Identifying Relative Changes in Social Risk Factors: An Analytic Approach.
Identifying Relative Changes in Social Risk Factors: An Analytic Approach.
复制标题
DOI：
10.1097/mlr.0000000000001441
复制
发表时间：
2021-02-01
期刊：
影响因子：
3
通讯作者：
Steiner, John F.
中科院分区：
文献类型：
--
作者：
Xu, Stanley;Goodrich, Glenn K.;Moore, Kelly R.;Manson, Spero M.;Gottlieb, Laura M.;Hessler, Danielle;Schroeder, Emily B.;Steiner, John F.
关键词：
个人经常报告同时存在的社会风险因素，例如粮食不安全、住房不稳定和交通障碍。比较成对的社会风险因素之间的相对变化可能会识别出那些更难以改变的因素。本研究的目的是开发一种方法来描述成对的社会风险因素的相对变化。这是一项前瞻性队列研究。城市印第安健康组织高血压护理随机对照试验的参与者。我们在 295 名试验参与者中测量了入组时、第 6 个月和第 12 个月的 7 个社会风险因素（住房、交通、食物、衣服、医疗保健、公用事业和债务）。我们假设成对比较可以识别不太可能随时间变化的社会风险因素。我们使用条件比值比 (OR) 和 95% 置信区间 (CI) 对每对进行排名。相对于住房，食品、服装、医疗保健、公用事业和债务在 0 至 6 个月期间变化更大（OR 分别为 2.3、3.4、4.7、3.5 和 3.4；所有 95% CI 均排除 1.0）。这些相同的社会风险因素在基线和 6 个月之间相对于交通也有更多变化（OR 分别为 2.8、3.4、4.9、4.7 和 4.1；所有 95% CI 均排除 1.0）。住房和交通风险因素的变化具有可比性（OR=0.7，95% CI：0.4-1.4）。 6 个月和 12 个月之间的相对变化相似。与其他社会风险因素相比，住房和交通的相对变化较小，并且可能更难以抵抗变化。了解社会风险因素之间的关系有助于确定干预的优先顺序。
Individuals often report concurrent social risk factors such as food insecurity, unstable housing, and transportation barriers. Comparing relative changes between pairs of social risk factors may identify those that are more resistant to change. The objective of this study was to develop a method to describe relative changes in pairs of social risk factors. This was a prospective cohort study. Participants in a randomized controlled trial of hypertension care in an Urban Indian Health Organization. We measured 7 social risk factors (housing, transportation, food, clothing, health care, utilities, and debts) at enrollment, 6, and 12 months among 295 participants in the trial. We hypothesized that pairwise comparisons could identify social risk factors that were less likely to change over time. We used conditional odds ratios (ORs) with 95% confidence intervals (CIs) to rank each pair. Food, clothing, health care, utilities, and debts had more changes between 0 and 6 months relative to housing (OR=2.3, 3.4, 4.7, 3.5, and 3.4, respectively; all 95% CI excluded 1.0). These same social risk factors also had more changes between baseline and 6 months relative to transportation (OR=2.8, 3.4, 4.9, 4.7, and 4.1, respectively; all 95% CI excluded 1.0). Changes in housing and transportation risk factors were comparable (OR=0.7, 95% CI: 0.4–1.4). Relative changes between 6 and 12 months were similar. Housing and transportation exhibited fewer relative changes than other social risk factors and might be more resistant to change. Awareness of the relationships between social risk factors can help define priorities for intervention.