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Clinician Experiences and Attitudes Regarding Screening for Social Determinants of Health in a Large Integrated Health System.

ABSTRACT: BACKGROUND:Clinical screening for basic social needs-such as food and housing insecurity-is becoming more common as health systems develop programs to address social determinants of health. Clinician attitudes toward such programs are largely unexplored. OBJECTIVE:To describe the attitudes and experiences of social needs screening among a variety of clinicians and other health care professionals. RESEARCH DESIGN:Multicenter electronic and paper-based survey. SUBJECTS:Two hundred fifty-eight clinicians including primarily physicians, social workers, nurses, and pharmacists from a large integrated health system in Southern California. MEASURES:Level of agreement with prompts exploring attitudes toward and barriers to screening and addressing social needs in different clinical settings. RESULTS:Overall, most health professionals supported social needs screening in clinical settings (84%). Only a minority (41%) of clinicians expressed confidence in their ability to address social needs, and less than a quarter (23%) routinely screen for social needs currently. Clinicians perceived lack of time to ask (60%) and resources (50%) to address social needs as their most significant barriers. We found differences by health profession in attitudes toward and barriers to screening for social needs, with physicians more likely to cite time constraints as a barrier. CONCLUSIONS:Clinicians largely support social needs programs, but they also recognize key barriers to their implementation. Health systems interested in implementing social needs programs should consider the clinician perspective around the time and resources required for such programs and address these perceived barriers.

SUBMITTER: Schickedanz A

PROVIDER: S-EPMC6721844 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Clinician Experiences and Attitudes Regarding Screening for Social Determinants of Health in a Large Integrated Health System.

Schickedanz Adam A Hamity Courtnee C Rogers Artair A Sharp Adam L AL Jackson Ana A

Medical care 20190601

<h4>Background</h4>Clinical screening for basic social needs-such as food and housing insecurity-is becoming more common as health systems develop programs to address social determinants of health. Clinician attitudes toward such programs are largely unexplored.<h4>Objective</h4>To describe the attitudes and experiences of social needs screening among a variety of clinicians and other health care professionals.<h4>Research design</h4>Multicenter electronic and paper-based survey.<h4>Subjects</h4 ...[more]

PMID: 31095061

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Project description:BackgroundAs more health care organizations integrate social needs screening and navigation programs into clinical care delivery, the patient perspective is necessary to guide implementation and achieve patient-centered care.ObjectivesTo examine patients' perceptions of whether social needs affect health and attitudes toward healthcare system efforts to screen for and address social needs.Research designMulti-site, self-administered survey to assess (1) patient perceptions of the health impact of commonly identified social needs; (2) experience of social needs; (3) degree of support for a health system addressing social needs, including which social needs should be screened for and intervened upon; and (4) attitudes toward a health system utilizing resources to address social needs. Analyses were conducted using multivariable logistic regression models with clinic site cluster adjustment.SubjectsAdult patients at seven primary care clinics within a large, integrated health system in Southern California.Main measuresSurvey measures of experience with, acceptability of, and attitudes toward clinical social determinants of health screening and navigation.Key resultsA total of 1161 patients participated, representing a 79% response rate. Most respondents (69%) agreed that social needs impact health and agreed their health system should ask about social needs (85%) and help address social needs (88%). Patients with social needs in the last year were more likely to (1) agree social needs impact health (OR 10.2, p < 0.001), (2) support their health system asking patients about social needs (OR 3.7, p < 0.001), and (3) support addressing patient social needs (OR 3.5, p < 0.001). Differences by social need history, gender, age, race, ethnicity, and education were found.ConclusionsMost patients at a large integrated health system supported clinical social needs screening and intervention. Differences in attitudes by social need history, gender, age, race, ethnicity, and education may indicate opportunities to develop more equitable, patient-centered approaches to addressing social needs.

Project description:BackgroundPreregistration, the open science practice of specifying and registering details of a planned study prior to knowing the data, increases the transparency and reproducibility of research. Large-scale replication attempts for psychological results yielded shockingly low success rates and contributed to an increasing demand for open science practices among psychologists. However, preregistering one's studies is still not the norm in the field. Here, we conducted a study to explore possible reasons for this discrepancy.MethodsIn a mixed-methods approach, we conducted an online survey assessing attitudes, motivations, and perceived obstacles with respect to preregistration. Respondents (N = 289) were psychological researchers that were recruited through their publications on Web of Science, PubMed, PSYNDEX, and PsycInfo, and preregistrations on OSF Registries. Based on the theory of planned behavior, we predicted that positive attitudes (moderated by the perceived importance of preregistration) as well as a favorable subjective norm and higher perceived behavioral control positively influence researchers' intention to preregister (directional hypothesis 1). Furthermore, we expected an influence of research experience on attitudes and perceived motivations and obstacles regarding preregistration (non-directional hypothesis 2). We analyzed these hypotheses with multiple regression models and included preregistration experience as a control variable.ResultsResearchers' attitudes, subjective norms, perceived behavioral control, and the perceived importance of preregistration significantly predicted researchers' intention to use preregistration in the future (see hypothesis 1). Research experience influenced both researchers' attitudes and their perception of motivations to preregister, but not the perception of obstacles (see hypothesis 2). Descriptive reports on researchers' attitudes, motivations and obstacles regarding preregistration are provided.DiscussionMany researchers had already preregistered and had a rather positive attitude toward preregistration. Nevertheless, several obstacles were identified that may be addressed to improve and foster preregistration.

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Clinician Experiences and Attitudes Regarding Screening for Social Determinants of Health in a Large Integrated Health System.

Publications

Clinician Experiences and Attitudes Regarding Screening for Social Determinants of Health in a Large Integrated Health System.

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