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一项基于社区的干预措施以解决健康的社会决定因素:一项试点研究。

A Community-Based Intervention to Address Social Determinants of Health: A Pilot Study.

作者信息

Delafield Nathan L, Havanur Amogh, Bonner Timethia J, Horsley Robert, Mead-Harvey Carolyn, Bersoux Sophie, White Kama, Ali Nyima, Milam Adam J

出版信息

Jt Comm J Qual Patient Saf. 2025 Aug 7. doi: 10.1016/j.jcjq.2025.08.002.

Abstract

BACKGROUND

This Innovation Report describes the feasibility and impact of an intervention focused on community-based social support to address social determinants of health (SDoH).

METHODS

This study followed adult patients (N = 12) referred by primary care teams at a Federally Qualified Health Center (FQHC) due to unresolved SDoH needs. Over 12 months, community volunteers (the Open Table Network Table) were paired with patients to address their primary SDoH needs. Primary outcomes included the implementation of the Open Table Network Table and resolution of the patients' primary SDoH needs, measured by achieving patient-defined goals. Secondary outcomes evaluated intervention impact on patient resilience, healthcare utilization, and other SDoH metrics (for example, economic stability). Semistructured qualitative interviews were conducted with participants postintervention. Primary outcomes were assessed qualitatively; secondary outcomes were tested using paired analyses.

RESULTS

Twelve patients were enrolled over 12 months, and their SDoH needs ranged from healthcare access to social isolation. Community volunteers resolved 91.7% of these primary SDoH needs, with a median volunteer effort of 47.5 hours (interquartile range [IQR] 22.5-73.0) provided to each participant. No statistically significant differences were seen in patient resilience, other SDoH metrics, or healthcare utilization postintervention. The intervention was implemented (that is, the intervention was feasible), but there were challenges to implementation, including recruitment of patients, the need for multiple connections, and the time commitment required by volunteers.

CONCLUSION

The Open Table Network Table was implemented at an FQHC but required considerable volunteer effort and creativity. Further research is needed to assess the scalability, sustainability, and long-term social and clinical impact of this intervention.

摘要

背景

本创新报告描述了一项以社区为基础的社会支持干预措施的可行性和影响,该措施旨在解决健康的社会决定因素(SDoH)。

方法

本研究跟踪了因未解决的SDoH需求而由联邦合格健康中心(FQHC)的初级保健团队转诊的成年患者(N = 12)。在12个月的时间里,社区志愿者(开放餐桌网络)与患者配对,以满足他们主要的SDoH需求。主要结局包括开放餐桌网络的实施情况以及患者主要SDoH需求的解决情况,通过实现患者设定的目标来衡量。次要结局评估干预措施对患者恢复力、医疗保健利用以及其他SDoH指标(例如经济稳定性)的影响。干预结束后,对参与者进行了半结构化定性访谈。主要结局进行定性评估;次要结局使用配对分析进行检验。

结果

在12个月内招募了12名患者,他们的SDoH需求范围从医疗保健获取到社会隔离。社区志愿者解决了91.7%的这些主要SDoH需求,为每位参与者提供的志愿者服务时间中位数为47.5小时(四分位间距[IQR]为22.5 - 73.0)。干预后,在患者恢复力、其他SDoH指标或医疗保健利用方面未观察到统计学上的显著差异。该干预措施得以实施(即该干预措施是可行的),但实施过程中存在挑战,包括患者招募、需要多次联系以及志愿者所需的时间投入。

结论

开放餐桌网络在一家FQHC得以实施,但需要志愿者付出相当大的努力和创造力。需要进一步研究来评估该干预措施的可扩展性、可持续性以及长期的社会和临床影响。

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