Screening for social determinants of health in primary care: A feasibility study

Background Social determinants of health (SDOH) critically influence population and individual health outcomes. Despite this, information on individual-level social risks are not collected routinely in primary care. General Practice is often the first point of contact for people with social issues.

Having better information on individual social risks can improve health outcomes through adaptations of care plans, being mindful of financial barriers to accessing medication, addressing behavioural health issues, helping with transportation and increased referral to community services through social prescribers.

Existing social risk screening tools have generally been created for North American audiences therefore a screening tool was developed following a systematic review and Delphi survey of key stakeholders for use in UK settings by EP (lead applicant).

Identifying those with unmet social needs will help support clinicians within consultations to provide better personalised care, will provide better information on local populations, allow for targeted support for those with unmet social need, help develop local services and inform public health policies.

Aims and Objectives Explore feasibility and practicalities of screening for SDOH in primary care using a previously designed tool. It will gather intelligence on the burden of social need to inform a larger programme grant.

Key objectives include comparing different data collection methods, evaluate reliability and validity of the screening tool, estimate social need burden in the studied population, explore participant perspectives and acceptability of screening, understand practicalities of screening in primary care and identifying statistical parameters to inform a randomised controlled trial in the larger programme of work.

Development work plan Cross-sectional screening for SDOH in deprived areas in the West Midlands collecting data through; AccuRX Florey (text message service platform where results automatically upload to primary care records), post with online option, telephone and within consultations.

Medical record linkage will gather information on characteristics of patients with social need and will estimate resource requirements for the larger programme grant.

Semi-structured interviews with approximately 15 patient participants and two focus groups with 6-8 practice staff from recruited practices to understand perspectives of screening and its processes, acceptability, barriers and facilitators Focus group with up to 8 community healthcare workers to gain their perspectives on screening for SDOH, how this could fit into their workflows and advice on reaching out to people from under-represented communities to inform the larger study Timelines for delivery Pre-start M1-3 M4-6 M7-9 M10-12 M13-15 M16-18 Recruitment of PDRA Regulatory approval WP1 WP2 Reporting, communication Preparation and submission of programme grant application Anticipated Impact and Dissemination Outcomes include estimating social need and healthcare burden in the studied population, gain initial estimates of reliability and validity of the screening tool, exploring acceptability, barriers and facilitators of