Screening for Social Determinants of Health at Federally Qualified Health Centers

Abstract

Purpose: The purpose of this quality improvement (QI) project was to enhance healthcare providers’ knowledge, confidence, and willingness to screen for social determinants of health (SDOH) within a group of federally qualified health centers (FQHC). Additionally, by piloting a screening tool and workflow, the project aimed to identify the most common social needs in the clinics and offer recommendations for future screening efforts. Background: Social determinants of health are the nonmedical factors that impact an individual’s well-being. Universal screening for SDOH is recommended by many professional organizations. However, screening rates remain low. Incorporating routine SDOH screening into practice can help providers identify vulnerable patients and address underlying needs, thereby improving health outcomes. Methods: Eligible healthcare providers from 11 United Community Health Center clinics were recruited to participate through convenience sampling. A 15-minute educational presentation on SDOH was delivered at a monthly staff meeting. A quantitative descriptive design, utilizing pre- and post- surveys, evaluated changes in provider knowledge, confidence, and willingness to screen for SDOH. Following the educational session, a two-week pilot of the PRAPARE toolwas implemented at select clinic sites. Results: A total of 14 responses were collected for the pre-survey and 10 for the post-survey. Data analysis revealed measurable differences for most provider outcomes, with increases in all but one mean score, as well as improvements or stability in all median scores. During the two-week pilot period, 24 PRAPARE screens were completed and documented. Of the patients 12 screened, 96% demonstrated at least one social risk factor and stress was reported by 75% of participants. Conclusions: A brief educational intervention has the potential to enhance healthcare providers' knowledge, confidence, and willingness to screen for SDOH. Further research is needed to address organizational readiness for implementation and to determine if the PRAPARE tool is the most appropriate screening method. Patients may benefit from additional support for managing stress.