Poster Type: Research

Category: Social Determinants of Health

Research Objectives: This project explored the relationship between multiple predictors measured in the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) assessment tool and chronic health diagnoses in patients seen in 2019 at Community Clinic, a federally qualified health center (FQHC), located in Northwest Arkansas.

Study Design/Methods: PRAPARE surveys were completed and results were reported by 6,481 patients in Community Clinic’s Electronic Medical Records (EMR). A comprehensive report of all factors recorded was produced from EMR PRAPARE SmartForm. After removing incomplete responses, survey results from 3,436 patients were used to explore risk factors for varied health outcomes. Logistic regressions examined the relationship between predictor variables, such as demographic factors (e.g., sex, race, and ethnicity) and social determinants of health measured in the PRAPARE survey, and hypertension and depression.

Principal Findings and Quantitative/Qualitative Results: Patients with a diagnosis of hypertension (n=274) had a significantly higher odd of suffering from housing insecurity (AOR=1.20, 95% CI: .790-1.828), experiencing quite a bit of stress (AOR=2.013, 95% CI: 1.248-3.248), and difficulty with consistent transportation (AOR=1.533, 95% CI: .792-2.925). Patients with a diagnosis of depression (n=18) demonstrated a significantly higher odd of suffering from housing insecurity (AOR=1.148, 95% CI: .290-4.547), experiencing very much stress (AOR=10.641, 95% CI: 1.244-91.036), and difficulty with transportation (AOR=3.094, 95% CI: .601-15.929). Those with depression reported participating in less regular socialization, with substantial amounts reporting socializing less than once a week (AOR=2.157, 95% CI: .544-8.548).

Conclusions on Impact on Health Centers: Due to small sample sizes within each diagnosis group and adjusted odds ratio in comparison to the number of total respondents, the associations found may be unreliable. However, within the group of hypertensive and depression patients, Community Clinic can look to provide assistance in the areas addressed by the PRAPARE tool. The patient advocates, behavioral health team and other medical staff at Community Clinic can aid in addressing the needs of these patients, regarding housing, transportation, and healthy socialization to improve health outcomes.

Author(s):

Abbie Luzius, MS, CHES, CTTTS, Community Development Manager, Community Clinic