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What Are The Top Social Determinants of Health Screening Tools?

Validated social determinants of health screening tools can be used on their own or be a jumping-off point for organizations developing their own customized surveys.

Sara Heath
By
Published: 10 May 2023

In order to address the social factors impacting patient well-being, healthcare organizations foremost need validated social determinants of health screening tools to uncover those social needs.

SDOH screening can happen using a few different strategies. While some organizations have used paper-based surveys as a part of patient intake, others have gone digital and integrated the surveys into the EHR.

But regardless of the medium, organizations all have to settle on the actual questions included in the survey.

Some healthcare organizations design their own SDOH screening tools. Doing so can be beneficial because it allows organizations to tailor questions to the issues that most likely impact their populations, as well as to the resources to which the organization may refer patients.

However, there are also a handful of standardized SDOH screening tools available that organizations either adopt in their entirety or draw from when creating their own customized surveys. These tools are beneficial because they are evidence-based and standardized, in some cases integrating well with disparate data systems. Validated social determinants of health screening tools include:

  • HealthBegins Upstream Risk Screening Tool
  • PRAPARE
  • Structural Vulnerability Assessment Tool
  • WellRx Toolkit
  • Kaiser Permanente’s Your Current Life Situation Survey
  • American Academy of Family Physicians (AAFP) Social Needs Screening Tool

Below, PatientEngagementHIT outlines the most common standardized social determinants of health screening tools available to providers. This list is in no particular order and it is not exhaustive.

HealthBegins Upstream Risk Screening Tool

The HealthBegins Upstream Risk Screening Tool, developed by community health and social services consulting non-profit HealthBegins, is a 28-question survey that focuses on economic stability, education, social and community context, neighborhood and physical environment, and food security. The survey designers omitted certain SDOH factors, like race and ethnicity data, as that information is already typically collected during primary care encounters.

The HealthBegins survey is paper-based and comes with suggested workflows. The survey is available online as a free PDF and offers recommendations about screening frequency, scoring instructions, and a framework for getting surveying up and running in clinics.

PRAPARE

PRAPARE—Protocol for Responding to & Assessing Patients’ Assets, Risks & Experience—was developed by the National Association for Community Health Centers to survey patients on social determinants of health. The tool looks at four key SDOH domains, including personal characteristics, family and home factors, money and resources, and social and emotional health.

That more specifically breaks down to questions regarding childcare, clothing, employment, food insecurity, housing, incarceration history, income, language preference, and medical needs such as insurance coverage.

The tool is broadly accessible, with users being able to integrate it into the EHR, the patient portal, or administer the tool using a paper-based survey. It also includes recommended workflows for clinics. It has been standardized across ICD-10, LOINC, and SNOMED. It’s available in 33 languages other than English.

Structural Vulnerability Assessment Tool

The Structural Vulnerability Assessment Tool was developed by researchers at UCLA to help providers screen for and then address social determinants of health. The survey is 43 questions long and assesses needs across six domains, including economic stability, education, social and community context, health and clinical care, neighborhood and physical environment, and food security.

The tool also asks users about experiences with discrimination, a useful metric as healthcare gains more information about how discrimination impacts health outcomes.

WellRx Toolkit

The WellRx Toolkit was developed as a pilot in the Office for Community Health (OCH) at the University of New Mexico in Albuquerque. The tool can be used within the EHR or on paper and includes user access to community resources to address any identified social needs.

The tool looks at key SDOH domains, including access to childcare, drug use, employment, food insecurity, and housing security.

The tool was designed to be offered at a third-grade reading level, poses questions in a yes-or-no format, and has been translated into Spanish.

Kaiser Permanente’s Your Current Life Situation Survey

The Your Current Life Situation Survey is a 32-question survey that looks at six domains of SDOH, including economic stability, education, social and community context, health and clinical care, neighborhood & physical environment, and food security. The survey is available via the EHR, patient portal, or on paper.

The survey also asks about access to childcare, access to dental care, activities of daily living, and legal or public benefits needs.

AAFP Social Needs Screening Tool

AAFP’s Social Needs Screening Tool is a 15-item questionnaire that assesses housing, food, transportation, utilities, and personal safety. The survey also looks at factors like employment, education, childcare, and financial strain. AAFP also hosts a short-form questionnaire that asks 11 questions.

The form is available in English and in Spanish. AAFP also offers assistive guides in how to implement SDOH screening in a clinic and how to build and action plan for patients screening positive for a social need and who state that they’d like help finding a resource.

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