How can you address social determinants of health in translational research?

Primeiro passo em qualquer projeto é a pergunta. Momento de reflexão e debater entre a equipe se é uma questão importante para ser estudada.

I have always felt that the first step is most important in ALL health problems because of differences in MHC loci, diets, exposure, and family history ... . T-Cell immune strength vs. B-Cell immune strength; meat eaters vs. vegetarians; dairy product consumers vs. non-dairy product consumers; people who live in warm, humid climates vs. people who live in dry, cold climates; and family history of diseases/mental illnesses.

Start your translational study by precisely defining the health issue you want to solve and pinpointing the target demographic. Recognize how the chosen population's socioeconomic, cultural, and environmental characteristics affect health outcomes. This initial stage guarantees focused interventions that are in line with the situation.

Did you know that clinical care only has about 20% impact on a patient's health outcomes? The remaining 80% can be attributed to social determinants of health, which are socioeconomic and environmental variables that directly affect a person's lifestyle Social determinants of health translational research should be tailored to the population of interest to determine which factors to examine

Clearly articulate the social determinants you’re investigating, such as access to care, socioeconomic status, or education, and how these may affect orthopedic health outcomes in the population of interest.

In addressing social determinants of health (SDOH) in translational research, let's rethink our terminology. Instead of 'stakeholders'—a term with a violent history—I propose 'interest-holders' to describe individuals or groups vested in the research, like patients, providers, policymakers, and funders. Engaging with interest-holders and communities, particularly underrepresented groups is vital. By involving them in co-designing, implementing, and evaluating our research, we gain invaluable insights into their unique perspectives, preferences, and priorities. This inclusive approach ensures our research is not only more culturally responsive and ethical but also more effective in addressing the complex realities of SDOH.

I've learned that collaboration is like having a team on this expedition. Engage with healthcare providers, community leaders, and those directly affected by social determinants. Their insights are like treasures, providing a deeper understanding of the issues and shaping more effective interventions.

Engaging with stakeholders means far more than involving them at the final stages of research to check a box that stakeholders were involved. It means meaningfully engaging populations affected by potential research from conception, hypothesis, question generation, the research process, all the way through to co-authoring the research and disseminating the findings back to the stakeholder population.

To fully comprehend the complexities of SDOH, active involvement with stakeholders and communities is essential. Work together with affected people, legislators, healthcare providers, and community leaders. To obtain a variety of viewpoints and views, analyse community needs and include stakeholders in the research process.

Involve patients, healthcare providers, policymakers, and community leaders to understand the multifaceted impact of these determinants. Their insights will be vital in framing research questions and interventions.

Choose data sources and research techniques that adequately convey the complexity of SDOH. Use mixed-method approaches to combine quantitative and qualitative data in order to obtain a thorough understanding. To guarantee that the community is involved in forming research questions and evaluating results, apply community-based participatory research (CBPR) techniques.

Collect data from medical records, surveys, and interviews that reflect the social contexts of your patients. Use both quantitative and qualitative methods to capture the breadth and depth of the issues.

These data sources are important. I especially like interviews because it gives the researcher an opportunity to speak with the affected population to identify where needed areas are not met, what the affected population would like to see in order to gain better access, ideas for better access, and more nuanced problems that prevent access.

Quantitative data source information is not sufficient to inform about the health problem a need to compliment with qualitative data via KII, FGD and others alike will elaborate well the problem

Patients time is valuable, just like the time of researchers. The time stakeholders give to research is time they could be working. Stakeholders should be compensated for the expertise they bring to the table. Treating stakeholders like the experts they are, especially if you're dealing with patients, is essential to maintaining the trust of the patient population you're studying. Whether the compensation be financial or non-financial (like co-authorship), patients time is a value asset and should be treated as such.

Evaluate the practical difficulties and ethical issues pertaining to your research in detail. Make sure confidentiality, privacy, and informed consent are given top priority. In order to promote a cooperative and moral research environment, it is important to address power disparities between communities and researchers. Think on how sustainable and feasible the suggested interventions are.

Although incentives are good way to go but at the same time it has a potential to be misused at various levels for personal gains. I think we need to educate people on the relevance of this data and use nudge behavioural techniques to do the same.

Ensuring that data collection and analysis processes are conducted ethically and with the consent and participation of the communities being studied is essential for building trust and maintaining the integrity of the research

Addressing ethical considerations is paramount in translational research. Informed consent, confidentiality measures and equitable recruitment practices safeguard the rights and well-being of participants. Cultural sensitivity and respect for community autonomy are essential ethical principles. Beneficence snd non-maleficence guide the research towards maximizing positive outcomes. Practical considerations are equally crucial in ensuring the sustainability. Interventions should be adaptable to the dynamic nature of the topic. Collaborative efforts with communities contribute to long-term improvements in addressing social determinants of health.

Publicar é muito importante. Reforço que devemos minimizar os vieses dos estudos com achados negativos. Que tendem a não ser publicados.

Share your results in a way that is accessible and actionable. This could mean publishing in open-access journals, presenting at community meetings, or creating policy briefs.

Translating findings is akin to decoding a complex message. Package your research findings in a way that's accessible to policymakers, healthcare providers, and the community. It's like crafting a universal language, ensuring your discoveries reach and resonate with diverse audiences.

For results from translational research to have impact the findings from the research should be translated effectively and appropriately in an easy to understand manner. For instance, charts and tables can be utilized in visualizing the results and outcomes while podcasts can be used to spread out and improve the accessibility of information laced with the research work in journals.

This is the most underrated part readjusting after identifying the flaws. China has a great way to do this as they run policy pilots before scaling and make flexible terms to leave space for redefining the errors or failures.

Translational research on social determinants of health can contribute to evidence-based policy recommendations and advocacy efforts aimed at addressing systemic issues that contribute to health disparities. Collaboration with policymakers and stakeholders to translate research findings into actionable policies and interventions is essential for achieving meaningful change in population health.

Measure the effectiveness of interventions derived from your research. Are health disparities being reduced? Is access to orthopedic care improving in underserved populations?

The outcomes of translational research should be further analysed into different perspectives for them to be effective in addressing the health issue in focus: 1. Biomedical perspectives-application of biological knowledge to address how social determinants affect health at physiological level. 2. Clinical perspective- how the outcomes can be harnessed clinically if need be to clinically address the social determinants of health 3. Population health perspective- how the outcomes influence formulation of new policies and improvement of existing policies to.address disparities 4. Implementation perspective- how the outcomes of research connect to the actual real life situation- the practicability of outcomes with a sustainability lens.

Strategies may involve tailoring interventions to account for socioeconomic factors, promoting equal access to healthcare resources, and considering cultural contexts to ensure the effectiveness of health initiatives across diverse populations.

Long-term engagement and sustainable interventions are key. Research should lead to actionable changes in clinical practice, policy, and patient

To present your research with a human element I also think it’s important to articulate your motivation for conducting the research every step of the way. Explain why you were motivated to even begin looking at the problem and why you wanted to provide viable solutions. Explain why the research and problem itself are important to you. I think this helps establish and maintain trust and transparency.

An example which stood the test of time is to be able to make technology especially those related to immunotherapies and the likes , affordable and accessible across and to people of all background.

Addressing social determinants of health requires a whole of government approach with contribution from all sectors (e.g., food industry, education, social care, housing, environment protection) as it goes way beyond healthcare