Grant: Operating Grant: SPOR PIHCI Network: Programmatic Grants

The social determinants of health (SDOH) are the conditions and processes at an individual, family, neighbourhood, community and societal level that impact on health. Numerous studies have confirmed the central role that SDOH play in creating and maintaining health inequities. While much is known about SDOH, we lack the individual-level data necessary to target interventions, and lack rigorously evaluated interventions to meet social needs in health settings. Sociodemographic data collected at the individual level, paired with interventions to meet social needs when identified, could address this problem. Further, robust sociodemographic data linked to electronic medical records (EMRs) can support quality improvement and new care pathways at the organizational level, planning and resource allocation at the system level, and advance research on health inequities. The SPARK Study is a cluster randomized controlled trial that will rigorously evaluate a "modest" versus "intensive" intervention to help address poverty when identified. While the primary outcome of this intervention is change in income attributable to the poverty intervention, we will capture data on additional impacts, including linkage to community resources, psychological stress and quality of life. To prepare for the trial, we will develop and validate a standard tool for sociodemographic data collection and social need identification, building on our previous research. We will also pilot test our tool, EMR integration, recruitment processes and study instruments before launching the full trial. Finally, we will collect qualitative data alongside the trial to evaluate implementation and better understand how the intervention to address poverty impacts on participants. This program of research will advance the ability of health providers, organizations and systems to collaborate with patients and communities to "go upstream" and address SDOH.