The Application of a Theoretical Framework to Assess the Acceptability of a Health-Related Social Needs Screening Tool Among Black Patients In New York City

这NRSA F31多样性建议女士. Deborah Onakomaiya旨在提供指导，培训， 推进研究经验，为Onakomaiya女士独立研究职业生涯做好准备， 执行科学和健康差距研究。本提案的研究部分旨在进行一项 混合方法研究，由可接受性（TFA）的理论框架通知，制定一个 对负责任的卫生社区健康相关社会需求的多层面理解 在NYU Langone Health接受护理的黑人患者中使用的筛查工具（AHC-HRSN） （NYULH）。最近的研究表明，在如何最好地确定患者与健康相关的社会需求方面存在重大差距 （HRSNs）并以尊重的方式提供帮助，维护患者的信任。为数不多的研究探讨了 HRSN工具的可接受性主要集中在医生和护理人员的角度， HRSN的可接受性或HRSN可接受性的驱动因素。到目前为止，还没有研究利用理论驱动的 一种系统评估HRSN筛查工具在黑人患者中可接受性的方法， 最有可能经历HRSN的高负担。成功解决问题的必要的第一步或先驱 HRSN旨在检查将接受筛选的人群（例如患者）对筛选工具的可接受性。 此外，随着2024年医疗保险和医疗补助服务中心和联合委员会的认可， 医疗保健组织要求增加HRSN筛查，需要进行研究证明 HRSN工具的可接受性。TFA能够很好地捕捉推动患者接受性的细微因素。 如果一种干预、实践或治疗被认为是可接受的，患者更有可能坚持治疗。 建议并从改善的临床结果中获益。此外，本提案的培训计划是 包括指导研究，教学和非正式培训，体验式学习和专业 发展活动。申请人将得到NYULH的多个资源和强大的 具有卫生服务研究、实施科学、健康差异研究方面专业知识的导师团队 和混合方法研究。研究培训计划将使Onakomaiya女士为一项研究做准备 a）学习和应用严格的实施和心理测量方法; B）发展专业知识 在卫生服务和卫生差距研究方面;以及c）产生和传播科学知识， 告知公共卫生实践。这项研究涵盖了NIMHD的一个高优先级领域，将是NIMHD的首批研究之一。 美国在像NYULH这样的综合卫生系统中检查拟议的项目。因为这个项目将利用 NYULH的基础设施已准备好在其患者中实施系统范围的HSRN筛查 人口该项目将支持NIMHD的目标，以促进研究，了解和改善健康 第二，创造和改进科学方法、衡量标准， 支持健康差异研究的措施和工具（国家健康和人的发展研究所-目标4）。

This NRSA F31 diversity proposal for Ms. Deborah Onakomaiya aims to provide mentorship, training, and advance research experiences to prepare Ms. Onakomaiya for an independent research career in implementation science and health disparities research. The research portion of this proposal aims to conduct a mixed-methods study, informed by the theoretical framework of acceptability (TFA), to develop a multidimensional understanding of the Accountable Health Communities Health-Related Social Needs Screening (AHC-HRSN) screening tool among Black patients who receive care at NYU Langone Health (NYULH). Recent studies suggest major gaps in how best to identify patients’ health-related social needs (HRSNs) and offer assistance in a respectful way that upholds patient trust. The few studies that explored the acceptability of HRSN tools largely focused on physician and caregiver perspectives and do not define acceptability of HRSN or the drivers for acceptability of HRSN. To date, no study has utilized a theory-driven approach to systematically assess the acceptability of HRSN screening tools among Black patients, who are most likely to experience a high burden of HRSN. An essential first step or precursor in successfully addressing HRSN is to examine the acceptability of screening tools among those who will be screened (e.g. patients). Additionally, with the 2024 Centers for Medicare & Medicaid Services and Joint Commission on Accreditation of Healthcare Organizations mandates to increase HRSN screening, there is a need for studies that demonstrate the acceptability of HRSN tools. TFA is well positioned to capture nuanced factors that drive patient acceptability. If an intervention, practice, or treatment is considered acceptable, patients are more likely to adhere to the recommendations and benefit from improved clinical outcomes. Also the training plan for this proposal is composed of mentored research, didactic and informal training, experiential learning and professional development activities. The applicant will be supported by several resources at NYULH and by a strong mentorship team with expertise in health services research, implementation science, health disparities research and mixed-methods research. The research-training plan will allow Ms. Onakomaiya to prepare for a research career by a) Learning and applying rigorous implementation and psychometric methods; b) developing expertise in health services and health disparities research; and c) generating and disseminating scientific knowledge to inform public health practice. This study covers a high priority area for NIMHD and will be one of the first in the U.S. to examine the proposed project in an integrated health system like NYULH . As this project will leverage NYULH’s infrastructure which is primed to implement system-wide screening for HSRNs among its patient population. This project will support NIMHDs goals to promote research to understand and to improve the health of racial/ethnic minorities (NIMHD- goal 1) and second, create and improve scientific methods, metrics, measures, and tools that support health disparities research (NIMHD-goal 4).