Implementing social interventions in primary care

Bloch, Gary; Rozmovits, Linda

doi:10.1503/cmaj.210229

Cited by 18 publications

(10 citation statements)

References 58 publications

(55 reference statements)

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“…Social prescribing programs that address income security, legal needs, health literacy, social isolation, employment, housing, transportation, and food security have been shown to improve well-being, health outcomes, and are cost-effective. 30 We previously found that parental HRQoL mediates the effect of the child's MS diagnosis on the child's HRQoL. Together with our present findings, this suggests that bidirectional relationships between HRQoL of children with MS and their parents.…”

Section: Discussionsupporting

confidence: 88%

Family health conditions and parental occupational status modify the relationship between pediatric-onset multiple sclerosis and parental health-related quality of life

et al. 2023

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Background: The health-related quality of life (HRQoL) of children with multiple sclerosis (MS) is mediated by the HRQoL of their parents. Understanding factors that modify the relationship between the child’s MS diagnosis and parental HRQoL would inform interventions to improve the HRQoL of both parents and children living with MS. Objective: We evaluated whether the association between an MS diagnosis during childhood and parental HRQoL is modified by the presence of a family health condition or low socioeconomic position (SEP). Methods: Parents of children with MS or the transient illness, monophasic-acquired demyelinating syndromes (monoADS), were enrolled in a prospective Canadian study. Multivariable models evaluated whether the association between a child’s MS diagnosis (vs. monoADS) and parental HRQoL was modified by ⩾1 family health conditions or low SEP. Results: Two hundred seven parents and their children with MS ( n = 65) or monoADS ( n = 142) were included. We found a synergistic effect of an MS diagnosis and a family health condition on parental HRQoL. We also found a synergistic effect of having MS and a low SEP on parental HRQoL. Conclusion: Parents of children with MS who have another family health condition or a low SEP are at particularly high risk for low HRQoL.

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Section: Discussionsupporting

confidence: 88%

Family health conditions and parental occupational status modify the relationship between pediatric-onset multiple sclerosis and parental health-related quality of life

et al. 2023

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“…A growing number of primary care providers are seeking to address this situation by developing approaches to the social risks to health. These approaches include the use of social risk screening tools, income security interventions, medical-legal partnerships, social prescribing initiatives, and employment assistance interventions [ 4 – 9 ]. The field of social interventions is now broad enough that we can begin to identify lessons learned and approaches to their development and implementation.…”

Section: Introductionmentioning

confidence: 99%

“…The literature on social interventions in primary care has focused largely on describing initiatives, evaluating their implementation and, to a lesser extent, on outcomes for primary care providers and their patients [ 4 , 19 ]. Prior qualitative studies have explored attitudes and general approaches to health inequities among primary care providers and managers [ 13 , 20 ], and the impact of specific interventions on health team structures and processes [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Implementing social interventions in primary care in Canada: A qualitative exploration of lessons learned from leaders in the field

Bloch

Rozmovits²

2023

PLoS ONE

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Purpose Primary health care providers and practices are increasingly instituting direct interventions into social determinants of health and health inequities, but experiences of the leaders in these initiatives remain largely unexamined. Methods Sixteen semi-structured interviews with Canadian primary care leaders in developing and implementing social interventions were conducted to assess barriers, keys to success, and lessons learned from their work. Results Participants focused on practical approaches to establishing and maintaining social intervention programs and our analysis pointed to six major themes. A deep understanding of community needs, through data and client stories, forms a foundation for program development. Improving access to care is essential to ensuring programs reach those most marginalized. Client care spaces must be made safe as a first step to engagement. Intervention programs are strengthened by the involvement of patients, community members, health team staff, and partner agencies in their design. The impact and sustainability of these programs is enhanced by implementation partnerships with community members, community organizations, health team members, and government. Health providers and teams are more likely to assimilate simple, practical tools into practice. Finally, institutional change is key to establishing successful programs. Conclusion Creativity, persistence, partnership, a deep understanding of community and individual social needs, and a willingness to overcome barriers underlie the implementation of successful social intervention programs in primary health care settings.

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“…Similarly, social prescribing, or the linking of patients with social needs to community resources, is supported by the UK’s National Health Service and has also been piloted by Canada’s Alliance for Healthier Communities. 1 …”

Section: Introductionmentioning

confidence: 99%

“…Medicaid provides healthcare coverage for lower income individuals and families, jointly funded by federal and state governments. Similarly, social prescribing, or the linking of patients with social needs to community resources, is supported by the UK’s National Health Service and has also been piloted by Canada’s Alliance for Healthier Communities 1…”

Section: Introductionmentioning

confidence: 99%

Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program

et al. 2022

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ObjectiveHealth systems are expanding efforts to address health and social risks, although the heterogeneity of early evidence indicates need for more nuanced exploration of how such programs work and how to holistically assess program success. This qualitative study aims to identify characteristics of success in a large-scale, health and social needs case management program from the perspective of interdisciplinary case managers.SettingCase management program for high-risk, complex patients run by an integrated, county-based public health system.Participants30 out of 70 case managers, purposively sampled to represent their interdisciplinary health and social work backgrounds. Interviews took place in March–November 2019.Primary and secondary outcome measuresThe analysis intended to identify characteristics of success working with patients.ResultsCase managers described three characteristics of success working with patients: (1) establishing trust; (2) observing change in patients’ mindset or initiative and (3) promoting stability and independence. Cross-cutting these characteristics, case managers emphasised the importance of patients defining their own success, often demonstrated through individualised, incremental progress. Thus, moments of success commonly contrasted with external perceptions and operational or productivity metrics.ConclusionsThemes emphasise the importance of compassion for complexity in patients’ lives, and success as a step-by-step process that is built over longitudinal relationships.

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Implementing social interventions in primary care

Cited by 18 publications

References 58 publications

Family health conditions and parental occupational status modify the relationship between pediatric-onset multiple sclerosis and parental health-related quality of life

Family health conditions and parental occupational status modify the relationship between pediatric-onset multiple sclerosis and parental health-related quality of life

Implementing social interventions in primary care in Canada: A qualitative exploration of lessons learned from leaders in the field

Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program

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