TY - JOUR
T1 - Social Determinants of Health Training in U.S. Primary Care Residency Programs
T2 - A Scoping Review
AU - Gard, Lauren A.
AU - Peterson, Jonna
AU - Miller, Corrine
AU - Ghosh, Nilasha
AU - Youmans, Quentin
AU - Didwania, Aashish
AU - Persell, Stephen D.
AU - Jean-Jacques, Muriel
AU - Ravenna, Paul
AU - O'Brien, Matthew J.
AU - Sanghavi Goel, Mita
N1 - Funding Information:
Funding/Support: This project is supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services under grant number UH1HP29963, Academic Units for Primary Care Training and Enhancement.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Purpose Medical training has traditionally focused on the proximate determinants of disease, with little focus on how social conditions influence health. The authors conducted a scoping review of existing curricula to understand the current programs designed to teach primary care residents about the social determinants of health (SDH). Method In January and March 2017, the authors searched seven databases. Eligible articles focused on primary care residents, described a curriculum related to SDH, were published between January 2007 and January 2017, and were based in the United States. Results Of the initial 5,523 articles identified, 43 met study eligibility criteria. Most programs (29; 67%) were in internal medicine. Sixteen studies (37%) described the curriculum development process. Overall, 20 programs (47%) were short or one-time sessions, and 15 (35%) were longitudinal programs lasting at least 6 months. Thirty-two programs (74%) reported teaching SDH content using didactics, 22 (51%) incorporated experiential learning, and many programs (n = 38; 88%) employed both. Most studies reported satisfaction and/or self-perceived changes in knowledge or attitudes. Conclusions The authors identified wide variation in curriculum development, implementation, and evaluation. They highlight curricula that considered community and resident needs, used conceptual frameworks or engaged multiple stakeholders to select content, used multiple delivery methods, and focused evaluation on changes in skills or behaviors. This review highlights the need not only for systematic, standardized approaches to developing and delivering SDH curricula but also for developing rigorous evaluation of the curricula, particularly effects on resident behavior.
AB - Purpose Medical training has traditionally focused on the proximate determinants of disease, with little focus on how social conditions influence health. The authors conducted a scoping review of existing curricula to understand the current programs designed to teach primary care residents about the social determinants of health (SDH). Method In January and March 2017, the authors searched seven databases. Eligible articles focused on primary care residents, described a curriculum related to SDH, were published between January 2007 and January 2017, and were based in the United States. Results Of the initial 5,523 articles identified, 43 met study eligibility criteria. Most programs (29; 67%) were in internal medicine. Sixteen studies (37%) described the curriculum development process. Overall, 20 programs (47%) were short or one-time sessions, and 15 (35%) were longitudinal programs lasting at least 6 months. Thirty-two programs (74%) reported teaching SDH content using didactics, 22 (51%) incorporated experiential learning, and many programs (n = 38; 88%) employed both. Most studies reported satisfaction and/or self-perceived changes in knowledge or attitudes. Conclusions The authors identified wide variation in curriculum development, implementation, and evaluation. They highlight curricula that considered community and resident needs, used conceptual frameworks or engaged multiple stakeholders to select content, used multiple delivery methods, and focused evaluation on changes in skills or behaviors. This review highlights the need not only for systematic, standardized approaches to developing and delivering SDH curricula but also for developing rigorous evaluation of the curricula, particularly effects on resident behavior.
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U2 - 10.1097/ACM.0000000000002491
DO - 10.1097/ACM.0000000000002491
M3 - Review article
C2 - 30334837
AN - SCOPUS:85059127775
VL - 94
SP - 135
EP - 143
JO - Academic Medicine
JF - Academic Medicine
SN - 1040-2446
IS - 1
ER -