• Wen Wan, Vivian Li, Marshall H Chin, David N Faldmo, Erin Hoefling, Michelle Proser, and Rosy Chang Weir.
• From University of Chicago, Chicago, IL (WW, MHC); Association of Asian Pacific Community Health Organizations, San Francisco, CA (VL, RCW); Siouxland Community Health Center, Sioux City, IA (DF, EH); National Association of Community Health Centers, Bethesda, MD (MP). wwan1@medicine.bsd.uchicago.edu.
• J Am Board Fam Med. 2022 Jul 1; 35 (4): 668-679.

IntroductionPRAPARE is a leading social risk screening tool. No studies yet have simplified the 22 PRAPARE social determinants of health (SDoH) into clusters to analyze associations with chronic disease outcomes.MethodsA federally qualified health center conducted cross-sectional PRAPARE screening on its general adult population. Exploratory and confirmatory factor analyses were used to identify SDoH clusters and construct cluster scores and SDoH total risk scores. Logistic regression assessed relationships between cluster scores and uncontrolled diabetes and/or hypertension.ResultsOf the 11,773 adults who answered the survey, 716 had diabetes only, 2,388 had hypertension only, 1,477 had both, and 7,192 had neither. We found 3 composite SDoH clusters (social background, social insecurities, insurance/employment) and 3 standalone clusters (housing status, social isolation, poverty). Among patients with diabetes, those at risk in social background, social insecurities, and insurance/employment were more likely to have uncontrolled diabetes. Among patients with hypertension, those at more risk in social insecurities were more likely to have uncontrolled hypertension.ConclusionsWe simplified the 22 PRAPARE SDoH into 3 composite clusters and 3 individual clusters and demonstrated the reliability and validity of PRAPARE. The 3 composite clusters were positively associated with uncontrolled diabetes and/or hypertension.© Copyright 2022 by the American Board of Family Medicine.

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