RT Journal Article
SR Electronic
T1 A Brief Tool to Screen Patients for Precarious Employment: A Validation Study
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 26
OP 30
DO 10.1370/afm.3053
VO 22
IS 1
A1 Ho, Julia W.
A1 Bellicoso, Emily
A1 Bondy, Madeleine
A1 Holness, Dorothy Linn
A1 Muntaner, Carles
A1 Nisenbaum, Rosane
A1 Ruco, Arlinda
A1 Hassen, Nadha
A1 Hanna, Andrew
A1 Pinto, Andrew D.
YR 2024
UL http://www.annfammed.org/content/22/1/26.abstract
AB PURPOSE Precarious employment, defined by temporary contracts, unstable employment, or job insecurity, is increasingly common and is associated with inconsistent access to benefits, lower income, and greater exposure to physical and psycholosocial hazards. Clinicians can benefit from a simple approach to screen for precarious employment to improve their understanding of a patient’s social context, help with diagnoses, and inform treatment plans and intersectional interventions. Our objective was to validate a screening tool for precarious employment.METHODS We used a 3-item screening tool that covered key aspects of precarious employment: non-standard employment, variable income, and violations of occupational health and safety rights and protections. Answers were compared with classification using the Poverty and Employment Precarity in Southern Ontario Employment Index. Participants were aged 18 years and older, fluent in English, and employed. They were recruited in 7 primary care clinic waiting rooms in Toronto, Canada over 12 months.RESULTS A total of 204 people aged 18-72 years (mean 38 [SD 11.3]) participated, of which 93 (45.6%) identified as men and 119 (58.3%) self-reported as White. Participants who reported 2 or more of the 3 items as positive were almost 4 times more likely to be precariously employed (positive likelihood ratio = 3.84 [95% CI, 2.15-6.80]).CONCLUSIONS A 3-item screening tool can help identify precarious employment. Our tool is useful for starting a conversation about employment precarity and work conditions in clinical settings. Implementation of this screening tool in health settings could enable better targeting of resources for managing care and connecting patients to legal and employment support services.