Top

BMC Health Services Research

Published in:

Open Access 01-12-2023 | Research article

Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH)

Author: Kaprea F. Johnson

Published in: BMC Health Services Research | Issue 1/2023

Abstract

Background

The purpose of this study was to validate a scale that can be used by healthcare service professionals, healthcare systems, educators, and researchers to assess health service professionals’ social determinants of health (SDOH) competency; with competency defined as their knowledge, awareness-biases, skills, and actual preparedness to address SDOH challenges.

Methods

An Exploratory Factor Analysis (EFA) was conducted with a sample of 220 health service professionals, and 6 factors were identified. A Confirmatory Factor Analysis (CFA) was conducted with 303 health service professionals and the 6-factor solution was supported, with 22 items.

Results

The reliability estimates for the 6 factors are as follows: Factor 1, Action Toward Addressing SDOH (a = .85); Factor 2, SDOH Knowledge (a = .94); Factor 3, Negative Attitude toward Addressing SDOH (a = .79); Factor 4, Systemic Accountability (a = .81); Factor 5, School Preparation (a = .86); and Factor 6, Perception of the Cause of SDOH (a = .94).

Conclusion

The ACN:SDH scale is the first validated measure that can be used to systematically appraise health service professionals’ SDOH competency.

Available only for authorised users

World Health Organization. Social determinants of health; 2018. https://www.who.int/social_determinants/en/. Accessed 6 Dec 2019.

Allen J, Balfour R, Bell R, Marmot M. Social determinants of mental health. Int Rev Psychiatry. 2014;26(4):392–407. https://doi.org/10.3109/09540261.2014.928270.CrossRefPubMed

Gurewich D, Garg A, Kressin NR. Addressing social determinants of health within healthcare delivery systems: a framework to ground and inform health outcomes. J Gen Intern Med. 2020;35(5):1571–5.CrossRefPubMedPubMedCentral

Alley DE, Asomugha CN, Conway PH, et al. Accountable health communities — addressing social needs through Medicare and Medicaid. N Engl J Med. 2016;374(1):8–11. https://doi.org/10.1056/nejmp1512532.CrossRefPubMed

Garg A, Boynton-Jarrett R, Dworkin PH. Avoiding the unintended consequences of screening for social determinants of health. JAMA. 2016;316(8):813. https://doi.org/10.1001/jama.2016.9282.CrossRefPubMed

Hunter KA, Thomson BA. scoping review of social determinants of health curricula in post-graduate medical education. Can Med Educ J. 2019;10(3):e61-71. https://doi.org/10.36834/cmej.61709.CrossRefPubMedPubMedCentral

Johnson KF, Brookover DL. School counselors’ knowledge, actions, and recommendations for addressing social determinants of health with students, families, and in communities. Prof Sch Couns J. 2021;25(1):1–12. https://doi.org/10.1177/2156759X20985847.CrossRef

Sisler SM, Schapiro NA, Stephan L, et al. Consider the root of the problem: increasing trainee skills at assessing and addressing social determinants of health. Transl Behav Med. 2019;9(3):523–32. https://doi.org/10.1093/tbm/ibz046.CrossRefPubMedPubMedCentral

Lavis J. Perspective: ideas at the margin or marginalized ideas? Nonmedical determinants of health in Canada. Health Aff. 2002;21:107–12. https://doi.org/10.1377/hlthaff.21.2.107.CrossRef

10.

Collins PA, Abelson J, Eyles JD. Knowledge into action? Health Policy. 2007;80(1):158–71. https://doi.org/10.1016/j.healthpol.2006.02.014.CrossRefPubMed

11.

Peeler AW. Strategies for cost saving through social determinants of health. J Healthc Manag. 2019;64(4):222–30. https://doi.org/10.1097/JHM-D-19-00113.CrossRefPubMed

12.

Hassan A, Scherer EA, Pikcilingis A, et al. Improving social determinants of health: effectiveness of a web-based intervention. Am J Prev Med. 2015;49(6):822–31. https://doi.org/10.1016/j.amepre.2015.04.023.CrossRefPubMed

13.

Parrill R. A framework for developing, implementing, and evaluating a social determinants of health initiative. J Healthc Manag. 2020;65(4):256–64. https://doi.org/10.1097/JHM-D-20-00098.CrossRefPubMed

14.

Mattessich PW, Rausch EJ. Cross-sector collaboration to improve community health: a view of the current landscape. Health Aff. 2014;33(11):1968–74. https://doi.org/10.1377/hlthaff.2014.0645.CrossRef

15.

Institute of Medicine (IOM). Measuring the impact of interprofessional education on collaborative practice and patient outcomes. Washington, DC: The National Academies Press; 2015. https://doi.org/10.17226/21726. https://www.ncbi.nlm.nih.gov/books/NBK338360/.CrossRef

16.

Andermann A. Taking action on the social determinants of health in clinical practice: a framework for health professionals. Can Med Assoc J. 2016;188(17–18):E474–83. https://doi.org/10.1503/cmaj.160177.CrossRef

17.

