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Social & Behavioral Determinants of Health

Research Origins

Aerial shot of neighborhoodUnder 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.  

SBD Papers collageIn 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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