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Background <p>Healthcare-based social need screening and referral (S&amp;R) among adult populations has produced equivocal results regarding social need resource connection.</p> Objective <p>Assess the efficacy of S&amp;R on resource connection (primary outcome) and unmet need reduction (secondary outcome).</p> Design <p>Intention-to-treat randomized controlled trial. Analyses adjusted for demographics (e.g., age, race), comorbidity (Elixhauser), and VA priority group (PG).</p> Participants <p>Veterans with and at-risk for cardiovascular disease and one of more (hereafter “ ≥ 1”) social needs receiving healthcare at one of three Veterans Healthcare Administration (VHA) medical facilities.</p> Intervention <p>Study arms represented referral strategies of varying intensity. Arm 1 (control) received generic resource information; Arm 2 (low intensity) received generic and tailored resource information; Arm 3 (high intensity) received all the above plus social work navigation assistance.</p> Main Measures <p>Post index surveys at 2-months assessed resource connection (connection to ≥ 1 new resources) and 6-months assessed need reduction (≥ 1 needs at the index screen no longer identified).</p> Key Results <p>A total of 479 Veterans were randomized: 50% were minoritized Veterans, mean age was 64, and 91% were male. Arm 3 was associated with greater resource connection but differences across study arms were not statistically significant. For example, compared to the control arm, participants in Arm 3 had higher but non-statistically significant odds of connecting to ≥ 1 resources (OR = 1.60, CI [.96, 2.67]).</p> Conclusions <p>Among VHA-enrolled Veterans, a high-intensity S&amp;R intervention was associated with a non-statistically significant increase in connection to social need resources. Further study needed to establish S&amp;R efficacy.</p> Trial Registration <p>NCT04977583.</p>

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Screening and Referral for Social Needs Among Veterans: A Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2025年1月23日

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  • Deborah Gurewich,
  • Kelly Hunt,
  • Barbara Bokhour,
  • Gemmae Fix,
  • Hannah Friedman,
  • Mingfei Li,
  • Amy M. Linsky,
  • Barbara Niles,
  • Melissa Dichter

摘要

Background

Healthcare-based social need screening and referral (S&R) among adult populations has produced equivocal results regarding social need resource connection.

Objective

Assess the efficacy of S&R on resource connection (primary outcome) and unmet need reduction (secondary outcome).

Design

Intention-to-treat randomized controlled trial. Analyses adjusted for demographics (e.g., age, race), comorbidity (Elixhauser), and VA priority group (PG).

Participants

Veterans with and at-risk for cardiovascular disease and one of more (hereafter “ ≥ 1”) social needs receiving healthcare at one of three Veterans Healthcare Administration (VHA) medical facilities.

Intervention

Study arms represented referral strategies of varying intensity. Arm 1 (control) received generic resource information; Arm 2 (low intensity) received generic and tailored resource information; Arm 3 (high intensity) received all the above plus social work navigation assistance.

Main Measures

Post index surveys at 2-months assessed resource connection (connection to ≥ 1 new resources) and 6-months assessed need reduction (≥ 1 needs at the index screen no longer identified).

Key Results

A total of 479 Veterans were randomized: 50% were minoritized Veterans, mean age was 64, and 91% were male. Arm 3 was associated with greater resource connection but differences across study arms were not statistically significant. For example, compared to the control arm, participants in Arm 3 had higher but non-statistically significant odds of connecting to ≥ 1 resources (OR = 1.60, CI [.96, 2.67]).

Conclusions

Among VHA-enrolled Veterans, a high-intensity S&R intervention was associated with a non-statistically significant increase in connection to social need resources. Further study needed to establish S&R efficacy.

Trial Registration

NCT04977583.