Screening Discordance and Characteristics of Patients With Housing-Related Social Risks
| Autor: | Kelly M. Doran, Richard Sheward, Emilia H De Marchis, Lawrence Chang, Alicia J. Cohen, Stephanie Ettinger de Cuba, Laura M. Gottlieb, Eric W. Fleegler, Megan Sandel |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Epidemiology business.industry Cross-sectional study media_common.quotation_subject Public Health Environmental and Occupational Health MEDLINE Logistic regression Cross-Sectional Studies Family medicine Intervention (counseling) Ill-Housed Persons Health care Housing medicine Humans Mass Screening Quality (business) Child Emergency Service Hospital business Mass screening media_common Screening measures |
| Zdroj: | American Journal of Preventive Medicine. 61:e1-e12 |
| ISSN: | 0749-3797 |
| Popis: | Healthcare systems are increasingly interested in identifying patients' housing-related risks, but minimal information exists to inform screening question selection. The primary study aim is to evaluate discordance among 5 housing-related screening questions used in health care.This was a cross-sectional multisite survey of social risks used in a convenience sample of adults seeking care for themselves or their child at 7 primary care clinics and 4 emergency departments across 9 states (2018-2019). Housing-related risks were measured using 2 questions from the Accountable Health Communities screening tool (current/anticipated housing instability, current housing quality problems) and 3 from the Children's HealthWatch recommended housing instability screening measures (prior 12-month: rent/mortgage strain, number of moves, current/recent homelessness). The 2-sided Fisher's exact tests analyzed housing-related risks and participant characteristics; logistic regression explored associations with reported health (2019-2020).Of 835 participants, 52% screened positive for ≥1 housing-related risk (n=430). Comparing the tools, 32.8% (n=274) screened discordant: 11.9% (n=99) screened positive by Children's HealthWatch questions but negative by Accountable Health Communities, and 21.0% (n=175) screened positive by the Accountable Health Communities tool but negative by Children's HealthWatch (p0.001). Worse health was associated with screening positive for current/anticipated housing instability (AOR=0.56, 95% CI=0.32, 0.96) or current/recent homelessness (AOR=0.57, 95% CI=0.34, 0.96).The 5 housing questions captured different housing-related risks, contributed to different health consequences, and were relevant to different subpopulations. Before implementing housing-related screening initiatives, health systems should understand how specific measures surface distinct housing-related barriers. Measure selection should depend on program goals and intervention resources. |
| Databáze: | OpenAIRE |
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