CHSU Discovery

Background: Social determinants of health (SDOH), including socioeconomic status and education, significantly impact health outcomes and disparities. However, addressing SDOH in clinical practice remains challenging. Camarena Health utilizes the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences (PRAPARE) tool at health education visits to identify SDOH factors in diabetes mellitus (DM) patients and provide solutions, but its limited utilization persists due to time restraints and additional resources needed to facilitate the management of these patients. SMART Aim: This quality improvement study seeks to investigate the factors hindering the effective utilization of the PRAPARE tool and propose changes to the health education workflow. Methods: A survey was distributed to the health educators at Camarena Health to identify existing constraints. Subsequent adjustments were made to improve PRAPARE tool distribution, including extending appointment times to allow for more SDOH discussions with patients. Results: Post-intervention, there was a notable increase in the ratio of patients scored to those who were not, initially attributed to extended time. However, since then, there has been a decreasing trend in the ratio of patients scored and total patients scored, secondary to inconsistent patient selection for screening and use of the PRAPARE tool. Conclusions: With the study ongoing, the current sample size is insufficient for conclusive findings. Nonetheless, the intervention demonstrates potential for enhancing the utilization of the PRAPARE tool; increased appointment times allow for addressing questions, language barriers, and resources distribution. Further data collection and analysis will provide a more comprehensive understanding of the long-term impact of these workflow changes.