{"id":"https://openalex.org/W4387879609","doi":"https://doi.org/10.3389/frhs.2023.1282292","title":"Finding meaning: a realist-informed perspective on social risk screening and relationships as mechanisms of change","display_name":"Finding meaning: a realist-informed perspective on social risk screening and relationships as mechanisms of change","publication_year":2023,"publication_date":"2023-10-23","ids":{"openalex":"https://openalex.org/W4387879609","doi":"https://doi.org/10.3389/frhs.2023.1282292","pmid":"https://pubmed.ncbi.nlm.nih.gov/37936880","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10626542"},"language":"en","primary_location":{"id":"doi:10.3389/frhs.2023.1282292","doi":"https://doi.org/10.3389/frhs.2023.1282292","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frhs.2023.1282292","pdf_url":null,"source":{"id":"https://openalex.org/S4386621993","display_name":"Frontiers in Health Services","issn_l":"2813-0146","issn":["2813-0146"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Health Services","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3389/frhs.2023.1282292","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5044347523","display_name":"Arwen Bunce","orcid":"https://orcid.org/0000-0003-2243-972X","observed_orcids":["https://orcid.org/0000-0003-2243-972X"]},"institutions":[{"id":"https://openalex.org/I4210133871","display_name":"Ochin","ror":"https://ror.org/03ft4ac91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210133871"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Arwen E. Bunce","raw_affiliation_strings":["Research Department, OCHIN Inc., Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Department, OCHIN Inc., Portland, OR, United States","institution_ids":["https://openalex.org/I4210133871"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Suzanne Morrissey","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210133871","display_name":"Ochin","ror":"https://ror.org/03ft4ac91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210133871"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Suzanne Morrissey","raw_affiliation_strings":["Research Department, OCHIN Inc., Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Department, OCHIN Inc., Portland, OR, United States","institution_ids":["https://openalex.org/I4210133871"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004561377","display_name":"Jorge Kaufmann","orcid":"https://orcid.org/0000-0002-1516-4636","observed_orcids":["https://orcid.org/0000-0002-1516-4636"]},"institutions":[{"id":"https://openalex.org/I165690674","display_name":"Oregon Health & Science University","ror":"https://ror.org/009avj582","country_code":"US","type":"education","lineage":["https://openalex.org/I165690674"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jorge Kaufmann","raw_affiliation_strings":["Oregon Health & Science University, Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Oregon Health & Science University, Portland, OR, United States","institution_ids":["https://openalex.org/I165690674"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045744221","display_name":"Molly Krancari","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210133871","display_name":"Ochin","ror":"https://ror.org/03ft4ac91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210133871"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Molly Krancari","raw_affiliation_strings":["Research Department, OCHIN Inc., Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Department, OCHIN Inc., Portland, OR, United States","institution_ids":["https://openalex.org/I4210133871"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Megan Bowen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210133871","display_name":"Ochin","ror":"https://ror.org/03ft4ac91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210133871"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Megan Bowen","raw_affiliation_strings":["Research Department, OCHIN Inc., Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Research Department, OCHIN Inc., Portland, OR, United States","institution_ids":["https://openalex.org/I4210133871"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5064706856","display_name":"Rachel Benson Gold","orcid":"https://orcid.org/0000-0001-6326-5012","observed_orcids":["https://orcid.org/0000-0001-6326-5012"]},"institutions":[{"id":"https://openalex.org/I4210114677","display_name":"Kaiser Permanente Center for Health Research","ror":"https://ror.org/028gzjv13","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1343052199","https://openalex.org/I4210114677"]},{"id":"https://openalex.org/I4210133871","display_name":"Ochin","ror":"https://ror.org/03ft4ac91","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210133871"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rachel Gold","raw_affiliation_strings":["Kaiser Center for Health Research, Portland, OR, United States","Research Department, OCHIN Inc., Portland, OR, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Kaiser Center for Health Research, Portland, OR, United States","institution_ids":["https://openalex.org/I4210114677"]},{"raw_affiliation_string":"Research Department, OCHIN Inc., Portland, OR, United States","institution_ids":["https://openalex.org/I4210133871"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5044347523"],"corresponding_institution_ids":["https://openalex.org/I4210133871"],"apc_list":{"value":2125,"currency":"USD","value_usd":2125},"apc_paid":{"value":2125,"currency":"USD","value_usd":2125},"fwci":1.5094,"has_fulltext":true,"cited_by_count":5,"citation_normalized_percentile":{"value":0.81954521,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":95,"max":97},"biblio":{"volume":"3","issue":null,"first_page":"1282292","last_page":"1282292"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12010","display_name":"Evaluation