Development of a brief questionnaire to identify families in need of legal advocacy to improve child health

UMMS Affiliation

Department of Pediatrics; Department of Family Medicine and Community Health

Publication Date


Document Type



Adult; Child Advocacy; Child Welfare; Child, Preschool; Humans; Massachusetts; *Needs Assessment; Patient Acceptance of Health Care; Predictive Value of Tests; Primary Health Care; *Questionnaires; Referral and Consultation


Community Health | Other Medical Specialties | Preventive Medicine


OBJECTIVE: To determine whether the medical-legal advocacy screening questionnaire (MASQ), a simple 10-item questionnaire, is able to screen families in a primary care setting for possible referral to legal services more effectively than the clinical interview alone.

METHODS: Family Advocates of Central Massachusetts (FACM) is a medical-legal collaboration that assists low-income families with legal issues that affect child health. A convenience sample of parents seen at each of 5 medical practices associated with FACM was recruited to complete the MASQ prior to a routine child health care visit. Physicians blinded to the result assessed family need for referral to FACM after their usual clinical encounter. The sensitivity and specificity of both the MASQ and provider assessment were calculated.

RESULTS: Two hundred fifty-five parents from 5 practices participated in the study. The MASQ identified 85 patients in need of legal services. Prior to reviewing the MASQ, the primary care providers identified 35 families in need of referral to the FACM. After completion of both the MASQ and the medical encounter, 37 families agreed to referral. The MASQ had sensitivity of 0.81 and specificity of 0.75 in predicting program referral. Provider assessment had sensitivity of 0.65 and specificity of 0.95 of predicting program referral.

CONCLUSIONS: Routine use of the MASQ would likely identify more patients in pediatric practices who would accept referral to legal assistance than reliance on provider impression alone after a routine clinical encounter.

DOI of Published Version



Ambul Pediatr. 2008 Jul-Aug;8(4):266-9. Epub 2008 May 27. Link to article on publisher's site

Journal/Book/Conference Title

Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association

Related Resources

Link to Article in PubMed

PubMed ID