Sub-population differences in connecting to resources to address social needs

Introduction: Evaluations of healthcare-based interventions to address social needs are flourishing but few assess for which sub-populations such interventions are comparatively more effective than others. Yet this is an additional lens for understanding what works and where improvements are needed.

Methods: Ad hoc sub-group analyses were conducted in 2024-2025 using data from a three-arm intent-to-treat randomized controlled trial (2021-2023). The control arm (Arm 1) received a postcard listing generic VA resources (e.g., National Call Center for Homeless Veterans). Intervention arms received the same plus tailored resource sheets (Arm 2), and tailored resource sheets plus navigation assistance from a social worker (Arm 3). The primary outcome was social need resource connection. Generalized linear models were used with random effects to account for intervention sites to conduct sub-group analyses based on Veteran sociodemographic and clinical characteristics (e.g., age, comorbidity, income). As-treated analysis was also conducted.

Results: Among Veterans who were low income but ineligible for VA disability benefits and Veterans with ≥ 4 Elixhauser comorbidities, those randomized to Arm 3 (versus Arm 1) were more likely to connect to ≥ 1 resources (OR=6.47, CI [1.87 22.37] and OR=2.18, CI [1.16, 4.10] respectively). Intervention Arm 3 (versus Arm 1) was also associated with higher odds of resource connection in the as-treated analysis (OR= 1.77, CI [1.04, 2.99]).

Conclusions: Specific Veteran sub-groups may benefit most from interventions designed to connect patients to social need resources. Given limitations of ad-hoc analyses, it will be important for future study to explore the generalizability of these findings.