The Baltimore Community-Based Organizations Neighborhood Network: Enhancing Capacity Together (CONNECT) Cluster RCT

Wu, Albert W.; Weston, Christine; Ibe, Chidinma A.; Ruberman, Claire; Bone, Lee R.; Boonyasai, Romsai T.; Hwang, Sandra; Gentry, Janice; Purnell, Leon; Ya, LU; Liang, Shuwen; Rosenblum, Michael

doi:10.1016/j.amepre.2019.03.013

Cited by 26 publications

(36 citation statements)

References 44 publications

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“…10 Interventions directly targeting community-based organizations have also had little impact on healthcare utilization. 11 Other studies, including one in the ED, have used a help-desk model of undergraduate volunteer navigators, and found no difference in ED utilization or need resolution. 12 Similar interventions requiring significant staffing, potentially including community health workers, have shown promise but may be more challenging to scale outside of academic centers.…”

Section: How Does This Improve Population Health?mentioning

confidence: 98%

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Samuels‐Kalow

Molina

Ciccolo

et al. 2020

WestJEM

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Introduction: Social risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; however, little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED. Methods: Qualitative interviews were conducted with a purposive sample of ED patients and local community organization staff. Participants completed a brief demographic survey, health literacy assessment, and qualitative interview focused on barriers/facilitators to social risk screening in the ED, and ideas for screening and linkage interventions in the ED. Interviews were conducted in English or Spanish, recorded, transcribed, and coded. Themes were identified by consensus. Results: We conducted 22 interviews with 16 patients and six community organization staff. Three categories of themes emerged. The first related to the importance of social risk screening in the ED. The second category encompassed challenges regarding screening and linkage, including fear, mistrust, transmission of accurate information, and time/resource constraints. The third category included suggestions for improvement and program development. Patients had varied preferences for verbal vs electronic strategies for screening. Community organization staff emphasized resource scarcity and multimodal communication strategies. Conclusion: The development of flexible, multimodal, social risk screening tools, and the creation and maintenance of an accurate database of local resources, are strategies that may facilitate improved identification of social risk and successful linkage to available community resources. [West J Emerg Med. 2020;21(4)964-973.] been used to describe these individual-level, adverse social determinants of health. For the purposes of this paper, we will term these "specific adverse social conditions that are associated with poor health" as social risk. 2 Social risks are

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Section: How Does This Improve Population Health?mentioning

confidence: 98%

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Samuels‐Kalow

Molina

Ciccolo

et al. 2020

WestJEM

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“…First, this study adds to the growing evidence base suggesting that theory based, holistic approaches using tailored, longitudinal, relationship‐based support appear to be effective in reducing hospital utilization, a desirable but elusive goal for health system‐based social interventions 12,23‐25 . This stands in contrast to other common approaches, including light‐touch social needs screening, augmented primary care, care management teams or domain‐specific interventions like transportation assistance 9‐11,26‐28 . Consistent and rigorous standardization of CHW hiring, training, work practices, caseloads, supervision, and infrastructure likely facilitated homogenous effects across trials.…”

Section: Discussionmentioning

confidence: 94%

“…However, it remains unclear how health systems can most effectively design and implement programs that target patients’ social needs and also reduce hospitalizations. Unfortunately, very few high‐quality studies of health system‐based social interventions have been able to demonstrate both improvements in health outcomes and reductions in healthcare utilization and cost 9‐12 …”

Section: Introductionmentioning

confidence: 99%

Effects of a standardized community health worker intervention on hospitalization among disadvantaged patients with multiple chronic conditions: A pooled analysis of three clinical trials

Vasan

Morgan

Mitra

et al. 2020

Health Services Research

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“…An assessment of programs designed to identify and support patients with unaddressed social needs have found that addressing social needs can lead to clinically meaningful improvements in outcomes like blood pressure and LDL-cholesterol 3 . More importantly, studies have found that addressing these social drivers ofhealth in the clinical setting can increase patient con dence in the availability of community resources 3 and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts 4 . Health care organizations, especially primary and ambulatory care clinics, are increasingly adopting social needs screening and linkages to community-based and social service assistance programs to address social needs as a part of their core services.…”

Section: Introductionmentioning

confidence: 99%

Intersecting Systemic and Personal Barriers to Accessing Social Services: Qualitative Interviews in Northern California

Placzek

Cruz

Chapdelaine

et al. 2021

Preprint

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Background. Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks.Methods. This is a qualitative assessment of patient-reported barriers to accessing and using social needs assistance programs. We conducted over 100 in-depth interviews with individuals in Northern California who participated in a navigation and referral program to help address their social needs and describe a unique framework for understanding how policies and systems intersect with an individual's personal life circumstances.Results. Individuals described two distinct domains of barriers: 1) systems-level barriers that were linked to the inequitable distribution of and access to resources, and 2) personal-level barriers that focused on unique limitations experienced by each patient and impacted the way that they accessed services in their communities. While these barriers often overlapped or manifested in similar outcomes, this distinction was key because the systems barriers were not things that individuals could control or overcome through their own initiative or by increasing individual capacity.Conclusions. Respondents describe intersecting systemic and personal barriers that compound patients’ challenges to getting their social needs met; this includes both a picture of the inequitable distribution of and access to social services and a profile of the limitations created by individual life histories. These results speak to the need for structural changes to improve adequacy, availability, and accessibility of social needs resources. These findings highlight the need for advocacy to address systems barriers, especially the stigma that is faced by people who struggle with a variety of health and social issues, and investment in incentives to strengthen relationships between health care settings and social service agencies.

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The Baltimore Community-Based Organizations Neighborhood Network: Enhancing Capacity Together (CONNECT) Cluster RCT

Cited by 26 publications

References 44 publications

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Effects of a standardized community health worker intervention on hospitalization among disadvantaged patients with multiple chronic conditions: A pooled analysis of three clinical trials

Intersecting Systemic and Personal Barriers to Accessing Social Services: Qualitative Interviews in Northern California

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