scholarly journals An evidence-based strategy to achieve equivalency and interoperability for social-behavioral determinants of health assessment, storage, exchange, and use

2019 ◽  
Vol 26 (2) ◽  
pp. 1477-1488
Author(s):  
Ruth E Wetta ◽  
Roberta D Severin ◽  
Heidi Gruhler
Keyword(s):  
Point Of Care ◽  
Healthcare Delivery ◽  
Secondary Analysis ◽  
Health Data ◽  
Social Determinant ◽  
Social Needs ◽  
Determinants Of Health ◽  
Social Risk ◽  
Social Risk Factors ◽  
Behavioral Determinants

The interoperable exchange of social-behavioral determinants of health data is challenging due to complex factors including multiple recommendations, multiple tools with varying domains, scoring, and cutpoints, and lack of terminology code sets for storing assessments and findings. This article describes a strategy that permits scoring by social-behavioral determinants of health domain to create interoperability and equivalency across tools, settings, and populations. The three-tier scoring strategy converts social-behavioral determinants of health data to (1) be used immediately at point of care by identifying social needs or social risk factors, (2) be consumed within analytics and algorithms and for secondary analysis, and (3) produce total scores that reflect social determinant burden and behavioral determinant burden across populations and settings within a healthcare system. The strategy supports the six uses recommended by the National Academy of Medicine, provides flexibility in choice of social-behavioral determinants of health tool, and leverages the power of social-behavioral determinants of health data in healthcare delivery.

Hunger: A Missed Opportunity for Screening in the Pediatric Emergency Department

2018 ◽  
Vol 57 (11) ◽  
pp. 1318-1325 ◽  
Author(s):  
Tamar Robinson ◽  
Leah Bryan ◽  
Veda Johnson ◽  
Terri McFadden ◽  
Sarah Lazarus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Emergency Department ◽  
Food Insecurity ◽  
Hospital Staff ◽  
Social Needs ◽  
Social Risk ◽  
Care Hospital ◽  
Social Risk Factors ◽  
Primary Care Hospital

Background. The American Academy of Pediatrics and pediatric community recognize the importance of addressing social determinants of health. There are limited data on the prevalence of food insecurity or literature establishing protocols assessing food insecurity in the emergency department (ED). Methods. Two anonymous surveys were administered, one to families during their ED visit and another to ED staff to assess perceptions on the ED’s role in providing social support. Results. Thirty-three of 214 respondents (15.4%) reported food insecurity and are associated with economic risk factors ( P < .0001) and a lack of primary care ( P = .008). Overall, 83.2% of the ED staff believed knowing information about families’ social risk factors would help patient care and 77.6% believed that the ED staff should address families’ social needs. Conclusions. Food insecurity affects a significant portion of ED families across income ranges. Screening for food insecurity in the ED is important given association with lack of primary care. Hospital staff supports screening and intervention.

scholarly journals Perinatal And Post-Partum Care From Early Pregnancy To Postpartum Period.

2021 ◽  
Vol 23 (11) ◽  
pp. 122-131
Author(s):  
Dr.Shiv Kumar Yadav ◽  
◽  
Dr.Jeet Bahadur Moktan ◽  
Dr.Yogendra Shrestha ◽  
Renukaradhya chitti ◽  
...  
Keyword(s):  
Post Partum ◽  
Perinatal Care ◽  
Social Needs ◽  
Social Risk ◽  
Social Changes ◽  
Social Risk Factors ◽  
Mesh Terms ◽  
Pubmed Database ◽  
Ongoing Support

Introduction: Despite the fact that just a few researchers have examined the prenatal and postpartum periods, the findings from those few studies suggest an increase in prevalence through out pregnancy and the first six months after delivery. Pregnancy is a pivotal period in a woman’s life, as she experiences significant emotional, physical, hormonal, and social changes. Pregnancy and the first six months after delivery (perinatal phase) can be taxing, leading in sleep deprivation, relationship difficulties, and feelings of isolation. Materials & Methods: Quality of care, perinatal care, India, hospital, intrapartum care, implementation, and still birth for period were searched in the PubMed database using MeSH terms. A narrative summary of the goals and outcomes was completed. Conclusions: This study compiles a list of all prenatal social needs interventions that have been described in the literature to date. The majority of therapies have been for IPV, according to the findings of this study, and interventions that combine counselling or ongoing support have the best likelihood of lowering social risk factors and improving clinical outcomes.

scholarly journals Social Determinants and Frailty in High-Need, High-Risk Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 179-179
Author(s):  
Kiranmayee Muralidhar ◽  
Willy Marcos Valencia ◽  
Fei Tang ◽  
Stuti Dang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
High Risk ◽  
Frailty Index ◽  
Univariate Analysis ◽  
Ordinal Logistic Regression ◽  
Social Needs ◽  
Social Risk ◽  
Social Risk Factors ◽  
Ordinal Logistic Regression Analysis

