Enhanced Digital Access to Bridge Social Needs and Reduce Health Disparities: The e-SINCERE Study

PROJECT SUMMARY Social context is tied to health outcomes, driving the rapid adoption of screening for tangible social needs (e.g. for housing, utilities, food) by healthcare systems. Our preliminary studies (R21HS026505, R01NR019944) underscore the potential for narrowing health disparities by linking social needs screenings in clinical settings –

particularly in emergency department (ED) settings where 50% of patients endorse one or more need – to United Way 211's (211) Service Navigators (SNs) through clinically-integrated and adaptable software solutions. However, 34% of those with social needs seen in EDs provided either another person’s phone

number or only an email address for outreach, a factor we have linked to a decreased likelihood of connecting to services; higher instances of housing, utilities, and transportation needs; and greater frequency of ED visits compared to those who provide their own telephone number. Moreover, 24% lacked home internet and faced

considerable difficulties in establishing service connections, particularly with navigating online forms. These findings highlight the role that Information and Communication Technology (ICT), specifically stable telephone access, internet, and digital navigation, may play in meeting patients' social needs and the ability of community

services to improve health outcomes. In this NIH stage 3 real-world efficacy study, we will utilize a community- engaged process and rapid cycle testing with partnering community, governmental, and clinical service representatives to develop, refine, and launch an ICT screening and access program (stable cellphones and

digital navigation) in three ED settings across the state of Utah. Then, in a randomized controlled trial of 600 ED patients with social needs and ICT access barriers, we will leverage existing screening and referral protocols to determine whether providing stable cellphones, 211 service outreach, and digital navigation

assistance to patients with social needs and ICT access barriers result in improved health outcomes over 6 months compared to patients who are offered cellphones and 211 service outreach alone. Our proposal meets the goals of the National Institute of Nursing Research (NINR) as it emphasizes the essential role of

technology access in fostering public health equity. By embedding advanced digital tools in social needs screenings and referrals, we aim to close the gap between recognizing social needs and connecting individuals to vital services using a scalable, sustainable approach.