Emergencies
Conditions
Keywords
social needs
Brief summary
The objective of this study is to to understand the most effective method for health-related social need (HRSN) screening in the challenging environment of an emergency department by randomizing patients to oral or written HRSN screening in the ED.
Detailed description
Bilingual research assistants (RA) will screen patients for eligibility based on the predetermined criteria and approach eligible patients with a brief description of the study and opportunity for participation. Interested participants will complete a verbal consent process to reduce the barriers to participation, a brief demographic questionnaire, and an assessment of health literacy (Newest Vital Sign) followed by the Partners Healthcare HRSN screener randomized to an oral v. iPad screening strategy. After completion of the screening tool, participants will complete a secondary questionnaire asking about satisfaction with the process, the presence of additional HRSN not recorded by the Partners HealthCare screener, and their perspectives on screening. At the conclusion, all participants will be provided with standardized, bilingual list of community resources to address each of the screening domains.
Interventions
OTHEROral HRSN screening
Verbal screening delivered by an RA
OTHERWritten HRSN screening
Patient completes written screen on iPad.
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. age ≥ 18 years patients and either a parent/guardian of a pediatric/cognitively disabled patient in the MGH ED, 2. triaged to the Acute, CDU, Fast Track, Urgent, and Pediatrics areas, 3. English- or Spanish-speaking, and 4. capable of informed consent.
Exclusion criteria
1. patients unwilling to have the interview audio-recorded, 2. medically unstable patients, and 3. Section 12, lack of capacity medical hold, sexual assault, child abuse, and emotionally distressed patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported Satisfaction With the Screening Process | Immediately after completing survey | Satisfaction with screening as measured by: Please tell us how satisfied you were with the questionnaire you just took: Extremely Quite a bit Somewhat A little bit Not at all |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Health Related Social Needs Reported | Immediately after completing survey | We will record the number of health related social needs reported |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Oral Screening Oral HRSN screening: Verbal screening delivered by an RA | 115 |
| Written Screening Written HRSN screening: Patient completes written screen on iPad. | 121 |
| Total | 236 |
Baseline characteristics
| Characteristic | Oral Screening | Written Screening | Total |
|---|---|---|---|
| Age, Continuous | 41 years STANDARD_DEVIATION 15 | 39 years STANDARD_DEVIATION 15 | 40 years STANDARD_DEVIATION 15 |
| Health literacy Adequate | 69 participants | 72 participants | 141 participants |
| Health literacy Limited | 42 participants | 46 participants | 88 participants |
| Health literacy Missing | 4 participants | 3 participants | 7 participants |
| Race/Ethnicity, Customized Black NH | 9 Participants | 5 Participants | 14 Participants |
| Race/Ethnicity, Customized Hispanic | 25 Participants | 28 Participants | 53 Participants |
| Race/Ethnicity, Customized Missing/declined | 2 Participants | 0 Participants | 2 Participants |
| Race/Ethnicity, Customized Other NH | 14 Participants | 16 Participants | 30 Participants |
| Race/Ethnicity, Customized White NH | 65 Participants | 72 Participants | 137 Participants |
| Sex/Gender, Customized Female | 72 Participants | 64 Participants | 136 Participants |
| Sex/Gender, Customized Male | 42 Participants | 55 Participants | 97 Participants |
| Sex/Gender, Customized Missing | 1 Participants | 1 Participants | 2 Participants |
| Sex/Gender, Customized Other | 0 Participants | 1 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 115 | 0 / 121 |
| other Total, other adverse events | 0 / 115 | 0 / 121 |
| serious Total, serious adverse events | 0 / 115 | 0 / 121 |
Outcome results
Primary
Self-reported Satisfaction With the Screening Process
Satisfaction with screening as measured by: Please tell us how satisfied you were with the questionnaire you just took: Extremely Quite a bit Somewhat A little bit Not at all
Time frame: Immediately after completing survey
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Oral Screening | Self-reported Satisfaction With the Screening Process | Extremely/quite a bit | 94 Participants |
| Oral Screening | Self-reported Satisfaction With the Screening Process | Somewhat/a little/ not at all | 12 Participants |
| Oral Screening | Self-reported Satisfaction With the Screening Process | Missing | 9 Participants |
| Written Screening | Self-reported Satisfaction With the Screening Process | Extremely/quite a bit | 97 Participants |
| Written Screening | Self-reported Satisfaction With the Screening Process | Somewhat/a little/ not at all | 15 Participants |
| Written Screening | Self-reported Satisfaction With the Screening Process | Missing | 9 Participants |
Secondary
Number of Health Related Social Needs Reported
We will record the number of health related social needs reported
Time frame: Immediately after completing survey
Population: Would you like any information about any of the HRSN topics?
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Oral Screening | Number of Health Related Social Needs Reported | None | 70 Participants |
| Oral Screening | Number of Health Related Social Needs Reported | At least one | 45 Participants |
| Written Screening | Number of Health Related Social Needs Reported | None | 93 Participants |
| Written Screening | Number of Health Related Social Needs Reported | At least one | 28 Participants |