对社会风险因素的查和干预:支持美国预防服务工作组的技术简报
Michelle Eder1, Michelle Henninger1, Shauna Durbin2
1Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|September 1, 2021
概括
有限的证据指导临床医生对社会风险因素和干预措施进行查. 需要更多的随机临床试验来证明广泛实施医疗保健的社会风险查和干预措施的健康结果.
科学领域:
- 医疗服务研究
- 公共卫生
- 健康的社会决定因素
背景情况:
- 关于社会风险因素查和有效干预措施的指导仍然有限.
- 社会风险因素对患者的健康状况产生重大影响.
- 美国预防服务工作组需要证据来做出建议.
研究的目的:
- 审查有关社会风险因素查和干预的研究.
- 为美国预防服务工作组的考虑提供信息.
- 确定在临床环境中解决健康的社会决定因素的有效策略.
主要方法:
- 对多个数据库进行系统审查 (例如,Cochrane,MEDLINE,社会学摘要).
- 包括2019年1月至2021年5月的证据,以及监视和关键线人采访.
- 对解决住房不稳定,粮食不安全,交通,公用事业,安全,教育和财政压力的个人和系统层面干预措施的分析.
主要成果:
- 许多多领域的社会风险选工具存在,但缺乏验证.
- 确定了106项干预研究,其中73项涉及多种社会风险.
- 粮食不安全,财政紧张和住房不稳定是最受研究的领域; 医疗保健利用率是一个常见的结果指标.
结论:
- 经常研究粮食不安全,经济紧张和住房不稳定的干预措施.
- 需要更多高质量的随机临床试验报告健康结果.
- 需要证据支持在医疗保健中广泛实施社会风险查和干预措施.
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