Usability Evaluation of a Portable Health Information Kiosk Using a SMAARTTM Intervention Framework

Empirical literature has shown that interventions to address social determinants of health are limited owing to poor integration of social and clinical data. The objective of this study was to describe a Sustainable, Multisector, Accessible, Affordable, Reimbursable, and Tailored framework (SMAARTTM) which was utilized to design and pilot test portable health information kiosk that can facilitate the integration of social determinants of health data with clinical data to enhance population health outcomes in global settings. The SMAART TM framework was designed using a combined approach of Data, Information Knowledge, Human Centered approach and behavioral humanistic and learning theories, and was applied to develop and evaluate an interactive, bi-lingual computer enabled portable health information kiosk. A convenience sample (recruitment based on accessibility to the researcher) of 149 individuals aged 18 years and above living in urban slum settings of India were enrolled in the year 2013. Subjective and objective data gathering included socio-demographics, clinical history, health behaviors and knowledge, attitude and practices. Weight and blood pressure levels were measured using physiological sensors. Usability assessment of the health information kiosk was also conducted. Results showed an increased burden of chronic non-communicable disease (NCD) risk factors and related knowledge, and lack of healthy lifestyle practices among urban slum individuals. Our study showed that the technology enabled SMAART TM framework can be utilized to develop an individual risk profile for better disease prevention, monitoring and management of chronic NCDs.

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Enhancing understandings of social determinants of health in China: Linkage and analysis of a national multilevel population health surveillance with routinely collected mortality records for 98 058 people in 31 provinces of mainland China

10.21203/rs.2.18425/v1 ◽

2019 ◽

Author(s):

Yunning Liu ◽

Thomas Astell-Burt ◽

Xiaoqi Feng ◽

Fan Mao ◽

Ruiming Liang ◽

...

Keyword(s):

Infectious Disease ◽

Social Determinants Of Health ◽

Population Health ◽

Social Determinants ◽

Communicable Disease ◽

Mainland China ◽

Health Surveillance ◽

Determinants Of Health ◽

County Level ◽

Injury Mortality

Abstract Background: The aim of this study was to enhance capability in research on social determinants of health in China by linking and analyzing routinely-collected death records over 5 years with national population health surveillance.Methods: Linkage of 98 058 participants in the 2010 China Chronic Disease and Risk Factor Surveillance (CCDRFS) to records in the national death surveillance data from 2011 to 2015 was conducted through a matching program involving identification numbers, name, gender and residential address, followed by a structured checking process. Multilevel regressions were used to investigate five-year odds of all-cause, non-communicable disease (NCD), infectious disease and injury mortality in relation to person- and county-level factors.Results: A total of 3,365 deaths were observed in the linked mortality and population health surveillance. Cross-checks and comparisons with national mortality distributions provided assurance that the linkage was reasonable. Geographic variation in mortality was observed via age and gender adjusted median odds ratios for all-cause mortality (>1.30), infectious disease (>2.01), NCD (>1.24) and injury (>1.12). Increased odds of all-cause and all three cause-specific mortality outcomes were higher with age and among men. Low educational attainment was a predictor of all-cause, NCD and injury mortality. Longer mean years of education at the county-level was only associated with lower injury mortality. Divorcees had a higher odd of all-cause and NCD mortality than singletons. Rurality was a predictor of all-cause and NCD mortality.Conclusion: The results of this study provide utility for future investigations of social determinants of health and mortality using linked data in China.

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Incorporating Geospatial Capacity within Clinical Data Systems to Address Social Determinants of Health

Public Health Reports ◽

10.1177/00333549111260s310 ◽

2011 ◽

Vol 126 (3_suppl) ◽

pp. 54-61 ◽

Cited By ~ 36

Author(s):

Karen Frederickson Comer ◽

Shaun Grannis ◽

Brian E. Dixon ◽

David J. Bodenhamer ◽

Sarah E. Wiehe

Keyword(s):

Social Determinants Of Health ◽

Clinical Data ◽

Social Determinants ◽

Determinants Of Health ◽

Data Systems

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Using Health Information Technology to Bring Social Determinants of Health into Primary Care: A Conceptual Framework to Guide Research

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2018.0071 ◽

2018 ◽

Vol 29 (3) ◽

pp. 949-963 ◽

Cited By ~ 10

Author(s):

Erika K. Cottrell ◽

Rachel Gold ◽

Sonja Likumahuwa ◽

Heather Angier ◽

Nathalie Huguet ◽

...

