PAST-DUE (Prevention and Social Determinants: Disparities and Utilization in Latino Elders)

逾期（预防和社会决定因素：拉丁裔老年人的差异和利用）

• 批准号: 10179262
• 负责人: John Heintzman
• 金额: $ 42.64万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179262
• 关键词: Accounting; Address; Adult; Affect; Age; American; Americas; Area; Cardiovascular system; Characteristics; Clinic; Clinical; Communities; Community Health Networks; Data; Data Linkages; Data Set; Databases; Demographic Factors; Economic Factors; Economics; Elderly; Electronic Health Record; Environmental Risk Factor; Foundations; Goals; Guidelines; Health; Health Personnel; Health Services; Healthcare; Hispanics; Immunization; Income; Individual; Insurance; Intervention; Knowledge; Language; Latino; Link; Literature; Low income; Migrant; Neighborhood Health Center; Not Hispanic or Latino; Older Population; Patient Care; Patients; Patterns of Care; Policies; Policy Maker; Population; Population Research; Prevention; Prevention Measures; Preventive care; Preventive healthcare; Preventive screening; Preventive service; Process; Provider; Public Health; Recommendation; Research; Risk; Risk Assessment; Risk Reduction; Screening for cancer; Services; Surveys; Time; United States; Vulnerable Populations; Work; aged; barrier to care; base; built environment; cardiovascular disorder prevention; care seeking; care systems; cohort; data resource; density; ethnic minority population; evidence base; evidence based guidelines; fracture risk; health care service; health care service utilization; health data; healthcare community; improved; innovation; longitudinal analysis; longitudinal dataset; novel; older patient; patient oriented; patient-level barriers; point of care; poor communities; population based; preference; racial and ethnic; response; screening; segregation; service uptake; service utilization; social determinants; social factors; social health determinants; success; uptake

Project Summary/Abstract Americans aged 60 and over underutilize recommended preventive healthcare. Older Latino-Americans underutilize preventive services to an even greater degree than non-Hispanic whites, but the factors that drive this disparity most heavily are poorly understood. Some evidence in the health services literature suggests that social determinants of health (individual- and community-level economic, social, and environmental factors) affect utilization of preventive health care. It is uncertain, however, which specific services may be most underused by older Latinos, and which social determinants are most strongly associated with this group's utilization. The dearth of knowledge about social determinants and preventive service utilization in older Latinos is due, at least in part, to the lack of comprehensive data on ambulatory health care utilization linked to data on individual- and community-level social determinants of health. This project will assess disparities in preventive service use between older Latinos and older non-Hispanic Whites, and identify the factors underlying those disparities. To do so, we will leverage a unique data resource from a large, national network of community health centers with shared electronic health record data that is linked to community-level social determinants of health data. This large, longitudinal dataset contains unprecedented data linkages which will let us assess disparities, evaluate which social determinants affect utilization and disparities, and determine which of these may do so most significantly over time; in so doing, we will address an important knowledge gap. Understanding the factors (individual or community) that most heavily impact preventive service use is crucial to the prioritization of population-based interventions to improve preventive screening. Understanding the relative impact of social determinants of health on preventive service use in older Latinos will enable action/intervention in three ways: 1. It will enable more informed policy decisions to improve public health and wellness in older Americans. 2. It will facilitate strategic partnerships between healthcare providers and community agencies poised to intervene in social factors in the lives of older Americans. 3. It will help clinical providers understand their patients' barriers to care utilization, and further point-of-care efforts to address these barriers that influence their older patients' utilization of recommended health care services.

项目摘要/摘要 60岁及60岁以上的美国人推荐的预防性医疗保健。年龄较大 拉丁美洲裔美国人将预防服务不足的程度与非西班牙裔更大的程度 白人，但是驱动这种差异最严重的因素知之甚少。一些 卫生服务文献中的证据表明，卫生的社会决定因素（个人 - 以及社区级的经济，社会和环境因素）影响预防性的利用 卫生保健。但是，尚不确定，哪些特定服务可能最不受限制 拉丁美洲人，哪些社会决定因素与该群体的利用率最密切相关。 缺乏有关社会决定因素和预防服务利用的知识 较旧的拉丁裔至少部分是由于缺乏关于门诊健康的全面数据 与个人和社区级别的健康决定因素有关的数据链接的护理利用。 该项目将评估较老的拉丁裔和老年人之间预防服务使用的差异 非西班牙裔白人，并确定这些差异的因素。为此，我们会 利用大型国家卫生中心的大型国家网络利用独特的数据资源 具有共享的电子健康记录数据，与社区级的社会决定因素有关 健康数据。这个较大的纵向数据集包含前所未有的数据链接 美国评估差异，评估哪些社会决定因素会影响利用率和差异，以及 随着时间的流逝，确定其中哪一个可能会大大显着；这样做，我们将解决 重要的知识差距。了解最严重的因素（个人或社区） 影响预防性服务的使用对于基于人群的干预措施的优先级至关重要 改善预防性筛查。 了解健康的社会决定因素对预防服务的相对影响 在较旧的拉丁裔中，将以三种方式启用行动/干预：1。 改善美国人的公共卫生和健康的政策决定。 2。它将有助于 医疗保健提供者与社区机构之间的战略伙伴关系 干预年龄较大的美国人生活中的社会因素。 3。它将帮助临床提供者 了解他们的患者的护理利用障碍，并进一步保健解决 这些影响其老年患者推荐医疗保健的障碍 服务。