Ethnographic investigation of factors affecting conceptualization and provision of social prescribing in outpatient primary care clinics in the United States

项目总结/摘要 拟议的研究金计划是一个跨学科研究项目， 医学和实施科学。这个项目是由艾德丽安强，克拉伦斯Gravlee博士监督 （部门）Ramzi Salloum（Dept.健康成果和生物信息学）和格兰特·哈雷尔 （部门）社区卫生和家庭医学）的资源和支持的佛罗里达大学 (UF)文学与科学学院，医学和UF临床翻译UF学院 科学研究所。该建议旨在使受训者具备成为一名 医生科学家谁桥梁之间的鸿沟社会科学和临床医学。社会 健康的决定因素（SDH）是众所周知的影响广泛的身体和心理健康的结果。 然而，很少有人知道医生如何识别和解释病人的社会信息，并采取行动， 这一信息，以支持他们的病人的健康和福祉。该提案将重点关注美国门诊患者 初级保健诊所有两个原因：初级保健优先考虑病人的整体福祉， 近年来，将SDH干预纳入小学教育的努力得到了重大推动。 护理诊所以前的调查主要集中在筛选工具的开发和有限的 干预措施侧重于特殊人群或特定的SDH。这种调查很少注意到 非正式的方法提供者和初级保健诊所已经开发出识别和解决临床相关的 社会条件在日常实践中，活动在这里统称为“社会处方”。因此， 基于跨学科卫生服务和实施科学文献的调查， 探索性部分，以便对这些尚未调查的做法进行描述和分析， 与社会处方有关的信念是有道理的。总体假设是，患者、提供者和 临床层面的因素影响初级保健提供者的概念和社会处方的实施 实践具体目标的提出有助于加深对社会科学知识翻译的理解 通过（1）确定影响社会处方的因素， 不同的初级保健提供者之间的概念化和（2）识别影响社会的因素， 规定在不同的初级保健提供者中实施。成功完成这些研究将 加强对影响社会处方的制定、实施和结果的因素的理解 不同护理环境的干预措施。这项研究直接针对多个临床和健康服务 研究兴趣领域由少数民族健康和健康差异的国家研究所定义。

Project Summary/Abstract The proposed fellowship plan is an interdisciplinary research project integrating training in anthropology, medicine, and implementation science. This project is supervised by Drs. Adrienne Strong, Clarence Gravlee (Dept. of Anthropology), Ramzi Salloum (Dept. of Health Outcomes and Bioinformatics), and Grant Harrell (Dept. of Community Health and Family Medicine) with the resources and support of the University of Florida (UF) College of Liberal Arts and Sciences, the UF College of Medicine and the UF Clinical Translational Sciences Institute. The proposal is designed to equip the trainee with the skills necessary to become a physician-scientist who bridges the divide between the social sciences and clinical medicine. Social Determinants of Health (SDH) are known to impact a wide array of physical and mental health outcomes. However, little is known about how physicians identify and interpret patient social information, and act upon this information in support of their patient’s health and wellbeing. This proposal will focus on US outpatient primary care clinics for two reasons: primary care prioritizes holistic well-being of patients through the life course and there has been a significant push in recent years to incorporate SDH interventions into primary care clinics. Previous investigations have focused primarily on development of screening tools and limited interventions focused on special populations or specific SDH. Such investigations pay little attention to the informal methods providers and primary care clinics have developed to identify and address clinically relevant social conditions in day-to-day practice, activities here collectively termed “social prescribing”. Thus, an investigation grounded in interdisciplinary health services and implementation science literature, with an exploratory component to allow for the description and analysis of these as yet uninvestigated practices and beliefs relating to social prescribing is warranted. The overarching hypothesis is that patient, provider, and clinic level factors affect primary care provider conceptualization and implementation of social prescribing practices. The specific aims will lead to greater understanding of knowledge translation of social science research to clinical medicine in primary care through (1) identification of factors affecting social prescribing conceptualization among diverse primary care providers and (2) identification of factors affecting social prescribing implementation among diverse primary care providers. Successful completion of these studies will enhance understanding of factors affecting development, implementation, and outcomes of social prescribing interventions across diverse care contexts. This research directly targets multiple Clinical and Health Service Research Interest Areas defined by the National Institute of Minority Health and Health Disparities.