A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health
Abstract Objectives Examining the social risks that influence the health of patients accessing emergency care can inform future efforts to improve health outcomes. The optimal modality for screening in the emergency department (ED) has not yet been identified. We conducted a mixed methods evaluation...
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Elsevier
2022-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12678 |
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| author | Wendy Macias‐Konstantopoulos Gia Ciccolo Alona Muzikansky Margaret Samuels‐Kalow |
| author_facet | Wendy Macias‐Konstantopoulos Gia Ciccolo Alona Muzikansky Margaret Samuels‐Kalow |
| author_sort | Wendy Macias‐Konstantopoulos |
| collection | DOAJ |
| description | Abstract Objectives Examining the social risks that influence the health of patients accessing emergency care can inform future efforts to improve health outcomes. The optimal modality for screening in the emergency department (ED) has not yet been identified. We conducted a mixed methods evaluation of the impact of screening modality on patient satisfaction with the screening process. Methods Patients were enrolled at a large urban academic ED and randomized to verbal versus electronic modalities following informed consent. Participants completed a short demographic survey, a brief validated health literacy test, and a social need and risk screening tool. Participants were purposively sampled to complete qualitative interviews balanced across 4 groups defined by health literacy scores (high vs limited) and screening modality. Quantitative outcomes included screening results and satisfaction with the screening process; qualitative questions focused on experience with the screening process, barriers, and facilitators to screening. Results Of 554 patients assessed, 236 were randomized (115 verbal, 121 electronic). Participants were 23% Hispanic, 6% non‐Hispanic Black, 58% non‐Hispanic White, 38% publicly insured, and 57% privately insured. Two‐thirds (67%) identified social needs and risks and the majority (81%) reported satisfaction with the screening. Screening modality was not associated with satisfaction with screening process after adjustment for language, health literacy, and social risk (adjusted odds ratio, 0.74; 95% confidence interval, 0.32, 1.71). Conclusion Screening modality was not associated with overall satisfaction with screening process. Future strategies can consider the advantage of multimodal screening options, including the use of electronic tools to streamline screening and expand scalability and sustainability. |
| format | Article |
| id | doaj-art-28580f3bd5df43b29e5666124202d7bf |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-28580f3bd5df43b29e5666124202d7bf2025-08-20T02:54:50ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-02-0131n/an/a10.1002/emp2.12678A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of healthWendy Macias‐Konstantopoulos0Gia Ciccolo1Alona Muzikansky2Margaret Samuels‐Kalow3Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USABiostatistics Center, Division of Clinical Research, Mass General Research Institute Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USAAbstract Objectives Examining the social risks that influence the health of patients accessing emergency care can inform future efforts to improve health outcomes. The optimal modality for screening in the emergency department (ED) has not yet been identified. We conducted a mixed methods evaluation of the impact of screening modality on patient satisfaction with the screening process. Methods Patients were enrolled at a large urban academic ED and randomized to verbal versus electronic modalities following informed consent. Participants completed a short demographic survey, a brief validated health literacy test, and a social need and risk screening tool. Participants were purposively sampled to complete qualitative interviews balanced across 4 groups defined by health literacy scores (high vs limited) and screening modality. Quantitative outcomes included screening results and satisfaction with the screening process; qualitative questions focused on experience with the screening process, barriers, and facilitators to screening. Results Of 554 patients assessed, 236 were randomized (115 verbal, 121 electronic). Participants were 23% Hispanic, 6% non‐Hispanic Black, 58% non‐Hispanic White, 38% publicly insured, and 57% privately insured. Two‐thirds (67%) identified social needs and risks and the majority (81%) reported satisfaction with the screening. Screening modality was not associated with satisfaction with screening process after adjustment for language, health literacy, and social risk (adjusted odds ratio, 0.74; 95% confidence interval, 0.32, 1.71). Conclusion Screening modality was not associated with overall satisfaction with screening process. Future strategies can consider the advantage of multimodal screening options, including the use of electronic tools to streamline screening and expand scalability and sustainability.https://doi.org/10.1002/emp2.12678health‐related social risksmultimodal screening strategypatient satisfactionscreening modalities |
| spellingShingle | Wendy Macias‐Konstantopoulos Gia Ciccolo Alona Muzikansky Margaret Samuels‐Kalow A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health Journal of the American College of Emergency Physicians Open health‐related social risks multimodal screening strategy patient satisfaction screening modalities |
| title | A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| title_full | A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| title_fullStr | A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| title_full_unstemmed | A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| title_short | A pilot mixed‐methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| title_sort | pilot mixed methods randomized controlled trial of verbal versus electronic screening for adverse social determinants of health |
| topic | health‐related social risks multimodal screening strategy patient satisfaction screening modalities |
| url | https://doi.org/10.1002/emp2.12678 |
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