Social and Behavioral Determinants of Health
The purpose of the Evidence-based Standardized Social and Behavior Determinants of Health (SBDH) Interventions is to provide a resource of basic and brief interventions for problems mapped to the Institute of Medicine’s (IOM) suggested SBDH problems. Initial research and IOM/Omaha System mapping was done by Dr. Karen Monsen and Omaha System Community of Practice colleagues in 2015-2016. The SBDH interventions provide a standard stock of interventions providers can draw upon to guide and document work done with the Social and Behavioral Determinants of Health. The interventions came from a combination of currently vetted standards on the Omaha System Guidelines webpage, the Institute for Clinical Systems Improvement (ICSI) Healthy Lifestyles guideline, and Neighborhood/workplace safety resources from the National Crime Prevention Council and the U.S. Centers for Disease Control and Prevention.
The purpose of the Social Determinants of Health Acute or Chronic Unstable Housing Interventions is to provide a shared care plan for individuals experiencing acute or chronic challenges to stable housing. The Big Data Nursing Science (BDNS) Social Determinants of Health workgroup set as a 2018 goal the creation of a user story as a test case for data stored in the Big Data warehouse. The concept of unstable housing was chosen because of the frequency and high impact of unstable housing on individual health and ability to fully participate in the healthcare system. The workgroup identified the problems included in this guideline. Nursing experts from various practice venues are included in this workgroup including individuals in public health, school health, vendors, informatics, and pediatrics. This workgroup modified a user story template created by the BDNS Nursing Value workgroup to accommodate the Omaha System Problem, Signs and Symptoms, Category, Target, Knowledge, Behavior and Status schema. There were four problems identified as impactful to unstable housing: communication with community resources, income, mental health and substance use. The interventions were selected from the SDOH pathway problems and interventions developed by the Omaha System Community of Practice.
Unique to this guideline is the use of a single sign/symptom as the focus of a care guideline. Stable housing is recognized as an important factor in the areas of school success and overall health and wellbeing. Additionally the guideline is coded to the Omaha System, SNOMED and LOINC across the entire schema.
Monsen, K. A., Brandt, J. K., Brueshoff, B., Chi, C. L., Mathiason, M. A., Swenson, S. M., & Thorson, D. R. (2017). Social determinants and health disparities associated with outcomes of women of childbearing age receiving public health nurse home visiting services. JOGNN, 46 (2), 292-303. doi: 10.1016/j.jogn.2016.11.014.
Monsen KA, Finn RS, Fleming TE, Garner EJ, LaValla AJ, Riemer JG. (2015, August). Rigor in electronic health record knowledge representation: lessons learned from a SNOMED CT clinical content encoding exercise. Informatics for Health and Social Care, 21, 1-15.
Martin KS. (2005). The Omaha System: A key to practice, documentation, and information management (Reprinted 2nd ed.). Omaha, NE: Health Connections Press.
Monsen KA, Neely C, Oftedahl G, Kerr MJ, Pietruszewski P, Farri O. (2012, August). Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System. Journal of Biomedical Informatics, 45(4), 719-725. Available: www.j-biomed-inform.com/article/S1532-0464(12)00094-9/fulltext.
Monsen KA, Foster DJ, Gomez T, Poulsen JK, Mast J, Westra BL, Fishman E. (2011, Fall). Evidence-based standardized care plans for use internationally to improve home care practice and population health. Applied Clinical Informatics, 2(3), 373-383. Available: http://aci.schattauer.de/en/contents/archive/issue/1422/manuscript/16710/show.html
Chan A, Hinz A, Heinstad D, Horgan D, Smith A, Porte E, Shelton E. (2008) Housing stability and school success for children: the effectiveness of the kids collaborative project. Paper discussion 2008 Annual Meeting of American Educational Research Association, New York, NY Available: http://rea.mpls.k12.mn.us/uploads/2008_aera_-_housing_stability_and_school_success_of_chlidren_03-27-2008_4.pdf
Stahre M, VanEenwyk J, Siegel P, Njai R. Housing Insecurity and the Association with Health Outcomes and Unhealthy Behaviors, Washington State, 2011. Prev Chronic Dis 2015;12:140511. DOI: http://dx.doi.org/10.5888/pcd12/140511