Commentary On “Designing an implementation strategy to increase health-related social needs screening: Applying the PRISM framework in a resource-limited clinical setting”

Because of the impact of the social determinants of health on a variety of social risk factors and, ultimately, health outcomes, there is growing interest in addressing patients’ social needs as part of routine health care. Screening for unmet health-related social needs can identify areas where additional resources (e.g., food, housing) are needed. Though several screening instruments exist, the use of these instruments has been low, particularly in resource-limited health care settings. To address this implementation gap, Byhoff and colleagues set out to engage relevant stakeholders (e.g., patients, community health workers, physicians), identify barriers to social needs screening, and design an implementation strategy tailored to the unique contexts of a Massachusetts-based Community Health Center. Guided by the Practical Robust Implementation and Sustainability Model (PRISM), the research team utilized multiple qualitative methods to identify barriers to the implementation of health-related social needs screening. Stakeholders identified myriad barriers, including stigma surrounding social needs screening, limitations incorporating social needs screening into the electronic medical record, and concerns about screening patients without the availability of social services to which they could refer patients. Using these findings, the research team designed a multi-component implementation strategy—utilizing paper-based screening, training and educating providers on the importance of social needs screening, revising existing workflows, and identifying champions within the community health center. This work highlights the ways that implementation methods can be employed in under-resourced settings to improve the adoption of evidence-based interventions—like health-related social needs screenings—and to promote equitable, person-centered care.

References:

Byhoff, E., LeClair, A. M., Smith, C. N., Roy, T. K., & Drainoni, M. L. (2024). Designing an implementation strategy to increase health-related social needs screening: Applying the PRISM framework in a resource-limited clinical setting. Transl Behav Med, 14(3), 197-205. doi:10.1093/tbm/ibad067