Mormer Elizabeth R, Berkeley Sara B Jones, Johnson Anna M, Ressel Kristin, Zhang Shuqi, Pastva Amy M, Bushnell Cheryl D, Duncan Pamela, Freburger Janet K
Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Arch Rehabil Res Clin Transl. 2024 Jul 18;6(3):100358. doi: 10.1016/j.arrct.2024.100358. eCollection 2024 Sep.
Social determinants are nonmedical factors frequently used to study disparities in health outcomes but have not been widely explored in regard to rehabilitation service utilization. In our National Institutes of Child Health and Human Development-funded study, Access to and Effectiveness of Community-Based Rehabilitation After Stroke, we reviewed several conceptual models and frameworks for the study of social determinants to inform our work. The overall objective of this special communication is to describe our approach to identifying, selecting, and using area-level measures of social determinants to explore the relationship between social determinants and rehabilitation use. We present our methods for developing a conceptual model and a methodologic framework for the selection of social determinant measures relevant to rehabilitation use, as well as an overview of publicly available data on social determinants. We then discuss the methodologic challenges encountered and future directions for this work.
社会决定因素是非医学因素，常用于研究健康结果的差异，但在康复服务利用方面尚未得到广泛探讨。在我们由美国国立儿童健康与人类发展研究所资助的研究“中风后社区康复的可及性与有效性”中，我们回顾了几种用于研究社会决定因素的概念模型和框架，以为我们的工作提供参考。本专题交流的总体目标是描述我们识别、选择和使用社会决定因素的区域层面测量指标来探索社会决定因素与康复利用之间关系的方法。我们介绍了开发概念模型的方法以及选择与康复利用相关的社会决定因素测量指标的方法框架，以及关于社会决定因素的公开可用数据的概述。然后，我们讨论了遇到的方法学挑战以及这项工作的未来方向。
