Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents
Abstract Background Up to 60% of preventable mortality is attributable to social determinants of health (SDOH), yet training on SDOH competencies is not widely implemented in residency. The objective of this study was to assess internal and family medicine residents’ competence at identifying and ad...
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doaj-2870cf7f50d547d68fb7bf3772f8f9cf2021-01-17T12:09:37ZengBMCBMC Medical Education1472-69202020-01-012011610.1186/s12909-020-1931-1Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residentsLauren A. Gard0Andrew J. Cooper1Quentin Youmans2Aashish Didwania3Stephen D. Persell4Muriel Jean-Jacques5Paul Ravenna6Mita Sanghavi Goel7Matthew J. O’Brien8Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineDivision of Cardiology, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics; Center for Primary Care Innovation, Institute for Public Health and Medicine, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineDepartment of Family and Community Medicine, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of MedicineAbstract Background Up to 60% of preventable mortality is attributable to social determinants of health (SDOH), yet training on SDOH competencies is not widely implemented in residency. The objective of this study was to assess internal and family medicine residents’ competence at identifying and addressing SDOH. Methods Residents’ perceived competence at identifying, discussing, and addressing SDOH in outpatient settings was assessed using a single questionnaire administered in March 2017. In this cross-sectional analysis, bivariate associations of resident characteristics with the following outcomes were examined: identifying, discussing, and addressing patients’ challenges related to SDOH through referrals. Results The survey was completed by 129 (84%) residents. Twenty residents (16%) reported an annual income of less than $50,000 during childhood. Overall, 108 residents (84%) reported previous SDOH training. Two-thirds had outpatient practices in Veterans Affairs or safety-net clinics. Thirty-nine (30%) intended to pursue a career in primary care. The following numbers of residents reported high levels of competence for performing these outcomes: identifying patients’ challenges related to SDOH: 37 (29%); discussing them with patients: 18 (14%); and addressing these challenges through referrals to internal and external resources: 13 (10%) and 11 (9%), respectively. Factors associated with higher competence included older age, lower childhood household income, prior education about SDOH, primary practice site and intention to practice primary care. Conclusions Most residents had previous SDOH training, yet only a small proportion of residents reported being highly competent at identifying or addressing SDOH. Providing opportunities for practical training may be a key component in preparing medical residents to identify and address SDOH effectively in outpatient practice.https://doi.org/10.1186/s12909-020-1931-1Social determinants of healthGraduate medical educationPrimary care |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lauren A. Gard Andrew J. Cooper Quentin Youmans Aashish Didwania Stephen D. Persell Muriel Jean-Jacques Paul Ravenna Mita Sanghavi Goel Matthew J. O’Brien |
spellingShingle |
Lauren A. Gard Andrew J. Cooper Quentin Youmans Aashish Didwania Stephen D. Persell Muriel Jean-Jacques Paul Ravenna Mita Sanghavi Goel Matthew J. O’Brien Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents BMC Medical Education Social determinants of health Graduate medical education Primary care |
author_facet |
Lauren A. Gard Andrew J. Cooper Quentin Youmans Aashish Didwania Stephen D. Persell Muriel Jean-Jacques Paul Ravenna Mita Sanghavi Goel Matthew J. O’Brien |
author_sort |
Lauren A. Gard |
title |
Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
title_short |
Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
title_full |
Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
title_fullStr |
Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
title_full_unstemmed |
Identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
title_sort |
identifying and addressing social determinants of health in outpatient practice: results of a program-wide survey of internal and family medicine residents |
publisher |
BMC |
series |
BMC Medical Education |
issn |
1472-6920 |
publishDate |
2020-01-01 |
description |
Abstract Background Up to 60% of preventable mortality is attributable to social determinants of health (SDOH), yet training on SDOH competencies is not widely implemented in residency. The objective of this study was to assess internal and family medicine residents’ competence at identifying and addressing SDOH. Methods Residents’ perceived competence at identifying, discussing, and addressing SDOH in outpatient settings was assessed using a single questionnaire administered in March 2017. In this cross-sectional analysis, bivariate associations of resident characteristics with the following outcomes were examined: identifying, discussing, and addressing patients’ challenges related to SDOH through referrals. Results The survey was completed by 129 (84%) residents. Twenty residents (16%) reported an annual income of less than $50,000 during childhood. Overall, 108 residents (84%) reported previous SDOH training. Two-thirds had outpatient practices in Veterans Affairs or safety-net clinics. Thirty-nine (30%) intended to pursue a career in primary care. The following numbers of residents reported high levels of competence for performing these outcomes: identifying patients’ challenges related to SDOH: 37 (29%); discussing them with patients: 18 (14%); and addressing these challenges through referrals to internal and external resources: 13 (10%) and 11 (9%), respectively. Factors associated with higher competence included older age, lower childhood household income, prior education about SDOH, primary practice site and intention to practice primary care. Conclusions Most residents had previous SDOH training, yet only a small proportion of residents reported being highly competent at identifying or addressing SDOH. Providing opportunities for practical training may be a key component in preparing medical residents to identify and address SDOH effectively in outpatient practice. |
topic |
Social determinants of health Graduate medical education Primary care |
url |
https://doi.org/10.1186/s12909-020-1931-1 |
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