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A comparative effectiveness trial of two patient-centered interventions for women with unmet social needs: Personalized support for progress and enhanced screening and referral

E. Poleshuck, M. Wittink , H.F. Crean, I. Juskiewicz, E. Bell, A. Harrington, C. Cerulli
J Womens Health

Background: Despite recent widespread acceptance that unmet social needs are critically relevant to health, limited guidance exists about how best to address them in the context of women's health care delivery. We aimed to evaluate two interventions: enhanced screening and referral (ESR), a screening intervention with facilitated referral and follow-up calls, and personalized support for progress (PSP), a community health worker intervention tailored to women's priorities. Materials and Methods: Women >18 years were screened for presence of elevated depressive symptoms in three women's health clinics serving primarily Medicaid-eligible patients. If eligible and interested, we enrolled and randomized women to ESR or PSP. Pre- and postintervention assessments were conducted. Primary outcomes were satisfaction, depression, and quality of life (QOL). Planned analyses of subgroup differences were also explored. Results: A total of 235 participants were randomized; 54% identified as African American, 19% as White, and 15% as Latina. Participant mean age was 30 years; 77% reported annual incomes below US $20,000/year; and 30% were pregnant at enrollment. Participants in both arms found the interventions satisfactory and improved for depression (p p = 0.05), lack of access to depression treatment (p = 0.02), pain (p = 0.04), and intimate partner violence (p = 0.02). Conclusions: Clinics serving women with unmet social needs may benefit from offering PSP or ESR. Distinguishing how best to use these interventions in practice is the next step.

Poleshuck E, Wittink M, Crean HF, Juskiewicz I, Bell E, Harrington A, Cerulli C. A comparative effectiveness trial of two patient-centered interventions for women with unmet social needs: personalized support for progress and enhanced screening and referral. J Womens Health (Larchmt). 2019 Sep 9. Epub ahead of print. PMID: 31502906. DOI: 10.1089/jwh.2018.7640.

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Publication year
Resource type
Peer Reviewed Research
Outcomes
Health & Health Behaviors
Population
Medicaid-insured
Screening research
Yes
Social Determinant of Health
Not Specified
Study design
Randomized Controlled Trial (RCT)