TABLE 5.
Illustrative quotes by theme from select participant interviews a
| Themes | Electronic screening experience | Verbal screening experience | ||
|---|---|---|---|---|
| Adequate health literacy | Limited health literacy | Adequate health literacy | Limited health literacy | |
| 1. Embarrassment, confidentiality and privacy concerns, concerns related to screening modality |
Quote 1: “I think it's smarter to have it electronically because if someone does have an issue, they may not want to say it to someone. Whereas if you kind of have it privately and only you can see it on the iPad, people are more likely to be truthful about what their needs are or concerns or difficulties. Whereas if you ask someone, they could be embarrassed or for another reason, just not tell the truth…”. Quote 2: “Yeah. I mean, one of the questions says, “Do you have enough money to feed your kids?” And I think a lot of people might not tell the truth, right? Because nobody wants to be in the position of not being able to feed their kids, right? So, I think electronic is much better than verbal.” |
Quote 1: “Well, for me, I do like verbally better because, when you asked me what I thought, everything that I didn't mention on the form? I told you. I told you my income, I told you how I'm struggling, but it made it more clear to you than if… it was better for the researcher to hear it verbally because I gave more information.” |
Quote 1: “I think doing it in person is a lot more fun. And I think you could get a lot—for me, I was able to be a little more thoughtful with the dialogue sharing between people.” Quote 2: “I can certainly imagine a situation in which someone did have a need but was, perhaps, embarrassed to share that in an oral survey and would be more inclined to be truthful if they were taking it in a more anonymous fashion.” |
Quote 1: “Just because it's on paper instead of just saying it, so you just read it… Probably people who are homeless or struggling with money situations and all that. It's a little embarrassing to be going through stuff like that sometimes for some people, so I feel like it would be better for them.” |
| 2. Missed HRSN in the formal survey |
Quote 1: “You would probably get more information from me if you were interviewing me face‐to‐face because you probably can add some questions to my answers. So, in that sense, yes. But I know what you're maybe asking about. Not having someone in front of me and feeling like maybe it's confidential and I'm just giving my answers to the iPad, not to the person, maybe it would be easier for me to open up if I really had some issues. You know what I mean?” Quote 2: “I don't know. Because it really depends on the person. I think doing the first screening here like you did with the iPad is nice because you can kind of find out that maybe there are some issues and then follow up with someone like if a person that comes in and talks, then I think that would be the best in my opinion.” |
Quote 1 a : R: “Do you think that it would have been different if we weren't asking you these questions but maybe the doctor was asking you or a nurse?” P: “Yeah, because sometimes I don't talk problems with doctors. Sometimes I hold back a little bit, which is not good because you're supposed to be able to talk to your doctor about everything. But it's just awkward.” |
Quote 1 a : R: “Do you think there's any information that we would have missed using an electronic survey or in the verbal survey, as well?” P: “I couldn't have told my story. Things like that. If someone wants to add– as a researcher, I think it's a benefit to hear additional things people might share…I mean, a lot of times it's the money issues. I know of people that forgo medicine because they don't have the money for it.” |
|
| 3. Concerns about feasibility, including logistics, timing, location of screening, and technical skills |
Quote 1: “Make sure they're comfortable with the electronics. Give them the option of a paper one if they don't want to do electronic one that you can [inaudible] later. So, if they're not comfortable with that or they've never seen an iPad or don't have one, don't know how to scroll through the questions together. Click on the box to get the keyboard to get the numbers or whatever. That might make them feel uncomfortable and maybe not want to proceed with the survey…”. Quote 2 a : R: “Do you think we should be asking these questions?” P: “Yes. I think so.” Quote 3: “I mean, not everybody goes to primary care doctor. Sometimes they cannot afford it and they go to emergency room. So probably asking in this setting is a good idea because you have a lot of people who just come here when they have emergencies, but they don't usually have someone who follows them up…”. |
Quote 1: “Because it's high anxiety and the pain and everything else you're experiencing being in an emergency room. And your mind is not really focused on answering questions, to be honest.” |
Quote 1: “I think that it's a really important tool to get information, as you said, about the community that the hospital, specifically, the emergency room is serving. I, personally, am not at risk for a lot of situations that were addressed in the survey. But I know that a lot of people are, and it's good for the hospital to be aware of that and be able to provide resources for those that are in need…”. |
Quote 1 a : R: “Speaking of those types of questions. Do you believe that we should be asking such questions of patients in an emergency department?” P: “Yes, it's fine. Yes, I like this, yes.” R: “Why?” P: “Well, because many times one doesn't know about things that would interest them. You, you are informed about this, about these programs. So, it's good. Yes, I like it.” R: “Okay. And do you believe that it is our job as a health system, that we should be asking our patients about their needs?” P: “Yes, it's fine. Yes, it's good. Yes, it doesn't bother me. It's fine.” Quote 2 a : R: “Okay. Okay. Do you think that it's better done here in the emergency department, or do you think it'd be better maybe in a primary care or in another situation?” P: “Probably the emergency room.” R: “Okay. Why do you think so?” P: “Because everybody comes here, and if you're homeless you're more likely maybe to come here because it's easier to get sick or get injured in any type of way, so.” |
Abbreviations: HRSN, health‐related social needs; P, participant; R, researcher.
In dialogue quotes.