A Systematic Literature Review of Health Center Efforts to Address Social Determinants of Health

Pourat, Nadereh; Lu, Connie; Huerta, Denisse M; Hair, Brionna Y.; Hoang, Hank; Sripipatana, Alek

doi:10.1177/10775587221088273

Cited by 8 publications

(12 citation statements)

References 29 publications

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“…This conclusion is consistent with Edwards’ seminal review of the urban/rural IPV divide [ 47 ], which found that rural women experienced more chronic and severe IPV and had more severe psychosocial and physical health outcomes, including increased post-traumatic stress disorder (PTSD), due to the lack of IPV-related services. In addition, the low percentage of practices adopting a proactive strategy may imply that GP practices lack sufficient motivation, or training, to implement this action in everyday practice [ 48 ]. This is one example of how proactive planning by policymakers and family medicine leaders can improve the quality of care for specific patient groups in the event of future pandemics.…”

Section: Discussionmentioning

confidence: 99%

Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries

Petrazzuoli

Collins

Poel

et al. 2023

IJERPH

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This paper explores the differences between rural and urban practices in the response to the COVID-19 pandemic, emphasizing aspects such as management of patient flow, infection prevention and control, information processing, communication and collaboration. Using a cross-sectional design, data were collected through the online PRICOV-19 questionnaire sent to general practices in 38 countries. Rural practices in our sample were smaller than urban-based practices. They reported an above-average number of old and multimorbid patients and a below-average number of patients with a migrant background or financial problems. Rural practices were less likely to provide leaflets and information, but were more likely to have ceased using the waiting room or to have made structural changes to their waiting room and to have changed their prescribing practices in terms of patients attending the practices. They were less likely to perform video consultations or use electronic prescription methods. Our findings show the existence of certain issues that could impact patient safety in rural areas more than in urban areas due to the underlying differences in population profile and supports. These could be used to plan the organization of care for similar future pandemic situations.

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Section: Discussionmentioning

confidence: 99%

Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries

Petrazzuoli

Collins

Poel

et al. 2023

IJERPH

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“…As a creation of the US federal agency housing the CMS, Healthy People has gained increasing popularity in informing hospital-led initiatives to address SDOH. For example, Pourat et al (28) use Healthy People to guide their systematic review of efforts undertaken by HRSA-funded health centers to address SDOH. However, the individual SDOH factors specified under Healthy People domains may not adequately encompass the types of SDOH hospitals should focus on.…”

Section: Literature Reviewmentioning

confidence: 99%

“…As mentioned earlier, this paper integrates the Healthy People 2030 SDOH framework and the IHI SDOH types to inform the search strategy (Figure 1). To identify individual SDOH search terms under the Healthy People SDOH domains, this study leveraged standardized SDOH terminology and keywords representing specific social and behavioral determinants of health in Healthy People, as well as published search algorithms from existing reviews that utilized the Healthy People framework (28,38). These terms were Next, Boolean search operators were used to combine all individual SDOH terms with a set of search terms to capture the care setting of interest.…”

