Table 3. Unadjusted and Adjusted Associations Between Social Risk Factors and Interest in Receiving Assistance, Stratified by Response to Social Risk Screening Questionsa.
| Variable | Participants with positive screening results for ≥1 social risk factor (n = 550) | Participants with negative screening results for all social risk factors (n = 301) | ||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value | Unadjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
| Participant characteristics | ||||||||
| Age range, y | ||||||||
| 18-44 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 45-64 | 0.79 (0.50-1.26) | .32 | 1.03 (0.67-1.58) | .91 | 1.22 (0.48-3.09) | .68 | 3.88 (0.67-22.35) | .13 |
| ≥65 | 0.61 (0.37-1.00) | .05 | 1.20 (0.70-2.05) | .51 | 0.92 (0.40-2.11) | .85 | 2.10 (0.42-10.43) | .36 |
| Race/ethnicity | ||||||||
| Non-Hispanic White | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Non-Hispanic Black | 3.78 (2.00-7.17) | <.001 | 2.22 (1.37-3.60) | .001 | 1.94 (1.08-3.49) | .03 | 0.57 (0.18-1.88) | .36 |
| Hispanic | 1.95 (1.34-2.85) | .001 | 0.74 (0.29-1.91) | .53 | 2.99 (1.02-8.81) | .05 | 1.51 (0.27-8.51) | .64 |
| Non-Hispanic other race or multiple races | 2.05 (1.10-3.80) | .02 | 1.36 (0.76-2.44) | .30 | 3.39 (0.80-14.28) | .10 | 1.43 (0.27-7.58) | .67 |
| Preferred language | ||||||||
| English | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Spanish | 1.55 (0.90-2.66) | .12 | 2.20 (0.97-4.97) | .06 | 2.45 (1.24-4.82) | .01 | 2.58 (0.49-4.70) | .17 |
| Educational level, y | ||||||||
| <12 | 1.84 (1.20-2.82) | .005 | 1.46 (0.81-2.65) | .21 | 1.01 (0.29-3.54) | .99 | 0.21 (0.02-2.18) | .19 |
| ≥12 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Household income, $ | ||||||||
| Missing | 10.74 (3.89-29.70) | <.001 | 3.93 (1.06-14.57) | .04 | 2.67 (0.49-14.61) | .26 | 2.23 (0.22-22.06) | .49 |
| 0-10 000 | 34.13 (17.2-67.58) | <.001 | 7.78 (2.96-20.44) | <.001 | 10.40 (3.91-27.65) | <.001 | 12.38 (2.94-52.15) | .001 |
| 10 001-25 000 | 12.16 (4.70-31.43) | <.001 | 3.90 (1.19-12.75) | .03 | 10.76 (5.06-22.86) | <.001 | 11.48 (2.44-53.94) | .002 |
| 25 001-50 000 | 12.16 (6.06-24.43) | <.001 | 5.45 (2.49-11.96) | <.001 | 2.36 (0.36-15.34) | .37 | 3.40 (0.41-28.37) | .26 |
| 50 001-75 000 | 3.62 (1.00-13.01) | .05 | 2.37 (0.59-9.51) | .22 | 1.78 (0.41-7.74) | .44 | 1.37 (0.28-6.77) | .70 |
| ≥75 001 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Self-reported health or caregiver-reported child’s health | ||||||||
| Excellent, very good, or good | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Fair or poor | 1.66 (1.03-2.69) | .04 | 1.50 (0.92-2.46) | .11 | 2.95 (1.53-5.71) | .001 | 4.22 (1.09-16.31) | .04 |
| Participant type | ||||||||
| Adult patient | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Adult caregiver of pediatric patient | 2.03 (1.12-3.68) | .02 | 1.35 (0.52-3.50) | .53 | 1.51 (0.53-4.25) | .44 | 2.60 (0.66-10.32) | .17 |
| Trust in clinician | ||||||||
| Complete (rating of 10) | 0.76 (0.48-1.19) | .23 | 1.13 (0.64-1.99) | .66 | 0.43 (0.12-1.55) | .20 | 0.56 (0.08-4.11) | .57 |
| High (rating of 8-9) | 0.72 (0.44-1.17) | .19 | 1.31 (0.77-2.23) | .31 | 0.49 (0.20-1.17) | .11 | 0.70 (0.18-2.69) | .60 |
| Medium to low (rating of 1-7) | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Any previous experience with discrimination in a health care setting | ||||||||
