Addressing Social Determinants of Health through Community-Based Participatory Research: The East Side Village Health Worker Partnership

2002 ◽  
Vol 29 (3) ◽  
pp. 326-341 ◽  
Author(s):  
Amy J. Schulz ◽  
Edith A. Parker ◽  
Barbara A. Israel ◽  
Alex Allen ◽  
Maggie Decarlo ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Health Worker ◽  
Social Determinants ◽  
Process Model ◽  
Determinants Of Health ◽  
Stress Process ◽  
East Side ◽  
Stress Process Model ◽  
Context Specific ◽  
Village Health

The authors describe the use of a stress process model by the East Side Village Health Worker Partnership (ESVHWP), a project of the Detroit Community-Academic Urban Research Center, as a framework for understanding social determinants of health. Specifically, the authors describe the development by the ESVHWP Steering Committee of a context-specific stress process model for east side Detroit residents. The authors examine data from in-depth interviews to illuminate actions taken by community members to reduce stressors or minimize their impact on health. Finally, the authors describe the use of this context-specific stress process model and data gathered regarding actions to address community stressors to inform the development of interventions by the ESVHWP to reduce stressors or strengthen the conditioning factors that reduce the impact of stress on health. On the basis of these results, the authors discuss opportunities and challenges for partnership approaches to addressing social determinants of health in urban communities.

scholarly journals Research Capacity Strengthening in American Samoa: Fa’avaeina le Fa’atelega o le Tomai Sa’ili’ili i Amerika Samoa

2019 ◽  
Vol 50 (2) ◽  
pp. 525-547
Author(s):  
Va’atausili Tofaeono ◽  
Lana Sue I Ka’opua ◽  
Angela Sy ◽  
Tyran Terada ◽  
Rachelann Taliloa-Vai Purcell ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Formative Evaluation ◽  
Research Capacity ◽  
American Samoa ◽  
Determinants Of Health ◽  
Capacity Strengthening ◽  
Research Capacity Strengthening ◽  
Context Specific

Abstract Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE’s research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE’s efforts. Evidential tailoring provided information on American Samoa (A.S.) social determinants of health; trainees indicated increased research commitment. Linguistic and sociocultural relevance tailoring were positively received; trainees reported increased interest in research praxis and initiated an A.S. research capacity-strengthening model. Social work assured knowledge parity in development/delivery of the training curriculum and culturally safe discussions on social determinants of health, territorial status and Samoan survivance. Findings are context-specific yet offer considerations for capacity-strengthening partnerships seeking to advance health equity.

Community Health Worker Intervention to Address Social Determinants of Health for Children Hospitalized With Asthma

2021 ◽  
Vol 11 (12) ◽  
pp. 1370-1376
Author(s):  
Sarah B. Schechter ◽  
Divya Lakhaney ◽  
Patricia J. Peretz ◽  
Luz Adriana Matiz
Keyword(s):  
Community Health ◽  
Social Determinants Of Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Social Determinants ◽  
Social Resources ◽  
Determinants Of Health ◽  
Social Resource ◽  
Asthma Outcomes ◽  
The Impact

BACKGROUND Social determinants of health (SDOH) contribute to racial disparities in asthma outcomes. Community health worker (CHW) programs represent a promising way to screen for SDOH and connect patients to resources, but the impact of CHW programs in the inpatient pediatric setting has been examined in few studies. In this study, we aimed to evaluate a CHW program for children hospitalized with asthma in a predominantly Hispanic community by examining rates of SDOH and social resource navigation. METHODS This pilot study involved a CHW intervention to improve pediatric asthma care. Patients were included if they were hospitalized with asthma over an 18-month period and enrolled in the CHW program during their hospitalization. In an intake interview, CHWs screened caregivers for SDOH and provided tailored social resource navigation. Descriptive statistics were used to assess rates of social risk factors and social resource navigation. RESULTS Eighty patients underwent SDOH screening. The majority of patients were Hispanic (81.3%, n = 65). Half of caregivers reported food or housing insecurity over the past 12 months (50.0%, n = 40), and most reported inadequate housing conditions (63.8%, n = 51). CHWs coordinated social resources for the majority of families (98.8%, n = 79), with the most common being food resources (42.5%, n = 34), housing resources (82.5%, n = 66), and appointment navigation (41.3%, n = 33). CONCLUSIONS CHWs identified a high burden of unmet social needs and provided associated social resource navigation in a largely Hispanic pediatric population hospitalized for asthma. CHW programs have potential to improve asthma outcomes by linking high-risk patients with social resources.

scholarly journals A Community Health Worker Intervention to Address the Social Determinants of Health Through Policy Change

2013 ◽  
Vol 35 (2) ◽  
pp. 119-123 ◽  
Author(s):  
Maia Ingram ◽  
Ken A. Schachter ◽  
Samantha J. Sabo ◽  
Kerstin M. Reinschmidt ◽  
Sofia Gomez ◽  
...  
Keyword(s):  
Community Health ◽  
Social Determinants Of Health ◽  
Health Worker ◽  
Policy Change ◽  
Community Health Worker ◽  
Social Determinants ◽  
Determinants Of Health ◽  
The Social