and Performance Assessment","score":0.0017999999690800905,"subfield":{"id":"https://openalex.org/subfields/1803","display_name":"Management Science and Operations Research"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/social-risk-screening","display_name":"social risk screening","score":0.9980000257492065},{"id":"https://openalex.org/keywords/social-determinants-of-health","display_name":"social determinants of health","score":0.9210000038146973},{"id":"https://openalex.org/keywords/primary-care","display_name":"primary care","score":0.7770000100135803},{"id":"https://openalex.org/keywords/community-health-clinics","display_name":"community clinics","score":0.8040000200271606},{"id":"https://openalex.org/keywords/person-centred-care","display_name":"person-centred care","score":0.6729999780654907},{"id":"https://openalex.org/keywords/normalization-process-theory","display_name":"Normalization Process Theory","score":0.6710000038146973},{"id":"https://openalex.org/keywords/implementation-strategies","display_name":"implementation strategies","score":0.38499999046325684}],"concepts":[{"id":"https://openalex.org/C2780665704","wikidata":"https://www.wikidata.org/wiki/Q959298","display_name":"Intervention (counseling)","level":2,"score":0.5328904390335083},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.4379439353942871},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4200581908226013},{"id":"https://openalex.org/C2779363792","wikidata":"https://www.wikidata.org/wiki/Q1104185","display_name":"Coaching","level":2,"score":0.4177165627479553},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.4036898910999298},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.3942415118217468},{"id":"https://openalex.org/C75630572","wikidata":"https://www.wikidata.org/wiki/Q538904","display_name":"Applied psychology","level":1,"score":0.3247174620628357},{"id":"https://openalex.org/C542102704","wikidata":"https://www.wikidata.org/wiki/Q183257","display_name":"Psychotherapist","level":1,"score":0.0}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/frhs.2023.1282292","doi":"https://doi.org/10.3389/frhs.2023.1282292","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frhs.2023.1282292","pdf_url":null,"source":{"id":"https://openalex.org/S4386621993","display_name":"Frontiers in Health Services","issn_l":"2813-0146","issn":["2813-0146"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Health Services","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10626542","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10626542","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10626542/pdf/frhs-03-1282292.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Health Serv","raw_type":"Text"},{"id":"pmid:37936880","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/37936880","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in health services","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:725f061871c948af997ee4755138ef91","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/725f061871c948af997ee4755138ef91","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Health Services, Vol 3 (2023)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/frhs.2023.1282292","doi":"https://doi.org/10.3389/frhs.2023.1282292","is_oa":true,"landing_page_url":"https://doi.org/10.3389/frhs.2023.1282292","pdf_url":null,"source":{"id":"https://openalex.org/S4386621993","display_name":"Frontiers in Health Services","issn_l":"2813-0146","issn":["2813-0146"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Health Services","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9537000060081482},{"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10","score":0.4000000059604645}],"study_designs":[],"awards":[{"id":"https://openalex.org/G3514478437","display_name":"ASCEND: ApproacheS to CHC ImplEmeNtation of SDH Data Collection and Action","funder_award_id":"R18DK114701","funder_id":"https://openalex.org/F4320337357","funder_display_name":"National Institute of Diabetes and Digestive and Kidney Diseases"},{"id":"https://openalex.org/G7734135162","display_name":null,"funder_award_id":"RI-OCHIN-01-MC","funder_id":"https://openalex.org/F4320308927","funder_display_name":"Patient-Centered Outcomes Research Institute"}],"funders":[{"id":"https://openalex.org/F4320308927","display_name":"Patient-Centered Outcomes Research Institute","ror":"https://ror.org/014q65q44"},{"id":"https://openalex.org/F4320337357","display_name":"National Institute of Diabetes and Digestive and Kidney