Improving Understanding of Screening Questions for Social Risk and Social Need Among Emergency Department Patients.
Improving Understanding of Screening Questions for Social Risk and Social Need Among Emergency Department Patients.
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DOI：
10.5811/westjem.2020.5.46536
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发表时间：
2020-08-20
期刊：
影响因子：
--
通讯作者：
Samuels-Kalow M
中科院分区：
文献类型：
--
作者：
Ciccolo G;Curt A;Camargo CA Jr;Samuels-Kalow M
随着最近医疗保健政策的变化，包括建立负责任的护理组织，对食品和住房不安全等社会风险的筛查在医疗保健系统中变得越来越普遍。然而，用于筛查的各种不同工具使跨系统比较具有挑战性。此外，大多数用于衡量社会风险的工具只在初级保健环境中进行了测试，对于急诊科(ED)使用可能不是最佳的。因此，这项研究的目标是创建一个简短的社交筛选工具，用于EDS。我们开发了一个初始工具，使用与医疗保险和医疗补助服务中心负责的健康社区筛查工具的五个核心类别相对应的公开问题。使用有声思考和言语探索的混合模式对有目的地抽样的参与者进行认知访谈的迭代周期，以理解/体验回答问题和潜在的理解挑战。在一个周期内达到主题饱和后，根据参与者的投入更换工具；完成周期，直到总体达到主题饱和。共有16名参与者(6名患者监护人和10名患者)在三个周期内完成了认知访谈。参与者的反馈包括进一步澄清和简化调查问题以提高理解的建议。因此，调查从涉及五个领域的16个问题缩减为涉及四个领域的10个问题。我们使用了一种迭代的认知访谈过程，开发了一种用于EDS的社交筛选工具。这一过程证明了患者输入对完善问卷的重要性，并为急诊室的使用提供了一个简短的筛选工具。
With recent healthcare policy changes, including the creation of accountable care organizations, screening for social risks such as food and housing insecurity has become increasingly common in the healthcare system. However, the wide variety of different tools used for screening makes it challenging to compare across systems. In addition, the majority of tools used to measure social risks have only been tested in primary care settings and may not be optimal for emergency department (ED) use. Therefore, the goal of this study was to create a brief social screening tool for use in EDs. We developed an initial tool using publicly available questions corresponding to the five core categories of the Centers for Medicare & Medicaid Services’ Accountable Health Communities Screening Tool. Iterative cycles of cognitive interviews with purposively sampled participants were performed using a hybrid model of think-aloud and verbal probing to understand/experience answering questions and potential comprehension challenges. After thematic saturation was reached in one cycle, the tool was changed per participant input; cycles were completed until thematic saturation was reached overall. A total of 16 participants (six patient guardians and 10 patients) completed cognitive interviews throughout three cycles. Participant feedback included suggestions for further clarification and simplification of survey questions for improved comprehension. The survey was thus reduced and simplified from 16 questions concerning five domains to 10 questions concerning four domains. We used an iterative cognitive interviewing process to develop a social screening tool for use in EDs. This process demonstrates the importance of patient input to refine questionnaires, and provides a brief screening tool for ED use.
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DOI：
10.1111/acem.13165
发表时间：
2017-05
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
Samuels-Kalow ME;Rhodes KV;Henien M;Hardy E;Moore T;Wong F;Camargo CA Jr;Rizzo CT;Mollen C
通讯作者：
Mollen C
影响因子：
3.1
作者：
Martel, Marc L.;Klein, Lauren R.;Cutts, Diana B.
通讯作者：
Cutts, Diana B.
影响因子：
3.1
作者：
Bottino, Clement J.;Rhodes, Erinn T.;Fleegler, Eric W.
通讯作者：
Fleegler, Eric W.
影响因子：
1.7
作者：
Ryan, Katherine;Gannon-Slater, Nora;Culbertson, Michael J.
通讯作者：
Culbertson, Michael J.
影响因子：
5.4
作者：
Metzl, Jonathan M.;Hansen, Helena
通讯作者：
Hansen, Helena