Validation of a Script to Facilitate Social Determinant of Health Conversations with Adolescent Patients

Giorgi, Emily M.; Drescher, Matthew J.; Winkelmann, Zachary K.; Eberman, Lindsey E.

doi:10.3390/ijerph192214810

Cited by 3 publications

(4 citation statements)

References 55 publications

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“…Many of the non-technical skills needed to care for patients will most likely be learned over time through experiences and interactions with different patients; however, there is a need for continuing professional development related to inclusion and equity for complex family dynamics. Athletic trainers will also need to gain a better understanding of the social determinants of health as they use FCC in their practice, as well as consider screening for these social factors to create individualized care plans and resources specific to the family [ 52 ]. Athletic training education programs should focus on exposing students, both clinically and didactically, to the challenges identified in this research study to incorporate FCC into their practice.…”

Section: Discussionmentioning

confidence: 99%

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers

Winkelmann

Uriegas

Mensch

et al. 2023

IJERPH

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Family-centered care (FCC) includes collaboration between families and healthcare providers, the creation of flexible policies, and the family taking an active role in the delivery of care. Secondary school athletic trainers provide care for underage patients in school-based health systems, making them responsible for maintaining communication with parents, guardians, and/or caregivers. This cross-sectional survey investigated the extent to which athletic trainers (n = 205) include aspects of FCC in their daily secondary school clinical practice (current practices = CP) and whether they believe that aspect of care is necessary for FCC to be provided in athletic training (perceived necessary = PN) in their everyday practice using the Family-Centered Care Questionnaire-Revised tool. The total mean score for the CP scale (mean = 26.83 ± 4.36) was significantly lower (p ≤ 0.01) than the PN scale (mean = 35.33 ± 4.17). All FCC subscales compared between CP and PN were significantly different (p ≤ 0.01), with each being of higher importance than CP in athletic training. Data analysis revealed four themes related to enhancing FCC in secondary schools: limited education and resources, staffing and space concerns, non-technical skills, and social determinants of health. Attention should be placed on developing resources and interventions for secondary school athletic trainers to collaboratively work with children and their support systems.

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Section: Discussionmentioning

confidence: 99%

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers

Winkelmann

Uriegas

Mensch

et al. 2023

IJERPH

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“…These findings are encouraging, as athletic trainers need to implement PCC and a BPS approach to patient care, particularly as part of a greater system in the secondary school setting. School-based health centers (SBHC) are an effective multi-sector approach in which public health intervention strategies can be implemented to address the SDOH within the adolescent patient population [ 19 , 20 , 21 ]. SBHCs, like secondary schools, often include athletic trainers and school nurses, both of whom work closely with adolescent patients and should be able to advocate for and address the various factors affecting them [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, providers in the secondary school setting have described feeling unsure how to discuss SDOH with their patients [ 23 , 24 ], as these conversations can be sensitive and difficult to have. A few concerns described in the previous literature are that providers feel that SDOH conversations could be uncomfortable for patients to discuss, they don’t want to jeopardize patient relationships, or they lack a way to initiate the conversation with their patients [ 21 , 25 , 26 ]. This could potentially lead to SSATs prioritizing the biological factors more frequently in their patient care than the psychosocial and social influences, even if just implicitly.…”

Section: Discussionmentioning

confidence: 99%

“…This could potentially lead to SSATs prioritizing the biological factors more frequently in their patient care than the psychosocial and social influences, even if just implicitly. One intervention that could benefit athletic trainers in the secondary school setting is a script designed to facilitate conversations between clinicians and adolescents related to SDOH [ 21 ]. If athletic trainers can initiate the discussion of SDOH, they can then assess the extent to which their patients are affected by them, thus leading to more effective care plans specifically tailored to individual patient needs [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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The Integration of Patient-Centered Care and the Biopsychosocial Model by Athletic Trainers in the Secondary School Setting

Mendoza

Drescher

Eberman

2023

IJERPH

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Our purpose was to explore the degree to which secondary school athletic trainers (SSATs) perceive they are integrating the principles of patient-centered care (PCC) and the biopsychosocial (BPS) model in their practice. We used a cross-sectional design to explore the primary research question. We used the Global Perceptions of Athletic Trainer Patient-Centered Care (GPATPCC) tool and the Biopsychosocial Model of Health (BPSMH) tool, both measured on a 4-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree, with an unscored “unsure” option). We sent the survey to 5665 SSATs through the National Athletic Trainers’ Association. Results indicate participants expressed strong agreement (mode = 4) with 7 of the 14 statements and agreement (mode = 3) with the remaining 7 statements of the GPATPCC tool (grand mean = 3.4 ± 0.8). Overall, participants rated their level of agreement on the BPSMH as agreeing (mode = 3) for each item (grand mean = 3.0 ± 1.0). SSATs perceive they are integrating the principles of PCC and the BPS model in clinical practice. These findings align with two previous studies concluding that patients, parents, and providers believe athletic trainers provide care that is focused on whole-person healthcare.

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Exploring the Use of a Social Determinants of Health Focused History Script to Facilitate Patient Conversations

Moll,

Eberman,

Picha

et al. 2023

Athletic Training Education Journal

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Context Screening for social determinants of health (SDOH) factors is fundamental to addressing barriers to health outcomes and identifying resources needed to provide patient-centered care. However, SDOH can be a difficult area of patient care to navigate without a screening tool. Objective To explore athletic training students’ abilities to screen for SDOH factors via standardized patient (SP) encounters and to describe the experience of screening for SDOH factors. Design Prospective, mixed-methods cohort study. Setting Simulation laboratory. Patients or Other Participants Fifty-four postbaccalaureate professional athletic training students (women = 43, men = 11; age = 23 ± 1 years). Intervention The same SP encounter was completed with 2 cohorts of athletic training students, with 1 intervention cohort (n = 29) screening for the SDOH without an aide and the control cohort (n = 25) screening with the mandatory use of a validated SDOH focused history script. Main Outcome Measures The SP encounters were evaluated using a tool containing an SDOH evaluation by domain and Athletic Training Milestone competencies. Following the SP encounter, each learner completed a postlearning survey. Data were analyzed using descriptive statistics, Mann-Whitney U tests, and thematic qualitative analysis. Results We identified a significant difference (P ≤ .001) for the overall screening for the SDOH, with the intervention cohort that was required to use the focused history script scoring significantly higher than the control cohort. The intervention cohort scored significantly higher (P ≤ .001) on the Athletic Training Milestones than the control cohort, but the intervention cohort self-rated their performance as lower during the reflection. Conclusion The use of the focused history script during the SP encounter highlighted the need for a screening tool to be present during the evaluation to facilitate a conversation about the SDOH. When health care students were not required to use the focused history script to screen for the SDOH, most failed to elicit information about the SDOH factors or performed poorly during the screening.

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Validation of a Script to Facilitate Social Determinant of Health Conversations with Adolescent Patients

Cited by 3 publications

References 55 publications

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers

Practices and Perceptions of Family-Centered Care: A Cross-Sectional Survey of Secondary School Athletic Trainers

The Integration of Patient-Centered Care and the Biopsychosocial Model by Athletic Trainers in the Secondary School Setting

Exploring the Use of a Social Determinants of Health Focused History Script to Facilitate Patient Conversations

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