a Office of Global Health, School of Nursing , University of Maryland Baltimore , Baltimore , USA.
b College of Nursing , The Ohio State University , Columbus , USA.
Ethn Health. 2019 Apr;24(3):341-351. doi: 10.1080/13557858.2017.1315369. Epub 2017 Apr 11.
Medical care alone cannot adequately improve population health or eliminate inequities; social determinants of health (SDH) must be addressed. This study's purpose was to describe the research, teaching, service, and clinical practice activities implemented by RWJF Nurse Faculty Scholars to act on the SDH.
A cross-sectional survey design was used with a sample of RWJF Nurse Faculty Scholars, chosen because they were provided specialized mentoring, grants, and other support that allowed them to explore SDH.
Respondents (n = 57) addressed SDH in their research (86.0%), teaching (68.4%), service (66.7%), and clinical practice (33.3%). Leading research foci were quality of health care (56.1%), social and physical environmental stressors (54.4%), and access to health care services (49.1%). Leading SDH areas in teaching were discrimination in society against vulnerable populations (54.4%), quality of health care received by vulnerable populations (50.9%), and vulnerable populations' access to health care services (50.9%). Service activities included addressing discrimination against diverse populations. Leading SDH areas in clinical practice were quality of health care received by vulnerable populations (28.1%), vulnerable populations' access to health care services (22.8%), and discrimination in society against vulnerable populations (19.3%). Respondents also addressed SDH through personal mentoring (71.9%); efforts to recruit and/or retain underrepresented faculty (59.6%); developing a diverse pipeline of nurses (59.6%); and participation on a diversity committee (40.4%).
The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice.
仅靠医疗保健无法充分改善人口健康或消除不平等现象;必须解决健康的社会决定因素(SDH)。本研究的目的是描述 RWJF 护士学院学者为解决 SDH 而开展的研究、教学、服务和临床实践活动。
采用横断面调查设计,对 RWJF 护士学院学者进行抽样调查,选择他们是因为他们获得了专门的指导、资助和其他支持,使他们能够探索 SDH。
受访者(n=57)在研究(86.0%)、教学(68.4%)、服务(66.7%)和临床实践(33.3%)中解决了 SDH 问题。主要研究重点是医疗保健质量(56.1%)、社会和物理环境压力源(54.4%)和获得医疗保健服务(49.1%)。教学中 SDH 的主要领域是弱势群体在社会中受到的歧视(54.4%)、弱势群体获得的医疗保健质量(50.9%)和弱势群体获得医疗保健服务的机会(50.9%)。服务活动包括解决对不同人群的歧视。临床实践中 SDH 的主要领域是弱势群体获得的医疗保健质量(28.1%)、弱势群体获得医疗保健服务的机会(22.8%)和弱势群体在社会中受到的歧视(19.3%)。受访者还通过个人指导(71.9%);努力招聘和/或留住代表性不足的教师(59.6%);培养多元化的护士队伍(59.6%);以及参与多样性委员会(40.4%)来解决 SDH。
RWJF 护士学院学者能够利用他们的奖项来解决 SDH;然而,需要进一步研究来评估所进行的 SDH 工作的影响。本研究的知识可以作为护士和其他卫生专业人员在研究、教学、服务和实践中解决 SDH 的专业工作的 SDH 要素和领域的路线图。