Social determinants of health correlations and resource usefulness at a Milwaukee free clinic for uninsured individuals: A cross-sectional study.

Introduction: Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured population. Methods: In this cross-sectional study, we screened adult patients without health insurance (N = 238) for nine traditional SDOH needs as well as their access to dental and mental health care between October 2021 and October 2022. Patients were surveyed at intervals greater than or equal to 30 days. We assessed correlations between SDOH needs and trends in patient-reported resource usefulness. Results: Access to dental care (64.7%) and health insurance (51.3%) were the most frequently endorsed needs. We found significant correlations (P ≤ 0.05) between various SDOH needs. Notably, mental health access needs significantly correlated with dental (r = 0.41; 95% CI = 0.19, 0.63), medications (r = 0.51; 95% CI = 0.30, 0.72), utilities (r = 0.39; 95% CI = 0.17, 0.61), and food insecurity (r = 0.42; 95% CI = 0.19, 0.64). Food-housing (r = 0.55; 95% CI = 0.32, 0.78), housing-medications (r = 0.58; 95% CI = 0.35, 0.81), and medications-food (r = 0.53; 95% CI = 0.32, 0.74) were significantly correlated with each other. Longitudinal assessment of patient-reported usefulness informed changes in the resources offered. Conclusions: Understanding prominent SDOH needs can inform resource offerings and interventions, addressing root causes that burden under-resourced patients. In this study, patient-reported data about resource usefulness prompted the curation of new resources and volunteer roles. This proof-of-concept study shows how longitudinally tracking SDOH needs at low-resource clinics can inform psychosocial resources.

CHECK UP: A student-designed model for creating innovative patient education materials that your patients will actually use.

OBJECTIVE: As appointments become more rushed, it is crucial that primary care clinicians consider new and effective ways to provide preventive health education to patients. Currently, patient education is often handouts printed from the electronic medical record system; however, these pieces of paper often do not have the desired impact. Well-established advertising methods reveal that repeated exposure is key in recall and swaying consumer decisions. The Creating Health Education for Constructive Knowledge in Underserved Populations (CHECK UP) Program is a medical student-led program that aims to improve patient recall of health information, health promoting behaviors and health outcomes by applying modified advertising concepts to the delivery of health education. METHODS: Patients were given large magnets containing health education information. These patients were interviewed 3-4 months afterwards to assess use and effectiveness of magnets as a means to provide health education. RESULTS: In total, 25 of the 28 patients given CHECK UP magnets agreed to participate. The majority of participants (23/25) kept the magnets and reported that they, as well as others in their households, see the magnets daily. All 23 participants recalled at least 1 health tip from 1 of the magnets. CONCLUSIONS: The use of non-traditional materials for patient education allowed for repeated exposure and recall of health information. Consideration for modified use of evidence-based advertising and marketing strategies for the delivery of patient education may be an easy and effective way to provide information to patients outside of the clinical setting and promote health behavioral changes.

Building a Successful, Socially-Distanced Family Medicine Clerkship in the COVID Crisis.

INTRODUCTION: In the wake of the COVID-19 pandemic, many family medicine clerkships across the United States are scrambling to provide meaningful medical education in a new clinical environment. Most medical schools have paused or severely limited the direct patient care that has been the core educational requirement of the clinical clerkships. The aim of this study was to develop and evaluate a curricular model that meets the family medicine clerkship learning objectives via telemedicine clinical instruction. METHODS: We created a clerkship where all clinical encounters took place by phone or video visits. Students were required to have telemedicine encounters with at least 20 patients over a 4-week clerkship. We also created a telemedicine illness script-writing assignment to prepare students and faculty for these encounters. We evaluated our curriculum by surveying participating students and faculty members. RESULTS: Student surveys revealed that all learning objectives were met during the telemedicine clerkship experience. Students felt they made a difference during the COVID-19 pandemic. Faculty felt that the medical students were helpful and that they were able to provide meaningful clinical instruction. CONCLUSION: Our study reveals that a family medicine clerkship can be successfully delivered using telemedicine and remote learning techniques. Senior medical students are a valuable resource and can have a meaningful clinical impact while learning more about family medicine. If social distancing precautions continue, this model can be used by other clerkships to continue medical education and provide medical care.