Grant Details
Grant Number: |
3R01CA237322-04S2 Interpret this number |
Primary Investigator: |
Henrikson, Nora |
Organization: |
Kaiser Foundation Research Institute |
Project Title: |
Advancing Health Equity Through Implementation Science: Phase II Administrative Supplement |
Fiscal Year: |
2023 |
Abstract
SUMMARY
Social determinants of health and its downstream social risks such as housing instability, food insecurity, and
financial strain, are key drivers of cancer health inequities. Healthcare systems’ engagement in identifying and
addressing social needs is a new and evolving field. In particular, limited resources exist to guide healthcare
clinics in selecting, implementing, and optimizing social service resource locators (SSRLs) for their specific
context. The purpose of this supplement is to draw on learnings from our team’s previous pilot efforts in
supporting clinics’ adoption of different SSRL approaches to develop a pragmatic guide for implementation of
social risk referral-making and documentation. This supplement is a collaborative effort across four ISC3
Centers: BRIDGE-C2, Harvard ISCCCE, OPTICC (Optimizing Implementation in Cancer Control) Center, and
Washington University-ISC3. We propose to: (1) develop a pragmatic, applied guidebook (the Guide) for clinics
seeking to implement, expand, or optimize efforts to address patient-reported social risks using Assistance
strategies; (2) use rapid-cycle testing to identify best practices for implementing the Guide; and (3) iterate and
disseminate the refined Guide. In Aim 1, we will develop a pragmatic Guide to help primary care practices: 1)
select an Assistance strategy and a related SSRL approach, and associated workflows for conducting these
strategies in practice, including documenting social risk referrals; and 2) adopt, optimize, and sustain these
workflows. Subsequently, in Aim 2 we will 1) provide the Guide to diverse clinics (urban and rural Federally
Qualified Health Centers; primary care clinics) at different stages of SSRL implementation, in three ISC3
laboratories; 2) identify facilitators and barriers to implementing the Guide; and 3) identify the support needed
to use the Guide. ISCCCE, OPTICC, and WU-ISC3 will use a series of rapid cycle turns with their clinical
partner sites. We will use the Phase I supplement outer context dataset to identify key social resource needs
that should be addressed in each clinic setting and rapid cycle testing using user-centered designed methods
will be used to refine the Guide based on pilot learnings. Rapid tests using OPTICC state II methods of small
changes for improvement will be tracked systematically. We will also track the implementation strategies used
to support the Guide’s use, whether provided by ISC3 center staff or participating clinic sites. Clinics were
selected to ensure variation in the ‘community vital signs’ associated with the populations they serve, as
determined using our outer contextual database that was developed in Phase 1, and in the stages of
implementing Assistance strategies, increasing generalizability. Finally, in Aim 3, we will finalize refining the
Guide based on the findings of Aim 2, and disseminate it as a public good. Ultimately, this proposal will lead a
public guide that can immediately be disseminated across ISC3 members’ community partners, and
nationwide.
Publications
None. See parent grant details.