Poverty screening implementation in a Canadian primary care clinic: acceptability and feasibility for patients and providers
Notice bibliographique
Résumé
Context While poverty is a risk factor for many chronic conditions, when it is recognized by care providers social screening can be used to positively impact patients’ health. Although there has been Canadian research on this topic, there have been no such studies in New Brunswick (NB). Objective This study fills a knowledge gap by asking: What is the adherence, acceptability, and feasibility of poverty screening administered by providers to patients of an NB primary care clinic? Study Design and Analysis The study is a concurrent mixed-methods implementation study. The quantitative data was analyzed using descriptive statistics and the qualitative data using inductive thematic analysis. Setting The study was set at St. Joseph’s Primary Care Clinic in Saint John, NB, Canada in 2023. Population Studied The study collected data from family physicians, nurse practitioners, and adult patients of the clinic. Intervention/Instrument Using an NB-specific clinical poverty screening tool, poverty screening was conducted by providers with in-person adult patients over a one-month period. Data was collected from patients following their primary care visit using a survey and medical records, and from providers using a pre- and post-intervention survey, a focus group, and screening records. Outcome Measures Key outcome measures included screening adherence, screening acceptability among patients, and screening acceptability and feasibility among providers as well as willingness to continue screening. Results Screening data was collected from n = 467 patient visits, medical records were pulled from n = 246 patient charts, survey data was collected from n = 59 patients, and survey and focus group data was collected from n = 4 practitioners. Three quarters (78.5%) of eligible patients were screened for poverty, and of these a third (35.8%) screened positive. Nearly all missed screens were attributed to forgetfulness (94.4%). Of screened patients, 94.4% reported feeling “very comfortable” or “comfortable.” The post-intervention survey showed a shift in provider’s willingness to continue poverty screening. Conclusions Poverty screening was seen as acceptable among patients and providers. Providers, however, have feasibility concerns in a clinical setting with limited resources for social interventions. Results are being used to determine the potential for continued and expanded screening as well as to inform changes to screening protocols.
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 | 0,019 | 0,034 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,009 | 0,002 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
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 ».