TY - JOUR
T1 - Unmet basic needs and health intervention effectiveness in low-income populations
AU - Kreuter, Matthew W.
AU - McQueen, Amy
AU - Boyum, Sonia
AU - Fu, Qiang
N1 - Funding Information:
This study was supported by funding from the National Cancer Institute ( P50-CA095815 ); however, the funder had no involvement with the design, conduct, analysis or reporting of the study. We thank the 2-1-1 Information Specialists and callers who participated in this study.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - Cancer prevention and control
KW - Health referrals
KW - Intervention studies
KW - Low-income population
KW - Tailored print reminder
KW - Telephone navigator
UR - http://www.scopus.com/inward/record.url?scp=84981294695&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2016.08.006
DO - 10.1016/j.ypmed.2016.08.006
M3 - Article
C2 - 27496395
AN - SCOPUS:84981294695
VL - 91
SP - 70
EP - 75
JO - Preventive Medicine
JF - Preventive Medicine
SN - 0091-7435
ER -