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December 2018 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.

Research Articles

An Individual Housing-Based Socioeconomic Status Measure Predicts Advance Care Planning and Nursing Home Utilization
A. Barwise, Y.J. Juhn, C.I. Wi, et al.
American Journal of Hospice and Palliative Care
A socioeconomic status (SES) measure based on individual housing value and size attributes was found to be associated with lower rates of advance directives and lower likelihood of discharge to home.

Association of a Care Coordination Model with Health Care Costs and Utilization
S.A. Berkowitz, S. Parashuram, K. Rowan, et al.
JAMA Network Open
A care coordination intervention that employed community health workers (CHWs) to address patients' barriers to care, including food and housing needs, was associated with reductions in costs, admissions, and ED visits for Medicaid but not for Medicare beneficiaries.

Developing a Screening Tool to Recognise Social Determinants of Health in Australian Clinical Settings
K. Browne-Yung, T. Freeman, M. Battersby, D.R. McEvoy, & F. Baum
Public Health Research & Practice
This study reports on the development and piloting of a self-administered social health screening tool among patients and clinicians in anxiety and sleep disorder clinics in Australia.

Identifying Food Insecurity in Health Care Settings: A Systematic Scoping Review of the Evidence
E.H. De Marchis, J.M. Torres, C. Fichtenberg, & L.M. Gottlieb
Family & Community Health
This systematic scoping review summarizes the evidence on health-care based food insecurity (FI) screening validity, acceptability, and implementation.

How Equity-Oriented Health Care Affects Health: Key Mechanisms and Implications for Primary Health Care Practice and Policy
M. Ford-Gilboe, C.N. Wathen, C. Varcoe, et al.
Milbank Quarterly
This study finds that providing more equity-oriented health care (EOHC) in primary health care, including trauma- and violence-informed, culturally safe, and contextually tailored care, predicts improved health outcomes across time for people living in marginalizing conditions.

Addressing Adverse Childhood Experiences and Health Risk Behaviors Among Low-Income, Black Primary Care Patients: Testing Feasibility of a Motivation-Based Intervention
E. Goldstein, J. Topitzes, J. Birstler, & R.L. Brown
General Hospital Psychiatry
This pilot study found that a two-session intervention that addresses adverse childhood experiences (ACEs), post-traumatic stress symptoms, and health risk behaviors (HRBs) among Black primary care patients was feasible and may help reduce stress and HRBs.

The Role of US Health Plans in Identifying and Addressing Social Determinants of Health: Rationale and Recommendations
M. Heisler, A. Navathe, K. DeSalvo, & K.G.M. Volpp
Population Health Management
This commentary makes four recommendations for ways in which health plans in the US can improve their beneficiaries' health by addressing social determinants of health: investing in systematic and standardized SDOH data collection and analytics; developing evidence-based community interventions; aligning with value-based payment transformation and sponsor programs; and introducing behavioral economic design into consumer incentives.

Social Disconnection Among Older Adults Receiving Care in the Emergency Department
D. Kandasamy, T.F. Platts-Mills, M.N. Shah, K.A. Van Orden, & M.E. Betz
The Western Journal of Emergency Medicine
This cross-sectional survey of community-dwelling older adults (≥65 years) receiving care at two US EDs found that half reported feeling socially disconnected and most were interested in being referred by the ED to transportation options (68%), food assistance (58%), and mental health resources (55%).

Development and Implementation of a Pediatric Adverse Childhood Experiences (ACEs) and Other Determinants of Health Questionnaire in the Pediatric Medical Home: A Pilot Study
K. Koita, D. Long, D. Hessler, et al.
PLoS One
This article describes the development and testing for both face validity and caregiver/provider acceptability of the Pediatric ACE and Other Determinants of Health Questionnaire, a 17-item adverse childhood experiences (ACEs) screening tool for pediatric primary care settings.

Supplemental Nutrition Assistance Program Size and Timing and Hypertension-Related Emergency Department Claims Among Medicaid Enrollees
C.O. Ojinnaka & C. Heflin
Journal of the American Society of Hypertension
Using SNAP data and Medicaid ED claims data from Missouri, the authors found that higher SNAP benefit amounts were associated with a decreased probability of hypertension-related ED claims.

