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Can Peer Navigators Address the Social Determinants of Health?

Peer navigators helped connect patients with services that would address the social determinants of health and also delivered emotional and empathetic support.

social determinants of health

Source: Thinkstock

By Sara Heath

- Non-clinical laypeople can effectively connect patients with support programs to help address the social determinants of health, making that service more efficient for managed care organizations (MCOs), according to a recent study in the American Journal of Accountable Care.

What’s more, these laypeople can provide emotional support that is the baseline of delivering compassionate, empathic healthcare, the report showed.

Healthcare industry professionals are increasingly shining a light on the importance of addressing the social determinants of health. However, there are a number of challenges to doing so, the researchers pointed out.

“A majority of physicians acknowledge that unmet social needs contribute to poor health outcomes, but most report a lack of time during the clinical appointment to address patients’ social needs in addition to their medical needs,” the research team stated. “They also may be unwilling or unable to address patients’ social determinants of health.”

Peer networks comprised of non-clinical laypeople may be effective in addressing the social determinants of health. Social support theories state that family, friends, and peers within a community can help protect patient health. Creating a peer social work network can help cut costs and make these programs more efficient, the researchers posited.

READ MORE: What are the Top Common Social Determinants of Health?

Additionally, some industry experts have indicated that the responsibility of addressing the social determinants of health should be born by health payers, such as managed care organizations (MCOs). MCOs carry financial risk in ways that most providers do not, making them the natural investors in a patient’s social needs.

The researchers sought to understand how non-clinical social need liaisons can facilitate a social support network within an MCO. The team tested the theory at HealthConnections, an MCO’s social needs program. CommUnity Liaisons worked in call centers where they directed patients to different service lines that could meet a social need.

The team investigated this approach by analyzing in-depth interviews, training tools, and program data.

This information showed that CommUnity Liaisons were able to use their own social backgrounds and expertise to connect callers with social supports.

To be clear, liaisons did not fulfill social needs themselves. For example, if a patient needed medical transportation services, the liaison forwarded the caller onto a rideshare group. The liaison did not arrange the ride herself.

READ MORE: Using Kiosks to Assess Social Determinants of Health in Veterans

Even still, these efforts proved fruitful, the report noted.

“In most circumstances, social support involves a combination of emotional, instrumental, informational, and appraisal support,” the researchers said. “According to the matching hypothesis of the social support theory, effective social support requires that supporters’ advice matches participants’ needs.”

The MCO recruited liaisons through vocational rehabilitation programs, recruitment firms specializing in people with disabilities, and the MCO’s website.

“The ideal qualities of a CommUnity Liaison included being empathetic, engaging, and investigatory and having similar ‘lived experiences’ as participants,” the team reported. “Required skills included interpersonal communication, computer aptitude, and knowledge of social service programs.”

Liaisons completed two weeks of training that included interpersonal skills, computer skills, motivational interviewing, observational listening, and mock phone calls.

READ MORE: What Providers Should Know to Improve Patient Access to Healthcare

The in-depth interviews highlighted the five areas in which liaisons fulfilled social support theory:

  • Participants sought informational support from CommUnity Liaisons.
  • A CommUnity Liaison’s main goal was to provide informational support through advice, suggestions, and information that participants could use to address their problems.
  • CommUnity Liaison interventions provided emotional support conveyed through empathy, love, trust, and caring. 
  • Participants contacted the CommUnity Assistance Line because they experienced adversity.
  • CommUnity Liaisons’ life experiences enabled empathic understanding and delivery of tailored information.

Most notably, the report found that liaisons delivered emotional support and comfort to callers. According to one interviewed liaison, providing emotional support was a precursor to providing other, more tangible support.

“Sometimes when they call, they’re emotional,” the liaison said of patient callers. “So, on our end, we have to find out the proper cause, and to bring them emotionally down, and see how we can help them.”

Overall, the researchers noted that CommUnity Liaisons proved an efficient strategy for MCOs to address the social determinants of health. Further research should investigate whether liaisons help cut costs.

“In implementing a program designed to address unmet social needs, a new social support role was created, the CommUnity Liaison,” the researchers concluded. “Similar to policies designed to increase funding opportunities for navigators and community health workers, future health policy could enhance the health workforce by promoting a role similar to the CommUnity Liaison.”

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