The First Step to Helping: Asking About Poverty
Notice bibliographique
Résumé
Abstract BACKGROUND: Canadian children living in poverty are more likely to experience poor health outcomes. Physicians have a unique opportunity to screen for poverty and other social determinants of health (SDOH) in order to intervene early and change their patients' health trajectories. It is well known in the literature to date that addressing SDOH in clinical practice can improve health outcomes, however, significant barriers have been identified that limit a physician’s ability to address these issues. The Child Poverty Assessment Tool (CPAT) was developed by an inter-professional team of physicians, social workers and community child health agency partners to provide healthcare providers with screening questions for the SDOH and resources to address identified SDOH needs. The tool was created to support physicians with links to the community and simple screening approaches to common social issues. OBJECTIVES: To develop an understanding of physicians' current SDOH screening practices and attitudes to screening for the SDOH in clinical practice; To explore the feasibility, accessibility, and relevance of the CPAT for paediatricians at an academic health science centre. DESIGN/METHODS: Using a qualitative grounded theory approach, seven consultant academic paediatricians were individually interviewed. The interviews were conducted using a semi-structured interview guide, and were digitally recorded and transcribed verbatim. Two team members independently coded the transcripts for recurrent themes. This project was undertaken as a Quality Improvement project and was conducted with appropriate ethical approval. RESULTS: Three major themes emerged regarding benefits of screening for SDOH: improved assessment of social issues, increased referrals to community supports and agencies, and appropriate modifications to treatment plans as informed by social issues. In addition to limiting billing models and time constraints, five major themes were identified as challenges to screening for SDOH: lack of knowledge of resources, upsetting family expectations, the physician’s own comfort in asking questions regarding the SDOH, the biomedical model of training, and physicians' understanding of their scope of practice. The CPAT was found to address some, but not all of these challenges. CONCLUSION: The results from the project elucidated important factors that influence the SDOH screening practices of paediatricians. While a structured tool (i.e. the CPAT) may provide support to physicians conducting screening, systemic and medical cultural barriers exist. Further research is needed to examine the effectiveness of implementing screening tools in clinical practice, and to identify solutions for systemic barriers to screening for poverty in paediatric populations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,018 | 0,009 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,006 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».