Patients' attitudes and perceptions regarding social needs screening and navigation: Multi-site survey in a large integrated health system

Background: As more health care organizations integrate social needs screening and navigation programs into clinical care delivery, the patient perspective is necessary to guide implementation and achieve patient-centered care. Objectives: To examine patients' perceptions of whether social needs affect health and attitudes toward healthcare system efforts to screen for and address social needs. Research Design: Multi-site, self-administered survey to assess (1) patient perceptions of the health impact of commonly identified social needs; (2) experience of social needs; (3) degree of support for a health system addressing social needs, including which social needs should be screened for and intervened upon; and (4) attitudes toward a health system utilizing resources to address social needs. Analyses were conducted using multivariable logistic regression models with clinic site cluster adjustment. Subjects: Adult patients at seven primary care clinics within a large, integrated health system in Southern California. Main Measures: Survey measures of experience with, acceptability of, and attitudes toward clinical social determinants of health screening and navigation. Key Results: A total of 1161 patients participated, representing a 79% response rate. Most respondents (69%) agreed that social needs impact health and agreed their health system should ask about social needs (85%) and help address social needs (88%). Patients with social needs in the last year were more likely to (1) agree social needs impact health (OR 10.2, p < 0.001), (2) support their health system asking patients about social needs (OR 3.7, p < 0.001), and (3) support addressing patient social needs (OR 3.5, p < 0.001). Differences by social need history, gender, age, race, ethnicity, and education were found. Conclusions: Most patients at a large integrated health system supported clinical social needs screening and intervention. Differences in attitudes by social need history, gender, age, race, ethnicity, and education may indicate opportunities to develop more equitable, patient-centered approaches to addressing social needs.