Dauner KN, Loomer L. A qualitative assessment of barriers and facilitators associated with addressing social determinants of health among members of a health collaborative in the rural Midwest. BMC Health Serv Res. 2021;21(1):1–12. https://doi.org/10.1186/s12913-021-06859-6.CrossRef

18.

Brimacombe M, Chaulk P, Eyles J, Kochling A, Lomas J, MacDonald G, Moase O, Pranger T, Rachlis M, Stoddart G. PEI system evaluation project: a guide to system evaluation: assessing the health and social services system in PEI. Prince Edward Island: Published; 1997.

19.

Institute of Medicine, Board on Health Care Services, & Committee on the Future of Rural Health Care. Quality through collaboration: the future of Rural Health (The Future of Rural Health Care). 1st ed. Washington, DC: National Academies Press; 2005 https://www.nap.edu/read/11140/chapter/1.

20.

Arredondo P, Toporek R, Brown SP, Jones J, Locke DC, Sanchez J, Stadler H. Operationalization of the multicultural counseling competencies. J Multicult Couns Dev. 1996;24(1):42–78. https://doi.org/10.1002/j.2161-1912.1996.tb00288.x.CrossRef

21.

Sue DW, Arredondo P, McDavis RJ. Multicultural counseling competencies and standards: a call to the profession. J Multicult Couns Dev. 1992;20(2):64–88. https://doi.org/10.1002/j.2161-1912.1992.tb00563.x.CrossRef

22.

Olson D, Oldfield B, Morales Navarro S. Standardizing social determinants of health assessments. Health Affairs Blog; 2019. Available at: https://www.pcpcc.org/2019/03/19/standardizing-social-determinants-health-assessments.

23.

Arredondo P, Toporek R, Brown SP, et al. Operationalization of the multicultural counseling competencies. J Multicult Couns Devel. 1996;24(1):42–78. https://doi.org/10.1002/j.2161-1912.1996.tb00288.x.CrossRef

24.

Sue DW, Arredondo P, McDavis RJ. Multicultural counseling competencies and standards: a call to the profession. J Multicult Couns Devel. 1992;20(2):64–88. https://doi.org/10.1002/j.2161-1912.1992.tb00563.x.CrossRef

25.

Boateng GO, Neilands TB, Frongillo EA, et al. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health. 2018;6:149. https://doi.org/10.3389/fpubh.2018.00149.CrossRefPubMedPubMedCentral

26.

Pedrero V, Bernales M, Chepo M, et al. Development of an instrument to measure the cultural competence of health care workers. Rev Saude Publica. 2020;54:29. https://doi.org/10.11606/s1518-8787.2020054001695.CrossRefPubMedPubMedCentral

27.

Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55. https://doi.org/10.1080/10705519909540118.CrossRef

28.

Brown TA. Confirmatory factor analysis for applied research. New York: The Guilford Press; 2015.

29.

Kline RB. Principles and practice of structural equation modeling. 4th ed. New York: Guilford Press; 2016.

30.

Kaiser H. A second generation little jiffy. Psychometrika. 1970;35(4):401–15 https://link.springer.com/article/10.1007/BF02291817.CrossRef

31.

Bartlett MS. A note on the multiplying factors for various chi square approximation. J R Stat Soc Series B Method. 1954;16(2):296–8 https://www.jstor.org/stable/2984057.

32.

Cohen J. A power primer. Psychol Bull. 1992;112:155–9. https://doi.org/10.1037/0033-2909.112.1.155.CrossRefPubMed

33.

Marzorati C, Pravettoni G. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes. J Multidiscip Healthc. 2017;10:101–6. https://doi.org/10.2147/JMDH.S122383.CrossRefPubMedPubMedCentral

34.

Institute of Medicine, Board on Health Care Services, & Committee on the Future of Rural Health Care. Introduction. In: Quality Through Collaboration: The Future of Rural Health (The Future of Rural Health Care). 1st ed. Washington, DC: National Academies Press; 2005:19–28. https://www.nap.edu/read/11140/chapter/1.

35.

Grimshaw JM, Eccles MP, Walker AE, et al. Changing physicians’ behavior: what works and thoughts on getting more things to work. J Contin Educ Health Prof. 2002;22:237–43. https://doi.org/10.1002/chp.1340220408.CrossRefPubMed

Title: Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH)
Author: Kaprea F. Johnson
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2023
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-09292-z

2024 ASCO Annual Meeting

Springer Medicine

Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH)

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Postabortion and safe abortion care coverage, capacity, and caseloads during the global gag rule policy period in Ethiopia and Uganda

Cost minimization analysis of a hexavalent vaccine in Argentina

Healthcare leaders’ and elected politicians’ approach to support-systems and requirements for complying with quality and safety regulation in nursing homes – a case study

Assessment of the operation status of electronic prescription at community pharmacies in Chengdu, China: a simulated patient study

Estimating the cost of HIV services for key populations provided by the LINKAGES program in Kenya and Malawi

Development of a brief, generic, modular resource-use measure (ModRUM): piloting with patients