Assessing Implementation of Social Screening Within US Health Care Settings: A Systematic Scoping Review.

Area of Science:

• Health Services Research
• Public Health
• Health Equity

Background:

• Healthcare reforms increasingly promote social needs screening.
• Limited synthesized research exists on implementing social screening in clinical settings.
• Understanding implementation research is crucial for practice and policy.

Purpose of the Study:

• To systematically review and synthesize research on the implementation of healthcare-based social screening.
• To identify facilitators and barriers to social screening reach, adoption, implementation, and maintenance.
• To inform best practices and policy for social screening initiatives.

Main Methods:

• Systematic scoping review of peer-reviewed literature (2011-2022).
• Searched PubMed and Embase using keywords for healthcare screening and social risk factors.
• Included studies on multi-domain social screening implementation with reported outcomes.

Main Results:

• Forty-two articles were included, analyzing reach, adoption, implementation, and maintenance.
• Screening reach varied by patient race/ethnicity and language preference.
• Workforce education and quality improvement projects boosted adoption.
• Time constraints were a key implementation barrier; standardized tools and community health workers/technology improved integration and disclosure.
• Limited data exists on screening maintenance, with one study showing a decline over time.

Conclusions:

• Significant evidence gaps remain in social screening implementation.
• Effective strategies for clinical workflow integration and maximizing screening equity require further investigation.
• Future research should focus on scaling best practices from emerging screening initiatives.