Social Determinants of Health Screening by Pre-clinical Medical Students during the COVID-19 Pandemic: A Service-Based Learning Case Study (Preprint)

2021 ◽  
Author(s):  
Tara Herrera ◽  
Kevin P Fiori ◽  
Heather Archer-Dyer ◽  
David W. Lounsbury ◽  
Judith Wylie-Rosett
Keyword(s):  
Medical Student ◽  
Community Health ◽  
Social Determinants Of Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Social Determinants ◽  
Social Needs ◽  
Determinants Of Health ◽  
Learning Approach ◽  
Health Record

BACKGROUND Background: Inclusion of social determinants of health is mandated for undergraduate medical education. However, little is known about how prepare pre-clinical students for “real world” screening and referrals to address social determinants of health. OBJECTIVE The pilot project objective was to evaluate the feasibility of using “real world” service-based learning approach in training pre-clinical students to assess social needs and make relevant referrals via the electronic medical record during in COVID-19 pandemic (May-June 2020). METHODS This project was designed to address an acute community service need and to teach pre-clinical second-year medical student (n=11) volunteers how to assess social needs and make referrals using the 10-item Social Determinants of Screening Questionnaire in the electronic health record (epic platform). Third-year medical student volunteers (n= 3), who had completed six clinical rotations, led the one-day skills development orientation and were available for on-going mentoring and peer support. All student-patient communication was by telephone, and bi-lingual (English/Spanish) students called the patients, who preferred to communicate in Spanish. We analyzed EHR data extracted from epic to evaluate screening and data extracted from REDCap to evaluate community health worker notes. We elicited feedback from the participating pre-clinical students to evaluate the future use of this community-based service-learning approach in our pre-clinical curriculum. RESULTS The pre-clinical students completed 45 screening interviews; 20 patients (44%) screened positive for at least one social need. Almost all (19/20) were referred to the community health worker. Half (8/16) patients, who had community health worker consultation, were connected with a relevant social service resource. The pre-clinical students indicated that project participation increased their ability to assess social needs and to make needed electronic health record referrals. Food insecurity was the most common social needs. CONCLUSIONS Practical exposure to social needs assessment has the potential to develop pre-clinical medical students’ ability to address social concerns prior to entering clinical clerkships in their third year of medical school. The students can also become familiar with the EHR prior to entering third year clerkships. Physicians, who are aware of social needs and have EMR tools and staff resources to act, can create workflows to make social needs assessment and services integral components of health care. Research studies and quality improvement initiatives need to investigate how to integrate screening for social needs and connecting patients to the appropriate social services into routine primary care procedures. CLINICALTRIAL not a clinical trial

scholarly journals Planned Relocation and Health: A Case Study from Fiji

2021 ◽  
Vol 18 (8) ◽  
pp. 4355
Author(s):  
Celia McMichael ◽  
Teresia Powell
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Good Health ◽  
Determinants Of Health ◽  
Mental Wellbeing ◽  
Group Discussions ◽  
Housing Design ◽  
Context Specific ◽  
Climatic And Environmental Change ◽  
Depth Interviews

In Fiji, low-lying coastal villages are beginning to retreat and relocate in response to coastal erosion, flooding and saltwater intrusion. Planned relocation is considered a last resort as a form of adaptation to the impacts of climatic and environmental change. The health impacts of planned relocation are poorly understood. This paper draws on data from multi-year research with residents of the iTaukei (Indigenous) Fijian village of Vunidogoloa. We used qualitative research methods to examine experiences of planned relocation, including residents’ accounts of their health and quality of life. In-depth interviews and group discussions were conducted with villagers living in a site of relocation, at four points in time (2015, 2016, 2019, and 2020). Twenty-seven people in Vunidogoloa, Fiji, participated in in-depth interviews, several on more than one occasion. Six group discussions with between eight to twelve participants were also conducted. Qualitative analytic software (NVivo) was used to analyse interview transcripts and identify themes. Villagers report both health benefits and challenges following planned relocation. Key facilitators for good health include movement away from some environmental risks to health, adequate drinking water and sanitation, food security including through farms and kitchen gardens, livelihood opportunities, improved access to schools and health services, and appropriate housing design. However, residents also refer to unanticipated risks to health including increased consumption of packaged goods and alcohol, disruptions to social structures and traditional values, and disrupted place attachment following movement away from a coastal site of belonging with consequences for mental wellbeing. Therefore, planned relocation has altered the social determinants of health in complex ways, bringing both health opportunities and risks. These results highlight the need for context-specific planning and adaptation programs that include meaningful involvement of community members in ongoing decision making, and call for an understanding of diverse social determinants of health that emerge and evolve in contexts of planned relocation.

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