2014Gottlieb L, Hessler D, Long D, Amaya A, Adler N.

iScreen is a social screening instrument used in one randomized controlled trial on screening validity, acceptability, and modality. The instruments includes 23 questions covering 16 psychosocial domains, including health insurance, health care access, behavioral and mental health, educational resources, housing quality and insecurity, financial strain, food insecurity, public benefits, child care, transportation, employment, safety issues, incarceration, child support, and immigration. The authors of the related publication note: “Some items (child care, immigration, school safety, public benefits, housing costs, housing safety, and housing stability) were adapted from the 10-item Medical Advocacy Screening Questionnaire used in previous studies. Other items were based on existing validated survey items on income security, food security, and neighborhood safety. Likert-scale response options were as follows: 1 = “not at all stressful,” 2 = “a little bit stressful,”3 = “moderately stressful,” 4 = “very stressful, ” 5 = “extremely stressful,” and 0 “issue listed is not applicable to my family.” Each social need was coded in a binary format as either 0 (if “not at all stressful” or “not applicable to my family”) or 1 (if “a little stressful” to “extremely stressful”) to indicate a positive disclosure.”

Download the questionnaire here.

Related publication:
Gottlieb L, Hessler D, Long D, Amaya A, Adler N. A randomized trial on screening for social determinants of health: the iScreen study. Pediatrics. 2014;134(6):e1611-1618. PMID: 25367545. DOI: 10.1542/peds.2014-1439.