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Subpopulation Differences in Connecting to Resources to Address Social Needs.

Deborah A Gurewich1, Hannah Friedman2, Mingfei Li3

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Healthcare interventions connecting Veterans to social needs resources show specific sub-groups benefit most. Social worker navigation significantly improved resource connection for low-income and high-comorbidity Veterans.

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Area of Science:

  • Health Services Research
  • Social Determinants of Health
  • Veterans Affairs Healthcare

Background:

  • Healthcare interventions addressing social needs are increasing.
  • Few studies identify specific sub-populations that benefit most from these interventions.
  • Understanding differential effectiveness is crucial for optimizing resource allocation and improving outcomes.

Purpose of the Study:

  • To evaluate the comparative effectiveness of a healthcare-based social needs intervention across different Veteran sub-populations.
  • To identify which Veteran sociodemographic and clinical characteristics are associated with differential intervention success.

Main Methods:

  • A three-arm randomized controlled trial (RCT) comparing a control group (generic resources) with two intervention arms (tailored resources, tailored resources plus social worker navigation).
  • Ad hoc sub-group analyses were performed using generalized linear models with random effects.
  • Analyses examined outcomes based on Veteran sociodemographic and clinical factors, including income and comorbidity count.

Main Results:

  • Veterans who were low-income and ineligible for VA disability benefits, and those with four or more Elixhauser comorbidities, showed significantly higher odds of connecting to social resources when receiving social worker navigation (Arm 3 vs. Arm 1).
  • Odds ratios for resource connection in Arm 3 versus Arm 1 were 6.47 (CI [1.87–22.37]) and 2.18 (CI [1.16–4.10]) for these respective sub-groups.
  • As-treated analysis also supported the effectiveness of the social worker navigation component.

Conclusions:

  • Specific Veteran sub-groups, particularly those with low income and high comorbidity burden, may derive the greatest benefit from enhanced social needs interventions.
  • Future research should aim to confirm these findings and explore their generalizability across diverse Veteran populations.