解决健康的社会决定因素的社区干预:一项试点研究。

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Nathan L Delafield, Amogh Havanur, Timethia J Bonner, Robert Horsley, Carolyn Mead-Harvey, Sophie Bersoux, Kama White, Nyima Ali, Adam J Milam
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引用次数: 0

摘要

背景:本创新报告描述了以社区为重点的社会支持干预措施的可行性和影响,以解决健康的社会决定因素(SDoH)。方法:本研究随访了由联邦合格健康中心(FQHC)初级保健团队转诊的成年患者(N = 12),原因是未解决的SDoH需求。在12个月的时间里,社区志愿者(开放表网络表)与患者配对,以解决他们的主要SDoH需求。主要结果包括开放表网络表的实施和患者主要SDoH需求的解决,通过实现患者定义的目标来衡量。次要结果评估了干预对患者恢复力、医疗保健利用率和其他SDoH指标(例如经济稳定性)的影响。干预后对参与者进行半结构化定性访谈。对主要结局进行定性评估;次要结局采用配对分析进行检验。结果:12名患者在12个月内入组,他们的SDoH需求从获得医疗保健到社会隔离不等。社区志愿者解决了91.7%的主要SDoH需求,每位参与者的志愿者平均工作时间为47.5小时(四分位数间距[IQR] 22.5-73.0)。干预后患者恢复力、其他SDoH指标或医疗保健利用率均无统计学显著差异。干预被实施了(即干预是可行的),但在实施过程中存在挑战,包括招募患者、需要多个连接、志愿者需要投入的时间。结论:开放式表格网络表在FQHC中得以实施,但需要大量志愿者的努力和创造力。需要进一步的研究来评估这种干预的可扩展性、可持续性以及长期的社会和临床影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Community-Based Intervention to Address Social Determinants of Health: A Pilot Study.

Background: This Innovation Report describes the feasibility and impact of an intervention focused on community-based social support to address social determinants of health (SDoH).

Methods: This study followed adult patients (N = 12) referred by primary care teams at a Federally Qualified Health Center (FQHC) due to unresolved SDoH needs. Over 12 months, community volunteers (the Open Table Network Table) were paired with patients to address their primary SDoH needs. Primary outcomes included the implementation of the Open Table Network Table and resolution of the patients' primary SDoH needs, measured by achieving patient-defined goals. Secondary outcomes evaluated intervention impact on patient resilience, healthcare utilization, and other SDoH metrics (for example, economic stability). Semistructured qualitative interviews were conducted with participants postintervention. Primary outcomes were assessed qualitatively; secondary outcomes were tested using paired analyses.

Results: Twelve patients were enrolled over 12 months, and their SDoH needs ranged from healthcare access to social isolation. Community volunteers resolved 91.7% of these primary SDoH needs, with a median volunteer effort of 47.5 hours (interquartile range [IQR] 22.5-73.0) provided to each participant. No statistically significant differences were seen in patient resilience, other SDoH metrics, or healthcare utilization postintervention. The intervention was implemented (that is, the intervention was feasible), but there were challenges to implementation, including recruitment of patients, the need for multiple connections, and the time commitment required by volunteers.

Conclusion: The Open Table Network Table was implemented at an FQHC but required considerable volunteer effort and creativity. Further research is needed to assess the scalability, sustainability, and long-term social and clinical impact of this intervention.

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来源期刊
CiteScore
3.80
自引率
4.30%
发文量
116
审稿时长
49 days
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