Social Connection is an umbrella term that encompasses the structural, functional, and quality aspects of how individuals connect to each other.
- Social Isolation Definition: Is objectively being alone, having few relationships, or infrequent social contact.
- Loneliness Definition: Is subjectively feeling alone. The discrepancy between one’s desired level of connection and one’s actual level.
- Social Support Definition: The actual or perceived availability of resources (e.g., informational, tangible, emotional) from others. Four types of social supportive behaviors: emotional, instrumental, informational, and appraisal.
Gravity Project social risk data elements are published in Value Set Authority Center (VSAC) value sets. The value sets can be identified by searching for "The Gravity Project" steward. You will need to create a free National Library of Medicine (NLM) account to access the value sets. Value sets will be updated bi-annually on June 30th and December 31st.
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Social Connection Data Elements
Please reach out to the Gravity Project at Gravityproject@hl7.org with any questions.
| # | Description | Updated | Link Historical files retained to provide the history of the consensus process, do not use for implementation purposes. Please refer to VSAC value sets for the most up-to-date codes. |
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| 1 | Historical Social Connection Master List | 11/09/2021 |
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Interventions Framework
# | Gravity Term | Gravity Definition |
1 | Assistance/Assisting | To give support or aid to; help |
2 | Coordination | Process of organizing activities and sharing information to improve effectiveness. |
3 | Counseling | Psychosocial procedure that involves listening, reflecting, etc., to facilitate recognition of course of action/solution. |
4 | Education | Procedure that is synonymous with those activities such as teaching, demonstration, instruction, explanation, and advice that aim to increase knowledge and skills, change behaviors, assist coping and increase adherence to treatment. |
5 | Evaluation of eligibility (for <x>) | Process of determining eligibility by evaluating evidence. |
6 | Evaluation/Assessment | Determination of a value, conclusion, or inference by evaluating evidence. |
7 | Provision | To supply/make available for use. |
8 | Referral | The act of clinicians/providers sending or directing a patient to healthcare professionals and/or programs for services (e.g., evaluation, treatment, aid, information etc.) |
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Screening Tools
# | Screening Tool | Description | Source(s) |
1 | Berkman-Syme Social Network Index (SNI) | This measure is a questionnaire to assess the type, size, closeness, and frequency of contacts in a respondent’s current social network | |
2 | Clinical Care Classification (CCC) v2.5 panel | The CCC System is used for assessing, documenting, and classifying patient care by nurses and other clinical professionals in various health care settings. | Question code: https://loinc.org/28212-9/ |
3 | DeJong Gierveld Loneliness Scale | This is a 6-item scale with three statements about ‘emotional loneliness’ and three about‘social loneliness’. | |
4 | Duke Social Support Index (DSSI) 10 | This is a 10 item screener to assess social support for use in diverse adult populations | |
5 | Functional Assessment of Chronic Illness Therapy (FACIT)
Social - family well-being | This is a collection of health-related quality of life (HRQOL) questionnaires that assess multidimensional health status in people with various chronic illnesses, including cancer. | Panel code: https://loinc.org/71141-6/ |
6 | Interpersonal Support Evaluation List (ISEL) | This screener includes a list of 40 statements concerning the perceived availability of potential social resources. | |
7 | NAM (NHANES) Social connection and isolation panel- social isolation score | The social connection and isolation panel is a set of five questions used to assess the number of types of social relationships on which a patient is connected and not isolated. | Panel code: https://loinc.org/76506-5/ |
8 | PhenX domain - Physical activity and physical fitness | This is a series of questions about the level of difficulty performing everyday activities | Panel code: https://loinc.org/62812-3/ |
9 | PhenX-social isolation protocol (UCLA Loneliness Scale) | The UCLA Loneliness Scale includes 20 questions used to assess how lonely the respondent feels. | Panel code: https://loinc.org/62933-7/ |
10 | PRAPARE | PRAPARE is a national effort to help health centers and other providers collect and apply the data they need to better understand their patients’ social determinants of health, transform care to meet the needs of their patients, and ultimately improve health and reduce costs. PRAPARE is both a standardized patient risk assessment tool as well as a process and collection of resources to identify and act on the social determinants of health. The PRAPARE Implementation and Action Toolkit is designed to provide interested users with the resources, best practices, and lessons learned to guide implementation, data collection, and responses to social determinant needs. | |
11 | PROMIS emotional support | This screener measures global, physical, mental, and social health for adults and children | |
12 | PROMIS instrumental support- version 2.0 T score | The PROMIS Instrumental Support item banks assess self-reported perceived availability of assistance with material, cognitive or task performance | Panel code: https://loinc.org/76791-3/
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13 | PROMIS short form - social isolation 6a - version 2.0 | PROMIS Social Isolation 6 item question bank with raw score and t score assesses perceptions of being avoided, excluded, detached,
disconnected from, or unknown by, others.
