in gynecologic oncology: An important step toward more informed and targeted care in the public safety net

Nyakudarika, Natsai; Holschneider, Christine H.; Sinno, Abdulrahman K.

doi:10.1002/cncr.33761

Cited by 7 publications

(17 citation statements)

References 27 publications

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“…By comparison, a similar study performed in Los Angeles among primarily Hispanic patients reported their population needed help reading hospital materials more frequently than needing more social support. 31 However, we feel these differences in findings further highlight the responsibility of health systems to consider not only the needs of gynecologic oncology patients in general, but of assessing and addressing the unique health equity needs of their own specific populations served.…”

Section: Limitationsmentioning

confidence: 92%

A pilot evaluation of social needs among gynecologic oncology patients in inpatient versus outpatient settings

Greenwood

Nora

Hartman

et al. 2023

Proceedings in Obstetrics and Gynecology

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The WHO defines social determinants of health (SDoH) as the conditions in which we are born, grow, work, and live as well as other large systems that positively or negatively affect our health. Many healthcare systems currently lack the resources and strategies required to accurately assess and address SDoH. Action must be taken because studies have found that chronic diseases, including cancer, are affected by SDoH. The aim of this study is to identify the incidence of social needs in an inpatient gynecologic oncology population and its relation to patient demographics and clinical diagnostic data to guide and inform future intervention. Patients agreeing to participate in the study completed a needs assessment survey during their inpatient stay at the hospital between November 2020 to March 2021. The survey contained seven questions, six of which were questions screening for social needs including food and housing security, transportation means, financial stability, health literacy, and social support. Responses were considered positive if any degree of need was reported. Demographic and cancer diagnosis data were then collected and included zip code, race, cancer stage and age at diagnosis, treatment history, and number of hospital admissions and length of stay over the past 12 months. The most substantial reported needs across all gynecologic malignancies were social support (65%), health literacy (37%), and financial need (22%). Less need was reported in the categories of food (11%), housing (7%), and transportation (4%). SDoH have been studied in the outpatient gynecologic population and the needs seen in this study are similar to the needs of that population. However, there are likely different challenges and frequencies of unmet need in the different types of gynecologic cancers that may affect the stage at which their cancer is diagnosed as well as the number of hospital admissions related to their cancer care.

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Section: Limitationsmentioning

confidence: 92%

A pilot evaluation of social needs among gynecologic oncology patients in inpatient versus outpatient settings

Greenwood

Nora

Hartman

et al. 2023

Proceedings in Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…In addition to including essential social need domains—food insecurity, housing instability, utility needs, financial resource strain, and transportation challenges—this survey was adapted to include questions on the optional social need domains of childcare accessibility, health literacy, and social isolation ( Figure ). 15 In addition, patients provided sociodemographic information and breast cancer history.…”

Section: Methodsmentioning

confidence: 99%

“…Individuals with cancer often report at least 1 unmet social need, especially within financial, informational, psychological, and physical domains . However, there is a critical knowledge gap evaluating the impact of unmet social needs on utilization of screening mammography and breast cancer stage at diagnosis, particularly in high-income settings with access to screening mammography …”

Section: Introductionmentioning

confidence: 99%

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Unmet Social Needs and Breast Cancer Screening Utilization and Stage at Presentation

Goel,

Lubarsky,

Hernandez

et al. 2024

JAMA Netw Open

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ImportanceUnmet social needs in local populations may hinder the development of targeted cancer control interventions aimed at improving screening utilization and early-stage breast cancer diagnosis to ultimately improve breast cancer survival disparities.ObjectiveTo evaluate if (1) city-funded screening mammography is associated with utilization of screening mammography, (2) unmet social needs are associated with utilization of screening mammography, and (3) unmet social needs are associated with later-stage disease at diagnosis.Design, Setting, and ParticipantsThis cohort study included patients with stages I-IV invasive ductal or lobular carcinoma treated at an academic medical center (including both an underserved safety-net hospital [SNH] and a National Cancer Institute–designated academic cancer center [ACC]) from 2020 to 2023. Eligible patients were aged 18 years or older and able to consent. Data were analyzed between July 2023 and September 2023.ExposureThe Health Leads Social Needs Screening Toolkit, a screening tool that gathers information on the most common social need domains affecting patient health.Main Outcomes and MeasuresUnivariable and multivariable logistic regression was utilized to evaluate the following primary outcomes: (1) routine screening mammography and (2) American Joint Committee on Cancer 8th edition clinical stage at presentation.ResultsOf the 322 women who completed the Health Leads Social Needs Screening Toolkit, 201 (62%) self-identified as Hispanic, 63 (19%) as non-Hispanic Black, and 63 (19%) as non-Hispanic White. Two hundred fifty-five (76%) patients with access to city-funded screening mammography completed a screening mammogram. Patients who presented to the SNH were more likely to present with late-stage disease compared with early-stage disease (15 of 48 [31%] vs 50 of 274 [18%]; P = .04). On multivariable logistic regression, not completing a screening mammography was associated with having an increasing number of unmet social needs (OR, 0.74; 95% CI, 0.55-0.99; P = .047) and an increasing age at diagnosis (OR, 0.92; 95% CI, 0.89-0.96; P &lt; .001). Moreover, increasing unmet social needs was significantly associated with late-stage diagnosis above and beyond screening mammography (OR, 1.38; 95% CI, 1.01-1.89; P = .04).Conclusions and RelevanceIn this cohort study, access to screening mammography did not translate to utilization of screening mammography, increasing unmet social needs were significantly associated with lower rates of screening mammography, and those with increasing unmet social needs were more likely to present with late-stage disease. This association transcended recruitment site (SNH vs ACC), indicating that patients in either hospital setting may benefit from unmet social needs screening to overcome access to care barriers associated with late-stage disease at diagnosis.

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“… 61 Social needs screening has been implemented successfully within gynecologic practices and demonstrates a significant opportunity for intervention. 62 , 63 These interventions can be in the form of the Health LEADS model, in which patients are screened, referred to social resources, and followed up to ensure successful resolution of their identified need. 64 …”

Section: Organizationalmentioning

confidence: 99%

An Intervention-Based Approach to Achieve Racial Equity in Gynecologic Oncology

Gamble,

Woodard,

Yakubu

et al. 2023

Obstetrics &Amp; Gynecology

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Racial inequities within gynecologic oncology exist at every step of the cancer continuum. Although the disparities have been well described, there is a significant gap in the literature focused on eliminating inequities in gynecologic cancer outcomes. The goal of this narrative review is to highlight successful, evidence-based interventions from within and outside of gynecologic oncology that alleviate disparity, providing a call to action for further research and implementation efforts within the field. These solutions are organized in the socioecologic framework, where multiple levels of influence—societal, community, organizational, interpersonal, and individual—affect health outcomes.

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Universal social needs assessment in gynecologic oncology: An important step toward more informed and targeted care in the public safety net

Cited by 7 publications

References 27 publications

A pilot evaluation of social needs among gynecologic oncology patients in inpatient versus outpatient settings

A pilot evaluation of social needs among gynecologic oncology patients in inpatient versus outpatient settings

Unmet Social Needs and Breast Cancer Screening Utilization and Stage at Presentation

An Intervention-Based Approach to Achieve Racial Equity in Gynecologic Oncology

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