Informatics Resources for Social Determinants of Health in School-Based Health Centers

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PROJECT SUMMARY Social determinants of health (SDoH) are associated with poor health outcomes and health disparities. The National Academies of Sciences, Engineering, and Medicine’s Future of Nursing Report encourages clinicians to address SDoH, which are the environmental conditions in which people live, learn, work, play, and worship, that can affect health, functioning, and quality-of-life. While there is a large corpus of knowledge associating SDoH with childhood asthma, a gap exists on screening of SDoH in school-based health centers (SBHCs). SBHCs care for children pre-kindergarten to 18 years of age, working collaboratively with the school nurse to advance the health and well-being of all youth. Although SBHCs have access to individual-level health information about the child, SBHC providers do not have easy access to SDoH information at the neighborhood and community level. Screening pediatric families for SDoH in a systematic way can facilitate connection to pertinent resources. However, there is a dearth of information regarding SDoH screening and the role of SBHCs in pediatric SDoH interventions. This project focuses on the critical need to identify the facilitators and barriers of SDoH information gathering behaviors in SBHCs. Through an exploratory sequential design, the project will include the development of an informatics resource providing SDoH information to SBHC providers. Asthma will serve as the first clinical condition for this novel work. The investigators will address three specific aims: Aim 1. Describe the information gathering behaviors for SDoH and asthma performed by school-based health providers (i.e., nurse practitioners, physicians, physician assistants) for preventative asthma care, and what barriers exist for information gathering. Aim 2. Develop and evaluate an informatics resource that provides actionable SDoH information related to the preventative management of asthma. Aim 3: Evaluate the feasibility of an informatics resource comprising SDoH among school-based health providers for use in the preventative management of asthma. The PI will receive research training through the rich scientific environment of Vanderbilt University. Training goals will focus on acquiring knowledge and skills in biomedical informatics, research methodology, qualitative focus groups, SDoH, and responsible conduct of research. The highly experienced mentorship team will provide support to make continued progress toward independence in a program of research focused on SDoH in school-based health centers, of which this project is a key component. Upon successful completion of the proposed study, contributions are expected to fill a critical knowledge gap with evidence that supports screening for SDoH by school-based health providers. These contributions will be significant because they are expected to provide a way to operationalize SDoH, to prevent asthma exacerbations, and address social needs to improve the lives of school-age children. The proposed study supports the mission of NINR through inquiry that addresses both the SDoH and Health Equity research lenses in the unique setting of school-based health centers.