Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals
Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals
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DOI：
10.1177/1090198115599396
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发表时间：
2016-04-01
影响因子：
4.2
通讯作者：
Boyum, Sonia
中科院分区：
文献类型：
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作者：
Thompson, Tess;Kreuter, Matthew W.;Boyum, Sonia
弱势群体成员对卫生服务的需求增加。将健康风险评估和转介纳入2-1-1等社会服务援助系统的一个好处是，这种系统有助于呼叫者解决其他领域(例如住房)的问题。致电密苏里州2-1-1(N=1,090)且至少有一种行为风险因素或癌症筛查需求的呼叫者被随机分配到三种健康转介干预措施中的一种：仅口头转介、口头转介+定制的邮寄提醒，或口头转介+电话健康导航器。1个月后，我们评估促使2-1-1电话的非健康问题是否已经解决。Logistic回归估计了问题得到解决对呼叫健康转诊的影响。来电者主要是女性(85%)，受过高中或以下教育(61%)；近一半(47%)的收入低于1万美元。最常见的服务要求是公用事业援助(35%)、家居/家庭问题(23%)和租金/按揭援助(12%)。在随访中，38%的呼叫者报告说，促使他们拨打2-1-1电话的所有问题都已得到解决，24%的人报告呼叫了健康转介。与问题未得到解决的人相比，解决所有问题提示2-1-1电话与联系健康转诊的几率更高(优势比=1.44，95%可信区间[1.02，2.05])。有助于满足与健康无关的需求并为实现与健康有关的目标提供支持的多方面干预措施可能会促进弱势人群的健康。
Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N = 1,090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After 1 month, we assessed whether the nonhealth problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (odds ratio = 1.44, 95% confidence interval [1.02, 2.05]) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations.