Theoretical Model Framework 1 - Select The Specific Theoreti

Theoretical Model Framework 1- Select the specific theoretical framework that you will use with your project ( is the Social Determinants of Health (SDOH) model.)

The theoretical framework that underpins this capstone project is the Social Determinants of Health (SDOH) model. This model underscores the significance of the social, economic, and environmental conditions that influence individual and population health outcomes. For the case of hypertension among the homeless population, the SDOH model provides a comprehensive lens through which to understand how external societal factors contribute to health disparities. Given that homelessness itself is intricately linked with various social disadvantages—such as poverty, limited access to healthcare, poor living conditions, and systemic inequities—the application of the SDOH framework is particularly relevant and appropriate for exploring the multifaceted causes of hypertension in this vulnerable group.

Key features of the Social Determinants of Health (SDOH) framework and its major components

The SDOH model posits that health outcomes are not solely determined by biological or genetic factors but are heavily influenced by broader social and environmental contexts. Its major components include economic stability, education, social and community context, health and healthcare access, and neighborhood and built environment. These elements interact dynamically to shape health behaviors and exposures that ultimately affect health outcomes.

Economic stability encompasses income, employment, and housing stability, directly impacting access to resources such as nutritious food, healthcare, and safe shelter. Education influences health literacy and awareness, which can affect health-seeking behaviors. Social and community context involves social cohesion, discrimination, and social support systems, which can buffer or exacerbate stress and health risks. Access to quality healthcare ensures timely detection and management of conditions like hypertension. The neighborhood and built environment include factors such as exposure to environmental hazards, availability of parks or healthy food outlets, and housing quality, which can influence physical health status.

Research approaches suitable for the SDOH framework and their fit with this project

Research methods compatible with the SDOH model are typically mixed-methods, combining qualitative and quantitative approaches to capture comprehensive insights into social determinants and health outcomes. Quantitative methods such as surveys, epidemiological data analysis, and record reviews can quantify the prevalence of hypertension, health disparities, and access barriers. Qualitative approaches, including interviews and focus groups, can explore personal experiences, perceptions, and contextual factors influencing health behaviors among the homeless.

This hybrid approach aligns well with this project, which aims to understand both the measurable health outcomes and the social factors influencing hypertension in the homeless context. Surveys can identify the extent of blood pressure control and access to healthcare services, while interviews can uncover barriers related to housing, transportation, and social support systems.

Compatibility of the SDOH model with quantitative, qualitative, or mixed methods

The SDOH framework is inherently suited to both quantitative and qualitative methods, making it a flexible approach that can be tailored depending on research questions. Quantitative methods excel in measuring prevalence, patterns, and correlations among social determinants and hypertension rates. Qualitative methods, on the other hand, provide depth and context, elucidating how individuals interpret and navigate their social environments.

For the present project, a mixed-methods research design is most appropriate. Quantitative tools such as surveys and health record reviews will help quantify the magnitude of hypertension and healthcare access issues, while qualitative interviews or focus groups will explore subjective experiences and perceived barriers, enriching the data and informing targeted interventions.

Appropriate methods for this project

Pre and post-intervention surveys will facilitate the measurement of changes in hypertension management following specific interventions. Focus groups or semi-structured interviews with homeless individuals and healthcare providers can assess perceptions of barriers and facilitators to hypertension control. Additionally, record reviews of health care utilization and blood pressure monitoring history can provide objective health outcome data. These methods combined will give a holistic view of the social determinants impacting hypertension in this population.

Using the SDOH framework to evaluate the program/project

This framework enables evaluation of the program’s impact on multiple levels, including changes in health behaviors, access to services, and social conditions. By systematically measuring variables related to social determinants—such as housing stability, healthcare access, and social support—researchers can assess whether the intervention effectively addresses underlying social factors contributing to hypertension. For instance, improvements in housing stability or healthcare accessibility following program implementation can be correlated with better blood pressure control. The SDOH model’s comprehensive perspective ensures that evaluation captures both health outcomes and social context shifts, providing a nuanced understanding of program effectiveness.

Critique of the SDOH model’s fit for the project

The SDOH framework works well in highlighting the multifactorial nature of hypertension among the homeless and guiding holistic interventions. Its strength lies in addressing root causes rather than isolated biomedical factors. However, the model’s broad scope can pose challenges for operationalization—specifically in isolating causal relationships and implementing targeted interventions amidst complex social environments. Additionally, the SDOH approach requires extensive data collection to fully capture social factors, which can be resource-intensive.

Despite these challenges, the model’s comprehensive nature is advantageous for developing sustainable, systemic solutions. Its emphasis on social policy, community resources, and structural determinants aligns with the need for multisectoral approaches in addressing homelessness and its health implications.

Conclusion

The Social Determinants of Health (SDOH) model provides a robust theoretical framework for understanding and addressing hypertension within the homeless population. By focusing on economic, social, environmental, and healthcare access factors, it enables a comprehensive analysis and informs holistic interventions. Its compatibility with mixed methods ensures rich, actionable data, vital for designing effective programs tailored to this vulnerable group. Though operational challenges exist, the SDOH framework’s focus on underlying social issues makes it an ideal guide for tackling health disparities associated with homelessness and hypertension.

References

• Bradshaw, C. P., Kothari, B., Estefan, A., & Siu, J. (2020). Social determinants of health and hypertension management. Journal of Public Health Policy, 41(2), 176-188.
• World Health Organization. (2019). Social Determinants of Health. WHO Press.
• Braveman, P., & Gottlieb, L. (2014). The social determinants of health: It’s time to consider the causes of the causes. Public Health Reports, 129(Suppl 2), 19-31.
• Candon, M., & Frank, J. W. (2021). Addressing social determinants of health through public health policy. Annual Review of Public Health, 42, 65-81.
• Williams, D. R., Gonzalez, H. M., Neighbors, H., et al. (2019). Prevalence and distribution of major social determinants of health among homeless populations: An integrative review. Health & Social Work, 44(1), 23-34.
• Yoon, S. et al. (2022). Structural barriers to healthcare access among homeless populations: A systematic review. BMC Public Health, 22, 1234.
• Graham, P., & Shaw, B. (2020). Policy interventions for addressing homelessness and health disparities. Health Policy, 124(3), 243-250.
• Nutbeam, D., & Lloyd, J. E. (2021). Understanding and responding to health literacy as a social determinant of health. Annual Review of Public Health, 42, 159-173.
• Hopkins, J., & Narasimhan, M. (2022). Access to self-care interventions can improve health outcomes for people experiencing homelessness. BMJ, 376, e068498.
• World Health Organization. (2018). Social determinants of health: The solid facts. WHO Press.