Social and Behavioral Determinants Project

Under the aegis of Dr. William Stead, the Center for Knowledge Management (CKM) partnered with the University of California, San Francisco, to evaluate a panel of measures recommended by the Institute of Medicine (IOM) committee for capturing patient data on the social and behavioral determinants of health in the clinical setting. The Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and World Health Organization have all identified the social determinants of health as key to the improvement of health outcomes and reduction of health disparities. Research has demonstrated the connection between health outcomes and sociological and behavioral factors such as social connectedness, education level, and exercise habits. However, there is not currently a standardized method for collecting information on these elements during the clinical encounter.

The IOM committee, assembled in 2013, carefully considered and selected a panel of measures to recommend for clinical use based on their relevance to healthcare, proven validation, and ease of implementation. The CKM has built upon this work to perform the necessary evaluation of the feasibility and validity of administering the identified measures as a combined panel. The study team investigated research questions important to the eventual implementation of the instrument, including considerations of question order and response patterns, time required for administration, and the extent to which questionnaire results align with previous research findings. The goal of this important work is to provide a proven measure to allow clinicians to understand and address social and behavioral influences on patient health.  The team’s results from this study are published in the American Journal of Preventive Medicine.

In Spring 2017, CKM extended the team’s research into the social and behavioral determinants of health.  Through a partnership with a local community health clinic, CKM conducted a pilot study to better understand the type and prevalence of social determinant needs in the community clinic setting, and subsequently used that information to understand the availability and coverage of resources that may help address identified social needs. A database of public health and community-based resources has been created by the CKM team and is available online. Partial results from this pilot study have been accepted as a poster presentation for the November 2017 annual meeting of the American Medical Informatics Association.

CKM Related Publications

  • Giuse NB, Koonce TY, Kusnoor SV, Prather AA, Gottlieb LM, Huang LC, Phillips SE, Shyr Y, Adler NE, Stead WW.  Institute of Medicine Measures of Social and Behavioral Determinants of Health: A Feasibility Study.  Am J Prev Med (2016), http://dx.doi.org/10.1016/j.amepre.2016.07.033
  • Prather AA, Gottlieb L, Giuse NB, Koonce TY, Kusnoor SV, Stead WW, Adler NE. National Academy of Medicine Social and Behavioral Measures: Associations With Self-Reported Health. Am J Prev Med. 2017 Mar 21. pii: S0749-3797(17)30157-5. doi: 10.1016/j.amepre.2017.02.010
  • Koonce TY, Kusnoor SK, Hurley ST, McClellan KM, Giuse NB. Combining social and behavioral determinants of health questionnaires to inform precision medicine in a community health center clinic. Accepted for presentation to the American Medical Informatics Fall Symposium November 2017.