Comparing the performance of two social risk screening tools in a vulnerable subpopulation.
Comparing the performance of two social risk screening tools in a vulnerable subpopulation.
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DOI：
10.4103/jfmpc.jfmpc_650_20
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发表时间：
2020-09
影响因子：
1.4
通讯作者：
Sharp AL
中科院分区：
文献类型：
--
作者：
Lewis CC;Wellman R;Jones SMW;Walsh-Bailey C;Thompson E;Derus A;Paolino A;Steiner J;De Marchis EH;Gottlieb LM;Sharp AL
研究表明，社会因素对健康产生深远影响，导致许多卫生系统纳入社会风险筛查。为了帮助医疗保健系统在各种筛查工具中进行选择，我们比较了两种工具，即“您当前的生活状况”(YCLS) 和“负责任的健康社区”(AHC) 筛查工具的关键心理测量属性。南加州 Kaiser Permanente 资助的交换成员 (n = 1008) 被随机邀请完成一项包含 YCLS 或 AHC 工具以及与护理体验和健康相关的其他衡量标准的调查。医疗保健使用情况是通过电子健康记录来衡量的。 AHC 和 YCLS 之间的协议是使用调整后的 kappas 对六个领域（食品 - 担忧、食品 - 支付、住房不安全、住房质量、交通、公用事业）进行评估的。为了评估预测的有效性，将 AHC 和 YCLS 上的项目与自我评估的健康状况和注射流感疫苗进行了比较。有反应者 (n = 450) 和无反应者 (n = 558) 在性别、语言和抑郁方面存在显着差异 (P < 0.05)，但在焦虑、种族/民族或医疗保健使用方面没有显着差异。除住房质量（kappa 0.52）外，AHC 和 YCLS 工具在所有项目（kappa > 0.60）上都达成了实质性一致。 AHC 工具中的六分之四和 YCLS 工具中的七分之四与自评健康相关（P < 0.03）。除了 AHC 工具上的实用程序外，没有社交需求与流感疫苗接种相关（P = 0.028）。在此示例中，AHC 和 YCLS 工具筛选社会风险的能力相似。观察到的差异可能源于问题的时间范围和措辞，这可用于指导医疗保健系统的选择。
Research shows the profound impact of social factors on health, lead many healths systems to incorporate social risk screening. To help healthcare systems select among various screening tools we compared two tools, the Your Current Life Situation (YCLS) and the Accountable Health Communities (AHC) Screening tools, on key psychometric properties. Kaiser Permanente Southern California subsidized exchange members (n = 1008) were randomly invited to complete a survey containing either the YCLS or the AHC tool, as well as other measures related to care experience and health. Healthcare use was measured through the electronic health record. Agreement between the AHC and YCLS was assessed using adjusted kappas for six domains (food – worry, food – pay, insecure housing, housing quality, transportation, utilities). To assess predictive validity, items on the AHC and YCLS were compared to self-rated health and receipt of a flu shot. Responders (n = 450) and non-responders (n = 558) significantly differed on sex, language, and depression (P < 0.05) but not anxiety, race/ethnicity, or healthcare use. Agreement between the AHC and YCLS tools was substantial on all items (kappas > 0.60) except for housing quality (kappa 0.52). Four out of six screening questions on the AHC tool and four out of seven on the YCLS tool were associated with self-rated health (P < 0.03). No social needs were associated with flu shot receipt except utilities on the AHC tool (P = 0.028). In this sample, the AHC and YCLS tools are similar in their ability to screen for social risks. Differences observed likely stem from the timeframe and wording of the questions, which can be used to guide selection in healthcare systems.