Domain Definition: Uncertain, limited, or no access to safe, reliable, accessible, affordable, and socially acceptable transportation infrastructure and modalities necessary for maintaining one’s health, well-being, or livelihood.
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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Transportation Data Elements
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| # | 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. |
|---|---|---|---|
| 1 | Historical Transportation Insecurity Master List | 06/21/21 |
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Adjudicated Data Element Submission StatisticsBelow is a list of how many of each food insecurity data element type has been adjudicated as of the date listed.#DateScreening Tool / QuestionsDiagnosis / NeedsGoalsInterventionsTOTAL110/29/202022 Tools / 36 Questions1804462210/15/202022 Tools / 36 Questions1804462310/1/202022 Tools / 36 Questions704451
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Interventions Framework
This is an updated draft (31 August 2020) of the framework for intervention data element concepts. Thank you to everyone who submitted comments on the initial version! | ||
# | 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 | 2018 National Health Interview Survey | The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States and is one of the major data collection programs of the National Center for Health Statistics (NCHS). | Access to health care and non emergency medical transportation: two missing links. Transportation research record 2005;1924(01):76-84. https://www.cdc.gov/nchs/nhis/1997-2018.htm#2002 |
2 | Accountable Health Communities (AHC)- HRSN (Health-Related Social Needs screening tool) | The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) have made the Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) Screening Tool to use in the AHC Model. | |
3 | American Academy of Family Physicians (AAFP) Social Needs Screening tool (Long) | This is tool is part of the EveryONE Project toolkit. The EveryONE Project offers a collection of tools and resources to use at the point of care to tackle your patients' social determinants of health. | A Practical Approach to screening for social determinants of health. Fam pract Manag. 2018 May-June; 25(3):7-12. http://www.nachc.org/research-and-data/ prapare/toolkit/ |
4 | American Academy of Family Physicians (AAFP) Social Needs Screening tool (Short) | This is tool is part of the EveryONE Project toolkit. The EveryONE Project offers a collection of tools and resources to use at the point of care to tackle your patients' social determinants of health. | A Practical Approach to screening for social determinants of health. Fam pract Manag. 2018 May-June; 25(3):7-12. https://www.aafp.org/dam/AAFP/documents/patient_care/everyone_project/patient-long-print.pdf |
5 | American Housing Survey | The American Housing Survey (AHS) has been the most comprehensive national housing survey in the United States since its inception in 1973, providing current information on the size, composition, and quality of the nation’s housing and measuring changes in our housing stock as it ages. | |
6 | CHFC SDH All Domains | ||
7 | Community Health Center Snohomish County Quick Check | ||
8 | Comprehensive Universal Behavior Screen (CUBS) | ||
9 | HealthLeads | The Health Leads Social Needs Screening Toolkit is a comprehensive blueprint for health systems seeking to identify and screen patients for adverse social determinants of health. | |
10 | North Carolina Healthy Opportunities Screening | ||
11 | PRAPARE | The Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) is a national effort to help health centers and other providers collect the data needed to better understand and act on their patients’ social determinants of health. | |
12 | PROMIS | This toolkit is meant to provide researchers with the information they need to understand how the health center model can support their research initiatives. It is intended to depict how health centers operate, their research interests, their research experience, and their research needs. | |
13 | SDOH Tool Community Health Central Washington (Internally developed screening tool) | ||
14 | Transportation Barriers Measure | The study uses the Rasch measurement model to examine the psychometric properties of a new measure designed to capture types of transportation and associated barriers within an urban context. | Measuring Health-related transportation barriers in urban settings J Appl Meas 2017;18(2):178-193. |
15 | Upstream Risks Screening Tool | Kaiser Permanente Northwest (KPNW) is an integrated health care delivery system that has implemented a comprehensive approach toward addressing its patients’ SDH. This article describes the tools and processes used at KPNW for identifying and addressing SDH. | Toward Addressing Social determinants of health: a health care system strategy. Perm J 2018;22:18-095 Published online 2018 Oct 22. doi: 10.7812/TPP/18-095
https://www.aamc.org/system/files/c/2/442878-chahandout1.pdf |
16 | WellRx | Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico |
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Terminology, Definitions and Resources
# | Term | Defintion or Description | Source(s) |
1 | Measuring Health-related Transportation Barriers in UrbanSettings | The current study uses the Rasch measurement model to examine thepsychometric properties of a new measure designed to capture types of transportation andassociated barriers within an urban context. | |
2 | Cost Benefit Analysis of Providing Non-Emergency Medical Transportation | In response to the importance of examining the need for improved access to NEMT nationally, TCRP launched Project B-27, “Cost Benefit Analysis of Providing Non- Emergency Medical Transportation.” The goal of this study was to compare the costs and benefits, including potentially large net health benefits, of providing NEMT to those who lack access to it. | |
3 | Traveling Towards Disease: Transportation Barriers to Health Care Access | Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. |
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Data Element Concept Leads
# | Role | Name | Organization | Biography |
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 | Alexandra King | CTAA | |
4 | Domain Subject Matter Expert | Jennifer Sisto Gall | Lyft | |
5 | Domain Subject Matter Expert | Ipek Nese Sener | Texas A&M Transportation Institute | |
6 | Domain Subject Matter Expert | Mara Schwartz | Lyft |