title: Unmet basic needs and health intervention effectiveness in low-income populations.
abstract: In the face of unmet basic needs, low SES adults are less likely to obtain needed preventive health services. The study objective was to understand how these hardships may cluster and how the effectiveness of different health-focused interventions might vary across vulnerable population sub-groups with different basic needs profiles. From June 2010-2012, a random sample of low-income adult callers to Missouri 2-1-1 completed a cancer risk assessment and received up to 3 health referrals for needed services (mammography, pap testing, colonoscopy, HPV vaccination, smoking cessation and smoke-free home policies). Participants received either a verbal referral only (N=365), verbal referral+tailored print reminder (N=372), or verbal referral+navigator (N=353). Participants reported their unmet basic needs at baseline and contacts with health referrals at 1-month post-intervention. We examined latent classes of unmet basic needs using SAS. Logistic regression examined the association between latent classes and contacting a health referral, by intervention condition. A 3 class solution best fit the data. For participants with relatively more unmet needs (C2) and those with money needs (C3), the navigator intervention was more effective than the tailored or verbal referral only conditions in leading to health referrals contacts. For participants with fewer unmet basic needs (C1), the tailored intervention was as effective as the navigator intervention. The distribution and nature of unmet basic needs in this sample of low-income adults was heterogeneous, and those with the greatest needs benefitted most from a more intensive navigator intervention in helping them seek needed preventive health services.
authors: Washington University, School of Social Work, Campus Box 1196, 1 Brookings Dr., St. Louis, MO 63130, United States. Electronic address: mkreuter@wustl.edu.
authors: Matthew W
authors: MW
authors: Kreuter
authors: Washington University, School of Medicine, Campus Box 8005, 4523 Clayton Ave., St. Louis, MO 63110, United States. Electronic address: amcqueen@dom.wustl.edu.
authors: Amy
authors: A
authors: McQueen
authors: Washington University, School of Social Work, Campus Box 1196, 1 Brookings Dr., St. Louis, MO 63130, United States. Electronic address: sboyum@wustl.edu.
authors: Sonia
authors: S
authors: Boyum
authors: Saint Louis University, College for Public Health and Social Justice, Salus Center Room 480, 3545 Lafayette Ave., St. Louis, MO 63104, United States. Electronic address: qjfu@slu.edu.
authors: Qiang
authors: Q
authors: Fu
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008923:Missouri; D009369:Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D011203:Poverty; D011314:Preventive Health Services / Q000379:methods*; D012017:Referral and Consultation; D018570:Risk Assessment / Q000379:methods; D016540:Smoking Cessation; D013315:Stress, Psychological; D013689:Telephone; D035862:Vulnerable Populations / Q000208:ethnology / Q000523:psychology
keywords: Cancer prevention and control; Health referrals; Intervention studies; Low-income population; Tailored print reminder; Telephone navigator