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Patient Perspectives on Addressing Social Needs in Primary Care Using a Screening and Resource Referral Intervention

  • Clarissa HsuEmail author
  • Stephanie Cruz
  • Hilary Placzek
  • Michelle Chapdelaine
  • Sara Levin
  • Fabiola Gutierrez
  • Sara Standish
  • Ian Maki
  • Mary Carl
  • Miriam Rosa Orantes
  • Duffy Newman
  • Allen Cheadle
Article

Abstract

Background

Interest is growing in interventions to address social needs in clinical settings. However, little is known about patients’ perceptions and experiences with these interventions.

Objective

To evaluate patients’ experiences and patient-reported outcomes of a primary care-based intervention to help patients connect with community resources using trained volunteer advocates.

Design

Qualitative telephone interviews with patients who had worked with the volunteer advocates. Sample and recruitment targets were equally distributed between patients who had at least one reported success in meeting an identified need and those who had no reported needs met, based on the database used to document patient encounters.

Participants

One hundred two patients.

Interventions

Patients at the study clinic were periodically screened for social needs. If needs were identified, they were referred to a trained volunteer advocate who further assessed their needs, provided them with resource referrals, and followed up with them on whether their need was met.

Approach

Thematic analysis was used to code the data.

Key Results

Interviewed patients appreciated the services offered, especially the follow-up. Patients’ ability to access the resource to which they were referred was enhanced by assistance with filling out forms, calling community resources, and other types of navigation. Patients also reported that interacting with the advocates made them feel listened to and cared for, which they perceived as noteworthy in their lives.

Conclusions

This patient-reported information provides key insights into a human-centered intervention in a clinical environment. Our findings highlight what works in clinical interventions addressing social needs and provide outcomes that are difficult to measure using existing quantitative metrics. Patients experienced the intervention as a therapeutic relationship/working alliance, a type of care that correlates with positive outcomes such as treatment adherence and quality of life. These insights will help design more patient-centered approaches to providing holistic patient care.

Notes

Acknowledgments

Contributors: We want to express our appreciation to all the patients that participated in the interviews for sharing their insights and experiences with us. We also acknowledge our colleagues at Contra Costa Health Services and Health Leads for their input into our data collection efforts and the development of this manuscript—Rohan Radhakrishna, MD; Concepcion Trevino James, MA; Tiombe F Mashama, HEd, MPA; Martin Lynch; Lisa Diemoz, MPH; Abigail Kroch, MPH PhD; Damon Francis, MD; and Sheena Nahm, PhD, MPH. We thank Chris Tachibana for providing technical editing for this manuscript.

Funding Information

The pilot and evaluation were funded by the Kaiser Foundation Health Plan, Inc.

Compliance with Ethical Standards

This project was reviewed by the Kaiser Permanente Washington Health Research Institute Institutional Review Board and determined to be “not research.”

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_5397_MOESM1_ESM.doc (40 kb)
ESM 1 (DOC 40.5 kb)

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Clarissa Hsu
    • 1
    Email author
  • Stephanie Cruz
    • 2
  • Hilary Placzek
    • 3
    • 4
  • Michelle Chapdelaine
    • 1
  • Sara Levin
    • 5
  • Fabiola Gutierrez
    • 4
  • Sara Standish
    • 4
  • Ian Maki
    • 1
  • Mary Carl
    • 4
  • Miriam Rosa Orantes
    • 5
  • Duffy Newman
    • 5
  • Allen Cheadle
    • 1
  1. 1.Kaiser Permanente Washington Health Research InstituteSeattleUSA
  2. 2.Department of AnthropologyUniversity of WashingtonSeattleUSA
  3. 3.Data ScienceClarify Health SolutionsSan FranciscoUSA
  4. 4.Health LeadsBostonUSA
  5. 5.Contra Costa Health ServicesMartinezUSA

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