Abstract B077: Evaluation of social resource screening, and factors associated with needs and referral for resources in cancer care: The Resource EQuIP study
Authors: Rositch Anne F. , Wethington Stephanie L. , Yu Ruoxi , Nkwain Angel , Topel Kristin , Beavis Anna L. 
Published: January 2023

Abstract
Objectives: Social resource needs are downstream, actionable modifiers of the social determinants of health. As such, they greatly contribute to the persistence of cancer health disparities. We sought to evaluate the prevalence of basic social needs and desire for referral in women presenting for Gynecologic Oncology care. Methods: We examined the data from a cohort of women presenting to an outpatient Gynecologic Oncology clinic from June 2021-May 2022 at an urban academic medical center where a social needs screening-and-referral protocol was implemented into routine care in the quality improvement “Resource EQuIP” study. We estimated the prevalence of social needs, as well as the type and urgency of those needs, and the proportion of individuals with needs who desired a referral to our community resource assistance partner. We examined these estimates by race and ethnicity using Fisher’s exact tests. We used multivariable Poisson regression to identify factors independently associated with having at least one social need. Results: Among 978 patients offered the screening questionnaire, 90% (n=877) completed it. Of those, the median age was 58 years (interquartile range: 47-67), and 62% were White, 26% Black, and 13% Other race. Five percent identified as Hispanic. Half of the patients (52%) had Private insurance, 10% Medicaid, 28% Medicare, and 10% had another type of insurance. Overall, 16% (n=142) had at least one social need (range 1-7 needs), which ranged from 28% among Black, 15% among Other race and 11% among White women (p&lt;0.01); 28% of Hispanic compared to 15% of non-Hispanic patients had needs (p&lt;0.01). Most common needs included financial (11%), transportation (5%), help reading hospital materials (3%), and food and housing insecurity (2%). Of those with needs, women of minority race more frequently reported their needs as urgent (20% Black and 29% Other vs. 7% White; p=0.02). More than half (59%) desired a referral to our community resource assistance partner, which also varied by race: 67% Black, 94% Other race, 40% White (p&lt;0.01), and by ethnicity: 92% of Hispanic and 56% of non-Hispanic women (p=0.02). On multivariable analysis, Black women were twice as likely to have a need compared to White women (RR=1.9, 95% CI: 1.4-2.8), and Hispanic women were 2.3 times as likely compared to non-Hispanic women (95% CI: 1.3-4.1). Having Medicaid vs. private insurance was associated with 2 times the risk of having a need (95% CI:1.3-3.0), and being a current smoker (RR=1.6, 95% CI: 1.04-2.5) or unmarried were associated with an increased risk (RR=1.9, 95%CI 1.3-2.7). Conclusions: While social needs were reported by fewer than one in five women in this diverse clinical population, women of minority race/ethnicity more frequently had social needs, and were more likely to desire referral to resources. Thus, these women may be more likely to benefit from social needs screening-and-referral programs, which could help us achieve cancer health equity. Analysis of program associations with attendance for care and health outcomes is ongoing.
Citation Format: Anne F. Rositch, Stephanie L. Wethington, Ruoxi Yu, Angel Nkwain, Kristin Topel, Anna L. Beavis. Evaluation of social resource screening, and factors associated with needs and referral for resources in cancer care: The Resource EQuIP study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B077.