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.

项目概要/摘要 60 岁及以上的美国人没有充分利用推荐的预防性医疗保健。年长的 拉丁美洲裔美国人未充分利用预防服务的程度甚至比非西班牙裔美国人还要严重 白人，但人们对造成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，健康的社会决定因素（个人- 和社区层面的经济、社会和环境因素）影响预防性措施的利用 卫生保健。然而，尚不确定哪些特定服务可能未被老年人充分利用。 拉丁裔，以及哪些社会决定因素与该群体的利用最密切相关。 缺乏关于社会决定因素和预防性服务利用的知识 老年拉丁美洲人至少部分是由于缺乏流动健康的全面数据 护理利用与个人和社区层面健康社会决定因素的数据相关。 该项目将评估拉丁裔老年人和老年人在预防性服务使用方面的差异 非西班牙裔白人，并确定这些差异背后的因素。为此，我们将 利用来自大型全国社区卫生中心网络的独特数据资源 共享电子健康记录数据，该数据与社区层面的社会决定因素相关 健康数据。这个大型纵向数据集包含前所未有的数据链接，这将让 我们评估差异，评估哪些社会决定因素影响利用率和差异，以及 确定其中哪一个随着时间的推移可能会产生最显着的作用；在此过程中，我们将解决一个 重要的知识差距。了解最重要的因素（个人或社区） 影响预防服务的使用对于优先考虑基于人群的干预措施至关重要 改善预防性筛查。 了解健康问题社会决定因素对预防服务的相对影响 在年长的拉丁裔中使用将通过三种方式实现行动/干预： 1. 它将实现更知情的情况 改善美国老年人的公共卫生和健康的政策决定。 2. 将有利于 医疗保健提供者和社区机构之间的战略伙伴关系准备 干预美国老年人生活中的社会因素。 3.它将帮助临床提供者 了解患者使用护理的障碍，并进一步采取护理点努力来解决 这些障碍影响老年患者利用推荐的医疗保健 服务。