Health-Related Social Needs Workforce: Health Care Worker Tasks, Functions, and Roles for Coordinating Cross-Sector Services

Abstract

As health care workers more and more asked to address patient social needs, their occupations become insufficient as proxy variable for health workforce planning and development. I propose the development of a function-based lens for health care workforce planning and development. In this dissertation study, I use worker tasks for coordination cross-sector services to address patient social needs to develop hypothesized worker functions and roles. I then assess the validity of these functions and roles.

This dissertation research was conducted in three phases. In the first phase, I used literature review to identify a set of tasks health care workers perform to coordinate cross-sector services. In the second phase, I conducted qualitative research using data collected through key informant interviews. In the third and final phase, I created a measurement scale using findings from Phase 1 and Phase 2, then assessed the scale’s validity using factor analyses. I also tested the hypothesized relationships between tasks, functions, and worker roles using confirmatory factor analysis and latent class analysis.

Through literature review, I identified key tasks that are part of the cross-sector service coordination process. Based on these findings, I formulated the hypothesis with three functions performed by workers: Detect, Connect, and Co-Design Workflow. I also hypothesized two function-based roles workers may assume when they are engaged in this work: Traditional Service Extenders (TSEs) and Connectors.

Phase 2’s qualitative research yielded themes that help contextualize the work itself and how workers interact with each other when they engage in coordinating cross-sector services. The themes support the hypothesized three functions but suggest the roles may not be as hypothesized. Key informants also helped with content validation of the measurement scales, pointing out additional tasks that should be included as scale items.

Phase 3’s quantitative research confirmed the validity of the three functions and their associated tasks. The latent class analysis found two classes of survey respondents, but the two classes do not correspond with function-based groupings. Instead, the one class has higher chance of performing each task while the other class of respondents has a lower chance of performing each task.

This study successfully developed a measurement scale for measuring functions Detect, Connect, and Co-Design Workflow as new variables for health care workforce planning with a function-based lens. The methods used in this study can be applied to study the “workforce for health”—those contributing to improving health of communities in daily work but are not traditionally considered as part of the health workforce. It can also help improve interprofessional education and practice. Finally, the hypothesized functions align well with the areas of focus in the National Academy of Sciences report on integrating social care and health care. My research provides a step forward with a tangible measurement scale and preliminary data that can help the field move forward.