To evaluate how and from where social risk data are extracted from EHRs for research purposes, and how observed differences may impact study generalizability. Systematic scoping review of peer-reviewed literature that used patient-level EHR data to assess 1 ± 6 social risk domains: housing, transportation, food, utilities, safety, social support/isolation. 111/9022 identified articles met inclusion criteria. By domain, social support/isolation was most often included ( = 68/111), predominantly defined by marital/partner status ( = 48/68) and extracted from structured sociodemographic data ( = 45/48). Housing risk was defined primarily by homelessness ( = 39/49). Structured housing data was extracted most from billing codes and screening tools ( = 15/30, 13/30, respectively). Across domains, data were predominantly sourced from structured fields ( = 89/111) versus unstructured free text ( = 32/111). We identified wide variability in how social domains are defined and extracted from EHRs for research. More consistency, particularly in how domains are operationalized, would enable greater insights across studies.
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http://dx.doi.org/10.1177/14604582231200300 | DOI Listing |
JAMA Netw Open
January 2025
Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (IMHAY), Santiago, Chile.
Importance: Mental health stigma is a considerable barrier to help-seeking among young people.
Objective: To systematically review and meta-analyze randomized clinical trials (RCTs) of interventions aimed at reducing mental health stigma in young people.
Data Sources: Comprehensive searches were conducted in the CENTRAL, CINAHL, Embase, PubMed, and PsycINFO databases from inception to February 27, 2024.
JAMA Netw Open
January 2025
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.
Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.
JAMA Psychiatry
January 2025
Harvard Medical School, Boston, Massachusetts.
Importance: In the 2020 Bostock v Clayton County decision, the US Supreme Court extended employment nondiscrimination protection to sexual minority adults. The health impacts of this ruling and similar policies related to sexual orientation-based discrimination are not currently known.
Objective: To estimate changes in mental health following the Bostock decision among sexual minority adults in states that gained employment nondiscrimination protection (intervention states) compared with those in states with protections already in place (control states).
Curr HIV/AIDS Rep
January 2025
Columbia University Irving Medical School, New York, NY, USA.
Purpose: This narrative review addresses post-2020, specific, complex challenges for use of and adherence to pre-exposure prophylaxis (PrEP) for HIV prevention among out-of-treatment people who use drugs (PWUD) at syringe services programs (SSPs).
Recent Findings: The COVID-19 pandemic and its associated changes to the provision of healthcare have significantly impacted HIV prevention, especially for PWUD. Through a synthesis of literature and clinical experience, we (1) characterize the operational changes imposed by the pandemic on SSPs that shaped the current HIV prevention landscape; (2) describe three levels of current challenges for PWUD, including consumer attitudes, non-medical and medical provider attitudes, and structural and scalability barriers; (3) characterize current models for PrEP in SSPs; and (4) offer practical recommendations for HIV prevention in harm reduction programs.
Matern Child Health J
January 2025
Office of the Director, Office of Readiness and Response, CDC, Atlanta, GA, USA.
Objectives: This study aimed to estimate the prevalence of homelessness shortly before or during pregnancy and describe differences in maternal characteristics and adverse birth outcomes between people reporting homelessness and not reporting homelessness.
Methods: We used 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 31 sites to estimate the prevalence of self-reported homelessness during the 12 months before giving birth. We used logistic regression models to evaluate the association between homelessness and adverse birth outcomes, specifically small for gestational age (SGA), low birth weight (LBW), and preterm birth (PTB).
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