There is a need to identify people at high risk for adverse outcomes of COVID-19 infection. In addition to clinical risk factors, social circumstances (i.e., going to work, taking public transportation, living in a high-density household) may also put some people at greater risk of exposure than others. Screening for social risk factors can be an important complement to screening for COVID symptoms and clinical risks that increase an individual’s likelihood of being infected with COVID.
Collaborating with several partners (see below), Dr. Leslie Hausmann, an investigator with HSR&D’s Center for Health Equity Research & Promotion (CHERP), led the development of COVID-19 social risk screening items for inclusion in the VA electronic health record. This screener is meant to accompany screening for COVID symptoms and clinical risks. The results are intended to be used in combination with symptoms and clinical risks to prioritize individuals for COVID testing. These questions also may be used separately to assess an individual’s need for counselling or assistance to minimize exposure.
Dr. Hausmann developed the COVID-19 social risk screening items in partnership with Ernest Moy, MD, Shannon Jordan, MPH, and Lauren Korshak, MS, RCEP from VA’s Office of Health Equity; in addition to Lisa Lehmann, MD, PhD, MSc, Chief Medical Officer for VISN1 (VA New England Healthcare System); Lauren Russell, MPP, Access Lead for VISN1; Alicia Cohen, MD, HSR&D’s Center of Innovation in Long-Term Services and Supports for Vulnerable Veterans; Jessica Breland, PhD, MS, HSR&D Career Development Awardee, VA Palo Alto Health Care System; Johanne Eliacin, PhD, HSPP, HSR&D Career Development Awardee; Juliette McClendon-Iacovino, PhD, VA Boston Healthcare System, and Utibe Essien, MD, CHERP.
Dr. Moy is working with Joe Francis, MD, VA’s Chief Improvement & Analytics Officer, and others to incorporate the items into VA’s computerized patient record system (CPRS), as well as an online version that may have a broader reach to Veterans. Dr. Hausmann also worked with Dr. Moy to develop a simplified scoring algorithm that is more suitable for use in settings that do not have electronic scoring mechanisms. To further extend the reach of these items, Dr. Hausmann uploaded the questions into the COVID Social Impact Survey Item Bank. More information about the resource is available at the COVID-19 Research Question Bank.
Note: Given the rapidly changing prevalence and impact of COVID-19, the VA COVID-19 Social Risks Screening Questions and scoring algorithm have not yet undergone psychometric testing. An individual’s symptoms and clinical risk profile should be considered in conjunction with their level of social risks when making testing or treatment decisions.