PRP133: Patient Priorities in Addressing Health-Related Needs in a Primary Care Setting

Hannah Shadowen, MPH; Kristen O'Loughlin, MA, MS; Jennifer Hinesley, PsyD; Alexander Krist, MD, MPH; Amber Haley, MPH


Context: Many patients with poorly controlled chronic conditions also have unhealthy behaviors, mental health challenges, and unmet social needs. Medical interventions may have limited benefit if patients are struggling to address these needs. We are studying an Enhanced Care Planning process using the My Own Health Report (MOHR) risk assessment and care planning tool, which includes wrap-around services (e.g. patient navigator, community health worker, and community programs) to help patients achieve their goals. After the patient identifies their mental health risks, social needs, and unhealthy behaviors, they are asked to identify one or two goals to get help with from their care team one need at a time.
Objective: We sought to understand how patients pick which unhealthy behavior, mental health risks, or social needs to address. Study Design: Qualitative study Setting or Dataset: Semi-structured interviews conducted via Zoom. Population: Residents of low resource neighborhoods in Richmond Virginia (n=8), family medicine adult patients from an urban underserved clinic (n=5), and a suburban more affluent clinic (n=5). Results: Preliminary results suggest that patients think all potential needs would be appropriate for care planning in primary care, except financial needs. Patients tended to prioritize mental health needs, wanting help, and believing mental health greatly influenced health. Diet and exercise were prioritized lower as patients thought they knew what changes they needed to make. Lastly, the relationship between provider and patient, as well as the ability of the clinic to act on screening results were critical aspects of patients' confidence in this process. Conclusions: Primary care provides an opportunity for identifying and addressing unhealthy behaviors, mental health challenges, and unmet social needs. However, little is known about patients’ thought process around addressing non-medical needs in this setting. To improve clinical care and chronic disease management, it is crucial that we understand these issues around prioritizing needs and the factors that influence willingness and comfort in accepting support in addressing them.

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