Provider and Staff Feedback on Screening for Social and Behavioral Determinants of Health for Pediatric Patients.
J Am Board Fam Med
; 32(3): 297-306, 2019.
Article
em En
| MEDLINE
| ID: mdl-31068394
ABSTRACT
INTRODUCTION:
Screening and referral for Social and Behavioral Determinants of Health (SDOH) are increasingly recommended in clinical guidelines and consensus statements. It is important to understand barriers and facilitators to implementation of standardized SDOH screening and referral practices, as well as the scope of current existing SDOH screening.METHODS:
We conducted a mixed-methods study to understand the current state of SDOH screening and to assess the barriers and facilitators to implementing a standardized SDOH screening and referral practice in Boston community health centers (CHCs) for pediatric patients. We requested all SDOH screening documents from 15 Boston CHCs and conducted provider and staff focus groups at intervention sites of an SDOH implementation pilot in Boston.RESULTS:
All CHCs screened in some form for SDOH, but there was no agreement on which domains to screen. Participating CHCs screened for a mean of 8 SDOH domains (range, 5 to 16). Overall, 16 SDOH domains emerged. From the focus groups, 5 themes emerged 1) provider perspectives, 2) work flow, 3) prior experience, 4) site resources and staffing, and 5) sustainability. There was little agreement among participants within each theme, as all were seen as barriers and facilitators depending on the respondent.DISCUSSION:
This study highlights the various SDOH screening methods currently used in Boston CHCs, and the need for workflow and process individualization of SDOH screening and referral. Providers and clinical staff should be part of the discussion when implementing SDOH screening and referral procedures to ensure appropriate work flow, staff buy-in, and to maximize resources available.Palavras-chave
Texto completo:
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Temas:
ECOS
/
Equidade_desigualdade
Bases de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
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Programas de Rastreamento
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Centros Comunitários de Saúde
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Disparidades nos Níveis de Saúde
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Determinantes Sociais da Saúde
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Guideline
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Qualitative_research
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Screening_studies
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Sysrev_observational_studies
Aspecto:
Determinantes_sociais_saude
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Equity_inequality
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Implementation_research
/
Patient_preference
Limite:
Adolescent
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Child
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Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Am Board Fam Med
Ano de publicação:
2019
Tipo de documento:
Article