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

Assessing baccalaureate nursing students’ knowledge and attitudes of social determinants of health after a health equity simulation

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Quyen Phan ◽  
Naomi Johnson ◽  
JoAnna Hillman ◽  
Daniel Geller ◽  
Laura P. Kimble ◽  
...  
Keyword(s):  
Nursing Students ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Baccalaureate Nursing ◽  
Baccalaureate Nursing Students ◽  
Determinants Of Health ◽  
Marginalized Populations ◽  
Knowledge And Attitudes ◽  
The Impact

AbstractObjectiveFor nursing students, competency in population health management involves acquiring knowledge and forming attitudes about the impact of the social determinants of health (SDoH) on health equity. The purpose of this pilot study was to assess nursing students’ knowledge and attitudes about the SDoH and health equity following a focused simulation activity.MethodBaccalaureate nursing students (N=182) participated in a ninety-minute health equity simulation and a post-simulation debrief. Forty-four students (23%) completed a 19-item post-simulation survey.ResultsSixty-four percent of participants reported positive attitude change in working with marginalized populations caused by the SDoH, and 89% reported being knowledgeable about the role of the registered nurse in addressing health equity. Seventy-five percent reported enhanced knowledge of the SDoH through the health equity simulation.ConclusionUsing health equity simulation may be effective in enhancing students’ knowledge, as well as their attitudes in caring for the health of marginalized populations by addressing the SDoH.

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