All too often, it seems, health care is focused on pills, procedures, and prognoses. Unfortunately, this approach frequently overlooks what is going on in patients' lives outside of clinics and hospitals that could adversely affect their health or deter them from seeking health care services. As a result, many of these patients are falling through the cracks of the U.S. health care system, particularly during the COVID-19 pandemic.
In an effort to better understand and find possible solutions for this dilemma, the National Institutes of Health has awarded a $2.7 million, four-year grant to Andrea Wallace, Ph.D., R.N., chair of health systems and community-based care in the Ï㽶ÊÓƵ of Utah College of Nursing. The research will explore different strategies for getting patients help for social needs such as housing, childcare, food, and transportation—and whether doing so improves health outcomes during the pandemic and in other situations.
Our research moves the conversation from just doing something toward doing something better.
"Health systems and clinicians have long known social circumstances are important, but there's little evidence about the best strategies for addressing these circumstances," Wallace says. "We hope that the results of our study will give much-needed information about how to best engage patients and consider preferences when addressing their social needs."
The study, called "Intensifying Community Referrals for Health: The SINCERE Intervention to Address COVID-19 Health Disparities," will build on previous research conducted by Wallace and her colleagues. In that work, the researchers asked patients who received emergency room care or COVID-19 testing about their social needs. They found that, despite communicating needs, many were either not aware of or receiving vital community services that could enhance their health.
The newly funded research seeks to determine if screening, community-based referrals, and follow-up can lead to a sustainable strategy for preventing COVID-19 transmission and reduce the social, behavioral, and economic impact of the COVID-19 pandemic. In addition, the research will seek to determine whether engaging patients in a health behavior change approach helps improve service follow-up. More broadly, the results could help determine if screening for social needs can lead to actions that improve overall health outcomes, especially for vulnerable and socioeconomically disadvantaged populations.
"Our research actively moves the focus from simply acknowledging the importance of social determinants to understanding how we can address these determinants in a way that works for patients," Wallace says. "It moves the conversation from just doing something toward doing something better."
In addition to Wallace, co-investigators include Jia-Wen Guo, Ph.D., R.N.; Bob Wong, Ph.D.; Brenda L. Luther, Ph.D., R.N.; Angela Fagerlin, Ph.D.; and Erin Rothwell, Ph.D.
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