Kosowan Leanne, Katz Alan, Howse Dana, Adekoya Itunuoluwa, Delahunty-Pike Alannah, Seshie Abigail Zita, Marshall Emily Gard, Aubrey-Bassler Kris, Abaga Eunice, Cooney Jane, Robinson Marjeiry, Senior Dorothy, Zsager Alexander, O'Rourke Joseph J, Neudorf Cory, Irwin Mandi, Muhajarine Nazeem, Pinto Andrew David
Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Primary Healthcare Research Unit, Memorial University of Newfoundland and Labrador, St John's, Newfoundland and Labrador, Canada.
BMJ Open. 2025 Sep 9;15(9):e091318. doi: 10.1136/bmjopen-2024-091318.
This study validates the previously tested Screening for Poverty And Related social determinants to improve Knowledge of and access to resources ('SPARK Tool') against comparison questions from well-established national surveys (Post Survey Questionnaire (PSQ)) to inform the development of a standardised tool to collect patients' demographic and social needs data in healthcare.
Cross-sectional study.
Pan-Canadian study of participants from four Canadian provinces (SK, MB, ON and NL).
192 participants were interviewed concurrently, completing both the SPARK tool and PSQ survey.
Survey topics included demographics: language, immigration, race, disability, sex, gender identity, sexual orientation; and social needs: education, income, medication access, transportation, housing, social support and employment status. Concurrent validity was performed to assess agreement and correlation between SPARK and comparison questions at an individual level as well as within domain clusters. We report on Cohen's kappa measure of inter-rater reliability, Pearson correlation coefficient and Cramer's V to assess overall capture of needs in the SPARK and PSQ as well as within each domain. Agreement between the surveys was described using correct (true positive and true negative) and incorrect (false positive and false negative) classification.
There was a moderate correlation between SPARK and PSQ (0.44, p<0.0001). SPARK correctly classified 71.4% of participants with or without a social need. There was strong agreement with most demographic questions. SPARK correctly classified 74.3% of participants as having financial insecurity. Clustering financial security questions had fewer false negatives (6.4%, n=11/171 vs 9.9%, n=17/171) and more false positives (19.3%, n=33/171 vs 11.1%, n=19/171) when compared with the question 'difficulty making ends meet'. When looking specifically at participants with high UCLA loneliness scores (>60), SPARK correctly classified 90.5% (n=176/191).
SPARK provides a brief 15 min screening tool for primary care clinics to capture social and access needs. SPARK was able to correctly classify most participants within each domain. Related ongoing research is needed to further validate SPARK in a large representative sample and explore primary care implementation strategies to support integration.
本研究将先前测试过的贫困及相关社会决定因素筛查工具（旨在提高对资源的认知并增加获取资源的机会，即“SPARK工具”）与成熟的全国性调查（调查后问卷，PSQ）中的对比问题进行验证，以为开发一种标准化工具提供参考，该工具用于收集医疗保健中患者的人口统计学和社会需求数据。
横断面研究。
对来自加拿大四个省份（萨斯喀彻温省、曼尼托巴省、安大略省和纽芬兰与拉布拉多省）的参与者进行全加拿大范围的研究。
192名参与者同时接受访谈，同时完成SPARK工具和PSQ调查。
调查主题包括人口统计学：语言、移民、种族、残疾、性别、性别认同、性取向；以及社会需求：教育、收入、药物获取、交通、住房、社会支持和就业状况。进行了同时效度分析，以评估SPARK与各个领域集群内个体层面的对比问题之间的一致性和相关性。我们报告了科恩kappa评分者间信度、皮尔逊相关系数和克莱默V系数，以评估SPARK和PSQ以及每个领域内需求的总体涵盖情况。使用正确（真阳性和真阴性）和错误（假阳性和假阴性）分类来描述调查之间的一致性。
SPARK与PSQ之间存在中等程度的相关性（0.44，p<0.0001）。SPARK正确分类了71.4%有或没有社会需求的参与者。在大多数人口统计学问题上有很强的一致性。SPARK正确将74.3%的参与者分类为存在经济不安全状况。与“难以维持收支平衡”这一问题相比，将经济安全问题聚类时假阴性较少（6.4%，n=11/171对9.9%，n=17/171），假阳性较多（19.3%，n=33/171对11.1%，n=19/171）。当专门查看加州大学洛杉矶分校孤独感得分高（>60）的参与者时，SPARK正确分类了90.5%（n=176/191）。
SPARK为初级保健诊所提供了一个15分钟的简短筛查工具，以获取社会和获取需求。SPARK能够在每个领域内正确分类大多数参与者。需要进行相关的正在进行的研究，以在大型代表性样本中进一步验证SPARK，并探索支持整合的初级保健实施策略。
