Lian Tyler, Reid Hadley, Rader Abigail, Dewitt-Feldman Sarah, Hezarkhani Elmira, Gu Elizabeth, Scott Malik, Kutzer Kate, Sandhu Sahil, Crowder Carolyn, Ito Kristin, Eisenson Howard, Bettger Janet Prvu, Shaw Ryan J, Lewinski Allison A, Ming David Y, Bosworth Hayden B, Zullig Leah L, Batch Bryan C, Drake Connor
Department of Population Health Science, Duke University School of Medicine, Durham, NC, United States.
School of Medicine, Duke University, Durham, NC, United States.
JMIR Res Protoc. 2022 Oct 11;11(10):e37316. doi: 10.2196/37316.
Health care providers are increasingly screening patients for unmet social needs (eg, food, housing, transportation, and social isolation) and referring patients to relevant community-based resources and social services. Patients' connection to referred services is often low, however, suggesting the need for additional support to facilitate engagement with resources. SMS text messaging presents an opportunity to address barriers related to contacting resources in an accessible, scalable, and low-cost manner.
In this multi-methods pilot study, we aim to develop an automated SMS text message-based intervention to promote patient connection to referred social needs resources within 2 weeks of the initial referral and to evaluate its feasibility and patient acceptability. This protocol describes the intervention, conceptual underpinnings, study design, and evaluation plan to provide a detailed illustration of how SMS technology can complement current social needs screening and referral practice patterns without disrupting care.
For this pilot prospective cohort study, this SMS text message-based intervention augments an existing social needs screening, referral, and navigation program at a federally qualified health center. Patients who received at least one referral for any identified unmet social need are sent 2 rounds of SMS messages over 2 weeks. The first round consists of 5-10 messages that deliver descriptions of and contact information for the referred resources. The second round consists of 2 messages that offer a brief reminder to contact the resources. Participants will evaluate the intervention via a survey and a semistructured interview, informed by an adapted technology acceptance model. Rapid qualitative and thematic analysis will be used to extract themes from the responses. Primary outcomes are implementation feasibility and patient acceptability. Secondary outcomes relate to intervention effectiveness: self-reported attempt to connect and successful connection to referred resources 2 weeks after the initial referral encounter.
The study received regulatory approval in May 2021, and we anticipate enrolling 15-20 participants for this initial pilot.
This protocol presents detailed implementation methods about a novel automated SMS intervention for social care integration within primary care. By sharing the study protocol early, we intend to facilitate the development and adoption of similar tools across different clinical settings, as more health care providers seek to address the unmet social needs of patients. Study findings will provide practical insights into the design and implementation of SMS text message-based interventions to improve social and medical care coordination.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37316.
医疗服务提供者越来越多地对患者进行未满足的社会需求(如食物、住房、交通和社会隔离)筛查,并将患者转介至相关的社区资源和社会服务机构。然而,患者与转介服务的联系率往往较低,这表明需要额外的支持来促进患者与资源的对接。短信提供了一个机会,能够以一种便捷、可扩展且低成本的方式消除与联系资源相关的障碍。
在这项多方法试点研究中,我们旨在开发一种基于自动短信的干预措施,以促进患者在初次转介后的2周内与转介的社会需求资源建立联系,并评估其可行性和患者可接受性。本方案描述了干预措施、概念基础、研究设计和评估计划,以详细说明短信技术如何在不干扰医疗服务的情况下补充当前的社会需求筛查和转介实践模式。
在这项试点前瞻性队列研究中,这种基于短信的干预措施增强了一家联邦合格健康中心现有的社会需求筛查、转介和导航项目。对于因任何已确定的未满足社会需求而至少收到一次转介的患者,在2周内发送2轮短信。第一轮包括5 - 10条短信,提供转介资源的描述和联系信息。第二轮包括2条短信,简要提醒患者联系这些资源。参与者将通过一项调查和一次半结构化访谈,依据一种经过调整的技术接受模型对干预措施进行评估。快速定性和主题分析将用于从回复中提取主题。主要结局是实施可行性和患者可接受性。次要结局与干预效果相关:初次转介接触后2周内自我报告的联系转介资源的尝试以及与转介资源的成功联系。
该研究于2021年5月获得监管批准,我们预计为这项初始试点招募15 - 20名参与者。
本方案介绍了一种用于初级保健中社会护理整合的新型自动短信干预措施的详细实施方法。通过尽早分享研究方案,我们旨在促进不同临床环境中类似工具的开发和采用,因为越来越多的医疗服务提供者寻求满足患者未满足的社会需求。研究结果将为基于短信的干预措施的设计和实施提供实际见解,以改善社会和医疗护理协调。
国际注册报告识别号(IRRID):DERR1 - 10.2196/37316。