Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Understanding OT and health science students’ knowledge of and comfort with addressing social determinants of health is important in preparing health professionals equipped to address these factors using a population health perspective. The purpose of this study was to design and test learning materials that infused social determinants into interprofessional education. Findings highlight how to carry out learning experiences responsive to the multiple factors contributing to health.
Primary Author and Speaker: Whitney Lucas Molitor
Additional Authors and Speakers: Moses Ikiugu
Contributing Authors: Ranelle Nissen, Sabina Kupershmidt, Denyelle Kenyon, and M. B. M. Avoseh
PURPOSE: Social, environmental, and lifestyle factors account for up to 60% of an individual’s health, yet these social determinants of health (SDH) are not often the focus in healthcare. This neglect may result in students being less familiar or comfortable in addressing SDH. The purpose of this study was to develop teaching/learning materials to help OT and other health science students learn about SDH and address those factors in order to enhance client health and wellbeing. The second purpose was to develop an instrument to assess students’ knowledge of SDH and comfort in addressing them during therapy.
METHODS: The materials developed consisted of a cases study and an instrument to assess student knowledge of SDH. The instrument consisted of three sections: 1) social factors; 2) the impact of social determinants of health on healthcare delivery; and 3) confidence in ability to address SDH that impact clients’ health. Each of the matrials were reviewed by a panel of experts in order to establish face and content validity. The learning materials were tested in a two-tier RCT during an interprofessional education (IPE) event. A total of 408 students from 16 health science programs in a Mid-Western public University participated in the study. Students in the experimental group used the newly developed case study in their problem-based learning activities during the IPE event, while those in the control group used an existing case study. The newly developed assessment was used to gather data from participating students before and after the IPE event. A chi-square goodness of fit test was used to determine the extent to which the panel of experts agreed that the materials developed were appropriate for teaching students SDH. Cronbach’s alpha was computed to determine the internal consistency reliability of the instrument developed to test student knowledge and sense of competence in addressing SDH. A mixed within and between effects MANOVA was used to test the main effect of using the developed learning materials on a linear combination of students’ knowledge and competence in addressing clients’ SDH.
RESULTS: The panel of expert reviewers largely (64%) strongly agreed that the case was appropriate for addressing SDH in IPE, χ2 (3, N = 10) = 10.8, p = .01. The internal consistency reliability for the instrument assessing student knowledge and competence in addressing the SDH was poor (α = .63 at pretest and .67 at posttest). However, this level of internal consistency reliability is acceptable for a newly developed instrument. The mixed MANOVA indicated that awareness of SDH improved for all students F (1, 364) = 149.6, p = .00; Wilk’s λ = .00, partial η2 = 0.29. However, there was no group by time interaction suggesting that no group changed more than the other, and therefore the newly developed case study was not more effective than prior interdisciplinary learning approaches in helping students learn improve awareness of SDH. Student level of comfort in addressing SDH improved from M = 6.2 (SD = 1.7) at pretest to M = 7.0 (SD = 1.6) after the IPE event, t(385) = -12.54, p = .000.
CONCLUSION: Few learning materials were developed to help OT students learn about SDH and how to address them. Also, we found no instruments designed to measure students’ knowledge and confidence in addressing these issues. We developed a case study and an assessment in order to address this identified need. The learning materials were found to be as effective as those previously used in IPE at the University where the study was conducted.
LEARNING OBJECTIVES: In this presentation, we will discuss how the materials and assessment were developed, and how these can be used in occupational therapy programs to facilitate student IPE on SDH.
References
Braveman, B. (2016). Population health and occupational therapy. American Journal of Occupational Therapy. 70(1), 1-6. http://dx.doi.org/10.5014/ajot.2016.701002
Sakellariou, D., & Pollard, N. (2012). A commentary on the social responsibility of occupational therapy education, Journal of Further and Higher Education, 1-15. https://doi.org/10.1080/0309877X.2011.645459
