SCC-PG: Optimizing sociotechnical interventions for healthcare access using community sensing

医疗保健系统越来越认识到健康的社会决定因素(SDOH)在影响个人获得促进健康的资源和生活环境的能力方面的关键重要性。SDOH的一个要素是交通劣势(TD)，指的是个人和社区一级缺乏可靠的交通工具，每年估计有360万人无法获得及时的医疗护理，对有色人种、农村社区、残疾人和低收入人口的影响不成比例。随着卫生系统寻求干预措施以减少可归因于TD的健康不平等，将社会和卫生数据整合和连接到决策、干预设计和影响评估的过程变得至关重要。为了弥补这些差距，SCC-PG项目将通过利用行业伙伴关系、新颖的数据收集和计算方法以及利益相关者的参与，长期推进数据知情、时间和地点响应的TD解决方案和其他SDOH干预措施。通过整合社区和个人层面的数据来衡量TD，这项研究将展示创新的资源分配模式，最终降低获得医疗保健的交通壁垒，改善医疗公平。虽然TD是公认的医疗保健获取障碍，但其定义、影响和相关干预措施是以零散的方式进行调查和实施的。了解这些关系可以支持定制干预措施的设计，以减少TD造成的健康差距。医疗保健系统目前依赖于粗略的数据，无法充分捕捉社区内SDOH需求的空间和时间变化。数据来源之间的互操作性以及SDOH数据将如何纳入决策也不清楚。通过规划拨款，我们的工作将1)通过广泛的利益相关者参与，促进TD的社会生态学理论的知识；2)开发社区传感方法，以解决缺乏细粒度TD/SDOH数据的问题，以便进行全面分析；以及3)演示将多级别TD/SDOH数据集成到北卡罗来纳州6个县流动诊所试点项目的决策优化框架中。我们的社会技术方法为基于系统的框架奠定了基础，以智能、可持续和整体的方式解决SDOH问题。这项工作旨在通过关注能够显著改善人口健康和公平的初级预防和上游风险降低战略来改善个人和社区的福祉。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Healthcare systems are increasingly recognizing the critical importance of the social determinants of health (SDOH) in impacting an individual’s ability to access health-promoting resources and living environments. One element of SDOH, transportation disadvantage (TD), refers to the absence of reliable transportation at the individual and community level, preventing an estimated 3.6 million people per year from accessing timely medical care, disproportionately impacting people of color, rural communities, disabled people, and low-income populations. The process of integrating and connecting social and health data to decision making, intervention design, and impact evaluation become critical as health systems seek interventions to lessen health inequity attributable to TD. To address these gaps, this SCC-PG project will advance data-informed time and place-responsive TD solutions and other SDOH interventions in the long term by leveraging industry partnerships, novel data collection and computational methods, and stakeholder engagement. By integrating community and individual level data to measure TD, this research will demonstrate innovative resource allocation models, ultimately reducing transportation barriers to healthcare access and improving health equity. While TD is a recognized barrier to healthcare access, its definition, impacts, and associated interventions are investigated and implemented in a fragmented manner. Understanding these relationships can support the design of customized interventions to reduce health disparities resulting from TD. Healthcare systems currently rely on coarse data that do not adequately capture spatial and temporal variations of SDOH needs within communities. Interoperability between data sources and how SDOH data will be incorporated into decision-making is also unclear. Through the planning grant, our work will 1) advance knowledge on socioecological theories of TD through extensive stakeholder engagement; 2) develop community sensing methods to address lack of granular TD/SDOH data to enable comprehensive analysis; and 3) demonstrate the integration of multilevel TD/SDOH data into optimization frameworks for decision-making for a mobile clinic pilot project in 6 North Carolina counties. Our sociotechnical approach lays the foundation for a systems-based framework to address SDOH in a smart, sustainable, and holistic manner. This work aims to improve the well-being of individuals and communities by focusing on primary prevention and upstream risk reduction strategies that can significantly improve population health and equity.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.