背景:与健康相关的社会需求与不良的健康结果相关,增加急性医疗保健的使用,和慢性疾病管理受损。鉴于这些负面结果,越来越多的国家卫生保健组织建议卫生系统将筛选和解决与健康相关的社会需求作为临床护理的常规部分,但是关于如何在临床环境中实施社会需求筛查以改善高血压等慢性疾病的管理的数据有限。SMS文本消息可能是筛查患者的有效方法;但是,关于使用它的可行性的数据有限。
目的:我们对高血压患者进行了一项横断面研究,以确定使用SMS短信筛查患者未满足的健康相关社会需求的可行性。
方法:我们从1个学术卫生系统中随机选择200名患者(≥18岁)。如果患者在学术卫生系统的17个初级保健诊所之一中被发现,并且位于福赛斯县,北卡罗来纳州。我们将样本限制在这些诊所之一的患者中,以提供有关当地社区资源的量身定制信息。为了确保参与者仍然是诊所内的患者,我们只包括前3个月访问过的人。SMS文本消息包括指向有关食物的6个问题的链接,住房,和交通。筛查阳性并感兴趣的患者收到了随后的消息,其中包含有关当地资源的信息。我们评估了完成问题的患者比例。我们还评估了完成问题的患者与未使用双变量分析的患者之间的人口统计学差异。
结果:在200名患者中,大多数是女性(n=109,54.5%),非西班牙裔白人(n=114,57.0%),并获得商业保险(n=105,52.5%)。符合资格的4446例患者与随机选择的200例患者之间的人口统计学没有显着差异。在200名患者中,SMS短信无法传递给9例(4.5%)患者,17例(8.5%)填写了社会需求问卷.我们没有观察到有和没有完成问卷的患者在人口统计学特征上的显著差异。在17人中,共有5人(29.4%)报告至少1项需求未得到满足,但只有2个选择接收资源信息。
结论:我们发现只有8.5%(n=17)的患者完成了基于SMS短信的健康相关社会需求问卷。SMS文本消息作为筛选该人群中的患者的单一模式可能不可行。未来的研究应评估基于SMS文本消息的社会需求筛查在其他人群中是否可行或与其他筛查方式配对时是否有效。
BACKGROUND: Health-related social needs are associated with poor health outcomes, increased acute health care use, and impaired chronic disease management. Given these negative outcomes, an increasing number of national health care organizations have recommended that the health system screen and address unmet health-related social needs as a routine part of clinical care, but there are limited data on how to implement social needs screening in clinical settings to improve the management of chronic diseases such as hypertension. SMS text messaging could be an effective and efficient approach to screen patients; however, there are limited data on the feasibility of using it.
OBJECTIVE: We conducted a cross-sectional study of patients with hypertension to determine the feasibility of using SMS text messaging to screen patients for unmet health-related social needs.
METHODS: We randomly selected 200 patients (≥18 years) from 1 academic health system. Patients were included if they were seen at one of 17 primary care clinics that were part of the academic health system and located in Forsyth County, North Carolina. We limited the sample to patients seen in one of these clinics to provide tailored information about local community-based resources. To ensure that the participants were still patients within the clinic, we only included those who had a visit in the previous 3 months. The SMS text message included a link to 6 questions regarding food, housing, and transportation. Patients who screened positive and were interested received a subsequent message with information about local resources. We assessed the proportion of patients who completed the questions. We also evaluated for the differences in the demographics between patients who completed the questions and those who did not using bivariate analyses.
RESULTS: Of the 200 patients, the majority were female (n=109, 54.5%), non-Hispanic White (n=114, 57.0%), and received commercial insurance (n=105, 52.5%). There were no significant differences in demographics between the 4446 patients who were eligible and the 200 randomly selected patients. Of the 200 patients included, the SMS text message was unable to be delivered to 9 (4.5%) patients and 17 (8.5%) completed the social needs questionnaire. We did not observe a significant difference in the demographic characteristics of patients who did versus did not complete the questionnaire. Of the 17, a total of 5 (29.4%) reported at least 1 unmet need, but only 2 chose to receive resource information.
CONCLUSIONS: We found that only 8.5% (n=17) of patients completed a SMS text message-based health-related social needs questionnaire. SMS text messaging may not be feasible as a single modality to screen patients in this population. Future research should evaluate if SMS text message-based social needs screening is feasible in other populations or effective when paired with other screening modalities.