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

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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).