From screening to support: exploring patient engagement with health-related social needs services

Introduction: Achieving health equity necessitates addressing social determinants of health. Value-based payment models encourage healthcare systems to address patients’ health-related social needs such as housing, food, and transportation. Leading organizations advocate for integrating social needs screening in clinical care to connect patients with necessary services. This study aimed to explore patients’ experiences and motivations for completing social needs screening during clinical visits and engaging with community service navigators. The goal is to inform more effective health system strategies for addressing social needs and ultimately enhance population health. 

Methods: This is a qualitative descriptive study involving clinical visits to adult or pediatric emergency departments or mobile clinics and COVID-19 testing sites within a large tertiary academic healthcare system in the intermountain U.S. Sixty-three patients (30 Spanish speaking and 33 English speaking) who screened positive for social needs were involved. Telephone interviews were conducted with participants who screened positive for social needs and who were referred to service navigators for community resources. Data were analyzed using NVIVO software, identifying key themes through open coding and consensus among content experts. 

Results: The results revealed that social needs screening facilitated the development of meaningful relationships, making patients feel cared for and supported. Patients initially had low expectations but were often pleasantly surprised and relieved by the resources provided. Although some patients successfully obtained the necessary resources, these sentiments were balanced by others who experienced discomfort or suspicion regarding the screening process. In addition, some patients encountered barriers such as ineligibility, technological challenges, and emotional burdens, which led to frustration and discouragement. 

Conclusions: Effective health-related social needs screening and referral processes can foster positive patient relationships and address significant social needs. However, the manner of screening and the support provided for navigating resources are crucial. Enhanced support systems are essential to overcome referral barriers and ensure that patients can access necessary services, contributing to improved health equity and reduced disparities.