F31NR020856

Informatics Resources for Social Determinants of Health in School-Based Health Centers - Project Summary

Social determinants of health (SDOH) are associated with poor health outcomes and health disparities. The National Academies of Sciences, Engineering, and Medicine's Future of Nursing report encourages clinicians to address SDOH, which are the environmental conditions in which people live, learn, work, play, and worship, that can affect health, functioning, and quality-of-life.

While there is a large corpus of knowledge associating SDOH with childhood asthma, a gap exists on screening of SDOH in school-based health centers (SBHCs). SBHCs care for children pre-kindergarten to 18 years of age, working collaboratively with the school nurse to advance the health and well-being of all youth.

Although SBHCs have access to individual-level health information about the child, SBHC providers do not have easy access to SDOH information at the neighborhood and community level. Screening pediatric families for SDOH in a systematic way can facilitate connection to pertinent resources. However, there is a dearth of information regarding SDOH screening and the role of SBHCs in pediatric SDOH interventions.

This project focuses on the critical need to identify the facilitators and barriers of SDOH information gathering behaviors in SBHCs. Through an exploratory sequential design, the project will include the development of an informatics resource providing SDOH information to SBHC providers. Asthma will serve as the first clinical condition for this novel work.

The investigators will address three specific aims:

Aim 1: Describe the information gathering behaviors for SDOH and asthma performed by school-based health providers (i.e., nurse practitioners, physicians, physician assistants) for preventative asthma care, and what barriers exist for information gathering.

Aim 2: Develop and evaluate an informatics resource that provides actionable SDOH information related to the preventative management of asthma.

Aim 3: Evaluate the feasibility of an informatics resource comprising SDOH among school-based health providers for use in the preventative management of asthma.

The PI will receive research training through the rich scientific environment of Vanderbilt University. Training goals will focus on acquiring knowledge and skills in biomedical informatics, research methodology, qualitative focus groups, SDOH, and responsible conduct of research. The highly experienced mentorship team will provide support to make continued progress toward independence in a program of research focused on SDOH in school-based health centers, of which this project is a key component.

Upon successful completion of the proposed study, contributions are expected to fill a critical knowledge gap with evidence that supports screening for SDOH by school-based health providers. These contributions will be significant because they are expected to provide a way to operationalize SDOH, to prevent asthma exacerbations, and address social needs to improve the lives of school-age children.

The proposed study supports the mission of NINR through inquiry that addresses both the SDOH and health equity research lenses in the unique setting of school-based health centers.

Vanderbilt University

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.361 - Nursing Research

National Institute of Nursing Research (NINR) [HHS - NIH]

Tennessee United States

State-Wide

Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship (Parent F31) (PA-21-051)