Exploration of patient work through the lens of the Patient Work System model (PWS) has typically concentrated on clinical tasks, noting only how broader contextual factors shape these tasks. The purpose of this research was to use the PWS to begin to explore patient work originating directly from these broader contextual factors, referred to as the social determinants of health. Transportation access to maternal health services was used as a topic for a case study. Semi-structured interviews with eight health care and human services professionals were analyzed through deductive and inductive processes. The results reflected the main factors of the PWS and identified unique sub-factors under person, physical environment, and organizational environment. This preliminary work demonstrates that there is potential to use the PWS to examine patient work arising from SDoH.
The maternal health crisis in the United States is becoming increasingly worse, with disparities continuing to escalate among marginalized populations. mHealth can contribute to addressing the Social Determinants of Health (SDOH) that produce inequities in maternal morbidity and mortality. Reducing inequities through mHealth can be achieved by designing these technologies to align with SDOH. As mHealth developed to support maternal health has primarily supported the extension of clinical care, there is an opportunity to integrate frameworks and methods from human factors/ergonomics and public health to produce thorough comprehension of SDOH through intentional partnerships with marginalized populations. Potential for this opportunity is presented through a case study derived from a community-based participatory research process focused on transportation access to maternal health services. Through multi-faceted, interdisciplinary, and community-based approaches to designing mHealth that attends to the systemic factors that generate and escalate inequities, improvements in the maternal health crisis could be realized.
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