Table 1. Key characteristics of included studies.
| Citation | Study population & setting | Screening tool name (if applicable) | Tool validation | Outline of tool development/validation |
|---|---|---|---|---|
| Barcelos Winchester (2019) | Delphi panel including experts in social work, nursing, public health, and psychology | Unnamed | Partially validated | Delphi process to develop, face validity established |
| Bechtel et al. (2022) | English speaking clinic patients aged ≥18 years attending a Federally Qualified Health Center in a large metropolitan city | Core 5 screening tool | Partially validated | The public health nurses established content validity of the Core 5 screening checklist in collaboration with a working group of 17 nurse experts in the SDoH |
| Beck, Klein & Kahn (2012) | Electronic health record review of 639 infants seen within the first month of life for Well Child Care encounters at an urban hospital-based Paediatric Primary Care Center | Social history template | Not validated | Developed after a review of the literature and in consultation with medical staff, social services, and the medical–legal partnership at the Paediatric Primary Care Center |
| Berkowitz et al. (2016) | Primary care patients at two hospital-based primary care practices with existing complex care management programme for high-risk Medicare patients | Health leads | Validation not specified | No validation details provided |
| Berkowitz et al. (2021) | Data collected from a system-wide electronic health record platform from adult patients attending the Internal Medicine or Family Medicine departments of a large health service. | Unnamed (“SDoH pilot questionnaire”) | Validation not specified | N/A |
| Berry et al. (2020) | 28 ‘key informants’, including leadership personnel, frontline staff, volunteers & primary care providers from two adult outpatient clinics and one paediatric clinic | Unnamed (“SDoH screening & referral program”) | Validation not specified | N/A |
| Bittner et al. (2021) | Patient data were extracted from the electronic health records of patients with a care provider at an independent practice affiliated with the Boston Children’s Hospital. | HNA screening tool | Partially validated | THE HNA includes previously (individually) validated questions (from the Health Leads screening toolkit) |
| Bradywood, Watters & Blackmore (2021) | Back pain patients seen in a neurosurgical clinic within an urban, tertiary-care hospital who progressed to surgery | Core 5 screening tool | Partially validated | Questions written at a fifth-grade reading level. Pilot studies found consensus in usability, reported increases in social support referrals for patients and documented reliability in measurement. |
| Browne-Yung et al. (2019) | Focus group participants involving consumers recruited from an independent volunteer health consumer group (most were retired allied health professionals) | Unnamed (“Social health screening tool”) | Not validated | The article outlines a three-phase development process involving focus groups and interviews |
| Chagin et al. (2021) | Patients receiving COVID-19 vaccines at multiple MetroHealth clinical locations. Screening occurred (1) in-person or by telephone, or (2) online through a patient portal questionnaire | Unnamed (“SDoH questionnaire”) | Partially validated | The questions were obtained from previously validated surveys |
| Ciccolo et al. (2020) | English and Spanish speaking adult patients and parents of paediatric patients with adequate or limited health literacy attending a large, urban Emergency Department | Adapted from the AHC-HRSN screening tool | Not validated | The goal of this study was to develop and optimize a social risk and social need screening tool for Emergency Department patients |
| Colvin et al. (2016) | Paediatric interns at a 265-bed children’s hospital. | IHELLP Questionnaire | Partially validated | This study ‘sought to determine the validity of screening for social needs’. Found high positive predictive value of IHELLP, but lower negative predictive value. |
| David et al. (2021) | Retrospective chart review at paediatric clinic, involving families of children 1–17 years who presented for in-person well child visits. The clinic serves an ethnically diverse, predominantly low-income patient population. | Unnamed | Validation not specified | N/A (available in English & Spanish) |
| Damas et al. (2022) | Adult patients with a diagnosis of IBD seen at one of the three gastroenterology clinics. | Social Barriers Score | Not validated | N/A (no validation) |
| de la Vega et al. (2019) | All new primary care patients at an urban, tertiary care academic medical cente; approximately 50% of patients are insured by Medicaid. | THRIVE Screening Tool | Not validated | N/A (no validation) |
| De Marchis et al. (2019) | Patients and adult caregivers of paediatric patients attending primary care and Emergency Department settings that served a minimum of 30% publicly insured or uninsured patients | AHC-HRSN screening tool | Validation not specified | N/A |
| Freibott et al. (2021) | Eight staff members who conducted the screening using the CSHI assessment tool participated in in-depth interviews. Five staff (from four hospitals) completed an electronic survey | CSHI assessment tool | Not validated | N/A (“no validation process for the screening procedures”) |
| Friedman et al. (2021) | Involved paediatric doctors, nurses, medical assistants, registration staff, social work, mental health providers & practice leadership. A total of 71% of the patient population in the neighbourhood is Hispanic, 48% are immigrants, >25% have household incomes below the poverty level. | Unnamed | Not validated | N/A Questions focused on SDoH were drawn from the American Academy of Paediatrics and The Joint Commission guidelines) |
| Gottlieb et al. (2014) | Adult caregivers seeking treatment of a child in a large, urban children’s hospital Emergency Department. A total of 70% of patients have Medicaid insurance; 33% of patients are African American and 42% Latino. | Iscreen | Partially validated | Some items based on existing validated surveys |
| Hensley et al. (2017) | Children and families attending a primary care clinic; largely serving patients in households with income at or less than the 200% poverty level | Health Begins | Validation not specified | No validation details provided |
