Form C4 Synchronous Focus Group Questions for Patients and Care

Form Approved

OMB No. 0955-XXXX

Exp. Date TBD

Access, Exchange, and Use of Social Determinants of Health Data in Clinical Notes (SDOH)

Synchronous Patients and Care Partners Focus Group:

Focus Group Guide (English)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0955-XXXX. The time required to complete this information collection is estimated to average 90 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer.

Focus Group Interview Guide: Patients/Care Partners

Synchronous Groups (English)

Introductory sentence: The Center for Disease Control and Prevention describes social determinants of health as the conditions in the places where people live, learn, work, and play that affect their health and quality of life.

1. What are Social Determinants of Health (SDOH)

1. Before participating in this group had you heard of the phrase Social Determinants of Health? What do you think it means?

2. Can you give some examples of things you think may be Social Determinants of Health?

3. (Moderator list some: race, ethnicity, preferred language, housing insecurity, food insecurity, social isolation, transportation access, sexual orientation, gender identify, intimate partner violence, veteran status): What do you think of this list? Are there any that you would add?

4. Can you give any specific examples of how you think Social Determinants of Health can affect health or health care? (Moderator give some examples if needed to get them talking. For example, how could food insecurity or lack of access to food impact health? How could lack of access to reliable transportation impact health care?)

5. Do you think it’s important for clinicians to know about some or all of the Social Determinants of Health on this list for their patients? Which ones?

2. Experiences You’ve Had with Clinicians/Health Systems Asking About Social Determinants of Health

   1. Do you use your clinician’s online patient portal to view your health information or communicate with your clinicians?

   2. Can you remember a time when you (or someone you care for) has been asked about any of the Social Determinants of Health we have discussed in this session? (Moderator: “Ask” can be someone directly asking, someone giving you something (paper or electronic) to fill out, a request that you complete something ahead of a visit on the patient portal or paper or otherwise)

   3. [Probe – tell us more about that time? What were you asked about? Were you asked to fill out a form or were these questions part of a conversation?

(Other possible probes: How often are you asked about Social Determinants of Health? At every visit? Who asks you about them?

In what format are you asked? (in person-orally, on a tablet or computer, kiosk in waiting room, on paper)? If you fill out a form with Social Determinants of Health questions (paper or electronic) does the clinician discuss it with you? If you don’t fill out a form, does the clinician you are seeing discuss Social Determinants of Health with you? Are you given opportunities to “tell your story” as it relates to Social Determinants of Health or are you asked only structured questions?

Have you ever been told why you are being asked these types of questions?

Have you ever been told you can choose to answer or not answer these types of questions?)

3. What Kind of Social Determinants of Health Information Would You Feel Comfortable Having in the Medical Record

1. Do you think it is important to record this information in your medical record?

   1. If yes, why? If no, why not? (Probe if needed: All of it? Some of it?)

2. Do you have any concerns about recording it in the record?

   1. What if you knew that the information would be shared with other clinicians involved in your care? Do you think this information should be available to all or some of the clinicians involved in your care?

      1. Why or why not?

   2. If you think some of the Social Determinants of Health information should be shared and some shouldn’t be, which types do you think should be and why?

   3. Would giving your permission to share the information with specific clinicians make you more comfortable with sharing your Social Determinants of Health information?

3. What kind of Social Determinants of Health information would you feel comfortable discussing vs. being documented?

4. Preference for how Social Determinants of Health Information is Collected
   
   

   1. How would you like Social Determinants of Health information to be collected? (probes include: During the visit with someone directly asking the questions? In the clinic via tablet, kiosk, computer, or paper form? Before the visit by questionnaire online in the patient portal? Other? If you prefer a person directly asking, who would you feel most comfortable talking to about this?)

5. Final question: Do you have any thoughts on the term Social Determinants of Health and if there are other terms that you think would be clearer to patients?

6. Parking lot question (if time): Would you be willing to use apps to send Social Determinants of Health information to your clinicians?