RT Journal Article
SR Electronic
T1 Development of PRAPARE Social Determinants of Health Clusters and Correlation with Diabetes and Hypertension Outcomes
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 668
OP 679
DO 10.3122/jabfm.2022.04.200462
VO 35
IS 4
A1 Wen Wan
A1 Vivian Li
A1 Marshall H. Chin
A1 David N. Faldmo
A1 Erin Hoefling
A1 Michelle Proser
A1 Rosy Chang Weir
YR 2022
UL http://www.jabfm.org/content/35/4/668.abstract
AB Introduction: PRAPARE is a leading social risk screening tool. No studies yet have simplified the 22 PRAPARE social determinants of health (SDoH) into clusters to analyze associations with chronic disease outcomes.Methods: A federally qualified health center conducted cross-sectional PRAPARE screening on its general adult population. Exploratory and confirmatory factor analyses were used to identify SDoH clusters and construct cluster scores and SDoH total risk scores. Logistic regression assessed relationships between cluster scores and uncontrolled diabetes and/or hypertension.Results: Of the 11,773 adults who answered the survey, 716 had diabetes only, 2,388 had hypertension only, 1,477 had both, and 7,192 had neither. We found 3 composite SDoH clusters (social background, social insecurities, insurance/employment) and 3 standalone clusters (housing status, social isolation, poverty). Among patients with diabetes, those at risk in social background, social insecurities, and insurance/employment were more likely to have uncontrolled diabetes. Among patients with hypertension, those at more risk in social insecurities were more likely to have uncontrolled hypertension.Conclusions: We simplified the 22 PRAPARE SDoH into 3 composite clusters and 3 individual clusters and demonstrated the reliability and validity of PRAPARE. The 3 composite clusters were positively associated with uncontrolled diabetes and/or hypertension.