Keyword(s):

Primary Care ◽

Information Technology ◽

Conceptual Framework ◽

Social Determinants Of Health ◽

Health Information Technology ◽

Health Information ◽

Social Determinants ◽

Determinants Of Health

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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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Home Care Nurses Claim Medicare Ignores Social Determinants of Health

Home Health Care Management & Practice ◽

10.1177/1084822319858349 ◽

2019 ◽

Vol 31 (4) ◽

pp. 224-230 ◽

Cited By ~ 1

Author(s):

William Cabin

Keyword(s):

New York ◽

Home Care ◽

Social Determinants Of Health ◽

Social Determinants ◽

Home Health ◽

Determinants Of Health ◽

Additional Patient ◽

Convenience Sample ◽

Related Services ◽

Home Care Nurses

There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded the ability of Medicare Advantage plans to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate that nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs.

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HOME CARE NURSES CLAIM MEDICARE IGNORES SOCIAL DETERMINANTS OF HEALTH

Innovation in Aging ◽

10.1093/geroni/igz038.554 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S154-S154

Author(s):

William D Cabin

Keyword(s):

New York ◽

Home Care ◽

Social Determinants Of Health ◽

Social Determinants ◽

Home Health ◽

Determinants Of Health ◽

Additional Patient ◽

Convenience Sample ◽

Related Services ◽

Home Care Nurses

Abstract There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs.

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US college students’ perceptions of social determinants of health, health equity and racial health disparities

Health Education Journal ◽

10.1177/0017896920910175 ◽

2020 ◽

Vol 79 (6) ◽

pp. 700-711

Author(s):

Rebecca Rich ◽

Angelia Paschal

Keyword(s):

College Students ◽

Health Disparities ◽

Social Determinants Of Health ◽

Health Equity ◽

Social Determinants ◽

Good Health ◽

Determinants Of Health ◽

Racial Health Disparities ◽

Cross Sectional ◽

Convenience Sample

Objective: Healthy equity (HE) implies the highest possible standard of health for all people while giving special attention to the needs of those at greatest risk of poor health, based on social conditions. The social determinants of health (SDH) are conditions within the environment in which people live that shape their opportunity to attain good health. Despite efforts to promote HE and address SDH, there is limited research on college students’ perceptions of these concepts. The purpose of this study was to understand college students’ perceptions, awareness and education on HE and SDH with a specific focus on racial health disparities. Methods: A 28-item questionnaire was distributed electronically to a cross-sectional, campus-wide convenience sample of undergraduates at a large public university in the southeast USA. Results: While many students reported having knowledge or understanding about HE, SDH and related concepts, most had negative attitudes and beliefs about them. Students reported good understanding of these terms, but also believed that health disparities were due to individual behaviours. Conclusion: The contradiction in results show that while college students may think they have a good understanding of HE and SDH, their education on the topics could be improved. Study findings should encourage health education specialists to shift their focus from merely providing information to promoting the application of that knowledge. By so doing, students may be able to bridge the gap between understanding health equity and applying their knowledge in everyday life.

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Social determinants of health in the Big Data mode of population health risk calculation

Big Data & Society ◽

10.1177/20539517211062881 ◽

2021 ◽

Vol 8 (2) ◽

pp. 205395172110628

Author(s):

Rachel Rowe

Keyword(s):

Public Health ◽

Big Data ◽

Social Determinants Of Health ◽

Population Health ◽

Social Determinants ◽

Determinants Of Health ◽

Individual Risk ◽

Risk Calculation ◽

Health And Illness ◽

The Usa

Amidst the climate of crisis surrounding the rise in opioid-related overdose in the USA, early in 2019, Google and Deloitte launched ‘Opioid360’. Here came a platform combining browser histories, credit, insurance, social media, and traditional survey data to sell the service of risk calculation in population health. Opioid360's approach to automating risk calculation not only promised to identify persons ‘at risk’ of opioid dependence, but also paved the way for broader applications anticipating common chronic diseases and coordinating logistical operations involved in pandemic response. Beginning with this experimental platform, this paper develops an analysis of the Big Data mode of risk calculation - an epistemological and political shift that involves technology companies, investors, insurers, governments, and public health institutions. The analysis focuses on the re-emergence of ‘social determinants of health’ (SDOH) in the rhetoric accompanying novel analytic platforms that estimate, calculate, and compute individual health risks. While the treatment of SDOH has always been a site of political contestation within the discipline of public health, powerful interests are crystallising around the concept and instrumentalising it in platforms that sell algorithmic prediction. Silicon Valley's breed of asset-oriented technoscience appears not only to be amplifying the behaviouralist elements of public health. Among the stakes of the Big Data mode is the paradoxical retreat from changing social conditions that contribute to the prevalence of health and illness in populations; and instead, the promotion of an apparatus for pricing and exchanging individual risk or excluding from services those who bear risk most acutely.

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