| Yes | 0.98 (0.71-1.35) | .89 | 0.71 (0.48-1.05) | .09 | 1.58 (0.57-4.38) | .38 | 1.37 (0.25-7.55) | .71 |
| No | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Order of response to survey questions | ||||||||
| Answered questions about social risk factors first | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Answered question about interest in receiving assistance first | 1.22 (0.85-1.76) | .27 | 1.48 (1.05-2.07) | .02 | 1.76 (0.66-4.67) | .26 | 1.52 (0.49-4.70) | .47 |
| Social risk screening | ||||||||
| No. of risk factorsb | 2.86 (2.15-3.82) | <.001 | 2.40 (1.68-3.42) | <.001 | NA | NA | NA | NA |
| Any exposure to social risk screening in health care setting within past 12 mo | ||||||||
| Yes | 1.78 (1.01-3.14) | .05 | 1.42 (0.90-2.26) | .14 | 1.26 (0.50-3.16) | .63 | 2.35 (1.47-3.74) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Any social risk assistance in health care setting within past 12 mo | ||||||||
| Yes | 3.98 (2.57-6.15) | <.001 | 1.66 (0.97-2.82) | .06 | 4.36 (0.99-19.29) | .05 | 2.00 (0.42-9.45) | .38 |
| No | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Any discomfort with questions in any screening domain | ||||||||
| Yes | 2.54 (1.26-5.10) | .009 | 1.43 (0.54-3.75) | .47 | 3.63 (0.81-16.20) | .09 | 5.75 (0.64-51.58) | .12 |
| No | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Perceptions of appropriateness of health care–based social risk screening | ||||||||
| Very appropriate or somewhat appropriate | 1.04 (0.73-1.50) | .81 | 0.74 (0.44-1.25) | .26 | 2.19 (0.74-6.43) | .16 | 3.69 (1.08-12.55) | .04 |
| Neither, very inappropriate, or somewhat inappropriate | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Comfort with integrating social risk data into EHR | ||||||||
| Completely comfortable or somewhat comfortable | 1.49 (0.92-2.42) | .11 | 1.48 (0.90-2.45) | .13 | 0.70 (0.29-1.69) | .43 | 0.42 (0.08-2.22) | .31 |
| Neither, completely uncomfortable, or somewhat uncomfortable | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Health care setting | ||||||||
| Primary care | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| Emergency department | 1.47 (0.72-3.02) | .30 | 1.39 (0.69-2.79) | .35 | 2.55 (1.03-6.32) | .04 | 4.27 (1.59-11.45) | .004 |
| Participants with public insurance or no insurance, % | ||||||||
| <80 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| ≥80 | 2.23 (1.15-4.34) | .02 | 1.62 (0.73-3.57) | .24 | 2.50 (0.91-6.86) | .07 | 1.91 (0.74-4.90) | .18 |
Abbreviations: EHR, electronic health record; NA, not applicable; OR, odds ratio.
a
The table shows all variables included in the adjusted analyses. Models were run as logistic regressions with clustered SEs that were categorized by clinical site. Sample size presented is the size after listwise deletion. Among participants interested in assistance, those excluded from the regression model were older and more likely to be Hispanic, to speak Spanish, to have lower educational levels and household income, and to report discomfort with answering the social risk screening questions (eTable 7 in the Supplement). Among participants not interested in assistance, those excluded from the regression model were older and more likely to be adult patients (vs adult caregivers), to have lower educational levels, to have been recruited from a primary care setting, and to report that health care–based social risk screening was less appropriate (eTable 7 in the Supplement).
b
The number of risk factors ranged from 0 to 5.