Perceived appropriateness of assessing for health-related socioeconomic risks among adult patients with cancer

Abstract

Abstract Cancer treatment can trigger or exacerbate health-related socioeconomic risks (HRSRs) (food/housing insecurity, transportation/utilities difficulties, and interpersonal violence). The ACS and NCI 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 healthcare-related factors were associated with perceived appropriateness of HRSR screening in healthcare 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 chi-squared and Fisher’s exact tests to test for significant associations. The sample included 154 patients (72% female, 90% aged 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 healthcare 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% versus 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 to those who did not (53%; p<.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.