OBJECTIVES Screening for social needs is recommended during clinical encounters but multi-item questionnaires can be burdensome. We evaluate if a single question about financial stress can be used to prescreen for food insecurity, housing instability, or transportation needs. METHODS We use retrospective medical record data from children (<11 years) seen at 45 primary pediatric care offices in 2022. Social needs screening was automated at well child visits and could be completed by the parent/guardian via the patient portal, tablet in the waiting room, or verbally with staff. We report the area under the receiver operating curve for the 5 response options of the financial stress question as well as sensitivity and specificity of the financial stress question ("not hard at all" vs any other response) to detect other reported social needs. RESULTS Of 137 261 eligible children, 130 414 (95.0%) had social needs data collected. Seventeen percent of respondents reported a housing, food, or transportation need. The sensitivity of the financial stress question was 0.788 for any one or more of the 3 other needs, 0.763 for food insecurity, 0.743 for housing instability, and 0.712 for transportation needs. Using the financial stress question as the first-step of a screening process would miss 9.7% of the families who reported food insecurity, 22.6% who reported housing instability, and 33.0% who reported transportation needs. CONCLUSIONS A single question screener about financial stress does not function well as a prescreen because of low sensitivity to reports of food insecurity, housing instability, and transportation needs.

中文翻译：

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筛选社会需求所需的单个财务安全问题的准确性。


目的 建议在临床接触期间筛查社会需求，但多项目问卷可能很繁琐。我们评估是否可以使用关于财务压力的单个问题来预先筛选粮食不安全、住房不稳定或交通需求。方法 我们使用 2022 年在 45 个初级儿科护理办公室看到的儿童 （<11 岁） 的回顾性病历数据。社会需求筛查在儿童健康就诊时自动进行，可以由父母/监护人通过患者门户、候诊室的平板电脑或与工作人员口头完成。我们报告了财务压力问题的 5 个回答选项的接受者操作曲线下面积，以及财务压力问题的敏感性和特异性（与任何其他回答相比“一点也不难”），以检测其他报告的社会需求。结果 在 137 261 名符合条件的儿童中，130 414 名 （95.0%） 收集了社会需求数据。17% 的受访者报告了住房、食物或交通需求。对于其他 3 种需求中的任何一种或多种，财务压力问题的敏感性为 0.788，对于粮食不安全为 0.763，对于住房不稳定为 0.743，对于交通需求为 0.712。使用财务压力问题作为筛选过程的第一步将错过 9.7% 报告粮食不安全的家庭、22.6% 报告住房不稳定的家庭和 33.0% 报告交通需求的家庭。结论 关于财务压力的单一问题筛选器不能很好地作为预筛选，因为对粮食不安全、住房不稳定和交通需求的报告敏感性低。