A Transdisciplinary Approach to the Evaluation of Social Determinants of Health s

评估健康社会决定因素的跨学科方法

• 批准号: 8075931
• 负责人: MICHAEL F DULIN
• 金额: $ 34.98万
• 依托单位: CAROLINAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8075931
• 关键词: Accident and Emergency department; Age; American; Area; Clinic; Clinical Data; Communities; Community Health; Community Health Services; Community Hospitals; Community Surveys; Country; County; Crime; Data; Data Collection; Databases; Development; Disadvantaged; Effectiveness of Interventions; Ethnic Origin; Evaluation; Family Practice; Food; Gender; Geographic Information Systems; Goals; Hazardous Substances; Health; Health Personnel; Health Services; Health Services Accessibility; Healthcare; Healthcare Systems; Hispanics; Hospitalization; Hospitals; Housing; Immigrant; Improve Access; Individual; Intervention; Lead; Life; Low income; Maps; Modeling; Neighborhoods; North Carolina; Outcome; Pattern; Policies; Population; Primary Health Care; Process; Provider; Public Hospitals; Qualitative Methods; Qualitative Research; Quality of life; Race; Recording of previous events; Recreation; Research; Research Methodology; Research Technics; Resources; Risk; School Nursing; Schools; Services; Social Network; Socioeconomic Status; Surveys; System; Transportation; Universities; Vulnerable Populations; community based participatory research; demographics; density; design; effective intervention; experience; health care service utilization; health disparity; improved; innovation; low socioeconomic status; medical specialties; member; metropolitan; novel; novel strategies; practice-based research network; research study; residence; skills; social; social health determinants; therapy design; tool

DESCRIPTION (provided by applicant): Individual and community health is adversely impacted by disparities in health outcomes for disadvantaged and vulnerable populations. Understanding the underlying causes of health disparities is an essential step in developing interventions designed to ameliorate them and subsequently improve overall community health. This study will examine multiple social determinates that can cause disparities including: deprived neighborhood conditions, inefficient social networks, low socioeconomic status, the presence of hazardous materials in or near a neighborhood, and the lack of access to primary care services with the goal of developing novel and innovated approached to improving community health. First, our collaborative team will look for associations between these social determinants and rates of hospitalizations, emergency department (ED) use, and ED use for primary care treatable or preventable conditions. Second, geospatial models will be developed using both hospital and community level data that will identify local areas where interventions to improve disparities would have the greatest impact. Third, the associations between social determinants and health outcomes as well as the geospatial models will be validated using community surveys and qualitative methods. Fourth, our community's rapidly growing and underserved Hispanic immigrant population will be the target of an intervention informed by the research process and designed, deployed, and evaluated using the geospatial tools and qualitative research findings. The purpose of this intervention will be to reduce health disparities by improving access to and utilization of primary care and preventative services. This project will occur within a primary care practice-based research network using key principles of community-based participatory research. An advisory board of community members, key stakeholders, primary care providers, and research team members will guide the process to assure that all findings are relevant and applicable to the targeted community. All findings will be disseminated through partnering organizations within the research network and will be made available for all community members to assist in the procurement of additional resources and to broaden the scope of the intervention to include all community members that suffer from health disparities. PUBLIC HEALTH RELEVANCE: This project is designed to ameliorate health disparities by examining the underlying social determinants that can negatively impact the health of underserved and disadvantaged community members - particularly the Hispanic immigrant population. This will be accomplished by using community-based participatory research methods to leverage hospital and community level data to identify at-risk community members who would benefit from enhanced social networks with the aim of helping them to obtain resources and access primary care services. The results of this study will demonstrate the importance of several novel approaches to ameliorating health disparities including the use of community-based participatory research, the effectiveness of interventions that target social networks, and the importance of primary care access in ameliorating health disparities.

描述（由申请人提供）：个人和社区健康受到弱势群体健康结果差异的不利影响。了解健康差异的根本原因是制定旨在改善健康差异并随后改善整体社区健康的干预措施的重要一步。本研究将研究可能导致差异的多种社会决定因素，包括：贫困的社区条件、低效的社交网络、低下的社会经济地位、社区内或附近存在有害物质，以及缺乏获得初级保健服务的机会，目的是开发新颖和创新的方法来改善社区健康。首先，我们的协作团队将寻找这些社会决定因素与住院率、急诊室 (ED) 使用率以及初级保健可治疗或可预防疾病的 ED 使用率之间的关联。其次，将使用医院和社区层面的数据开发地理空间模型，这些数据将确定改善差距的干预措施将产生最大影响的当地区域。第三，将使用社区调查和定性方法来验证社会决定因素与健康结果以及地理空间模型之间的关联。第四，我们社区快速增长且服务不足的西班牙裔移民人口将成为干预措施的目标，该干预措施由研究过程提供信息，并使用地理空间工具和定性研究结果进行设计、部署和评估。这项干预措施的目的是通过改善初级保健和预防服务的获取和利用来减少健康差距。 该项目将在基于初级保健实践的研究网络中进行，使用基于社区的参与性研究的关键原则。由社区成员、主要利益相关者、初级保健提供者和研究团队成员组成的咨询委员会将指导这一过程，以确保所有研究结果都与目标社区相关并适用。所有研究结果将通过研究网络内的合作组织传播，并将提供给所有社区成员，以协助采购额外资源并扩大干预范围，以包括所有遭受健康差距的社区成员。 公共卫生相关性：该项目旨在通过研究可能对服务不足和弱势社区成员（尤其是西班牙裔移民人口）的健康产生负面影响的潜在社会决定因素来改善健康差距。这将通过使用基于社区的参与性研究方法来实现，利用医院和社区层面的数据来识别高危社区成员，他们将受益于增强的社交网络，旨在帮助他们获得资源和获得初级保健服务。这项研究的结果将证明几种改善健康差距的新方法的重要性，包括使用基于社区的参与性研究、针对社交网络的干预措施的有效性，以及获得初级保健对改善健康差距的重要性。