Help Desk: A Student Initiative to Help Address the Social Determinants of Health (2019-2020)

Background

Addressing the social determinants of health (SDOH) is a critical step in reducing health disparities. Leading health agencies have organized SDOH into six groups: food security, economic stability, education, neighborhood and physical environment, community and social context and the healthcare system. Studies indicate that SDOH account for nearly 70% of all health outcomes.

While there has been considerable and quality research identifying SDOH and the mechanisms that explain their impact, the best approaches to integrating health services with community and social services are yet to be defined.

Community health centers are at the forefront of interacting with patients who face unmet social needs. Thus, identifying opportunities to address SDOH within the constraints of a community health system’s workflow and resources is essential. Student volunteers, eager for meaningful clinical experiences, are a low-cost and untapped resource that community health centers can leverage to help address patients’ unmet social needs.

Project Description

This Bass Connections project will expand and evaluate a “Help Desk” program at Lincoln Community Health Center, in which student volunteers are included in the process that connects patients to community-based resources. The study will help facilitate data-driven improvements in implementation and establish the foundation for sustainability.

As a federally qualified health center in Durham, North Carolina, Lincoln cares for a particularly vulnerable population. The Lincoln Behavioral Health team currently screens patients for unmet social needs and refers them to community services. However, patients face many hurdles when looking for community-based resources, like identifying a service location accessible by public transport or understanding service eligibility criteria.

Beginning in Spring 2019, student volunteers will help patients navigate these barriers and thereby increase use of community resources. Furthermore, feedback from patients will help the behavioral health and student team to evaluate the capacity, appropriateness and effectiveness of the various community-based organizations to which they refer their patients.

The project team will serve as executive leadership for the Help Desk program and manage a volunteer cohort external to the project team. The team will be divided into three task forces:

  • Task Force 1: Health Service Delivery (HSD)
  • Task Force 2: Quality Improvement and Evaluation (QIE)
  • Task Force 3: Community Relations, Communications and Health Policy (CRCHP).

This project team also has the opportunity to inform state policy as North Carolina transitions to Medicaid managed care and recognizes the importance of addressing SDOH for population health management. In partnership with other community health centers in the state, the team will assess the barriers and facilitators to implementing standardized SDOH screening in response to new state policy. Findings from the Help Desk projects will be of interest to policymakers looking to sustain value-based care. Ultimately, this project aims to improve patients’ use of community resources, support volunteers’ development of pre-health professional core competencies and inform state policy.

Anticipated Outputs

Fully functional and sustainable student volunteer Help Desk program at Lincoln Community Health Center; implementation toolkit on adopting student Help Desk model; manuscripts for publication; policy briefs; dissemination of findings through project website and blogs

Student Opportunities

Ideally, this project team will include 6 undergraduates and 3 graduate students. Enthusiastic and dedicated students from a variety of disciplines are welcome to apply; however, an interest in public health and health systems is a must.

Each graduate student will lead a task force. Ideally, the task force composition will be as follows:

  • Task Force 1 (HSD): one graduate student (health professions student, such as from the School of Nursing); two undergraduate students with Spanish skills and interests in qualitative research and education
  • Task Force 2 (QIE): one graduate student with strong quantitative and data visualization skills (e.g., Masters in Interdisciplinary Data Science, M.Sc. in Global Health, Ph.D. candidate in School of Nursing); two undergraduate students with interests in data science (majors may include computer science, statistics, sociology, global health, etc.)
  • Task Force 3 (CRCHP): one graduate student (preferably M.P.P. or Duke-Margolis affiliate) and two undergraduate students with interests in community-based work, policy and ethics.

The project will facilitate collaborative learning through integrated research, skills development and weekly service. Students will work closely with the Lincoln Behavioral Health team to fine-tune a community-based directory that can be used for referrals. Students will also conduct surveys with Lincoln staff to ensure that the Help Desk is a meaningful and productive partnership for Lincoln.

Each team member is also expected to volunteer at the Help Desk for two to four hours each week, serving in a volunteer role.

Selected students will have the opportunity to travel to conferences to present research findings. 

Timing

Spring 2019 – Spring 2020

  • Spring 2019: Kick-off meeting with new team; introduction to previous Bass Connections project team; begin volunteer onboarding process with Lincoln Community Health Center
  • Fall 2019: Complete summer reading on social determinants of health; didactic training in social determinants, community engagement, quality improvement and implementation science; begin volunteering at Lincoln Help Desk; begin task force meeting and individual roles
  • Spring 2020: HSD task force conducts semi-structured interviews with students involved in the program and with Lincoln staff; QIE task force begins develops implementation toolkit; CHCHP collects data for project; CRCHP writes and disseminates policy brief

Crediting

Independent study credit available for fall and spring semesters

See earlier related team, Global Alliance on Disability and Health Innovation (GANDHI): What Makes Innovation Stick? (2018-2019).

Help Desk model.

/faculty/staff Team Members

  • Janet Prvu Bettger, School of Medicine-Orthopaedic Surgery*
  • Cynthia Broderius, Arts & Sciences
  • Connor Drake, School of Medicine-Duke Personalized Health Care*
  • Tara Ilsley-Murillo, School of Medicine-Community and Family Medicine: Community Health
  • Leslie Parkins, PAS Adm - Doce
  • Jen'nan Read, Arts & Sciences-Sociology
  • Laura Richman, School of Medicine-Population Health Sciences
  • Taruni Santanam, Margolis Center for Health Policy
  • Gillian Sanders Schmidler, School of Medicine-Population Health Sciences|Margolis Center for Health Policy

/zcommunity Team Members

  • Lincoln Community Health Center

Theme(s):