Social Work Students Take on Community Health: A Community Engagement Pilot Project

Overview: To advance health equity the social determinants of health must be addressed in the community. In collaboration with the hospital, 16 social work interns were placed on community health teams located in primary care offices and ambulances. Since the pilot program’s inception hospitalizations and emergency room visits have significantly decreased.Proposal text:

Introduction: There is little consensus about how primary care providers should assess issues such as food insecurity, lack of transportation, housing needs, or underlying trauma (Fraze, Brewster, Lewis et al., 2019). A study of primary pediatric care providers found only 28% were comfortable asking about social and financial needs (Lax, Bathory, & Braganza, 2021). To advance health equity the social determinants of health must be addressed in the community.

Objectives: 1) Address the social determinants of health in the community by adding social work interns to settings social work was not previously present. 2) Expand opportunities for social work students in health care.

Intervention: In partnership with the School of Social Work, the local hospital created teams to address the social determinants of health for community patients. The teams consisted of community health workers, social workers and paramedics with the purpose of providing home and community-based supports to patients. Social Work interns were placed in areas where social workers were not previously established, including primary care medical offices and ambulances. The school and hospital each contributed financially to hire a social worker whose responsibility was to be a field liaison and educator for social work interns, as well as providing supervision to community health workers and faith health volunteers. The position was developed to be exclusively educational while also addressing the needs of the community. The students’ primary roles were to assess barriers, link patients to services such as physician care, public benefits’ programs and community services, escalate care to appropriate care providers, and lead or connect to classes for self-management of chronic conditions.

Results: In the three semesters since this program’s inception 1100 patients have been seen by 16 BSW and MSW interns. There have been tremendous gains in improving the health of the community. The hospital has seen a 3.49-million-dollar reduction in charges. There has been a 43% decrease in admissions to the behavioral health hospital and a 27% decrease in emergency room visits. Students and their allied health partners have shared how rewarding being on the community health team has been since they can see the direct benefits of their work.

Conclusion: Considering the success of this pilot project the hospital is expanding the program to include more social work interns as well as public health students. Other areas of practice are seeking to replicate the model of a dedicated educational social work supervisor, including the college campus to address student anxiety and domestic violence shelters in rural communities.

References
Fraze, T. K., Brewster, A. L., Lewis, V. A., Beidler, L. B., Murray, G. F., & Colla, C. H. (2019).
Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician
Practices and Hospitals. JAMA network open, 2(9), e1911514. https://doi.org/10.1001/jamanetworkopen.2019.11514

Lax, Y., Bathory, E., & Braganza, S. (2021). Pediatric primary care and subspecialist providers’
comfort, attitudes and practices screening and referring for social determinants of health. BMC Health Services Research, 21, 1-7.
doi:http://dx.doi.org/10.1186/s12913-021-06975-3