Research Origins
Under the aegis of Dr. William Stead, the Center for Knowledge Management (CKM) partnered with the University of California, San Francisco, to evaluate a panel of measures recommended by the National Academy of Medicine (NAM) committee for capturing patient data on the social and behavioral determinants of health in the clinical setting. The Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and World Health Organization have all identified the social determinants of health as key to the improvement of health outcomes and reduction of health disparities.
Research has demonstrated the connection between health outcomes and sociological and behavioral factors such as social connectedness, education level, and exercise habits. However, there is not currently a standardized method for collecting information on these elements during the clinical encounter. The NAM committee, assembled in 2013, carefully considered and selected a panel of measures to recommend for clinical use based on their relevance to healthcare, proven validation, and ease of implementation.
Research Study Series
CKM has built upon this work to perform the necessary evaluation of the feasibility and validity of administering the identified measures as a combined panel. The study team investigated research questions important to the eventual implementation of the instrument, including considerations of question order and response patterns, time required for administration, and the extent to which questionnaire results align with previous research findings. The goal of this important work is to provide a proven measure to allow clinicians to understand and address social and behavioral influences on patient health. The team’s results from this study are published in the American Journal of Preventive Medicine. The team’s second study of the NAM questionnaire, also published in the American Journal of Preventive Medicine, revealed SBD determinants were associated with poorer physical and mental health and determined participant responses were not influenced by social desirability bias.
In Spring 2017, CKM extended the team’s research into the social and behavioral determinants of health. Through a partnership with a local community health clinic, CKM conducted a pilot study to better understand the type and prevalence of social determinant needs in the community clinic setting, and subsequently used that information to understand the availability and coverage of resources that may help address identified social needs. A database of public health and community-based resources has been created by the CKM team and is available online. Results from this study were presented at the November 2017 annual meeting of the American Medical Informatics Association and more extensively published in BMC Public Health.
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CKM Related Publications
- Kusnoor SV, Koonce TY, Hurley ST, McClellan KM, Blasingame MN, Frakes ET, Huang LC, Epelbaum MI, Giuse NB. Collection of Social Determinants of Health in the Community Clinic Setting: A Cross-sectional Study. BMC Public Health. 2018 Apr 24;18(1):550. doi: 10.1186/s12889-018-5453-2.
- Koonce TY, Kusnoor SK, Hurley ST, McClellan KM, Giuse NB. Combining Social and Behavioral Determinants of Health Questionnaires to Inform Precision Medicine in a Community Health Center Clinic. American Medical Informatics Fall Symposium November 2017.
- Prather AA, Gottlieb LM, Giuse NB, Koonce TY, Kusnoor SV, Stead WW, Adler NE. National Academy of Medicine Social and Behavioral Measures: Associations With Self-Reported Health. Am J Prev Med. 2017 Oct;53(4):449-456.
- Giuse NB, Koonce TY, Kusnoor SV, Prather AA, Gottlieb LM, Huang LC, Phillips SE, Shyr Y, Adler NE, Stead WW. Institute of Medicine Measures of Social and Behavioral Determinants of Health: A Feasibility Study. Am J Prev Med. 2017 Feb; 52(2):199-206.