Identifying health-related social needs among cancer patients with comorbidities

Abstract

Introduction: Health-related social needs (HRSNs) stem from structural inequities and may also lead to worse health outcomes. Previous studies show worse cancer outcomes for Black cancer patients than other racial groups in the US. We aimed to describe differences between HRSNs identified via a standardized screening tool and weekly conversations with a community health worker (CHW) among Black cancer patients.Methods: CHWs administered an 8-item HRSN screening tool at baseline. Over six-months, CHWs called participants weekly and recorded HRSN in a call log. We compared baseline screening answers with call logs to identify differences in types and timing of identified needs.Results: We collected HRSN from n = 57 participants. The screening tool identified 16 participants (28%) with 1+ HRSN, while in weekly calls 49 participants (86%) discussed 1+ HRSN. Top needs were financial strain, food insecurity, and transportation in both approaches. However, the screening tool failed to capture many needs that emerged in discussion and some HRSN were only shared after >3 weekly calls, suggesting a need to build trust and rescreen patients.Conclusion: We found that a single time or modality for screening may miss HRSN. Future studies should consider the impact of assessing and addressing HRSN on cancer disparities.Trial registration: ClinicalTrials.gov identifier: NCT04836221.

Keywords

• Breast cancer
• social needs
• prostate cancer
• community health worker
• disparities