SOCIAL DETERMINANTS OF HEALTH SCREENING AND MITIGATION STRATEGIES: A
CYSTIC FIBROSIS QUALITY IMPROVEMENT PROCESS
Abstract
Introduction: Lower socioeconomic status is associated with
significantly poorer outcomes in weight, lung function, and pulmonary
exacerbation rates in People with CF (PwCF). Global aim: We aim to
reduce health disparities and inequities faced by PwCF by screening for
and addressing unmet social needs. Specific aims: We aimed to increase
routine Social Determinants of Health (SDoH) screening of eligible PwCF
from 0% to 95% and follow-up within two weeks for those PwCF who
screened positive and requested assistance from 0% to 95% by December
31, 2021. Methods: The Model for Improvement methodology was employed. A
process map and a simplified failure mode effects analysis chart were
created for the screening and SDoH follow-up process. Those who screened
positive for SDoH and requested assistance, a follow-up contact was made
to offer intervention. Intervention: Adult PwCF who had at least one UVA
Clinic encounter in 2021 were screened for SDoH. The SDoH screening tool
included eight domains: housing, food, transportation, utilities,
health-care access, medication access, income/employment and education.
Follow-up was completed with all PwCF who screened positive for SDoH.
Results: A total of 132 of 142, (93.0%) PwCF eligible for screening
completed the SDoH screening. Of the PwCF who completed screening, 56
(42.4%) screened positive for SDoH. A follow-up rate of 100% was
achieved in June 2021 and maintained through December 2021. Conclusion:
Implementing screening for SDOH and follow-up to mitigate social
difficulties in adult PwCF at UVA was successful and could be reproduced
at other CF care center.