Development of PRAPARE Social Determinants of Health Clusters and Correlation with Diabetes and Hypertension Outcomes

Journal of the American Board of Family Medicine: JABFM

article

Wen Wan¹  Vivian Li²  Marshall H. Chin¹  David N. Faldmo³  Erin Hoefling³  Michelle Proser⁴  Rosy Chang Weir² 

[1] University of Chicago;Asian Pacific Community Health Organizations;Siouxland Community Health Center;National Association of Community Health Centers

关键词: Community Health Centers;    Cross-Sectional Studies;    Diabetes Mellitus;    HbA1c;    Hypertension;    Logistic Models;    Risk Factors;    Social Determinants of Health;    Vulnerable Populations;   

DOI  :  10.3122/jabfm.2022.04.200462

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Introduction: PRAPARE is a leading social risk screening tool. No studies yet have simplified the 22 PRAPARE social determinants of health (SDoH) into clusters to analyze associations with chronic disease outcomes.Methods: A federally qualified health center conducted cross-sectional PRAPARE screening on its general adult population. Exploratory and confirmatory factor analyses were used to identify SDoH clusters and construct cluster scores and SDoH total risk scores. Logistic regression assessed relationships between cluster scores and uncontrolled diabetes and/or hypertension.Results: Of the 11,773 adults who answered the survey, 716 had diabetes only, 2,388 had hypertension only, 1,477 had both, and 7,192 had neither. We found 3 composite SDoH clusters (social background, social insecurities, insurance/employment) and 3 standalone clusters (housing status, social isolation, poverty). Among patients with diabetes, those at risk in social background, social insecurities, and insurance/employment were more likely to have uncontrolled diabetes. Among patients with hypertension, those at more risk in social insecurities were more likely to have uncontrolled hypertension.Conclusions: We simplified the 22 PRAPARE SDoH into 3 composite clusters and 3 individual clusters and demonstrated the reliability and validity of PRAPARE. The 3 composite clusters were positively associated with uncontrolled diabetes and/or hypertension.

【 授权许可】

CC BY