Unmet basic needs and health intervention effectiveness in low-income populations.
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.
['Kreuter|Matthew W|MW|', 'McQueen|Amy|A|', 'Boyum|Sonia|S|', 'Fu|Qiang|Q|']
D000328:Adult D055088:Early Detection of Cancer D005260:Female D058015:Health Communication D006801:Humans D008297:Male D008403:Mass Screening D008923:Missouri D009369:Neoplasms D011203:Poverty D011314:Preventive Health Services D012017:Referral and Consultation D018570:Risk Assessment D016540:Smoking Cessation D013315:Stress, Psychological D013689:Telephone D035862:Vulnerable Populations
Low-income population Health referrals Cancer prevention and control Intervention studies Tailored print reminder Telephone navigator