| Panel code: https://loinc.org/76802-8/ |
14 | PROMIS short form - social isolation 8a - version 2.0 | PROMIS Social Isolation 8 item question bank with raw score and t score assesses perceptions of being avoided, excluded, detached, disconnected from, or unknown by, others. | Panel code: https://loinc.org/76803-6/ |
15 | PROMIS short form- social isolation 4a- version 2.0 | PROMIS Social Isolation 4 item question bank with raw score and t score assesses perceptions of being avoided, excluded, detached,
disconnected from, or unknown by, others.
| Panel code: https://loinc.org/76801-0/ |
16 | PROMIS- social isolation | PROMIS Social Isolation item bank assesses perceptions of being avoided, excluded, detached,
disconnected from, or unknown by, others. There are two administration options for this assessment, short forms (4a, 6a, 8a) and computerized adaptive test
(CAT). | |
17 | Upstream Social Isolation Risk Screener (U-SIRS) | This is a 13 item screener used to assess social isolation risks among community dwelling older adults | |
18 | UCLA Three-Item Loneliness Scale | A 3 question scales that measures the 3 dimensions of loneliness: relational connectedness, social connectedness, and self perceived isolation | |
19 | Duke-UNC Functional Social Support Questionnaire | This is a 8 item questionnaire originally created for women, men, HIV-positive, adults in rural Rwanda to determine functional social support | |
20 | ENRICHD Social Support | The ENRICHD Social Support Instrument (ESSI) is
a 7-item self-report survey that assesses social support. | |
21 | DUKE SOCIAL SUPPORT AND STRESS SCALE (DUSOCS) | The Duke Social Support and Stress Scale (DUSOCS) is a validated, 24-item self-report questionnaire for measuring family and nonfamily social support and stress | |
22 | Lubben Social Network Scale 12
Lubben Social Network Scale 6 | This scale is a self-report measure of social engagement including family and friends. There are two versions of this scale included; the short, 6 item scale and the 12 item scale | |
23 | RAND Medical Outcomes Study (MOS) Social Support Survey | This scale is a brief, multidimensional, self-administered, social support survey that was developed for patients in the Medical Outcomes Study (MOS), a two-year survey that was developed for patients with chronic conditions. | |
24 | Multidimensional Scale of Perceived Social Support (MSPSS) | The Multidimensional Scale of Perceived Social Support (Zimet et al., 1988) is a 12-item measure of perceived adequacy of social support from three sources: family, friends, & significant other | |
25 | OARS Social Resources Scale | The resulting brief, valid, and reliable instruments have been used for purposes as varied as individual clinical assessment of personal functional status, surveys of the status of adult populations, assessment of service utilization and service requirements, longitudinal investigations in community, clinic and long-term care settings, and training of service providers. | |
26 | Oslo social support scale (OSSS-3) | The Oslo Social Support Scale (OSSS-3) for different age groups for men and women and to further investigate the factor structure in the general population. | |
27 | PERSONAL RESOURCE QUESTIONNAIRE (PRQ2000) | The PRQ is a reliable and valid tool for measuring perceived social support across a wide range of populations. |
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Data Element Concept Leads
# | Role | Name | Organization | Bio |
1 | Clinical Informatics Director | Sarah DeSilvey | Pediatric Faculty, Larner College of Medicine at the University of Vermont | |
2 | Value Set Subject Matter Expert | Linda Hyde | EMI Advisors, LLC | |
3 | Domain Subject Matter Expert | Julianne Holt-Lunstad | Brigham Young University | |
4 | Domain Subject Matter Expert | Edward Garcia | Foudation for Social Connection | |
5 | Domain Subject Matter Expert | Matt Pantell | University of California San Francisco | |
6 | Domain Subject Matter Expert | Carla Perissinotto | University of California San Francisco |