Relationship between intervention dosage and success of resource connections in a social needs intervention.

OBJECTIVES: Social needs interventions in medical settings aim to mitigate the effects of adverse social circumstances on health outcomes by connecting vulnerable patients with resources. This study examined the relationship between intervention dosage and the success of resource connections using data from a social needs intervention in multiple clinical settings across the US. STUDY DESIGN: The intervention uses a case management approach to connect patients with unmet needs to resources and services in the community. Intervention dosage was conceptualized as the number of contacts between the navigator and the patient, categorized as direct contact (phone vs. in person) and indirect contact (initiated by the navigator vs. patient). Success of the intervention was conceptualized as 'none,' 'partial,' or 'optimal' for each patient, based on the number of social needs the resource connections addressed. METHODS: Administrative data were extracted for 38,404 unique patients who screened positive for unmet resource needs between 2012 and 2017. Owing to the large sample size, statistical corrections were made to reduce type I error. RESULTS: Multinomial logistic regression analyses showed that higher intervention dosage was related to greater success of resource connections, after adjusting for the patient and site characteristics, and the number of needs (odds ratios ranged from 1.62 to 2.89). In-person contact, although received by only 25% of the patients, was associated with the highest probability of optimal success. CONCLUSIONS: This study demonstrates a feasible way to conceptualize an intervention dose for a social needs intervention that uses a case management approach and has implications for how intervention delivery may improve success of resource connections.

Measurement of immunoglobulin G, A and M concentrations in boar seminal plasma.

How the immune system relates to the boar reproductive tract is not well defined. This is an important area of study because disease-causing agents may be transmitted through boar semen. We have previously identified porcine reproductive and respiratory syndrome virus (PRRSV) in boar semen and wanted to identify PRRSV-specific antibodies within seminal plasma. However, literature documenting total immunoglobulin concentration or the predominant immunoglobulin isotype in boar semen was not available. Therefore, we developed a sandwich enzyme-linked immunoassay (ELISA) to quantitate total IgG, IgA and IgM in seminal plasma from 16 healthy, nonvaccinated, adult boars (n = 102 semen samples). In seminal plasma, IgG was the predominant isotype followed by IgA and IgM. Mean levels +/- the standard deviation followed by the 95% confidence interval of IgG, IgA and IgM were 23.2 +/- 14 microg/mL (15.5 to 31.0), 4.8 +/- 2.5 microg/mL (3.5 to 6.2) and 3.7 +/- 1.7 microg/mL (2.7 to 4.7), respectively. These concentrations of immunoglobulins in seminal plasma were considerably lower than in other swine secretions, which might allow for the survival of infectious agents in boar semen.