Andrea Quiñones-Rivera, MD, MPH; Holly E. Wing, MA; Jill Barr-Walker, MS, MPH; Megan Yee, BA; Jessica M. Harrison, LCSW; Laura M. Gottlieb, MD, MPH
Corresponding Author: Laura M. Gottlieb, MD, MPH; University of California, San Francisco. Email: Laura.Gottlieb@ucsf.edu
Section: Clinical Review
Publication Date: July 23, 2021
Background: Initiatives to identify and intervene on patients’ socioeconomic needs in the context of health care delivery are expanding. Little information has been compiled across studies on health care providers’ knowledge, attitudes, beliefs, and behaviors (KABB) regarding socioeconomic risk screening and referral interventions. Methods: We conducted a systematic scoping review of providers’ KABB related to health care-based socioeconomic risk screening and referral interventions using PubMed, Embase, Web of Science, PsycINFO, and the UCSF Social Interventions Research and Evaluation Network Evidence and Resource Library. Included studies assessed health care providers’ KABB about socioeconomic risk screening and referral interventions conducted in clinical settings. Results: Of 14,757 studies evaluated, 53 were eligible for inclusion. Study designs were heterogeneous. Provider outcome measures included attitudes and beliefs (n=42), provider behaviors (n=35), and provider knowledge (n=26). The majority of providers in included studies expressed positive attitudes towards addressing patients’ socioeconomic risks. Participants endorsed concerns regarding insufficient knowledge and resources to address these risks, time and workflow disruption, and potential negative impacts of screening and referral programs on patient-provider relationships. Concerns were more frequently reported in studies assessing providers’ KABB outside the context of an existing clinical screening and referral program. Exposure to screening and referral programs led to increases in providers’ positive attitudes, socioeconomic risk screening rates, and reported knowledge about intervention options. Conclusions: Participation in socioeconomic risk screening and referral programs appears to influence providers’ perception of implementation barriers. Future research should explore providers’ concerns about sufficiently addressing identified risks.