The CONECT-6 case-finding tool to identify patients with complex needs: A few tips to promote understanding

Patients with complex health and social care needs (hereafter “complex needs”) often use services provided by different professionals, calling for integrated care to adequately meet their needs.¹ In a previous publication,² our team presented the COmplex NEeds Case-finding Tool—6 (CONECT-6), a case-finding tool including six yes or no questions, for early identification of people with complex needs who frequently use emergency department services. Even with the most robust psychometric properties, health assessment questionnaires often pose challenges for vulnerable populations, such as a lack of clarity or a lack of specificity to capture the respondents' unique and complex situations.^3-6 It is good practice to provide respondents with some advice and guidelines to facilitate the questionnaires' administration and promote their understanding.⁶ This article aims to propose a few tips to ensure better understanding when administering CONECT-6 to people who frequently use emergency department services to identify if they have complex needs.

As with many other validated questionnaires, many people raised questions regarding CONECT-6 despite its simple formula and previous validation.⁶ The most frequent challenges encountered across sites were: (1) for the first, third, and sixth items, people tended to elaborate on their specific situation, leaving the research team to either choose a ‘yes’ or ‘no’ option or to rephrase the question to elicit a ‘yes’ or ‘no’ response; and (2) the second and fifth items sometimes needed more explanation.

The research team, including patient partners, met and shared strategies they used to facilitate respondents' understanding and proposed tips. English-speaking members of the team worked on the English version while French-speaking members worked on the French version. Teamwork and discussions ensured that the questionnaires maintained their original meaning. Here are the proposed tips to administer the CONECT-6 tool in Tables 1 and 2.

This paper proposes tips to promote participant understanding when completing the CONECT-6 questionnaire. This 6-item questionnaire remains a useful case-finding tool to identify people with complex health and social needs in the emergency department for recruitment in research projects or in clinical programs.

The authors declare no conflict of interest.