Abstract The VA Geriatrics and Extended Care Data Analysis Center uses national predictive modelling to identify High-Need High-Risk (HNHR) Veterans, to provide targeted services and reduce hospitalization and institutionalization risk. To learn the needs of Miami VA HNHR Veterans, we mailed a needs-assessment survey to 2124 Veterans, of whom 634 responded (29.8% response rate). The average respondent age was 70.5±9.2. Among them, 127(20%) were &lt;65 years old, 326(51.4%) were 65-74, and 179(28.2%) were ≥75; 389(61.4%) White, 225(35.5%) Black/African Americans; 515(81.2%) were Non-Hispanic, 111(17.5%) Hispanic/Latino; 173(27.3%) were high school graduates, 350(55.2%) had at least some college credit, 39(6.2%) had a master’s degree or more and 536(84.5%) were health literate. As per Morley’s FRAIL scale, 266(42%) were frail, 242(38.2%) were pre-frail and 87(13.7%) were robust. Social risk factors possibly associated with frailty were analyzed using ordinal logistic regression. Univariate analysis showed significant association with poor health literacy, having a caregiver, social isolation, transportation trouble, delayed or missed doctors’ appointments due to transportation, a negative perception of aging, likelihood of depression, being homebound, inability to use the internet, lack of technology for video conferencing and lack of email use (p≤0.01). Through multivariate ordinal logistic regression analysis, adjusting for patients’ age and Jen Frailty Index, we found that the same social risk factors other than internet use showed significant association with frailty (p≤0.01). HNHR Veterans have complex social needs with a limited ability to manage their chronic conditions, necessitating interventions that address not only their medical issues but also their access barriers and social support.

scholarly journals Implementing screening for social determinants of health using the Core 5 screening tool

2021 ◽  
Vol 10 (3) ◽  
pp. e001362
Author(s):  
Alison Bradywood ◽  
Treasa "Susie" Leming-Lee ◽  
Richard Watters ◽  
Craig Blackmore
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Screening Tool ◽  
Social Needs ◽  
Social Risk ◽  
Social Risk Factors ◽  
Risk Screening ◽  
The Core

Social determinants of health (SDOH) have been documented to underpin 80% of overall health and are being increasingly recognised as key factors in addressing tertiary health outcomes. Yet, despite the widespread acceptance of the association of SDOH with health outcomes, more than two-thirds of hospitals do not screen for social risk factors that indicate individual-level adverse SDOH. Such screening for social risk factors represents the first step in connecting patients with resources and documents the prevalence of social needs. The aim of this project was to implement the Core 5 social risk screening tool and evaluate its efficacy and usability in identifying social risk factors in a presurgical spine population. Prior to this implementation, screening for social risk had not been performed. The Model for Improvement provided a framework for implementing and evaluating the Core 5 social risk screening tool. Methods included implementation of a patient self-report social risk screening tool, referral workflow to connect patients with needed resources and evaluation of staff feasibility in using the Core 5 tool. The results indicated that the screening tool identified patients with social risk factors and staff reported perceptions of efficacy and usability in clinical workflow. Overall, 52 of 88 (59%) of subjects in the presurgical spine population were effectively screened. Of these, five patients (10%) had identified social needs that needed to be addressed prior to surgery. The staff usability survey for the Core 5 tool demonstrated high acceptance and usability, with an average score of 4.4 (out of 5). Future work should evaluate the efficacy of the screening tool in other ambulatory and tertiary settings.

scholarly journals Food Insecurity Among Older Urban Subsidized Housing Residents: The Importance of Social Connectedness

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 136-136
Author(s):  
Judith Gonyea ◽  
Arden O'Donnell ◽  
Alexaandra Curley
Keyword(s):  
Food Insecurity ◽  
Social Connectedness ◽  
Later Life ◽  
Social Determinant ◽  
Subsidized Housing ◽  
Household Food Security ◽  
Social Risk ◽  
Social Risk Factors ◽  
Logistic Regression Models ◽  
Social Determinant Of Health

Abstract Poverty and food insecurity are associated with poor health in later life. Although housing is recognized as a social determinant of health; relatively little research has explored food insecurity in the marginalized population of older subsidized housing residents. In this study, we examined factors associated with food insecurity and particularly how social connectedness was associated with food insecurity. We hypothesized that social connection measures (i.e., loneliness, sense of belonging) independent of sociodemographic, health and food program variables would contribute to food insecurity. Our data are from interviews with 216 residents ages 55-plus (50% Black, 45% LatinX). The 6-item USDA Household Food Security Survey found high rates of food insecurity, 40% for ages 55-69 and 20% for ages 70-plus. Multivariate logistic regression models revealed that loneliness was significantly related to food insecurity even after other factors were controlled. Discussion centers on strategies for addressing social risk factors to ameliorate food insecurity.

An Integrated Social and Behavioral System Approach to Evaluation of Healthcare Information Technology for Polychronic Conditions

2021 ◽  
pp. 1-14
Author(s):  
Thomas T.H. Wan ◽  
Bing Long Wang
Keyword(s):  
Information Technology ◽  
Healthcare Delivery ◽  
Healthcare Information Technology ◽  
Theoretical Frameworks ◽  
Behavioral Determinants ◽  
The Public ◽  
Behavioral System ◽  
Practical Evaluation ◽  
Efficiency And Effectiveness ◽  
Behavioral System Approach

Healthcare delivery systems are evolving with the advances in health information technology (HIT) development and its applications to coordinated or guided care for polychronic conditions. The design features of artificial intelligence in healthcare reflect the public interest in optimizing care coordination and communication between providers and patients. This article offers a practical evaluation and assessment of the relevance of theoretical frameworks and appropriate methodologies to formalize a multi-criteria optimization of a logic model applicable for achieving the system’s efficiency and effectiveness. In specifying theoretical constructs and evaluation methods for HIT evaluation, a three-fold purpose is to show the relevance of personal and behavioral determinants of HIT use, articulate the need for developing a transdisciplinary framework, and formulate appropriate multilevel modeling and causal analysis of the determinants of HIT use and its impacts on chronic care.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

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