PO.PR01.01 · 预防研究
NHIS中的HRSN与CRC筛查建议
HRSNs and CRC screening recommendation in NHIS
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摘要 Abstract
中文摘要
背景：健康相关社会需求（HRSN），包括食物不安全、住房不稳定和经济困难，日益被认为是预防性医疗的障碍。临床医生建议是结直肠癌（CRC）筛查采纳的主要驱动因素。然而，在具有全国代表性的人群中，特定HRSN和共存的社会风险模式如何与临床医生建议相关联，人们知之甚少。
方法：我们分析了汇总的2021年和2023年美国国家健康访谈调查（NHIS）横断面数据，对象为45-75岁无癌症病史的成人（未加权n=6,500；加权=2760万）。经调查加权的逻辑回归估计了过去12个月内临床医生建议的校正比值比（aOR）。我们检查了细分的食物不安全类别、HRSN负担计数，并使用潜类别分析（LCA）检查了潜在的社会风险亚组。分析按种族/族裔和出生地分层；交互项检验了效应修饰。
结果：总体而言，约16%的成人报告在过去12个月内收到临床医生的筛查建议。在非西班牙裔白人成人中，经济困难与几率增加相关（aOR=1.32，95% CI: 1.11-1.56）。在西班牙裔成人中，食物不安全与较高几率相关（aOR=2.94，95% CI: 1.59-5.42），而住房不稳定与较低几率相关（aOR=0.38，95% CI: 0.16-0.88）。LCA鉴定出三种不同的HRSN构型：低/无HRSN（85%）、中等/混合（5%）和高HRSN负担（10%）。高负担成人的建议几率略高（aOR=1.33，95% CI: 0.99-1.78）。种族与HRSN的交互作用在住房不稳定方面具有统计学显著性。
结论：特定和聚集性的社会需求与临床医生的CRC筛查建议相关，其模式因种族/族裔和出生地而异。社会风险评估可能有助于更公平的预防性医疗参与。声明：在本工作准备过程中，作者使用了OpenAI ChatGPT以协助措辞和表达清晰度。使用该工具后，作者审阅并编辑了内容，并对摘要的准确性和完整性负全部责任。
查看英文原文 English abstract
Background: Health-related social needs (HRSNs), including food insecurity, housing instability, and financial hardship, are increasingly recognized as barriers to preventive care. Clinician recommendation is a primary driver of colorectal cancer (CRC) screening uptake. However, little is known about how specific HRSNs and co-occurring social risk patterns relate to clinician recommendations in nationally representative populations.
Methods We analyzed pooled 2021 and 2023 National Health Interview Survey (NHIS) cross-sections among adults 45-75 years without cancer history (unweighted n = 6,500; weighted = 27.6 million). Survey-weighted logistic regression estimated adjusted odds ratios (aORs) for clinician recommendations in the past 12 months. We examined granular food insecurity categories, HRSN burden counts, and latent social-risk subgroups using latent class analysis (LCA). Analyses were stratified by race/ethnicity and nativity; interaction terms tested effect modification.
Results: Overall, roughly 16% of adults reported a clinician's screening recommendation in the past 12 months. Among non-Hispanic White adults, financial hardship was associated with increased odds (aOR = 1.32, 95% CI: 1.11-1.56). Among Hispanic adults, food insecurity was associated with higher odds (aOR = 2.94, 95% CI: 1.59-5.42) while housing instability was associated with lower odds (aOR = 0.38, 95% CI: 0.16-0.88). LCA identified three distinct HRSN configurations: Low/No HRSN (85%), Moderate/Mixed (5%), and High HRSN Burden (10%). High-burden adults had marginally higher odds of recommendation (aOR = 1.33, 95% CI: 0.99-1.78). Race-by-HRSN interactions were statistically significant for housing instability.
Conclusions Specific and clustered social needs are associated with clinician recommendations for CRC screening, with differential patterns by race/ethnicity and nativity. Social risk assessment may support more equitable preventive care engagement. Disclosure: During the preparation of this work, the author used OpenAI ChatGPT to assist with wording and clarity. After using this tool, the author reviewed and edited the content and takes full responsibility for the accuracy and integrity of the abstract.
利益披露 Disclosure
I. Casarez, None..
U. Nataren Geronimo, None..
B. Aceves, None.