title: Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals.
abstract: Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N= 1,090) with at least one behavioral risk factor or cancer screening need were randomly assigned to one of three health referral interventions: verbal referrals only, verbal referrals + a tailored mailed reminder, or verbal referrals + telephone health navigator. After 1 month, we assessed whether the nonhealth problems that prompted the 2-1-1 call had been resolved. Logistic regression estimated effects of having the problem resolved on calling a health referral. Callers were predominantly female (85%) and had a high school education or less (61%); nearly half (47%) had incomes under $10,000. The most common service requests were for utility assistance (35%), home/family problems (23%), and rent/mortgage assistance (12%). At follow-up, 38% of callers reported that all problems prompting their 2-1-1 call had been resolved, and 24% reported calling a health referral. Resolving all problems prompting the 2-1-1 call was associated with a higher odds of contacting a health referral (odds ratio = 1.44, 95% confidence interval [1.02, 2.05]) compared to people whose problems were not resolved. Multifaceted interventions that help meet non-health-related needs and provide support in reaching health-related goals may promote health in vulnerable populations.
authors: Washington University in St. Louis, St. Louis, MO, USA tessthompson@wustl.edu.
authors: Tess
authors: T
authors: Thompson
authors: Washington University in St. Louis, St. Louis, MO, USA.
authors: Matthew W
authors: MW
authors: Kreuter
authors: Washington University in St. Louis, St. Louis, MO, USA.
authors: Sonia
authors: S
authors: Boyum
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006301:Health Services Needs and Demand; D006801:Humans; D007255:Information Services; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008923:Missouri; D020380:Needs Assessment; D012017:Referral and Consultation; D012307:Risk Factors; D064890:Social Determinants of Health; D012947:Social Work / Q000706:statistics & numerical data; D013689:Telephone; D035862:Vulnerable Populations / Q000208:ethnology
keywords: cancer; health promotion; prevention; social determinants of health; strategy; vulnerable populations