An Interprofessional Urban Health Elective Focused on the Social Determinants of Health
A. Pinto, M. To, A. Rucchetto, M. Sharma, & K. Rouleau
Canadian Medical Education Journal
This article reports on lessons from an interprofessional urban health elective developed to focus on the social determinants of health in Toronto, Canada.

Association Between Supplemental Nutrition Assistance Program Participation and Cost-Related Medication Nonadherence Among Older Adults with Diabetes
J.A. Pooler & M. Srinivasan
JAMA Internal Medicine
In this repeated cross-sectional study of 1,302 older adults with diabetes, participants in the Supplemental Nutrition Assistance Program were 5.3 percentage points less likely to report cost-related medication nonadherence compared with eligible nonparticipants (p=.03).

Accuracy and Acceptability of a Screening Tool for Identifying Intimate Partner Violence Perpetration among Women Veterans: A Pre-Implementation Evaluation
G.A. Portnoy, S.G. Haskell, M.W. King, R. Maskin, M.R. Gerber, & K.M. Iverson
Women’s Health Issues
A new intimate partner violence (IPV) perpetration screening tool (a modified 5-item Extended Hurt/Insult/Threaten/Scream) was found to be acceptable and appropriate for use with women veterans and accurate when compared with the 2-item Revised Conflict Tactics Scales.

Clinical-Community Partnerships to Reduce Food Insecurity Among High-Need, High-Cost Medicaid Patients
K. Rediger & D.R.B. Miles
Annals of Internal Medicine
This commentary highlights the role that partnerships between clinical programs and community-based organizations can play in helping address food insecurity and improving health in vulnerable patients.

Emergency Departments as the Health Safety Nets of Society: A Descriptive and Multicenter Analysis of Social Worker Support in the Emergency Room
S. Selby, D. Wang, E. Murray, & E. Lang
Cureus
This study describes the needs related to social work referrals in four urban emergency rooms.

Effects of a Community-Based Care Management Model for Super-Utilizers
P. Sevak, C.N. Stepanczuk, K.W.V. Bradley, et al.
American Journal of Managed Care
A high-intensity care management program adapted from a promising model developed by the Camden Coalition of Healthcare Providers was found to reduce utilization and spending in aggregate, although estimates for most of the individual outcome measures were not statistically significant.

PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings
A. Shakil, P.G. Day, J. Chu, S.B. Woods, & K. Bridges
Family Medicine
This study tested the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool, a 5-item questionnaire designed to detect and prompt provider investigation into child abuse in clinical settings, by comparing it to the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure. It found PedHITSS performed as well as CTSPC in identifying and differentiating victims and nonvictims of child abuse.

Complexities of Addressing Food Insecurity in an Urban Population
D. Swavely, V. Whyte, J.F. Steiner, & S.L. Freeman
Population Health Management
In this study of a food insecurity screening and referral program for recently discharged adult patients, the authors found that two-thirds of food insecure patients were already receiving SNAP and that less than a quarter of patients referred to food resources connected with them. Barriers to connecting with resources included not remembering the information provided, being overwhelmed with poor health or other social determinants of health, having competing priorities, not perceiving the need for food assistance, and experiencing system barriers.

Reports

Addressing Social Determinants of Health via Medicaid Managed Care Contracts and Section 1115 Demonstrations
D. Crumley, J. Lloyd, M. Pucciarello, & B. Stapelfeld
Center for Health Care Strategies
This report identifies common ways that states incentivize and require SDH-related activities in Medicaid managed care contracts and approved § 1115 demonstrations.

How to Pay for It: Financing Community Health Workers in Transitions Clinics
L. Hogan & T. Macdonald Mendez
California Health Care Foundation
This brief report describes different mechanisms California clinics can use to fund community health workers in post-incarceration Transitions Clinic programs, including the Health Homes Program, Whole Person Care, and Medi-Cal Administrative Services.