Collecting Social Determinants of Health Data in the Clinical Setting: Findings from National PRAPARE Implementation

Weir, Rosy Chang; Proser, Michelle; Jester, Michelle; Li, Vivian; Hood-Ronick, Carlyn M; Gurewich, Deborah

doi:10.1353/hpu.2020.0075

Cited by 106 publications

(92 citation statements)

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“…While there is a general consensus that the majority of determinants that drive health happen outside a clinical setting, there is a demand for healthcare providers to better understand a patients’ social risks when providing care [ 6 ]. Overall, our findings further support the benefits of recording social determinants of health among those seeking care from a community health center to identify patients who require a more robust care plan and follow-up as well as to mitigate poor health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are unique in that the PRAPARE tool, while used widely across the nation’s community health centers [ 6 , 27 ], has not been examined as an instrument for predicting factors associated with infectious disease prevalence and epidemiology. Thus, our findings indicate that the utilization of PRAPARE tool may help to improve communication and response to infectious disease prevention and control during health crises, such as the COVID-19 pandemic, by increasing the care team’s knowledge of those seeking care and those disproportionally affected by the disease [ 6 , 20 ]. This study can also provide insight into the need for strategies that intervene upstream to ultimately protect the public and prevent the spread of communicable diseases, such as COVID-19 [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Using the PRAPARE Tool to Examine Those Tested and Testing Positive for COVID-19 at a Community Health Center

Luzius

Dobbs

Hammig

et al. 2021

J. Racial and Ethnic Health Disparities

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The PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences) tool is an instrument that has been used to assess social determinants of health within community health centers in the US. We sought to examine the association between PRAPARE scores and getting tested for and testing positive with the SARS-CoV-2 virus. We used medical record data collected from a community health center in the US between March-August 2020. Employing logistic regression analyzes, we explored the association between demographic factors, history of screening positive for depression, and PRAPARE scores and patients’ odds of getting tested and testing positive for COVID-19. While variables such as ethnicity mirrored similar findings from other sources, we found the PRAPARE score to be associated with increased odds of being tested for COVID-19; however, it was not significantly associated with testing positive. These findings can help health care workers and health educators craft messages to explain screening protocols for communicable diseases, such as COVID-19, to best reach vulnerable populations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Using the PRAPARE Tool to Examine Those Tested and Testing Positive for COVID-19 at a Community Health Center

Luzius

Dobbs

Hammig

et al. 2021

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

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“…Health related social needs (HRSN), including transportation, food insecurity, housing stability and interpersonal violence which are more downstream factors that impact health care, also result directly in both poorer outcomes and weaker health system performance (17,(21)(22)(23). Thus, efforts to systematically collect information on HRSN in clinical settings and develop solutions to address HRSN are on the rise (12,13,16,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Few clinicbased HRSN studies to date, however, have focused on measuring HRSN in languages other than English or Spanish or in diverse immigrant populations, including Asian Americans (AA), where cultural factors and immigration experiences can pose additional barriers to accessing care and routine preventive services (33).…”

Section: Introductionmentioning

confidence: 99%

Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

Tsui

Yang

Anuforo

et al. 2021

Front. Public Health

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Research Objective: Initiatives to address social determinants of health (SDOH) and measure health-related social needs (HRSN) within clinic settings are increasing. However, few have focused on the specific needs of Asian Americans (AA). We examine the prevalence of HRSN during a period spanning the COVID-19 pandemic to inform strategies to improve cancer screening and primary care among AA patients.Methods: We implemented a self-administered HRSN screening tool in English and Chinese, traditional (T) or simplified (S) text, within a hospital-affiliated, outpatient primary care practice predominantly serving AA in New Jersey. HRSN items included food insecurity, transportation barriers, utility needs, interpersonal violence, housing instability, immigration history, and neighborhood perceptions on cohesion and trust. We conducted medical chart reviews for a subset of participants to explore the relationship between HRSN and history of cancer screening.Results: Among 236 participants, most were Asian (74%), non-US born (79%), and privately insured (57%). One-third responded in Chinese (37%). Half reported having ≥1 HRSN. Interpersonal violence was high across all participants. Transportation needs were highest among Chinese-T participants, while food insecurity and housing instability were higher among Chinese-S participants. Lower-income patients had higher odds of having ≥2 HRSN (OR:2.53, 95% CI: 1.12, 5.98). Older age and public insurance/uninsured were significantly associated with low neighborhood perceptions.Conclusions: We observed higher than anticipated reports of HRSN among primary care patients in a suburban, hospital-affiliated practice serving AA. Low neighborhood perceptions, particularly among Chinese-S participants, highlight the importance of addressing broader SDOH among insured, suburban AA patients. These study findings inform the need to augment HRSN identification to adequately address social needs that impact health outcomes and life course experiences for Asian patients. As HRSN measuring efforts continue, and COVID-19's impact on the health of minority communities emerge, it will be critical to develop community-specific referral pathways to connect AA to resources for HRSN and continue to address more upstream social determinants of health for those who are disproportionately impacted.

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“…Several validated SDH assessment tools have been developed including the standardized questionnaires from the National Academy of Medicine (NAM) and Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) [ 18 ]. These SDH screening tools have been employed in previous studies including the Kusnoor et al cross-sectional study [ 18 ], Gold et al pilot study [ 19 ], and Weir et al study [ 20 ]. Kusnoor et al used a hybrid survey composing of questions from NAM, PRAPARE, and Survey of Household Economics and Decisionmaking (SHED) to assess the social and behavioral determinants of health (SBDs) in 100 patients from Connectus Health Vine Hill, an urban community health clinic [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Gold et al also adopted a hybrid questionnaire incorporating questions from NAM and PRAPARE to investigate SDH domains in 1,130 patients in three Pacific Northwest community health centers (CHC) [ 19 ]. Weir et al implemented the PRAPARE survey in three cohorts across seven health centers [ 20 ]. All three studies identified a ubiquity of social risks in the CHC setting.…”

Section: Introductionmentioning

confidence: 99%

Investigating Social Determinants of Health in an Urban Direct Primary Care Clinic

Tou

Prakash

Jeyakumar

et al. 2020

Cureus

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Direct primary care (DPC) is an emerging model of care distinguished by lower price points for quality comprehensive services. The affordability of DPC attracts a broad patient population that may encompass a wide range of socioeconomic needs. It is critical to identify social determinants of health (SDH) in DPC practices to design strategies aimed to mitigate social risk factors, especially for vulnerable populations that can only afford DPC. As part of this SDH screening initiative, the purpose of the present descriptive study was to assess the SDH characteristics of patients from an urban DPC clinic. To identify these SDH factors, a cohort of 31 patients from the DPC clinic was asked to complete a questionnaire from the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE). The survey outcomes revealed top socioeconomic needs in the domains of stress (77.4%), insurance (51.6%), social integration and support (38.7%), unmet medicine or healthcare needs (35.5%), and unemployment (32.2%). In adopting a community-based participatory research (CBPR) approach, the research team shared the survey outcomes with the DPC clinic to facilitate improvements in overall patient care and implementation of services aimed to address social risk factors as identified in the study.

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Collecting Social Determinants of Health Data in the Clinical Setting: Findings from National PRAPARE Implementation

Cited by 106 publications

References 0 publications

Using the PRAPARE Tool to Examine Those Tested and Testing Positive for COVID-19 at a Community Health Center

Using the PRAPARE Tool to Examine Those Tested and Testing Positive for COVID-19 at a Community Health Center

Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

Investigating Social Determinants of Health in an Urban Direct Primary Care Clinic

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