Susan
Chemmanoor and Avery Bernazard
While unmet social needs are major drivers of health outcomes, most health systems are not fully equipped with the social services to adequately address them. We implemented an intervention that enables undergraduate volunteers to screen patients for unmet social needs and subsequently refer them to community resources. Planning included observation of exemplary programs, development of a community-based organization directory, and evaluation of the center's patient population, clinical workflows, and data infrastructure. A peer-to-peer training model for students was designed by integrating a social determinants of health curriculum. The program works across three different sites in Durham, North Carolina, and has screened 2948 patients and provided 1445 initial referrals from 1/1/2022 to 10/16/2024. The adaptable workflow makes this program a widely- applicable tool for identifying social needs within a healthcare setting and advancing SDOH education for pre-health students. The Role of Patient Education in Improving Health Knowledge in Elective Spine Surgery
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Authors:
Susan Chemmanoor and Avery Bernazard
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Health literacy, the ability to effectively utilize information to make health-related decisions, plays a critical role in health outcomes and patient well-being. Poor health literacy rates are associated with worse spine surgery outcomes, especially for low- income, non-white, and older patients. These patients typically experience worsened pain, heightened anxiety, decreased satisfaction, longer lengths of stay, and higher readmission rates. Improving health literacy and patient education prior to elective spine surgery is of critical importance. Investigating the efficacy of informational intervention in improving spine surgery health literacy has broad clinical applications. The purpose of this systematic review is to understand what interventions effectively improve disease knowledge and health literacy in elective spine surgery patients. PubMed, Scopus, and Web of Science were systematically searched for eligible studies published prior to August 2024. Studies were eligible if participants underwent elective spine surgery and were 18 years or older at enrollment. Studies utilizing mobile health strategies, informational videos, pamphlets, and in-depth health-provider briefings were all eligible. Two reviewers assessed each study's risk of bias using the methodological index for non- randomized studies (MINORS). Qualitative analysis was used to assess the relationship between educational intervention and spine surgery patient outcomes. Due to the heterogeneity of the data, statistical analysis was not performed. Extracted data from 11 studies, with a combined cohort of 1662 patients, showed that both discussion-based and virtual interventions that delivered information about the respective surgical procedure and recovery process saw significant improvement in patient information and postoperative anxiety. All studies reported significantly high patient satisfaction scores. However, three studies reporting length of stay, readmission rates, and postoperative pain saw nonsignificant changes in these metrics. Patient education has a clear relationship with improved patient information, satisfaction, and anxiety. Discussion-based and virtual educational interventions effectively improve health literacy, supporting their clinical utility in the perioperative phase to support elective spine surgery patients. Implementing such intervention may reduce health disparities and improve recovery for spine surgery patients.
Source:
Duke University / 2025
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Co-authors:
Susan Chemmanoor and Avery Bernazard