title: Institute of Medicine Measures of Social and Behavioral Determinants of Health: A Feasibility Study.
abstract: BACKGROUND
  Social and behavioral factors are known to affect health but are not routinely assessed in medical practice. To date, no studies have assessed a parsimonious panel of measures of social and behavioral determinants of health (SBDs). This study evaluated the panel of SBD measures recommended by the Institute of Medicine and examined the effect of question order.
  
  
  METHODS
  Adults, aged ≥18 years, were recruited using ResearchMatch.org for this randomized, parallel design study conducted in 2015 (data analyzed in 2015-2016). Three versions of the SBD measures, sharing the same items but in different orders of presentation (Versions 1-3), were developed. Randomized to six groups, participants completed each version at least 1 week apart (Weeks 1-3). Version order was counterbalanced across each administration and randomization was stratified by gender, race, and age. Main outcomes were effect of question order, completion time, and non-response rates.
  
  
  RESULTS
  Of 781 participants, 624 (80%) completed the Week 1 questionnaire; median completion time for answering all SBD questions was 5 minutes, 583/624 participants answered all items, and no statistically significant differences associated with question order were observed when comparing responses across all versions. No significant differences in responses within assignment groups over time were found, with the exception of the stress measure for Group 5 (p=0.036).
  
  
  CONCLUSIONS
  Question order did not significantly impact participant responses. Time to complete the questionnaire was brief, and non-response rate was low. Findings support the feasibility of using the Institute of Medicine-recommended questionnaire to capture SBDs.
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: nunzia.giuse@vanderbilt.edu.
authors.forename: Nunzia B
authors.initials: NB
authors.lastname: Giuse
authors.affiliation: Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Taneya Y
authors.initials: TY
authors.lastname: Koonce
authors.affiliation: Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Sheila V
authors.initials: SV
authors.lastname: Kusnoor
authors.affiliation: Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Aric A
authors.initials: AA
authors.lastname: Prather
authors.affiliation: Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Gottlieb
authors.affiliation: Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Huang
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Phillips
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.affiliation: Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, California; Center for Health and Community, University of California San Francisco, San Francisco, California.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: William W
authors.initials: WW
authors.lastname: Stead
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006306:Health Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011897:Random Allocation; D064890:Social Determinants of Health / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States; D055815:Young Adult