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April 2019 Research Round-Up

Below we highlight recent literature on screening for and/or addressing social needs in clinical settings. To receive the Research Round-Up in your email, sign up for our monthly newsletter.

Find these articles and many more in our searchable Evidence Library.

Journal Articles

Collaboration in Health Care and Social Service Networks for Older Adults: Association with Health Care Utilization Measures
A.L. Brewster, C.T. Yuan, A.X. Tan, C.G. Tangoren, & L.A. Curry
Medical Care
The authors of this paper analyzed collaborative ties among health care and social service organizations in 20 US communities with either high or low performance on avoidable health care use and spending for Medicare beneficiaries. They found that high performance communities had deeper cross-sector collaborative ties between health care and social service organizations.

Moonstone: A Novel Natural Language Processing System for Inferring Social Risk from Clinical Narratives
M. Conway, S. Keyhani, L. Christensen, et al.
Journal of Biomedical Semantics
This paper presents the Moonstone system, a freely available, open source natural language processing system designed to extract social risk factors (housing situation, living alone, and social support) from clinical text.

Integrating Legal Services with Primary Care: The Health Justice Program
G. Drozdzal, R. Shoucri, J. Macdonald, K. Radford, A.D. Pinto, & N. Persaud
Canadian Family Physician
This commentary describes the development and operation of the Health Justice Program, a Canadian multi-partner medical-legal program informed by the medical-legal partnership model.

Recurrence of Maltreatment after Newborn Home Visiting: A Randomized Controlled Trial
M.A. Easterbrooks, C. Kotake, & R. Fauth
American Journal of Public Health
In this randomized controlled trial, a home visiting program reduced the recurrence of child protective services (CPS) maltreatment reports by 32% and increased the length of time between initial and additional CPS reports.

Also see the accompanying editorial: To Prevent Child Maltreatment, Home Visiting Programs are One Part of a Complete Response
H. Kim
American Journal of Public Health
In this commentary, the author discusses strategies for measuring home visiting program impacts on child maltreatment and challenges to efficient service provision.

Addressing Social Determinants of Health: Challenges and Opportunities in a Value-Based Model
A. Garg, C.J. Homer, & P.H. Dworkin
This perspective piece identifies three challenges (an insufficient social safety net, concerns about family autonomy, and diversion of resources from one at-risk population to another) and two opportunities (engaging diverse sectors to improve child health and a Medicaid-supported integrated SDH care model) related to the strong interest in addressing social risks in value-based care environments.

Homeless Status Documentation at a Metropolitan Hospital Emergency Department
S.J. Lee, P. Thomas, H. Newnham, et al.
Emergency Medicine Australasia
This Australian study found that hospital emergency department administrative data substantially under-recognized the prevalence of patient homelessness compared to prospective screening of housing status.

Cost-Effectiveness of Financial Incentives for Improving Diet and Health Through Medicare and Medicaid: A Microsimulation Study
Y. Lee, D. Mozaffarian, S. Sy, et al.
PLoS Medicine
The authors estimated the health and economic impacts of two healthy food subsidies – a 30% subsidy on fruits and vegetables and a 30% subsidy on a wider range of healthy foods – using nationally representative data and a validated microsimulation model. Both scenarios generated substantial health gains and were highly cost-effective.

Implementation of an Intimate Partner Violence Screening Program in a University Health Care Clinic
J. McCarthy & A. Bianchi
Journal of American College Health
This one-group pre-post study found that a university clinic-based intimate partner violence (IPV) screening program was associated with increases in providers’ knowledge, attitudes, and self-efficacy of IPV screening.

Medical-Legal Partnerships to Enhance Residency Training in Advance Care Planning
J.M. Pettit, A.M. Ryan, J. Armin, & B.D. Weiss
Family Medicine
The authors describe the development and evaluation of a curriculum involving clinicians and attorneys working together to teach first-year family medicine residents about leading advance care planning. They found that this medical-legal partnership teaching approach may be more effective than other curricula.

Integrating Social and Behavioral Determinants of Health into Population Health Analytics: A Conceptual Framework and Suggested Road Map
Z. Predmore, E. Hatef, & J.P. Weiner
Population Health Management
The authors of this article propose a conceptual framework for the integration of social and behavioral data into population health analytics platforms to better address social and behavioral risk factors. The authors present three use cases: patient care, predictive risk modeling within health care delivery systems, and community engagement and investment.


The Role of Medicaid Expansion in Care Delivery at Community Health Centers
C. Lewis, A. Coleman, M.L. Abrams, & M.M. Doty
The Commonwealth Fund
This brief uses data from the Commonwealth Fund 2018 National Survey of Federally Qualified Health Centers to compare the experiences of health centers in states that have and have not expanded Medicaid. One key finding is that health centers in Medicaid expansion states were more likely to address social needs of patients.

Integrating Health Care and Social Services for People with Serious Illness: Proceedings of a Workshop
L. Graig, S.M. Cruz, & J. Alper
National Academies of Sciences, Engineering, and Medicine
This publication summarizes a National Academies of Sciences, Engineering, and Medicine workshop to better understand the challenges and opportunities related to integrating health care and social service for people with serious illness.

Promoting Caregiver and Child Health Through Housing and Stability Screening in Clinical Settings
R. Sheward, A. Bovell-Ammon, N. Ahmad, G. Preer, S. Ettinger de Cuba, & M. Sandel
Zero to Three
This paper describes existing and emerging approaches to screening families for unstable housing in clinical settings.

System-Level Approach to Addressing Health-Harming Legal and Social Needs: A Case Study of the NYC Health + Hospitals and LegalHealth Medical-Legal Partnership
J. Theiss, J. Schrag, & J.A. Teitelbaum
National Center for Medical Legal Partnership
This case study provides a detailed description of the medical-legal partnership between NYC Health + Hospitals and LegalHealth – the largest medical-legal partnership in the country.