Addressing Social Determinants of Health through Interprofessional Education: The Household-Centered Care Program

Overview: This presentation will provide an overview of strategies, challenges and lessons learned while designing and implementing an interprofessional education program aimed at preparing learners from Medicine, Nursing, and Social Work to address social determinants of health through community engagement.Proposal text: In the last decade there has been growing recognition that the ability to work effectively in interprofessional teams addressing complex medical and social needs is essential to provide quality of care and to address social determinants of health that contribute to differential outcomes (Adler et al., 2016; Donnelly et al., 2019; Institute of Medicine, 2015; Pullon et al., 2016). Interprofessional education is a key strategy to ensure learners have the knowledge, skills, and abilities needed to successfully practice in newly emerging collaborative or integrated healthcare contexts (Frenk et al., 2010; Institute of Medicine, 2015; Nester, 2016; World Health Organization, 2010). Developing skills in relationship building, collaboration, and communication can strengthen the health care system, contribute to shared decision-making, and promote positive patient and community care outcomes (Addy et al., 2015; Taylor et al., 2016; Terry et al., 2015; Jones & Phillips, 2016; Browne et al., 201; Chan, Chi, Ching, & Lam, 2010; Nimmagadda & Murphy, 2014; Sims, 2011). Although social workers have a long-standing history of engaging in collaborative practice, social work students have been traditionally excluded from large scale IPE opportunities and there is a limited evidence describing the experience of learners and faculty (Archibald & Estreet, 2017; Jones & Phillips, 2016; Rubin et al., 2017). The purpose of this presentation is threefold. First, we aim to illustrate how a team of faculty from Medicine, Nursing and Social Work collaboratively developed and implemented the Household-Centered Care Program in a large metropolitan setting. Second, curricular components and learning objectives will be reviewed to illustrate alignment with discipline-based competencies and standards. Finally, preliminary data about formative and outcome evaluations, challenges, and lessons learned will be discussed to further inform the development of the program.
Methodology: A total of 123 learners from Medicine, Nursing and Social Work participated in interprofessional seminars, online simulations, and home-visits/team projects from July 2020 to May 2021. Formative feedback was collected from learners, preceptors, and community partners regarding each component of the program using a repeated measure design. Outcome evaluation via standardized tools [SPICE-R and Interprofessional Professionalism Assessment (IPA)] assessed increasing interprofessional competencies of learners.

Results: Preliminary data indicate that participants valued learning together, engaging in simulations to refine their skills, and that the program increased knowledge and critical thinking about health and healthcare delivery. Lessons learned and barriers to implementation were identified. The most pressing obstacle was establishing a common calendar among vastly different academic settings, roles, and schedules. Additionally, collaborative practice and truly interprofessional experiences challenged the “traditional” hierarchy present among professions, and the imbalance of power between participants and faculty.
Implications: Despite ongoing challenges originated by the COVID-19 pandemic, interprofessional education programs grounded in community engagement can be successful in fostering learners’ knowledge, competencies, and skills needed to promote community health. For social work learners, the HCC program offered the opportunity to further understand the unique contribution of social work in the health care arena, while also developing foundational skills in assessment, intervention, and evaluation of practice with families experiencing multiple barriers to care.