COVID-19, Social Determinants of Health, Vulnerable Populations
Conditions
Brief summary
The goal of this real world efficacy study is to understand the benefit of universal social needs screening, community-based service referrals, and telephonic follow-up as a scalable strategy for preventing COVID-19 transmission, and for addressing the secondary health effects of the social, behavioral, and economic changes following the COVID-19 pandemic. With statewide community service providers, existing health information technology, and piloted methods, we seek to determine the effectiveness of universal social needs screening and community service referrals - the SINCERE intervention - in improving health outcomes of COVID-19 vulnerable and socioeconomically disadvantaged populations and whether intensive follow-up and collaborative goal-setting helps overcome barriers to community service use by patients seen in the emergency department and seeking COVID testing at community-based and mobile clinic locations.
Interventions
BEHAVIORALSINCERE
Each goal setting session will involve templated prompts in 211's ServicePoint to guide the creation of a patient-centered "action plan" specifying what, when, how much, and how often patients will engage in a behavior (e.g., "I will work on filling out eligibility paperwork for 30 minutes on Wednesday evening"). Again, following clear prompts, ISs negotiate the "action plan" with patients until patients can rate their level of confidence for achieving this behavior a 7 on a scale from 0 to 10.
BEHAVIORALScheduled Follow-Up
Adding to the standard Call + Resources protocol, those assigned to scheduled follow-up will receive a proactive call from 211 every 2 weeks for 3 months to explore additional service needs. These calls will be unstructured, guided by participant requests and 211 IS prompts.
OTHERStandard of Care
211 ISs contact referred patients, provide referral services, and follow up in an ad-hoc manner.
Sponsors
Andrea Wallace
National Institute of Nursing Research (NINR)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Caregiver)
Masking description
Services to which participants are referred will not be aware of the participant's inclusion in the research study or their study arm.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adult (\> 17 years) * English or Spanish speaking * Completed the referral process at the UHealth ED, one of the COVID-19 testing sites or the Primary Children's ED and indicated both social needs and willingness to receive service low- and no-cost referrals from the United Way 211 community referral service * Able to be reached by phone during the intervention OR able to complete surveys sent by text or email
Exclusion criteria
* Those unable to communicate verbally * Those living in nursing facilities, or those who are not otherwise responsible for self-care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Global Health over 12-week time period | Baseline, 2-week, 4-week and 12-week surveys | Standardized PROMIS v1.2 Global Health. 10 questions create one outcome score. Each question is on a 1-5 scale with higher numbers indicating lower severity. The outcome variable will be PROMIS v1.2 Global Health with Time included as a variable in the model. |
| Change in Depression over 12-week time period | Baseline, 2-week, 4-week and 12-week surveys | Standardized PROMIS Depression - Short Form 8b. 8 questions create one outcome score. Each question is on a 1-5 scale with higher numbers indicating higher severity. The outcome variable will be PROMIS Anxiety with Time included as a variable in the model. |
| Change in Anxiety over 12-week time period | Baseline, 2-week, 4-week and 12-week surveys | Standardized PROMIS Anxiety- Short Form 7a. 7 questions create one outcome score. Each question is on a 1-5 scale with higher numbers indicating higher severity. The outcome variable will be PROMIS Anxiety with Time included as a variable in the model. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAndrea Wallace, PhD
University of Utah
Outcome results
None listed