Table 1.
Additional Illustrative Quotes from Participant Interviews
| Theme | Subtheme | Quotes |
|---|---|---|
| Relevance of social and behavioral risk factors | Social and behavioral risk factors affect health | “If the doctor doesn’t know that you smoke and you have hypertension or any other condition, it’s a matter of life and death.” (Smoking) |
| “Alcohol can have such consequences for one’s body, one’s health, and one’s cognition and one’s well-being and social behaviors.” (Alcohol use) | ||
| “[Financial strain] does affect your wellbeing, just your stress levels and if financially you don’t have enough to eat that’s going to affect your health.” (Financial strain) | ||
| “Because not having transportation to make it to your doctor is very stressful indeed. I’ve been in that situation. I missed a lot of doctor’s appointments early in my career, and it was very problematic.” (Transportation need) | ||
| “If [a patient] had a decent amount of social connection and now that’s dropped, for whatever reason, illness, divorce, whatever, that person now might be a bit more apt to be stressed and depressed versus if he had people and outlets to reach out to.” (Social connections) | ||
| PCPs should know the patient as a whole person | “Since your primary care physician is your first line of defense or care, I think it’s important that they know what’s going on with you.” (All domains) | |
| Sharing social and behavioral risk factors | Prefer in-person discussion with PCP | “Forms are helpful for eliminating a lot of questions, but I’d rather have the questions asked in person. I’d rather have a personal conversation about it.” (All domains) |
| Role of survey tool in social and behavioral risk factor screening | “It could be done where you just do a self-administered form first and then the healthcare provider looks that over. The important piece, though, is it should then be reviewed in real-time with you with the healthcare provider.” (All domains) | |
| Open-ended approach | “I would ask a general question first and then if they didn’t really get more specific, then ask the second and third question. [For example,] ‘In the world of COVID, how are you dealing with it, how are you handling the stress? What are the things that you do to deal with it?’” (All domains) | |
| Importance of framing the discussion | “Preface it that these are issues that a lot of people are dealing with and can really impact health and wellbeing, so that’s the reason we are trying to discuss them with our patients to make sure we’re addressing your needs as best we can” (All domains) | |
| Trust in PCP | “A doctor is somebody that you have to confidence in as a person and you have to be able to talk about things that aren’t necessarily obviously medical problems. And so, you want to be able to have a sense of trust and the sense that the doctor knows you as a person and not just as a set of measurements of different components of your blood and so on.” (All domains) | |
| Addressing social and behavioral risk factors | Does not expect PCP to address social and behavioral risk factors | “I’m not sure that’s his area. Doctors, they took all types of chemistry and physics and science courses, they didn’t take a lot of accounting, finance, tax and investment courses, so I don't think they have the expertise to give you that kind of advice.” (Food insecurity) |
| Wants PCP to acknowledge social and behavioral risk factors | “I was just sharing with her about the frustrations I’ve had with my weight gain over this coronavirus and how I seem to put everybody first except myself and just her acknowledgement of that was really—she’s so awesome as far as listening and acknowledging it.” (Stress) | |
| Wants PCP to consider social and behavioral risk factors when making recommendations | “Talking about what we do to relieve stress. I usually meditate and do Qigong. Well, I haven’t been doing it the last few weeks. So it would be, ‘Well, why are you not doing it? What are the things you usually do? If you’re doing them now, great. If you’re not doing it, what do you need to do to get yourself back to doing it?’” (Stress) | |
| Wants to receive a list of community resources | “It would be great, like, if they had resources to refer you to that might even be outside the healthcare system. Like, ‘Oh, here’s a resource list of how you can get assistance with transportation or how you could get assistance with food or whatever the thing might be.’ The things that are out in the community.” (All domains) | |
| “I think it’s always more helpful if something’s tailored, but I also don’t know how realistic that is. I think in general, from the patient point of view, you get a very generic pamphlet and that’s sometimes not as helpful or not as attractive. Patients might pay less close attention to something that seems really generic.” (All domains) | ||
| Wants in-person case management | “Have an on-call somebody who works in the doctor’s office, who can come in and sit down with you and say, ‘I see that you indicated you’ve been having some domestic problems with violence. Would you like to talk about that with me?’” (Intimate partner violence) |