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screening for social determinants of health (PRAPARE)

Indications: - screening for social determinants of health facilitates identification of patient needs & tailoring of referrals to community-based services [3] Procedure: - active & passive information retrieval methods may be used in clinical environments to screen for social determinants of health [1] - a manual screening process completed in primary care offices is an example of an active screening process - active screening can identify - social integration (social isolation) - domestic safety - financial resources - food insecurity - transportation - housing - psychosocial stress [1] - data mining of electronic medical records is an example of a passive screening process - passive screening can identify - financial resources - psychosocial stress [1] - Protocol for Responding to & Assessing Patients' Assets, Risks, & Experiences (PRAPARE) is the most common social needs protocol used for assessment of social determinants of health by U.S. hospitals, health systems, & health plans [5] - PRAPARE is part of a national effort to collect data on social determinants of health as drivers of poor health outcomes & higher health-related costs [5] - the National PRAPARE implementation is a recognized standardized protocol that accounts for social determinants of health [4] - screening for social determinants of health must be done with sensitivity, cultural competence, & available intervention - done inappropriately, it may compromise therapeutic relationships & marginalize patients [2] Notes: - a protocol to review barriers & facilitators of screening for social determinants of health in order to develop evidence-based interventions is described [6]

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References

  1. Stewart de Ramirez S, Shallat J, McClure K, Foulger R, Barenblat L. Screening for Social Determinants of Health: Active and Passive Information Retrieval Methods. Popul Health Manag. 2022 Dec;25(6):781-788. PMID: 36454231
  2. Johnson CB, Luther B, Wallace AS, Kulesa MG. Social Determinants of Health: What Are They and How Do We Screen. Orthop Nurs. 2022 Mar-Apr 01;41(2):88-100. PMID: 35358126 Review.
  3. Mullen LG, Oermann MH, Cockroft MC, Sharpe LM, Davison JA. Screening for the social determinants of health: Referring patients to community-based services. J Am Assoc Nurse Pract. 2023 Dec 1;35(12):835-842. PMID: 37471525
  4. Weir RC, Proser M, Jester M, Li V, Hood-Ronick CM, Gurewich D. Collecting Social Determinants of Health Data in the Clinical Setting: Findings from National PRAPARE Implementation. J Health Care Poor Underserved. 2020;31(2):1018-1035. doi: 10.1353/hpu.2020.0075. PMID: 33410822
  5. Drake C, Batchelder H, Lian T et al Implementation of social needs screening in primary care: a qualitative study using the health equity implementation framework. BMC Health Serv Res. 2021 Sep 17;21(1):975. PMID: 34530826 PMCID: PMC8445654 Free PMC article.
  6. Gagnon K, Ortiz-Siberon A, Patel ND et al Identifying facilitators, barriers, and strategies to implement social determinants of health screening, referral, and follow-up in the US: a scoping review protocol. JBI Evid Synth. 2022 Jun 1;20(6):1568-1577. PMID: 35184099 Free PMC article.