Perceived Appropriateness of Assessing for Health-related Socioeconomic Risks Among Adult Patients with Cancer

• Type of Material: Article
• Authors: Milkie Vu, Northwestern University; Kelly Boyd, The University of Chicago Medicine; Emilia H de Marchis, University of California, San Francisco; Bridgette G Garnache, The University of Chicago; Laura M Gottlieb, University of California, San Francisco; Cary P Gross, Yale University; Nita K Lee, The University of Chicago; Stacy Tessler Lindau, The University of Chicago; Sophia Mun, Yale University; Victoria A Winslow, The University of Chicag; Jennifer A Makelarski, The University of Chicago
• Language: English
• Date: 2023-04-03
• Publisher: American Association for Cancer Research
• Publication Version: Final Published Version
• Copyright Statement: © 2023, The Authors; Published by the American Association for Cancer Research
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1158/2767-9764.CRC-22-0283
• Title of Journal or Parent Work: Cancer Research Communications
• Volume: 3
• Issue: 4
• Start Page: 521
• End Page: 531
• Keywords: cancer treatment

Abstract

Cancer treatment can trigger or exacerbate health-related socioeconomic risks (HRSR; food/housing insecurity, transportation/utilities difficulties, and interpersonal violence). The American Cancer Society and National Cancer Institute recommend HRSR screening and referral, but little research has examined the perceptions of patients with cancer on the appropriateness of HRSR screening in healthcare settings. We examined whether HRSR status, desire for assistance with HRSRs, and sociodemographic and health care–related factors were associated with perceived appropriateness of HRSR screening in health care settings and comfort with HRSR documentation in electronic health records (EHR). A convenience sample of adult patients with cancer at two outpatient clinics completed self-administered surveys. We used χ2 and Fisher exact tests to test for significant associations. The sample included 154 patients (72% female, 90% ages 45 years or older). Thirty-six percent reported ≥1 HRSRs and 27% desired assistance with HRSRs. Overall, 80% thought it was appropriate to assess for HRSRs in health care settings. The distributions of HRSR status and sociodemographic characteristics were similar among people who perceived screening to be appropriate and those who did not. Participants who perceived screening as appropriate were three times as likely to report prior experience with HRSR screening (31% vs. 10%, P = 0.01). Moreover, 60% felt comfortable having HRSRs documented in the EHR. Comfort with EHR documentation of HRSRs was significantly higher among patients desiring assistance with HRSRs (78%) compared with those who did not (53%, P < 0.01). While initiatives for HRSR screening are likely to be seen by patients with cancer as appropriate, concerns may remain over electronic documentation of HRSRs.