Assessing Social Needs and Engaging Community Health Workers in Underserved Kansas Counties: Insights From Primary Care Providers and Clinic Managers.

INTRODUCTION: Rural and under-resourced urban communities face unique challenges in addressing patients' social determinants of health needs (SDoH). Community health workers (CHWs) can support patients experiencing social needs, yet little is known about how rural and under-resourced primary care clinics are screening for SDoH or utilizing CHWs. METHODS: Interviews were conducted with primary care clinic providers and managers across a geographically large and predominately rural state to assess screening practices for SDoH and related community resources, and perspectives on using CHWs to address SDoH. Interviews were conducted by phone, recorded, and transcribed. Data were analyzed using thematic analysis. We completed interviews with 27 respondents (12 providers and 15 clinic managers) at 26 clinics. RESULTS: Twelve (46.1%) clinics had a standardized process for capturing SDoH, but this was primarily limited to Medicare wellness visits. Staffing and time were identified as barriers to proper SDoH screening. Lack of transportation and affordable medication were the most cited SDoH. While respondents were all aware of CHWs, only 8 (30.8%) included a CHW on their care team. Perceived barriers to engaging CHWs included cost, space, and availability of qualified CHWs. Perceived benefits of engaging CHWs in their practice were: assisting patients with navigating resources and programs, relieving clinical staff of non-medical tasks, and bridging language barriers. CONCLUSIONS: Rural and under-resourced primary care clinics need help in identifying and addressing SDoH. CHWs could play an important part in addressing social needs and promoting preventive care if financial constraints could be addressed and local CHWs could be trained.

Acoustic and perceptual characteristics of vowels produced during simultaneous communication.

UNLABELLED: This study investigated the acoustical and perceptual characteristics of vowels in speech produced during simultaneous communication (SC). Twelve normal hearing, experienced sign language users were recorded under SC and speech alone (SA) conditions speaking a set of sentences containing monosyllabic words designed for measurement of vowel duration, formant frequencies, and fundamental frequency in consonant-vowel-consonant (CVC) syllables and 60 listeners audited the speech samples. Although results indicated longer sentence and vowel durations for SC than SA, the data showed no difference in spectral characteristics of vowels produced during SC versus SA, indicating no degradation of vowel spectrum by rate alteration during SC. Further, no difference was found in listeners' ability to identify vowels produced during SC versus SA, indicating no degradation of vowel perceptual cues during SC. These conclusions are consistent with previous research indicating that temporal alterations produced by SC do not produce degradation of segmental acoustical characteristics of spoken English. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe simultaneous communication; (2) explain the role of simultaneous communication in communication with children who are deaf; (3) describe vowel acoustics in English speech; (4) discuss methods of measuring vowel perception; (5) specify the acoustic characteristics of vowels produced during simultaneous communication; and (6) specify the ability of listeners to perceive vowels in speech produced during simultaneous communication.