A logic framework for evaluating social determinants of health interventions in primary care

Coughlin, Steven S.; Mann, Paul C.; Vernon, Marlo M.; Young, Lufei; Ayyala, Deepak Nag; Sams, Richard; Hatzigeorgiou, Christos

doi:10.21037/jhmhp.2019.09.03

Cited by 33 publications

(36 citation statements)

References 45 publications

(67 reference statements)

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“…Continued education and primary prevention are necessary to improve limited health literacy and health outcomes for these specific populations across communities. 14 Translating these findings back to the local level can help inform public health and primary care practitioners to prioritize individuals who are at risk or may have limited health literacy. 15 - 17 This study also supports additional programs and expanded educational efforts to continue efforts to enhance education and ultimately improve primary care for the 51% of the population with less than high health literacy.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey

Woods

Ali

Medina

et al. 2023

J Prim Care Community Health

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Health literacy continues to be an issue among minority groups. Population surveys are one strategy used to help better understand health disparities. The Behavioral Risk Factor Surveillance System (BRFSS) in Kansas added health literacy questions to the survey in 2012. This study examined population health literacy levels and health trends from 2012 to 2018. The health status variables included health care coverage status, general health rating, presence of chronic conditions, and length of time since the last check-up. The percentage of individuals reporting low health literacy decreased from 67% in 2012 to 51% in 2018. The percentage of participants with income levels less than $15 000 was 9% in 2012 and 7% in 2018. Health literacy was lowest among the age group 18 to 24-year-olds, those who identified as multiracial, separated, not graduated from high school, out of work for more than 1 year, income less than $10 000, with other living arrangements, and living in a suburban county of metropolitan statistical area. Additionally, many health conditions improved, and those reporting health insurance increased slightly. The study demonstrates how health literacy continues to be an issue, and how education and primary prevention are necessary to improve limited health literacy and health outcomes. Findings from both state-level and national BRFSS population surveys can help educate the public health and clinical health services workforce to provide better care and address health disparities for highrisk populations.

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Section: Discussionmentioning

confidence: 99%

Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey

Woods

Ali

Medina

et al. 2023

J Prim Care Community Health

View full text Add to dashboard Cite

show abstract

“…Housing security status is a common component of social needs screening tools [49,69,72,89,98,161,162]. Knowing that a patient is homeless or unstably housed can have an influence on clinical decision making [163][164][165][166]. Stabilizing housing is a key aim and outcome of inter-professional interventions and medical-legal partnership programmes [21,96,97,107,[167][168][169][170][171].…”

Section: Housingmentioning

confidence: 99%

Primary care-based interventions to address the financial needs of patients experiencing poverty: a scoping review of the literature

Parry

Vanstone

Grignon

et al. 2021

Int J Equity Health

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Background It is broadly accepted that poverty is associated with poor health, and the health impact of poverty has been explored in numerous high-income country settings. There is a large and growing body of evidence of the role that primary care practitioners can play in identifying poverty as a health determinant, and in interventions to address it. Purpose of study This study maps the published peer-reviewed and grey literature on primary care setting interventions to address poverty in high-income countries in order to identify key concepts and gaps in the research. This scoping review seeks to map the tools in use to identify and address patients’ economic needs; describe the key types of primary care-based interventions; and examine barriers and facilitators to successful implementation. Methods Using a scoping review methodology, we searched five databases, the grey literature and the reference lists of relevant studies to identify studies on interventions to address the economic needs-related social determinants of health that occur in primary health care delivery settings, in high-income countries. Findings were synthesized narratively, and examined using thematic analysis, according to iteratively identified themes. Results Two hundred and fourteen papers were included in the review and fell into two broad categories of description and evaluation: screening tools, and economic needs-specific interventions. Primary care-based interventions that aim to address patients’ financial needs operate at all levels, from passive sociodemographic data collection upon patient registration, through referral to external services, to direct intervention in addressing patients’ income needs. Conclusion Tools and processes to identify and address patients’ economic social needs range from those tailored to individual health practices, or addressing one specific dimension of need, to wide-ranging protocols. Primary care-based interventions to address income needs operate at all levels, from passive sociodemographic data collection, through referral to external services, to direct intervention. Measuring success has proven challenging. The decision to undertake this work requires courage on the part of health care providers because it can be difficult, time-consuming and complex. However, it is often appreciated by patients, even when the scope of action available to health care providers is quite narrow.

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“…For health care, this discussion paper highlights three frameworks because they consider both community and individual approaches for the SDoH, social risk factors, and HRSN. Additional frameworks or logic models are available for exploring and evaluating outcomes of interventions [9,10].…”

Section: Selecting a Framework For Addressing Sdoh Social Risk Factors And Hrsnmentioning

confidence: 99%

Social Determinants of Health 201 for Health Care: Plan, Do, Study, Act

Magnan

2021

NAM Perspectives

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Understanding the social determinants of health (SDoH), social risk factors, and health-related social needs (HRSN) is critical to creating equitable health and care for all patients and communities. Health care systems need to understand their role in enacting relevant strategies, processes, and policies. One way that health care systems can explore what processes and policies work for their patients and their community is using the Plan-Do-Study-Act (PDSA) model. This discussion paper provides frameworks and approaches to using PDSA cycles to implement SDoH, social risk factors, and HRSN efforts, as a follow-up to the 2017 NAM Perspectives discussion paper Social Determinants of Health 101 for Health Care: Five Plus Five [1].

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A logic framework for evaluating social determinants of health interventions in primary care

Cited by 33 publications

References 45 publications

Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey

Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey

Primary care-based interventions to address the financial needs of patients experiencing poverty: a scoping review of the literature

Social Determinants of Health 201 for Health Care: Plan, Do, Study, Act

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