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Table 5 Study outcomes

From: Study protocol: a pragmatic, stepped-wedge trial of tailored support for implementing social determinants of health documentation/action in community health centers, with realist evaluation

RE-AIM
component
Outcome measures
Reach • Rate of clinic encounters where SDH is documented: among any patients and targeted patients
Effectiveness—secondary outcome
(among patients with/at risk for diabetes, a subset of study CHC patients)
Rate of all/targeted patients seen that month who have:
 • Controlled diabetes risks (BP < 140/80; A1c < 7.0%; BMI < 30; LDL < 100 mg/dL)
 • Incident comorbidities, e.g., retinopathy, neuropathy
 • Up-to-date diabetes tests (lipid panel, HbA1c, eye/foot exams)
Adoption—primary outcome Rate of
 • All patients seen for whom SDH data are documented
 • Targeted patients seen for whom SDH data are documented
 • Patients with an identified SDH need with documented referrals to community agencies: overall; among those who requested clinic assistance; and according to reported SDH needs
Implementation • Participation in implementation support activities
• Realist evaluation results
Maintenance • All measures over time
• Change in diabetes risks/measures over time