SRF032: Identifying barriers and facilitators for family physicians in Ontario around routine poverty screening: research in progress
Azar Bayat, MD, Family medicine resident; Amrita Roy, MD, PhD, CCFP
Context: Income is a significant social determinant of health. Family physicians may be well-placed to identify poverty among their patients, and attempt to address. To this end, a poverty screening tool by the Centre for Effective Practice is being promoted by the College of Family Physicians of Canada for use by family physicians in all patient visits. It involves asking the question: “Do you ever have difficulty making ends meet at the end of the month?” Based on response, patients are informed about potential government benefits. Objective: To determine: 1) Are family physicians in Ontario routinely screening their patients for poverty? 2) What are the individual-level and practice-level characteristics of family physicians who routinely screen, as compared to those who do not routinely screen? 3) What are perceived barriers to routine screening reported by family physicians? Human Subjects Review: Institutional research ethics board approval will be secured. Design: A brief online survey using both closed-ended and open-ended questions will be administered. Pre-testing and pilot-testing will be done ahead of the full study. Data will be analyzed with descriptive, bivariate and multivariable statistical methods, to test hypotheses and answer research questions. Answers to open-ended questions will be compiled and tabulated. Setting: Licensed family physicians currently practicing office-based primary care in Ontario are eligible to participate. Anticipated Results: Based on previous small-scale and qualitative studies conducted in this area, we hypothesize barriers such as appointment time constraints, lack of physician expertise or knowledge about resources around poverty, physician discomfort, and perceived ineffectiveness of screening in changing patient outcomes. We hypothesize that facilitators will include having social workers involved as part of multidisciplinary family health teams, OHIP billing incentives for screening, and targeted education and training of physicians. Conclusions: Identification of barriers and facilitators - at the physician level, the clinic level, and the level of local service systems - can help guide interventions to facilitate incorporation of routine screening more widely. Information on barriers at the systems level will be particularly timely in Ontario, where healthcare delivery is currently being restructured into Ontario Health Teams.