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Review ArticleClinical Review

Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review

Andrea Quiñones-Rivera, Holly E. Wing, Jill Barr-Walker, Megan Yee, Jessica M. Harrison and Laura M. Gottlieb
The Journal of the American Board of Family Medicine July 2021, 34 (4) 820-831; DOI: https://doi.org/10.3122/jabfm.2021.04.210039
Andrea Quiñones-Rivera
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
MD, MPH
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Holly E. Wing
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
MA
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Jill Barr-Walker
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
MS, MPH
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Megan Yee
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
BA
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Jessica M. Harrison
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
PhD(c), LCSW
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Laura M. Gottlieb
From LAC-USC Department of Emergency Medicine, Los Angeles, CA (AQR); Center for Health and Community, University of California, San Francisco (HEW, LMG); ZSFG Library, University of California, San Francisco (JBW); Medical College of Wisconsin, Milwaukee (MY); Department of Social and Behavioral Sciences, University of California, San Francisco (JMH); Department of Family and Community Medicine, University of California, San Francisco (LMG).
MD, MPH
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    Figure 1.

    PRISMA flow diagram of included studies in the review. Abbreviation: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Tables

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    Table 1.

    Study Characteristics

    Study DesignStudy SettingTarget Social NeedTargeted Providers
    Intervention studies
    • RCT 25–27 (3)

    • Quasi-experimental with comparison group28–32,43,44 (7)

    • Quasi-experimental without comparison group 33–42,45–60 (26)

    Nonintervention studies
    • Cross-sectional surveys, interviews, and focus groups61–77 (17)

    Primary care
    • Adult25,28,35,52,69 (5)

    • Pediatric26,27,32,34,39,40,43,44,53,56,58,70,72–74,76 (16)

    • Mixed/unknown33,42,51,54,60,61,65,68,71,77 (10)

    Inpatient
    • Adult41,48 (2)

    • Pediatric29,33,50 (3)

    Emergency department49,63,67 (3)
    Medical school31,36,37,47 (4)
    Multiple settings/other30,38,45,46,55,59,62,64,66,75 (10)
    • Multiple SDoH26–33,36–40,43,44,46,51,54,56,59–63,65–68,73–77 (33)

    • Food insecurity34,45,52,53,58,69,70,72 (8)

    • Health literacy25,41,42,47,48,57,71 (7)

    • Housing35,49 (2)

    • Legal services50,55 (2)

    • Other64 (1)

    • Physicians25,28,33–35,39,45,50–54,56,58–70,72,75–77 (30)

    • Resident physicians25–27,29,30,32,39–46,51,55,58,63,66,73,74 (21)

    • Nurses48–50,53,55,57,60,67,75 (9)

    • Nurse practitioners35,39,52,53,69–71 (7)

    • Social workers49,50,52,75 (4)

    • Community health workers/certified recovery specialists33,37 (2)

    • Medical students31,36–38,45,47 (6)

    • Pharmacists75 (1)

    • Clinic staff/other allied health professionals33,34,42,55,59,60,63,67,69 (9)

    • RCT, randomized controlled trials; SDoH, social determinants of health.

    • View popup
    Table 2.

    Provider Outcomes Related to Social Care Activities in Clinical Settings

    KnowledgeAttitudes and BeliefsBehaviors
    • Prevalence/awareness of patients' social needs25,32,35,38,41,42,44,47,59,70,72,75

    • Health impacts of social needs36,41,45,63,68,71

    • Awareness of resources/referrals27,30,43–46,55–57,59,64,69,72,75

    • Importance of SDoH30,31,35,44,45,61,62,65,67,73,75–77

    • Acceptability of social care programs25,26,33,48–53,56,58,67,69–72,75

    • Comfort identifying/addressing social need(s) 26,32,37,39,41,43,45,46,61,64–68,70,74–77

    • Provider role in social care programs35,43,45,51,52,59,61–63,67,70,72,73,75

    • Barriers to screening and referral program implementation32–35,39,43,52–56,58–64,66,69,70,72,75,76

    —Lack of time32,34,39,43,56,59,60,63,66,69,70,72,75
    —Lack of training/knowledge34,52,56,60,63,64,70,72,75,76
    —Lack of resources35,43,52–54,56,59–62,66,69,70,75
    —Lack of comfort screening43,61,64,70,72
    —Provider burden33,35,54,59,62,69,72
    —Patient discomfort33,34,53,55,56,58,60,70,72,75
    —Not appropriate in health setting54,72
    • Effects on provider-patient relationship34,36,52–56,59,70,72,75

    • Social risk screening rates/activities26,27,29,32,34,35,39,43–46,48,51,53,55,56,63,64,68–76

    • Referral activities26,45,46,55,63,68

    • Clinical care adjustment25,29,32,42,54,57,59,66,75

    • Documentation40,58,68

    • Time spent on intervention26,39,74

    • Productivity28

    • SD, standard deviation.

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The Journal of the American Board of Family     Medicine: 34 (4)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 4
July/August 2021
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Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review
Andrea Quiñones-Rivera, Holly E. Wing, Jill Barr-Walker, Megan Yee, Jessica M. Harrison, Laura M. Gottlieb
The Journal of the American Board of Family Medicine Jul 2021, 34 (4) 820-831; DOI: 10.3122/jabfm.2021.04.210039

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Provider Impacts of Socioeconomic Risk Screening and Referral Programs: A Scoping Review
Andrea Quiñones-Rivera, Holly E. Wing, Jill Barr-Walker, Megan Yee, Jessica M. Harrison, Laura M. Gottlieb
The Journal of the American Board of Family Medicine Jul 2021, 34 (4) 820-831; DOI: 10.3122/jabfm.2021.04.210039
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    • Introduction
    • Methods
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    • Provider Attitudes and Beliefs
    • Provider Behaviors
    • Discussion
    • Limitations
    • Conclusions
    • Acknowledgments
    • Appendix 1. Search Strategy
    • Appendix 2. Characteristics of Included Studies
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Keywords

  • Attitude of Health Personnel
  • Outcome Measures
  • Referral and Consultation
  • Scoping Review
  • Social Determinants of Health
  • Social Support
  • Socioeconomic Factors

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