Impact of a Low-Intensity Resource Referral Intervention on Patients’ Knowledge, Beliefs, and Use of Community Resources: Results from the CommunityRx Trial

Tung, Elizabeth L.; Abramsohn, Emily; Boyd, Kelly; Makelarski, Jennifer A.; Beiser, David G.; Chou, Chiahung; Huang, Elbert S.; Ozik, Jonathan; Kaligotla, Chaitanya; Lindau, Stacy Tessler

doi:10.1007/s11606-019-05530-5

Cited by 34 publications

(51 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interventions that can increase the likelihood of obtaining resources have been the focus of previous publications, though few have examined the impacts on specific subpopulations. 5,7,14,[19][20][21][23][24][25][26][39][40][41][42][43] Positive prior experiences do influence patient perspectives of health care-based social care activities. 17,18 But interest in assistance-and the impact of related interventions-also may be influenced by cultural and demographic characteristics (eg, perceived stigma associated with receipt of benefits, documentation status, or preferred language).…”

Section: Safety Concernmentioning

confidence: 99%

Do Patients Want Help Addressing Social Risks?

2020

View full text Add to dashboard Cite

Evaluations of health care-based screening programs for social risks often report that a relatively small proportion of patients screening positive for social risk factors are interested in receiving assistance from their health care teams to address them. The relatively low number of patients who desire assistance is relevant to the growing number of initiatives in US health care settings designed to collect data on and address patients' social risks. We highlight multiple studies that have found differences between positive risks screens and desire for assistance. We explore possible explanations for those differences-focusing on the fallibility of screening tools as well as patient preferences, priorities, and lived experiences-and the potential implications for health equity.

show abstract

Section: Safety Concernmentioning

confidence: 99%

Do Patients Want Help Addressing Social Risks?

2020

View full text Add to dashboard Cite

show abstract

“…In clinical settings, interventions to address social needs have centered on recruiting assistance from nonprofits, expanding culturally competent practices, and increasing patient engagement [9][10][11][12]. Efforts from the voluntary sectors have been particularly useful, as these organizations are positioned to be the bridge between the clinic and resources necessary to address social needs.…”

Section: Discussionmentioning

confidence: 99%

“…Efforts from the voluntary sectors have been particularly useful, as these organizations are positioned to be the bridge between the clinic and resources necessary to address social needs. For example, the NOWPOW program links together a patient's electronic health record with community-based databases to generate prescriptions for patients in need [10,13]. Also, there is great utility in expanding culturally competent practices, such as the use of interpreters and providing language-appropriate materials.…”

Section: Discussionmentioning

confidence: 99%

Examination of social determinants of health among patients with limited English proficiency

et al. 2021

View full text Add to dashboard Cite

Objectives The purpose of this study is to examine the prevalence of social needs by English proficiency using data from Northwell Health’s social determinants of health screening program. The screening program evaluates 12 domains of social needs: material need, employment, medical-legal assistance, health insurance, public benefits, health literacy, transportation, medical care, utilities, housing quality, food security, and housing insecurity. We have identified patients to have limited English proficiency if they have selected a language other than English as their primary language. Results The study population includes 92,958 individuals; of these, 83,445 (89.8%) patients are English proficient, and 9513 (10.2%) patients have limited English proficiency. A higher percentage of patients with limited English proficiency has social needs, including material need, employment, medical-legal assistance, health insurance, public benefit, health literacy, medical care, utility bill, poor housing quality, and food insecurity (all p-values < 0.05). In multivariable logistic regression models adjusting for sociodemographic information, LEP status (odds ratio = 1.36 [1.25–1.49]) has been associated with having social needs. These findings suggest that system-wide SDH screening and referral programs should identify ways to ensure capturing social needs among patients with limited English proficiency.

show abstract

“…Key outcomes, including self-efficacy for finding and knowledge about healthful community resources improved. [ 10 , 16 ] In addition, the CRx-1 and 2 studies yielded evidence of both intervention and information spread. Soon after the intervention was deployed at the first community health center, a physician “hacked” the CRx system in order to be able to use the intervention at a clinic site where he worked outside the target geography, thereby causing unexpected, but desirable spread of the intervention to other communities.…”

Section: Introductionmentioning

confidence: 99%

Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention

et al. 2021

Self Cite

View full text Add to dashboard Cite

CommunityRx (CRx), an information technology intervention, provides patients with a personalized list of healthful community resources (HealtheRx). In repeated clinical studies, nearly half of those who received clinical “doses” of the HealtheRx shared their information with others (“social doses”). Clinical trial design cannot fully capture the impact of information diffusion, which can act as a force multiplier for the intervention. Furthermore, experimentation is needed to understand how intervention delivery can optimize social spread under varying circumstances. To study information diffusion from CRx under varying conditions, we built an agent-based model (ABM). This study describes the model building process and illustrates how an ABM provides insight about information diffusion through in silico experimentation. To build the ABM, we constructed a synthetic population (“agents”) using publicly-available data sources. Using clinical trial data, we developed empirically-informed processes simulating agent activities, resource knowledge evolution and information sharing. Using RepastHPC and chiSIM software, we replicated the intervention in silico, simulated information diffusion processes, and generated emergent information diffusion networks. The CRx ABM was calibrated using empirical data to replicate the CRx intervention in silico. We used the ABM to quantify information spread via social versus clinical dosing then conducted information diffusion experiments, comparing the social dosing effect of the intervention when delivered by physicians, nurses or clinical clerks. The synthetic population (N = 802,191) exhibited diverse behavioral characteristics, including activity and knowledge evolution patterns. In silico delivery of the intervention was replicated with high fidelity. Large-scale information diffusion networks emerged among agents exchanging resource information. Varying the propensity for information exchange resulted in networks with different topological characteristics. Community resource information spread via social dosing was nearly 4 fold that from clinical dosing alone and did not vary by delivery mode. This study, using CRx as an example, demonstrates the process of building and experimenting with an ABM to study information diffusion from, and the population-level impact of, a clinical information-based intervention. While the focus of the CRx ABM is to recreate the CRx intervention in silico, the general process of model building, and computational experimentation presented is generalizable to other large-scale ABMs of information diffusion.

show abstract

Impact of a Low-Intensity Resource Referral Intervention on Patients’ Knowledge, Beliefs, and Use of Community Resources: Results from the CommunityRx Trial

Cited by 34 publications

References 24 publications

Do Patients Want Help Addressing Social Risks?

Do Patients Want Help Addressing Social Risks?

Examination of social determinants of health among patients with limited English proficiency

Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention

Contact Info

Product

Resources

About