Effects of an Education Intervention on Implementing a Social Determinants of Health Screening Tool in Primary Care
The purpose of the project is as follows: (a) Assess an education intervention regarding Social Determinants of Health (SDH) on clinical staff, (b) Integrate and evaluate a SDH screening tool called PRAPARE into clinical practice, and (c) Describe the findings of patients who were screened. SDH are social and environmental conditions in which people are born, live, work, and play.SDH accounts for approximately 90% of a person’s health status, and healthcare is responsible for the remaining 10%. The Institute of Medicine recommends screening and addressing SDH in primary care to improve health status, but little research has been done evaluating screening tools or impact.Racial minorities and those living below the poverty level are at disproportionate risk of being uninsured, lacking access to care, receiving poorer quality of care, and experiencing worse health outcomes. In 2015 the National Association for Community Health Centers developed a 20-question screening tool PRAPARE to assess and address patients’ SDH.An education intervention regarding SDH and the PRAPARE tool was provided to clinic staff. One survey was sent to clinical staff after training, and a second survey was sent 12 weeks later. In addition, a convenience sample of adults in a primary care setting was screened over a 12-week period using PRAPARE. A descriptive analysis was used to illustrate the results of both patient and staff responses.Of the clinical staff trained, 15 completed both the post-education survey, and the second survey evaluating the implementation of PRAPARE. Participants rated the training highly. Nonetheless, participants expressed concern with their comfort in being able to integrate PRAPARE into practice, comfort in utilizing the tool, and identified lack of time as the biggest barrier. Of 222 patients screened, the mean age was 53.4 years, 73.9% were Black/African American, 18% Spanish speaking, 78.8% were living below the poverty line, 40% were unemployed and seeking work, 35% did not have housing, 37% were socially isolated, and 22% lacked access to food. There was no statistically significant correlation between the PRAPARE score and either Hemoglobin A1c or blood pressure.
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