社会的リスク因子に対するスクリーニングと介入:米国の予防サービスタスクフォースを支援する技術的説明書

Michelle Eder¹, Michelle Henninger¹, Shauna Durbin²

¹Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.

JAMA

|September 1, 2021

まとめ

臨床医が社会的危険因子と介入のスクリーニングを行うには限られた証拠が必要です社会リスクスクリーニングと医療の普及のための介入による健康上の結果を示すために,より多くのランダム化臨床試験が必要である.

科学分野:

医療サービス研究
公衆衛生
健康の社会的決定因子

背景:

社会的リスク要因のスクリーニングと効果的な介入に関するガイドラインは依然として限られている.
社会的なリスク要因は患者の健康に大きく影響します
予防サービスタスクフォースは勧告を基に証拠を求めています

研究の目的:

社会的リスク因子に対するスクリーニングと介入に関する研究を見直す.
予防サービス・タスク・フォースの見解を伝えるため
臨床環境における健康の社会的決定因子に対処するための効果的な戦略を特定する.

主な方法:

複数のデータベース (例えば,コクラン,MEDLINE,社会学概要) の体系的なレビュー.
2019年1月から2021年5月までの証拠と,監視と主要情報提供者のインタビューが含まれています.
住居の不安定性,食糧不足,交通,公益事業,安全,教育,財政的な負担に対処する個人およびシステムレベルの介入の分析.

主要な成果:

多くの多領域の社会リスクスクリーニングツールが存在しますが,検証は欠けている.
106の介入研究が特定され,そのうち73は複数の社会的リスクに対処した.
食糧不安,財政的ストレス,住居の不安定性が最も研究された分野であり,医療利用は一般的な結果の指標でした.

結論:

食糧不足,財政的緊張,住宅の不安定性に対する介入は頻繁に研究されています.
より多くの高品質のランダム化臨床試験で健康上の結果が報告される必要がある.
医療における社会的リスクスクリーニングと介入の広範な実施を支える証拠が必要です.

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