Diseases","ror":"https://ror.org/00adh9b73"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4387879609.pdf","grobid_xml":"https://content.openalex.org/works/W4387879609.grobid-xml"},"referenced_works_count":55,"referenced_works":["https://openalex.org/W1276207796","https://openalex.org/W1836470756","https://openalex.org/W1978372683","https://openalex.org/W1999451956","https://openalex.org/W2015114767","https://openalex.org/W2040098616","https://openalex.org/W2054693505","https://openalex.org/W2061326246","https://openalex.org/W2062454910","https://openalex.org/W2072250234","https://openalex.org/W2083507189","https://openalex.org/W2085637447","https://openalex.org/W2088864483","https://openalex.org/W2095813565","https://openalex.org/W2103823988","https://openalex.org/W2122199229","https://openalex.org/W2124199620","https://openalex.org/W2127559536","https://openalex.org/W2128248134","https://openalex.org/W2150236945","https://openalex.org/W2158472660","https://openalex.org/W2163406783","https://openalex.org/W2181017272","https://openalex.org/W2225155599","https://openalex.org/W2404722780","https://openalex.org/W2464700444","https://openalex.org/W2517787876","https://openalex.org/W2788394720","https://openalex.org/W2884646530","https://openalex.org/W2894436594","https://openalex.org/W2914050166","https://openalex.org/W2915785250","https://openalex.org/W2944807484","https://openalex.org/W2949361593","https://openalex.org/W2966421613","https://openalex.org/W2982441784","https://openalex.org/W2990947921","https://openalex.org/W3033646657","https://openalex.org/W3035351126","https://openalex.org/W3130634373","https://openalex.org/W3136607558","https://openalex.org/W3176361910","https://openalex.org/W3179209773","https://openalex.org/W3182603438","https://openalex.org/W3186780864","https://openalex.org/W3216784913","https://openalex.org/W4210845093","https://openalex.org/W4213145258","https://openalex.org/W4287734794","https://openalex.org/W4297003150","https://openalex.org/W4309474336","https://openalex.org/W4324353147","https://openalex.org/W4353050231","https://openalex.org/W4360991786","https://openalex.org/W4364360935"],"related_works":["https://openalex.org/W4407331055","https://openalex.org/W4364360935","https://openalex.org/W7129092119","https://openalex.org/W4384820277","https://openalex.org/W6987111097","https://openalex.org/W7214493054","https://openalex.org/W4387210163","https://openalex.org/W4287543010","https://openalex.org/W4388719699","https://openalex.org/W7160946423"],"abstract_inverted_index":{"Background:":[0],"Social":[1],"risk":[2,30,130,165,217,249,286],"screening":[3,31,131,166,218,287],"rates":[4,245],"in":[5,33,132,288,320],"many":[6],"US":[7],"primary":[8],"care":[9,136,333],"settings":[10],"remain":[11],"low.":[12],"This":[13,315],"realist-informed":[14],"evaluation":[15],"explored":[16],"the":[17,38,46,52,65,83,98,104,110,125,143,146,149,160,163,173,179,199,215,222,242,252,263,277,297,338],"mechanisms":[18,312],"through":[19],"which":[20,326],"a":[21],"tailored":[22],"coaching":[23],"and":[24,54,58,77,107,137,154,182,185,189,192,201,241,271,299,304,329,335],"technical":[25],"training":[26],"intervention":[27,84,150,200,264,278,302],"impacted":[28,140,155],"social":[29,129,164,216,248,285,321],"uptake":[32],"26":[34],"community":[35],"clinics":[36,53,210],"across":[37],"United":[39],"States.":[40],"Methods:":[41],"Evaluation":[42],"data":[43],"sources":[44],"included":[45],"documented":[47],"content":[48],"of":[49,71,74,109,127,148,159,162,229,246,301,313,323,340],"interactions":[50],"between":[51,172,178,186,231],"implementation":[55,167,174,305],"support":[56,175,180,308],"team":[57,176,181],"electronic":[59],"health":[60,324,332],"record":[61],"(EHR)":[62],"data.":[63],"Following":[64],"realist":[66,99,117,253,293],"approach,":[67],"analysis":[68],"was":[69,95],"composed":[70],"iterative":[72],"cycles":[73],"developing,":[75],"testing":[76],"refining":[78],"program":[79,100,118,223,254,294],"theories":[80,101,224,255,295],"about":[81,124],"how":[82],"did-or":[85],"didn't-work,":[86],"for":[87],"whom,":[88],"under":[89],"what":[90],"circumstances.":[91],"Normalization":[92,257],"Process":[93,258],"Theory":[94,259],"applied":[96],"to":[97,102,142,196,202,205,226,236],"enhance":[103],"explanatory":[105],"power":[106],"transferability":[108],"results.":[111],"Results:":[112],"Analysis":[113],"identified":[114],"three":[115],"overarching":[116],"theories.":[119],"First,":[120],"clinic":[121,156,183,187,194,232],"staff":[122,190,195,233],"perceptions":[123],"role":[126],"standardized":[128],"person-centered":[133,239],"care-considered":[134],"\"good\"":[135],"highly":[138],"valued-strongly":[139],"receptivity":[141],"intervention.":[144],"Second,":[145],"physicality":[147],"materials":[151],"facilitated":[152],"collaboration":[153],"leaders'":[157],"perception":[158],"legitimacy":[161],"work.":[168],"Third,":[169],"positive":[170],"relationships":[171,310],"members,":[177],"champions,":[184],"champions":[188],"motivated":[191],"inspired":[193],"engage":[197],"with":[198,256],"tailor":[203],"workflows":[204],"their":[206],"settings'":[207],"needs.":[208],"Study":[209],"did":[211,279],"not":[212,280],"always":[213],"exhibit":[214],"patterns":[219],"anticipated":[220],"by":[221],"due":[225],"discrepant":[227],"definitions":[228],"success":[230],"(improved":[234],"ability":[235],"provide":[237],"contextualized,":[238],"care)":[240],"trial":[243],"(increased":[244],"EHR-documented":[247],"screening).":[250],"Aligning":[251],"constructs":[260],"clarified":[261],"that":[262,307],"as":[265,311],"implemented":[266],"emphasized":[267],"preparation":[268],"over":[269],"operationalization":[270],"appraisal,":[272],"providing":[273],"insight":[274],"into":[275],"why":[276],"successfully":[281],"embed":[282],"sustained":[283],"systematic":[284],"participating":[289],"clinics.":[290],"Conclusion:":[291],"The":[292],"highlighted":[296],"effectiveness":[298],"importance":[300],"components":[303],"strategies":[306],"trusting":[309],"change.":[314],"may":[316],"be":[317],"particularly":[318],"important":[319],"determinants":[322],"work,":[325],"requires":[327],"commitment":[328],"humility":[330],"from":[331],"providers":[334],"vulnerability":[336],"on":[337],"part":[339],"patients.":[341]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":3}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2023-10-24T00:00:00"}
