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Lyles C, Berrean B, Buenaventura A, Milter S, Hernandez DD, Sarkar U, Gutierrez C, Palmer N, Brown III W. Building a Client Resource and Communication Platform for Community-Based Organizations to Address Health and Social Needs: Co-Design Study. JMIR Hum Factors 2024; 11:e53939. [PMID: 39157908 PMCID: PMC11342060 DOI: 10.2196/53939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 08/20/2024] Open
Abstract
Background Connecting individuals to existing community resources is critical to addressing social needs and improving population health. While there is much ongoing informatics work embedding social needs screening and referrals into health care systems and their electronic health records, there has been less focus on the digital ecosystem and needs of community-based organizations (CBOs) providing or connecting individuals to these resources. Objective We used human-centered design to develop a digital platform for CBOs, focused on identification of health and social resources and communication with their clients. Methods Centered in the Develop phase of the design process, we conducted in-depth interviews in 2 phases with community-based organizational leadership and staff to create and iterate on the platform. We elicited and mapped participant feedback to theory-informed domains from the Technology Acceptance Model, such as Usefulness and Ease of Use, to build the final product and summarized all major design decisions as the platform development proceeded. Results Overall, we completed 22 interviews with 18 community-based organizational leadership and staff in 2 consecutive Develop phases. After coding of the interview transcripts, there were 4 major themes related to usability, relevance, and external factors impacting use. Specifically, CBOs expressed an interest in a customer relationship management software to manage their client interactions and communications, and they needed specific additional features to address the scope of their everyday work, namely (1) digital and SMS text messaging communication with clients and (2) easy ways to identify relevant community resources based on diverse client needs and various program eligibility criteria. Finally, clear implementation needs emerged, such as digital training and support for staff using new platforms. The final platform, titled "Mapping to Enhance the Vitality of Engaged Neighborhoods (MAVEN)," was completed in the Salesforce environment in 2022, and it included features and functions directly mapped to the design process. Conclusions Engaging community organizations in user-centered design of a health and social resource platform was essential to tapping into their deep expertise in serving local communities and neighborhoods. Design methods informed by behavioral theory can be similarly employed in other informatics research. Moving forward, much more work will be necessary to support the implementation of platforms specific to CBOs' needs, especially given the resources, training, and customization needed in these settings.
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Affiliation(s)
- Courtney Lyles
- UC Davis Center for Healthcare Policy and Research, UC Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Beth Berrean
- Technology Services Unit, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Ana Buenaventura
- Technology Services Unit, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Svetlana Milter
- Technology Services Unit, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Dayana Daniel Hernandez
- Technology Services Unit, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Urmimala Sarkar
- Department of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - Christian Gutierrez
- Department of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - Nynikka Palmer
- Department of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - William Brown III
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Steeves-Reece AL, Nicolaidis C, Richardson DM, Frangie M, Gomez-Arboleda K, Barnes C, Kang M, Goldberg B, Lindner SR, Davis MM. "It Made Me Feel like Things Are Starting to Change in Society:" A Qualitative Study to Foster Positive Patient Experiences during Phone-Based Social Needs Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12668. [PMID: 36231967 PMCID: PMC9566653 DOI: 10.3390/ijerph191912668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Many healthcare organizations are screening patients for health-related social needs (HRSN) to improve healthcare quality and outcomes. Due to both the COVID-19 pandemic and limited time during clinical visits, much of this screening is now happening by phone. To promote healing and avoid harm, it is vital to understand patient experiences and recommendations regarding these activities. We conducted a pragmatic qualitative study with patients who had participated in a HRSN intervention. We applied maximum variation sampling, completed recruitment and interviews by phone, and carried out an inductive reflexive thematic analysis. From August to November 2021 we interviewed 34 patients, developed 6 themes, and used these themes to create a framework for generating positive patient experiences during phone-based HRSN interventions. First, we found patients were likely to have initial skepticism or reservations about the intervention. Second, we identified 4 positive intervention components regarding patient experience: transparency and respect for patient autonomy; kind demeanor; genuine intention to help; and attentiveness and responsiveness to patients' situations. Finally, we found patients could be left with feelings of appreciation or hope, regardless of whether they connected with HRSN resources. Healthcare organizations can incorporate our framework into trainings for team members carrying out phone-based HRSN interventions.
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Affiliation(s)
- Anna L. Steeves-Reece
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Christina Nicolaidis
- School of Social Work, Portland State University, Portland, OR 97201, USA
- Division of General Internal Medicine and Geriatrics, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Dawn M. Richardson
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
| | - Melissa Frangie
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Katherin Gomez-Arboleda
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Chrystal Barnes
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Minnie Kang
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Bruce Goldberg
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
| | - Stephan R. Lindner
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
- Center for Health Systems Effectiveness, Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Melinda M. Davis
- School of Public Health, Portland State University—Oregon Health & Science University, Portland, OR 97201, USA
- Oregon Rural Practice-Based Research Network, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
- Department of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
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