{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:30:27Z","timestamp":1790109027593,"version":"4.0.1"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Nursing"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Research shows low health confidence predicts poor involvement in self-care and is associated with increased use of costly healthcare services. To improve overall health and reduce health inequities, the relevance and urgency of identifying the relationship between social determinants of health and health confidence are great.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study explored relationships between social determinants of health and health confidence in adults at an urgent care center in southern California.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The descriptive cross-sectional study collected data via survey from 240 English- and Spanish-speaking adults (18\u201393 years) receiving care for any medical condition between 15 and 17 August 2022. Patients in need of immediate medical attention were excluded. The survey encompassed The\n                      <jats:italic toggle=\"yes\">PRAPARE screening instrument<\/jats:italic>\n                      , sociodemographic questions, and a single health confidence question. Bivariate analysis identified significant differences in health confidence for a logistic regression model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-seven percent (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009107) of participants reported low confidence in managing their health and well-being. Low health confidence was observed in those with unmet needs (\n                      <jats:italic toggle=\"yes\">\n                        \u03c7\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:italic>\n                      \u2009=\u20094.16,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.042), and varying levels of stress (\n                      <jats:italic toggle=\"yes\">\n                        \u03c7\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:italic>\n                      \u2009=\u200913.76,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.008). Low health confidence was common in low-income (\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      \u2009=\u20092.23,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.028) and greater social risk groups (\n                      <jats:italic toggle=\"yes\">\n                        \u03c7\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:italic>\n                      \u2009=\u200919.7,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Participants in contact with friends or family 1 to 5 times per week (vs.\u2009&gt;5 times) were more likely to report low health confidence; those with high levels of stress were more likely to report low health confidence (vs. no stress).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the insidious prevalence of social determinants of health and the impact of social isolation and stress on health confidence, providing the basis for implementing standardized social determinants of health screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23779608251344038","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T03:14:10Z","timestamp":1747278850000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Social Determinants of Health and Health Confidence: A Cross-Sectional Study"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3937-8753","authenticated-orcid":false,"given":"Laura","family":"Truman","sequence":"first","affiliation":[{"name":"University of San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5253-3357","authenticated-orcid":false,"given":"Patricia","family":"Calero","sequence":"additional","affiliation":[{"name":"University of San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Etland","sequence":"additional","affiliation":[{"name":"University of San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9891-5369","authenticated-orcid":false,"given":"Razel B.","family":"Milo","sequence":"additional","affiliation":[{"name":"University of San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5726-5905","authenticated-orcid":false,"given":"Cynthia D.","family":"Connelly","sequence":"additional","affiliation":[{"name":"University of San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2018-000411"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150132720921329"},{"key":"e_1_3_2_4_1","unstructured":"Centers for Disease Control and Prevention. (2024). Social determinants of health. https:\/\/www.cdc.gov\/about\/priorities\/why-is-addressing-sdoh-important.html"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.05.078"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.171154"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.11514"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2018.03.170249"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.01763"},{"key":"e_1_3_2_11_1","unstructured":"Harvard Medical School. Medical Student COVID-19 Action Network. (2021). 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