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Objective: To determine whether a 6- or 12-month look-back period affected rates of reported social risks in a social risk survey for use in the Veterans Health Administration and to assess associations of social risks with overall health and mental health. Study Design: Cross-sectional survey of respondents randomized to 6- or 12-month look-back period. Data Sources and Study Setting: Online survey with a convenience sample of Veterans in June and July 2021. Data Collection/Extraction Methods: Veteran volunteers were recruited by email to complete a survey assessing social risks, including financial strain, adult caregiving, childcare, food insecurity, housing, transportation, internet access, loneliness/isolation, stress, discrimination, and legal issues. Outcomes included self-reported overall health and mental health. Chi-squared tests compared the prevalence of reported social risks between 6- and 12-month look-back periods. Spearman correlations assessed associations among social risks. Bivariate and multivariable logistic regression models estimated associations between social risks and fair/poor overall and mental health. Principal Findings: Of 3418 Veterans contacted, 1063 (31.10%) responded (87.11% male; 85.61% non-Hispanic White; median age = 70, interquartile range [IQR] = 61-74). Prevalence of most reported social risks did not significantly differ by look-back period. Most social risks were weakly intercorrelated (median |r| = 0.24, IQR = 0.16-0.31). Except for legal issues, all social risks were associated with higher odds of fair/poor overall health and mental health in bivariate models. In models containing all significant social risks from bivariate models, adult caregiving and stress remained significant predictors of overall health; food insecurity, housing, loneliness/isolation, and stress remained significant for mental health. Conclusions: Six- and 12-month look-back periods yielded similar rates of reported social risks. Although most individual social risks are associated with fair/poor overall and mental health, when examined together, only adult caregiving, stress, loneliness/isolation, food, and housing remain significant. KEYWORDS health status disparities, questionnaire design, social determinants of health, social risk factors, Veterans, 1 | INTRODUCTION The conditions in which people are born, grow, live, work, and age, known as social determinants of health, account for an estimated 50% of healthcare outcomes and [...]

Objective: To assess the psychometric properties and construct validity of a survey of primary care providers' (PCPs') experience of specialty care coordination, which is a counterpart to our existing survey ('CSC-Specialist') that measures specialists' experience of specialty care coordination. Data Sources: We surveyed PCPs from Veterans Health Administration medical centers and community-based outpatient clinics nationwide (N = 1576) in April 2018. Study Design: We developed candidate items through literature review, existing surveys, PCP interviews, and expert opinion. We used exploratory and confirmatory factor analysis to develop scales and multivariable linear regression to determine their association with PCPs' overall experience of coordination. Data Collection: The online survey included 23 candidate scale items about specialty care coordination and a single item asking respondents to rate their overall experience of specialty care coordination on a 0-10 scale. All VA PCPs were eligible. We sent survey invitations to PCPs following local Section Chiefs' email introduction (N = 926) and by directly emailing two random samples (N = 400 and N = 6653), overall response rate across the three nonoverlapping samples = 24 percent. Principal Findings: Analyses identified 20 items forming 6 scales with strong psychometric properties and predictive power for overall coordination. Two scales are identical to CSC-Specialist scales: 'Communication' (k = 3, [alpha] = 0.87) and 'Data Transfer' (k = 2, [alpha] = 0.92); one is similar: 'Relationships and Collaboration' (k = 6, [alpha] = 0.90). The three remaining scales address the PCP's unique perspective: 'Role Clarity' (k = 3, [alpha] = 0.85), 'Role Agreement' (k = 3, [alpha] = 0.75), and 'Making Referrals' (k = 3, [alpha] = 0.75). The six scales together explained 67 percent of the variance in PCPs' overall coordination experience with specialists. Conclusions: The Coordination of Specialty Care-Primary Care Provider Survey (CSC-PCP) is a novel 20-item survey that can be used in quality improvement or health services research, alone or in combination with the CSC-Specialist, to evaluate coordination of care as experienced by either or both participants. KEYWORDS consultation, coordinated care, primary care, psychometrics, specialty care, survey research, 1 | INTRODUCTION Primary care serves as a central point for coordinating patient care across a variety of health care settings. (1-3) Over 100 million primary care visits yearly result [...]

Objective: To develop an online survey of care coordination with primary care providers as experienced by medical specialists, evaluate its psychometric properties, and test its construct validity. Data Sources: Physicians (N = 633) from 13 medical specialties across the Veterans Health Administration. Study Design: We developed the survey based on prior work (literature review, specialist interviews) and by adapting existing measures and developing new items. Multitrait scaling analysis and confirmatory factor analysis were used to assess scale structure. We used multiple linear regression to examine the relationship of the final coordination scales to specialists' overall experience of care coordination. Data Collection: November 2016-December 2016. Principal Findings: Results suggest a 13-item, four-factor survey [Relationships (k = 4), Roles and Responsibilities (k = 4), Communication (k = 3), and Data Transfer (k = 2)] that measures the medical specialist experience of coordination with good internal consistency reliability, convergent validity, discriminant validity, and goodness of fit. Together, the four scales explained nearly 50 percent of the variance in specialists' overall experience of care coordination. Conclusions: The 13-item Coordination of Specialty Care--Specialist Survey (CSC-Specialist) is the first of its kind. It can be used alone or embedded in other surveys to measure four domains of care coordination as experienced by medical specialists. KEYWORDS consultation, coordinated care, psychometrics, specialty care, survey research, 1 | INTRODUCTION Over 100 million specialty care visits occur yearly in the United States. (1) They commonly result in fragmented health care involving missed and unmet needs, (2) duplicated [...]