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）在影响个人获得健康促进资源和生活环境的能力方面的至关重要性。SDOH的一个要素，交通劣势（TD），是指在个人和社区层面缺乏可靠的交通工具，每年约有360万人无法获得及时的医疗服务，对有色人种，农村社区，残疾人和低收入人群造成不成比例的影响。随着卫生系统寻求干预措施以减少归因于TD的健康不平等，将社会和健康数据与决策、干预措施设计和影响评估相结合的过程变得至关重要。为了解决这些差距，SCC-PG项目将通过利用行业合作伙伴关系，新颖的数据收集和计算方法以及利益相关者的参与，长期推进数据知情的时间和地点响应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，最终减少医疗保健的交通障碍，提高健康公平性。虽然TD是获得医疗保健的公认障碍，但其定义，影响和相关干预措施的调查和实施是分散的。 了解这些关系可以支持定制干预措施的设计，以减少TD造成的健康差异。医疗保健系统目前依赖于粗略的数据，这些数据不能充分捕获社区内SDOH需求的空间和时间变化。数据源之间的互操作性以及如何将SDOH数据纳入决策也不清楚。通过规划补助金，我们的工作将1）通过广泛的利益相关者参与，推进TD的社会生态理论的知识; 2）开发社区感知方法，以解决缺乏颗粒TD/SDOH数据，使全面的分析;和3）展示多层次TD/SDOH数据集成到优化框架的决策移动的诊所试点项目在6个北卡罗来纳州县。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。这项工作的目的是改善个人和社区的福祉，重点是初级预防和上游减少风险的战略，可以显着改善人口的健康和公平。这个奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的知识价值和更广泛的影响审查标准进行评估的支持。

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.