Motivators, Barriers, and Preferences to Engagement With Offered Social Care Assistance Among People With Diabetes: A Mixed Methods Study

被引:7
|
作者
Cohen, Alicia J. [1 ,2 ,3 ]
Isaacson, Nicole [4 ]
Torby, Michelle [4 ]
Smith, Alyssa [4 ]
Zhang, Guanghao [5 ]
Patel, Minal R. [4 ]
机构
[1] VA Providence Healthcare Syst, Ctr Innovat Long Term Serv & Supports LTSS COIN, Providence, RI USA
[2] Brown Univ, Dept Family Med, Warren Alpert Med Sch, Providence, RI 02912 USA
[3] Brown Univ, Sch Publ Hlth, Dept Hlth Serv Policy & Practice, Providence, RI 02912 USA
[4] Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, 1415 Washington Hts,SPH 1,Room 3810, Ann Arbor, MI 48109 USA
[5] Univ Michigan, Dept Biostat, Sch Publ Hlth, Ann Arbor, MI 48109 USA
关键词
FOOD INSECURITY; DISTRESS;
D O I
10.1016/j.amepre.2022.02.022
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: A substantial proportion of patients screening positive for social risks either decline assistance or do not follow-up with offered resources. This study examined patient interest in and engagement with offered social care assistance among adults with poorly controlled diabetes at an academic medical center. Methods: Surveys (n=307) and purposively sampled follow-up interviews (n=40) were conducted 6 months after randomization to receive guided online self-navigation or in-person assistance to address unmet social needs. Integrated mixed methods (data collected in 2019-2021) explored the motivators, barriers, and preferences regarding the uptake of offered assistance. Results were analyzed in 2021 using descriptive statistics, rapid qualitative analysis, and joint display models. Results: A total of 77% of people randomized to online self-navigation and 14% randomized to in-person assistance engaged with offered assistance. Motivators for engagement were similar across groups and included ease of use, anticipating assistance that could address 1 or more needs, and interest in learning more about available resources. Barriers to engagement included not needing or desiring assistance, participants perceiving that offered assistance was not relevant to their needs or that they would not qualify, competing priorities/forgetting, previous negative experiences or stigma, and technology or access challenges (online self-navigation group). Preferences around offered assistance that directly addressed barriers to uptake included changing messaging and framing around offered help and the ability to tailor modalities. Conclusions: There are key barriers to the use of social care assistance that may directly reflect the process by which individuals are screened and offered assistance. Strategies to increase uptake should be patient centered and ideally provide multiple options for type of assistance and mode of engagement. (C) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc.
引用
收藏
页码:S152 / S163
页数:12
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