Psychometric Properties of the Korean Version of the Health Literacy on Social Determinants of Health Questionnaire (K-HL-SDHQ) v1 (protocols.io.7aqhidw)

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

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Awareness of Hospice Care Among Rural African-Americans: Findings From Social Determinants of Health Framework

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211057847 ◽

2021 ◽

pp. 104990912110578

Author(s):

Hyunjin Noh ◽

Hee Y. Lee ◽

Lewis H. Lee ◽

Yan Luo

Keyword(s):

Health Literacy ◽

Social Determinants Of Health ◽

Social Isolation ◽

Social Determinants ◽

Hospice Care ◽

Demographic Characteristics ◽

Black Belt ◽

Determinants Of Health ◽

Black Belt Region ◽

Alabama's Black Belt

Background: Despite the need for hospice care as our society ages, adults in the U.S.’s southern rural region have limited awareness of hospice care. Objective: This study aims to assess the rate of awareness of hospice care among rural residents living in Alabama’s Black Belt region and examine social determinants of health (SDH) associated with the awareness. Methods: A cross-sectional survey was conducted among a convenience sample living in Alabama’s Black Belt region (N = 179, age = 18-91). Participants’ awareness of hospice care, demographic characteristics (ie, age and gender), and SDH (ie, financial resources strain, food insecurity, education and health literacy, social isolation, and interpersonal safety) were assessed. Lastly, a binary logistic regression was used to examine the association between SDH and hospice awareness among participants while controlling for demographic characteristics. Results: The majority of participants had heard of hospice care (n = 150, 82.1%), and older participants (50 years old or older) were more likely to report having heard of hospice care ( OR = 7.35, P < 0.05). Participants reporting worries about stable housing (OR = 0.05, P < 0.05) and higher social isolation were less likely to have heard of hospice care ( OR = 0.53, P < 0.05), while participants with higher health literacy had a higher likelihood to have heard of it ( OR = 2.60, P < 0.01). Conclusions: Our study is the first study assessing the status of hospice awareness among residents of Alabama’s Black Belt region. This study highlighted that factors including age and certain SDH (ie, housing status, health literacy, and social isolation) might be considered in the intervention to improve hospice awareness.

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Development and validation of the Social Determinants of Health Questionnaire and implications for “Promoting Food Security and Healthy Lifestyles” in a complex urban food ecosystem

Ecology of Food and Nutrition ◽

10.1080/03670244.2018.1481835 ◽

2018 ◽

Vol 57 (4) ◽

pp. 261-281

Author(s):

Preety Gadhoke ◽

Salome Pemberton ◽

Ava Foudeh ◽

Barrett P. Brenton

Keyword(s):

Food Security ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Healthy Lifestyles ◽

Health Questionnaire ◽

The Social ◽

Development And Validation

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Social Determinants of Health as Potential Influencers of a Collaborative Care Intervention for Patients with Hypertension

Ethnicity & Disease ◽

10.18865/ed.31.1.47 ◽

2021 ◽

Vol 31 (1) ◽

pp. 47-56

Author(s):

Chidinma A. Ibe ◽

Carmen Alvarez ◽

Kathryn A. Carson ◽

Jill A. Marsteller ◽

Deidra C. Crews ◽

...

Keyword(s):

Health Literacy ◽

Community Health ◽

Social Determinants Of Health ◽

Community Health Workers ◽

Social Determinants ◽

Collaborative Care ◽

Health Workers ◽

Determinants Of Health ◽

Nurse Care ◽

Care Intervention

Objectives: The use of collaborative care teams, comprising nurse care managers and community health workers, has emerged as a promising strategy to tackle hypertension disparities by addressing patients’ social determinants of health. We sought to identify which social determinants of health are associated with a patient’s likelihood of engaging with collaborative care team members and with the nurse care manager’s likelihood of enlisting community health workers (CHW) to provide additional support to patients.Methods: We conducted a within-group longitudinal analysis of patients assigned to receive a collaborative care intervention in a pragmatic, cluster randomized trial that aims to reduce disparities in hypertension control (N=888). Generalized estimating equations were used to identify which social determinants of health, reported on the study’s baseline survey, were associated with the odds of patients engaging with the collaborative care intervention, and of nurses deploying community health workers.Results: Patients who were unable to work and those with higher health literacy were less likely to engage with the collaborative care team than those who were employed full time or had lower health literacy, respectively. Patients had a greater likelihood of being referred to a community health worker by their care manager if they reported higher health literacy, perceived stress, or food insecurity, while those reporting higher numeracy had lower odds of receiving a CHW referral.Implications/Conclusions: A patient’s social determinants of health influence the extent of engagement in a collaborative care intervention and nurse care manager appraisals of the need for supplementary support provided by community health workers.Ethn Dis. 2021;31(1):47-56; doi:10.18865/ed.31.1.47

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Exploring the Role of Critical Health Literacy in Addressing the Social Determinants of Health

10.17226/26214 ◽

2021 ◽

Author(s):

◽

Keyword(s):

Health Literacy ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Critical Health Literacy ◽

The Social

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Social determinants of health associated with hemodialysis non-adherence and emergency department utilization: a pilot observational study

BMC Nephrology ◽

10.1186/s12882-019-1673-7 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Kamna S. Balhara ◽

Lori Fisher ◽

Naya El Hage ◽

Rosemarie G. Ramos ◽

Bernard G. Jaar

Keyword(s):

Risk Factors ◽

Health Literacy ◽

Observational Study ◽

Social Determinants Of Health ◽

Resource Utilization ◽

Social Determinants ◽

Determinants Of Health ◽

Emergency Department Utilization ◽

Convenience Sample ◽

Physical Limitations

Abstract Background Dialysis patients who miss treatments are twice as likely to visit emergency departments (EDs) compared to adherent patients; however, prospective studies assessing ED use after missed treatments are limited. This interdisciplinary pilot study aimed to identify social determinants of health (SDOH) associated with missing hemodialysis (HD) and presenting to the ED, and describe resource utilization associated with such visits. Methods We conducted a prospective observational study with a convenience sample of patients presenting to the ED after missing HD (cases); patients at local dialysis centers identified as HD-compliant by their nephrologists served as matched controls. Patients were interviewed with validated instruments capturing associated risk factors, including SDOH. ED resource utilization by cases was determined by chart review. Chi-square tests and ANOVA were used to detect statistically significant group differences. Results All cases visiting the ED had laboratory and radiographic studies; 40% needed physician-performed procedures. Mean ED length of stay (LOS) for cases was 17 h; 76% of patients were admitted with average LOS of 6 days. Comparing 25 cases and 24 controls, we found no difference in economic stability, educational attainment, health literacy, family support, or satisfaction with nephrology care. However, cases were more dependent on public transport for dialysis (p = 0.03). Despite comparable comorbidity burdens, cases were more likely to have impaired mobility, physical limitations, and higher severity of pain and depression. (p < 0.05). Conclusions ED visits after missed HD resulted in elevated LOS and admission rates. Frequently-cited SDOH such as health literacy did not confer significant risk for missing HD. However, pain, physical limitations, and depression were higher among cases. Community-specific collaborations between EDs and dialysis centers would be valuable in identifying risk factors specific to missed HD and ED use, to develop strategies to improve treatment adherence and reduce unnecessary ED utilization.

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