Approaches to Identifying Social Needs: The SECURE RCT.

Area of Science:

• Health Services Research
• Social Determinants of Health
• Patient Engagement

Background:

• Social risk screening is increasingly used in healthcare.
• Screening may not align with resource desire and can deter resource acceptance due to fear of repercussions.
• Existing evidence suggests a disconnect between screening outcomes and patient interest in social resources.

Purpose of the Study:

• To evaluate the impact of social risk screening versus a resource menu on caregivers' desire for and engagement with social resources.
• To compare the effectiveness of different methods for eliciting needs among caregivers in a pediatric hospital setting.

Main Methods:

• A randomized controlled trial involving adult caregivers in emergency and primary care clinics.
• Participants were assigned to a social risk screener, a resource menu, or no social assessment.
• Outcomes included desire for resources, engagement with navigation, and reported resource use at 30-day follow-up, analyzed using chi-squared tests and regression.

Main Results:

• The resource menu arm showed a significantly higher proportion of caregivers desiring resources compared to the screening arm (38.4% vs 29.0%).
• Caregivers preferring non-English languages were more likely to desire resources with a menu (OR 2.7).
• A dose-response relationship was observed between engagement with navigation and the number of desired resource domains; 40.1% reported using the resource map.

Conclusions:

• A resource menu effectively elicits caregivers' desire for social resources by focusing on prioritized needs.
• Social risk screening is not necessary for identifying caregivers' needs for social resources.
• This approach can improve the connection between patients and needed social support services.