Section: Search Strategymentioning

confidence: 99%

Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature

Rangachari,

Thapa,

Sherpa

et al. 2024

Front. Public Health

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BackgroundDespite the incentives and provisions created for hospitals by the US Affordable Care Act related to value-based payment and community health needs assessments, concerns remain regarding the adequacy and distribution of hospital efforts to address SDOH. This scoping review of the peer-reviewed literature identifies the key characteristics of hospital/health system initiatives to address SDOH in the US, to gain insight into the progress and gaps.MethodsPRISMA-ScR criteria were used to inform a scoping review of the literature. The article search was guided by an integrated framework of Healthy People SDOH domains and industry recommended SDOH types for hospitals. Three academic databases were searched for eligible articles from 1 January 2018 to 30 June 2023. Database searches yielded 3,027 articles, of which 70 peer-reviewed articles met the eligibility criteria for the review.ResultsMost articles (73%) were published during or after 2020 and 37% were based in Northeast US. More initiatives were undertaken by academic health centers (34%) compared to safety-net facilities (16%). Most (79%) were research initiatives, including clinical trials (40%). Only 34% of all initiatives used the EHR to collect SDOH data. Most initiatives (73%) addressed two or more types of SDOH, e.g., food and housing. A majority (74%) were downstream initiatives to address individual health-related social needs (HRSNs). Only 9% were upstream efforts to address community-level structural SDOH, e.g., housing investments. Most initiatives (74%) involved hot spotting to target HRSNs of high-risk patients, while 26% relied on screening and referral. Most initiatives (60%) relied on internal capacity vs. community partnerships (4%). Health disparities received limited attention (11%). Challenges included implementation issues and limited evidence on the systemic impact and cost savings from interventions.ConclusionHospital/health system initiatives have predominantly taken the form of downstream initiatives to address HRSNs through hot-spotting or screening-and-referral. The emphasis on clinical trials coupled with lower use of EHR to collect SDOH data, limits transferability to safety-net facilities. Policymakers must create incentives for hospitals to invest in integrating SDOH data into EHR systems and harnessing community partnerships to address SDOH. Future research is needed on the systemic impact of hospital initiatives to address SDOH.

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“…Most of the available literature supports the utility of a warm handoff in engaging patients in treatment with IPC services and providers [9][10][11]. Moreover, clinicians and experts endorse the use of a warm handoff, noting its utility in practice and from patient feedback about the benefits of a warm handoff including reducing feelings of stigma, providing early access to mental health services, and establishing trusting therapeutic alliances [8,9,[12][13][14][15].…”

Section: A Warm Handoffmentioning

confidence: 99%

Examining the Utility of a Telehealth Warm Handoff in Integrated Primary Care for Improving Patient Engagement in Mental Health Treatment: Randomized Video Vignette Study

Fountaine¹,

Iyar²,

Lutes³

2023

JMIR Form Res

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Background A warm handoff from a physician to a mental health provider is often patients’ first contact with psychological services and provides a unique opportunity for improving treatment engagement in integrated primary care (IPC) settings. Objective In light of the COVID-19 pandemic, this study sought to examine the impact of different types of telehealth mental health referrals on both the anticipated likelihood of accepting treatment services and anticipated likelihood of continued treatment engagement. Methods A convenience sample of young adults (N=560) was randomized to view 1 of 3 video vignettes: warm handoff in IPC, referral as usual (RAU) in IPC, or RAU in standard primary care. Results Logistic associations between referral type and the likelihood of referral acceptance (χ21=10.9, P=.004) and the likelihood of continued engagement (χ21=32.6, P<.001) were significant. Participants who received a warm handoff were significantly more likely to anticipate both accepting the referral (b=0.35; P=.002; odds ratio 1.42, 95% CI 1.15-1.77) and engaging in continued treatment (b=0.62; P<.001; odds ratio 1.87, 95% CI 1.49-2.34) compared with those who received RAU in the standard primary care condition. Furthermore, 77.9% (436/560) of the sample indicated that they would be at least somewhat likely to access IPC mental health services for their own mental health concerns if they were readily available in their own primary care physician’s office. Conclusions A telehealth warm handoff resulted in the increased anticipated likelihood of both initial and continued engagement in mental health treatment. A telehealth warm handoff may have utility in fostering the uptake of mental health treatment. Nonetheless, a longitudinal assessment in a primary care clinic of the utility of a warm handoff for fostering referral acceptance and continued treatment engagement is needed to hone the adoptability of a warm handoff process and demonstrate practical evidence of effectiveness. The optimization of a warm handoff would also benefit from additional studies examining patient and provider perspectives about the factors affecting treatment engagement in IPC settings.

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A Systematic Literature Review of Health Center Efforts to Address Social Determinants of Health

Cited by 8 publications

References 29 publications

Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries

Differences between Rural and Urban Practices in the Response to the COVID-19 Pandemic: Outcomes from the PRICOV-19 Study in 38 Countries

Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature

Examining the Utility of a Telehealth Warm Handoff in Integrated Primary Care for Improving Patient Engagement in Mental Health Treatment: Randomized Video Vignette Study

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