Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings
Abstract Background Poverty is associated with increased morbidity related to multiple child and adult health conditions and increased risk of premature death. Despite robust evidence linking income and health, and some recommendations for universal screening, poverty screening is not routinely cond...
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-019-1085-0 |
| _version_ | 1818386954136322048 |
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| author | Eva Purkey Imaan Bayoumi Helen Coo Allison Maier Andrew D. Pinto Bisola Olomola Christina Klassen Shannon French Michael Flavin |
| author_facet | Eva Purkey Imaan Bayoumi Helen Coo Allison Maier Andrew D. Pinto Bisola Olomola Christina Klassen Shannon French Michael Flavin |
| author_sort | Eva Purkey |
| collection | DOAJ |
| description | Abstract Background Poverty is associated with increased morbidity related to multiple child and adult health conditions and increased risk of premature death. Despite robust evidence linking income and health, and some recommendations for universal screening, poverty screening is not routinely conducted in clinical care. Methods We conducted an exploratory study of implementing universal poverty screening and intervention in family medicine and a range of pediatric care settings (primary through tertiary). After attending a training session, health care providers (HCPs) were instructed to perform universal screening using a clinical poverty tool with the question “Do you ever have difficulty making ends meet at the end of the month?” for the three-month implementation period. HCPs tracked the number of patients screened and a convenience sample of their patients were surveyed regarding the acceptability of being screened for poverty in a healthcare setting. HCPs participated in semi-structured focus groups to explore barriers to and facilitators of universal implementation of the tool. Results Twenty-two HCPs (10 pediatricians, 9 family physicians, 3 nurse practitioners) participated and 150 patients completed surveys. Eighteen HCPs participated in focus groups. Despite the self-described motivation of the HCPs, screening rates were low (9% according to self-reported numbers). The majority of patients either supported (72%) or were neutral (22%) about the appropriateness of HCPs screening for and intervening on poverty. HCPs viewed poverty as relevant to clinical care but identified time constraints, physician discomfort, lack of expertise and habitual factors as barriers to implementation of universal screening. Conclusions Poverty screening is important and acceptable to clinicians and patients. However, multiple barriers need to be addressed to allow for successful implementation of poverty screening and intervention in health care settings. |
| first_indexed | 2024-12-14T04:02:15Z |
| format | Article |
| id | doaj.art-5decc501b7614c7583736dfcb301b452 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-14T04:02:15Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-5decc501b7614c7583736dfcb301b4522022-12-21T23:17:55ZengBMCInternational Journal for Equity in Health1475-92762019-12-011811910.1186/s12939-019-1085-0Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settingsEva Purkey0Imaan Bayoumi1Helen Coo2Allison Maier3Andrew D. Pinto4Bisola Olomola5Christina Klassen6Shannon French7Michael Flavin8Department of Family Medicine, Queen’s UniversityDepartment of Family Medicine, Queen’s UniversityDepartment of Pediatrics, Queen’s UniversityKingston, Frontenac and Lennox & Addington Public Health UnitDepartment of Family and Community Medicine, Faculty of Medicine, University of Toronto, Dalla Lana School of Public Health, University of Toronto, The Upstream Lab, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s HospitalQueen’s UniversityDepartment of Family Medicine, Queen’s UniversityDepartment of Pediatrics, Queen’s UniversityDepartment of Pediatrics, Queen’s UniversityAbstract Background Poverty is associated with increased morbidity related to multiple child and adult health conditions and increased risk of premature death. Despite robust evidence linking income and health, and some recommendations for universal screening, poverty screening is not routinely conducted in clinical care. Methods We conducted an exploratory study of implementing universal poverty screening and intervention in family medicine and a range of pediatric care settings (primary through tertiary). After attending a training session, health care providers (HCPs) were instructed to perform universal screening using a clinical poverty tool with the question “Do you ever have difficulty making ends meet at the end of the month?” for the three-month implementation period. HCPs tracked the number of patients screened and a convenience sample of their patients were surveyed regarding the acceptability of being screened for poverty in a healthcare setting. HCPs participated in semi-structured focus groups to explore barriers to and facilitators of universal implementation of the tool. Results Twenty-two HCPs (10 pediatricians, 9 family physicians, 3 nurse practitioners) participated and 150 patients completed surveys. Eighteen HCPs participated in focus groups. Despite the self-described motivation of the HCPs, screening rates were low (9% according to self-reported numbers). The majority of patients either supported (72%) or were neutral (22%) about the appropriateness of HCPs screening for and intervening on poverty. HCPs viewed poverty as relevant to clinical care but identified time constraints, physician discomfort, lack of expertise and habitual factors as barriers to implementation of universal screening. Conclusions Poverty screening is important and acceptable to clinicians and patients. However, multiple barriers need to be addressed to allow for successful implementation of poverty screening and intervention in health care settings.https://doi.org/10.1186/s12939-019-1085-0PovertySocial determinants of healthScreeningHealth care |
| spellingShingle | Eva Purkey Imaan Bayoumi Helen Coo Allison Maier Andrew D. Pinto Bisola Olomola Christina Klassen Shannon French Michael Flavin Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings International Journal for Equity in Health Poverty Social determinants of health Screening Health care |
| title | Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| title_full | Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| title_fullStr | Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| title_full_unstemmed | Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| title_short | Exploratory study of “real world” implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| title_sort | exploratory study of real world implementation of a clinical poverty tool in diverse family medicine and pediatric care settings |
| topic | Poverty Social determinants of health Screening Health care |
| url | https://doi.org/10.1186/s12939-019-1085-0 |
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