Abstract
Inequities in social determinants of health (SDH) are major contributors to persistent health disparities across the cancer continuum. While screening tools to address patient non-medical social needs have been developed, little evidence of screening tool effectiveness or guidance on implementation is available. Our pilot study examines the use of a social needs screening tool in a high need primary health care setting in the U.S.-Mexico border region. A 4-item SDH screening tool assessed for food insecurity, lack of transportation, legal issues, or domestic violence. The study objective is to identify facilitators and barriers to appropriate referrals for social needs from the perspective of patients and providers. The PRECEDE-PROCEED model is used to guide intervention development. This study focuses on the PRECEDE (Pre- disposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) portion of the PRECEDE-PROCEED model to identify factors that impact the use of the developed SDH screening tool. Data collection uses a mixed-methods approach through the review of patient electronic medical records (EMR) and qualitative interviews of clinic patients, physicians, and staff. Data focuses on the factors influencing the use of the SDH screening tool, the subsequent social service referrals, as well as the associated rate of in-clinic SDH tool utilization through physician and patient reported use and EMR review. Data collection and analysis are currently ongoing. Themes identified during preliminary analyses include the importance of patient-physician relationships, barriers to SDH assessment during the clinical encounter, and potential policy and clinic-level facilitators to the screening tool’s implementation. The study findings will be applied to the development of an educational intervention targeting primary care residency programs. This intervention will improve the way providers address SDH needs of patients ensuring more wholistic patient care
Citation Format: Sashiel Piña, Mary Alice Scott, Rhianna Thomas, McKayla Tsabetaye, Abigail Kane, Iván De la Rosa, Kerianne Chandler, Rachel Ceballos. A mixed-methods assessment of SDH screening tool and its contribution to health [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-027.