March 2017 Research Round-Up
Each month, our newsletter will include a list of the most recent articles and reports published in the field. Below are articles published since Jan 1, 2017. See more articles like these in the searchable SIREN Evidence Library.
Hospital readmission and social risk factors identified from physician notes
A.S. Navathe, F. Zhong F, V.J. Lei, et al.
This study compares the prevalence of five health risks and two social factors, housing insecurity and social support, in physician notes, claims data and EHRs. The authors found that identification of poor social support was more common in physician notes than in the other two administrative data sources (16% vs. 0%), but that identification of housing insecurity was similar for all data sources (~1%).
Something new in the air: Paying for community-based environmental approaches to asthma prevention and control
M.M. Tschudy, J. Sharfstein, E. Matsui, et al.
This paper describes two new payment models that are becoming available to pay for environmental interventions to reduce asthma: enhanced fee-for-service reimbursement and set payments per patient that cover asthma-related costs.
Defining success in resolving health-related social needs
R. Perla, M. Stiefel, D. Francis, N. Shah
The authors make recommendations for how to define success for screening and navigation efforts to enable comparisons of interventions across health systems and support learning, improvement, and research.
Screening for food insecurity in six Veterans Administration Clinics for the Homeless, June-December 2015
T.P. O'Toole, C.B. Roberts, E.E. Johnson
Authors assessed findings from a food-insecurity screening of a national sample of Veterans Administration clinics for homeless and formerly homeless veterans. A total of 270 patients were screened. Integrating screening for food insecurity among patients in clinical settings was well received by both patients and health care providers.
Increasing use of a healthy food incentive: A waiting room intervention among low-income patients
A.J. Cohen, C.R. Richardson, M. Heisler, et al.
Providing information about healthy food incentives in the clinic waiting room was associated with a nearly fourfold increase in uptake of a SNAP incentive program, as well as clinically and statistically significant increases in produce consumption.
Understanding Medicaid Managed Care investments in members' social determinants of health
L. Gottlieb, S. Ackerman, H. Wing, R. Manchanda
This study aimed to explore how Medicaid Managed Care Organization (MMCO) leaders interpret their roles and responsibilities around SDH, how they garner resources to develop and sustain interventions to address SDH, and how they perceive the influences of external organizations on related activities.
Implementation of a food insecurity screening and referral program in student-run free clinics in San Diego, California
S. Smith, D. Malinak, J. Chang, et al.
Three quarters of screened patients in this study were food insecure, including 31% with very low food security. A food insecurity registry and referral tracking system revealed that by January 2016, 201 participants were receiving monthly boxes of food onsite, 66 used an off-site food pantry, and 64 were enrolled in the Supplemental Nutrition Assistance Program (SNAP).
Institute of Medicine measures of social and behavioral determinants of health: A feasibility study
N.B. Giuse, T.Y. Koonce, S.V. Kusnoor, et al.
This study evaluated the panel of measures recommended by the Institute of Medicine. It found that question order had no impact on responses and that for all measures except stress, responses were stable over time.
Interprofessional medical-legal education of medical students: Assessing the benefits for addressing social determinants of health
R. Pettignano, L. Bliss, S. McLaren, S. Caley
This study examines the impact of a four-session didactic interprofessional curriculum for third-year medical students and law students on interprofessional collaboration to address client/patient SDH issues and health-harming legal needs. Post-intervention survey results indicated that students self-reported an increased likelihood to screen patients for SDH issues and an increased likelihood to refer patients to a legal resource.
The role of patient navigators in building a medical home for multiply diagnosed HIV-positive homeless populations
M. Sarango, A. de Groot, M. Hirschi, C.A. Umeh, S. Rajabiun
Through 81 in-depth interviews with clinic staff and 2 focus groups with patient navigators, the authors found that patient navigators played an important role in creating a PCMH by working with clients to schedule and complete appointments, develop comprehensive care plans, forging critical relationships with providers both within and outside of health care systems, providing holistic support to increase patient self-management, and assisting in achieving housing stability.
Abused women's experiences of a primary care identification and referral intervention: A case study analysis
C. Bradbury-Jones, M. Clark, J. Taylor
This qualitative case study investigated 10 abused women's experiences of a nurse-level domestic violence identification and referral intervention in the UK. Women were overwhelmingly positive about the program and all reported perceptions of increased safety and improved health.
States' influences on Medicaid investments to address patients' social needs
L.M. Gottlieb, A. Quinones-Rivera, R. Manchanda, H. Wing, S. Ackerman
In this qualitative study, MMCO executives highlighted both general and state-specific regulations that limit MMCOs from incorporating SDH-oriented solutions into care delivery, including regulations governing claimable expenses, rate determination, and enrollment eligibility. MMCO leaders also made recommendations to State Medicaid Agencies to help overcome perceived barriers.