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N/A N=479 Randomized Other

Unmet Social Needs Study

Cardiovascular Disease · Hypertension · Diabetes Mellitus · Hyperlipidemia

Enrolled (actual)
479
Serious AEs
0.0%
Results posted
Jul 2024
Primary outcome: Primary: Number of Participants Who Connected With a New Resource — 40; 41; 51 Participants — p=0.6243

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Unmet Need Screening (Behavioral); Unmet Need Referral - Resource Sheet (Behavioral); Unmet Need Referral Assistance (Behavioral)
Age
Pediatric, Adult, Older Adult
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Jun 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants Who Connected With a New Resource
40; 41; 51 0.6243
PRIMARY
Mean Count of Resources Connected To
0.40; 0.40; 0.47 0.856
SECONDARY
Unmet Need Reduction - Any
82; 73; 74 .5582
SECONDARY
Emergent Visits (Urgent Care and Emergency Department Visits)
0.19; 0.53; -0.01 0.2105
SECONDARY
Medication Adherence
0.01; 0.01; 0.03 0.9775
SECONDARY
Clinic Visit Appointment Attendance ("No-show")
-0.14; -0.06; 0.22 0.8623
SECONDARY
Systolic Blood Pressure (BP)
-1.20; -0.27; -0.23 0.5701
SECONDARY
Hemoglobin A1c (HbA1c)
-0.42; -0.03; 0.11 0.0870
SECONDARY
Unmet Need Reduction - Percent
30.37; 27.11; 27.88 0.3063
SECONDARY
Diastolic Blood Pressure (BP)
-0.43; -1.17; -0.11 0.4134

Summary

The impacts of unmet social needs, such as homelessness, inconsistent access to food, and exposure to violence on health are well-established, especially for cardiovascular disease. A limited but growing body of evidence suggests that screening for and addressing these needs - also referred as social determinants of health -- in clinic settings helps to connect patients to resources to address unmet needs and has the potential to improve health outcomes. Veterans carry a high burden of unmet needs. At present, VA systematically screens for only two unmet needs; homelessness and food insecurity. The investigators propose to assess the efficacy of systematically screening Veterans for nine unmet needs (i.e., housing, food insecurity, utility insecurity, transportation, legal problems, employment, safety, stress, and social isolation), and compare the effect of referral mechanisms of varying intensity on Veterans' connection to resources, reduction of unmet needs, treatment adherence, reduced preventable hospitalizations, and clinical outcomes.

Eligibility Criteria

Inclusion Criteria

  • Veterans enrolled in one of three VA medical centers:
  • 1) VA Boston Healthcare System
  • 2) Corporal Michael J. Crescenz VA Medical Center (Philadelphia)
  • 2) Ralph H. Johnson VA Medical Center (Charleston)
  • Veterans with, or at risk for, cardiovascular disease (CVD) who had at least 1 PC visit in the prior year
  • CVD patients are defined as those with International Classification of Disease 10 (ICD10) diagnoses indicating:
  • coronary artery disease
  • cerebrovascular disease
  • peripheral artery disease
  • Patients at-risk for CVD are defined as having diagnoses of hypertension, diabetes mellitus (DM), or hyperlipidemia

Exclusion Criteria

  • Impaired decision-making
  • Illiterate or have limited or no English proficiency
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04977583). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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