| Kausar et al. (2022) | All patients admitted to one of the 12 hospitals who had at least one documented social risk factor, except for patients admitted to maternity/paediatrics. | Unnamed (“Social risk factor screening module”) | Partially validated | A committee of health care professionals and administrative personnel developed the screening module, with consideration of best practices, validated survey questions, and the communities served by the hospital. |
| Kusnoor et al. (2018) | Adult, English-speaking patients, presenting to an urban community health care clinic serving an underinsured population | PRAPARE | Validated | When possible, questions included in PRAPARE were obtained from validated instruments. A PRAPARE validation fact sheet has since been developed outlining ‘gold standard’ instrument validation. |
| Macias-Konstantopoulos et al. (2022) | Emergency Department patients (or parents/legal guardians of paediatric-age patients) of a large urban academic medical centre who were English- or Spanish-speaking | Unnamed | Validation not specified | The tool was developed for the primary care setting by the health system in which the study was conducted (available in English and Spanish). |
| Mayo et al. (2022) | Families of children receiving care at the paediatric outpatient clinic in the prior year. Children in the sample predominantly identified as Black or African American (90%) and 91% were insured with public insurance (Medicaid). | Adapted from SEEK | Partially validated | The study screening tool was adapted from a validated screening tool (the SEEK questionnaire) and was reviewed by an expert in the field |
| Ovalle et al. (2021) | Data obtained from the electronic health record at a Children’s Hospital Medical Center, on children younger than 13 years attending for a well-child visit. | SRS Questionnaire (EHR-embedded) | Not validated | Developed through review of validated questions and screens (i.e., the Survey on Income and Program Participation, the Children’s Food Security Scale, Primary Care Evaluation of Mental Disorders Procedures, and the Partner Violence Screen) and local consensus of primary care physicians, nurses, social workers, and legal advocates |
| Page-Reeves et al. (2016) | 3,048 patients attending the family medicine clinics that serve a large, low-income population | Well Rx | Partially validated | The 11-item questionnaire (available in English or Spanish), was ‘pre-tested’ and conformed to low literacy needs |
| Power-Hays et al. (2020) | Universal screening for SDoH occurred in the paediatric hematology clinic at a large medical centre. The screening tool was offered in English, Spanish, and Haitian Creole, if low literacy—clinic staff read the screener to families. | WECARE | Validated | Previously validated in BMC’s paediatric primary care network |
| Ray et al. (2020) | Caregivers of children ≤5 years presenting to a paediatric ED. | Unnamed | Partially validated | Items were synthesised from previously validated tools (WECARE and PRAPARE); also assessed social support with questions from the Medical Outcomes Study social support survey. |
| Rinehart et al. (2021) | The outpatient clinic serves a diverse paediatric population (age 0–21 years) that is 51% Hispanic, 40% African American, and 9% mixed race/ other race (internal data.) Most patients (90%) are insured by Medicaid. | Unnamed (“The screener”) | Partially validated | Screening questions were developed with input from faculty and staff. Many were adapted from SDoH screening tools currently used in the USA (including HealthLeads and Hunger Vital Signs). Focus groups were conducted with providers and caretakers in the early stages of development, and screening questions were modified in response to feedback. |
| Selvaraj et al. (2019) | Participants were English- and Spanish-speaking parents or guardians of 2-week to 17-year-old children attending wellchild visits at paediatric primary care sites. | ASK Tool | Partially validated | The ASK Tool was mainly developed from validated questions in the literature and the WeCare tool. The child resilience question was not validated and led to a large number of false positives. |
| Sokol et al. (2021) | Parents of paediatric patients (prior to a health maintenance paediatric examination). In some clinics, if the patient was aged ≥ 11 years, the patient completed the screening tool | Unnamed (“SDoH screening tool”) | Partially validated | Questions to assess food insecurity were validated items (Hager et al., 2010). Questions to assess housing insecurity, utility insecurity, financial strain, transportation needs, employment needs, elder or child-care needs, and literacy needs were adapted from prior tools, including the PREPARE tool. |
| Sundar (2018) | Stakeholders in a primary care clinic in a suburban community. The population is racially diverse and about 17% live below the poverty line. | YCLS | Partially validated | Not validated for primary care |
| Tedford et al. (2022) | English- and Spanish-speaking caregivers of patients <18-years-old presenting to a children’s hospital. | p-SINCERE | Not validated | Adapted the SINCERE tool for the paediatric population (p-SINCERE). The adjustments entailed including child-inclusive language, but no structural changes to the were made as the p-SINCERE tool was still administered to the adult caregivers. |
| Tong et al. (2018) | 17 primary care clinicians from 12 practices within one health system | Unnamed | Not validated | Adapted from National Academies social needs measures and supplemented with additional questions from the Hennepin County Life-style survey. |
| Uwemedimo & May (2018) | Caregivers accompanying patients aged 0–18 years attending a General Pediatric Practice for a preventive care visit. Patients are ethnically and socio-economically diverse; >2/3 receive health insurance coverage through Medicaid. | FAMNEEDS | Partially validated | Designed after review of published tools. Multiple iterations & formats were tested with caregivers to assess understanding of question constructs, frequency and time duration for completion, particularly among LEP and immigrant families. |
| Wallace et al. (2020) | Patients discharged from a large academic centre emergency department | Unnamed | Not validated | Development involved adapting 10 existing questions recommended by Health-Leads in their Social Needs Screening Toolkit. |
Note:
AHC, Accountable health communities health-related social needs; Core 5, SDoH screening checklist; CSHI, connecticut social health initiative assessment tool; HNA, health needs assessment screening tool; IHELLP, income, housing, education, legal status, literacy, personal safety questionnaire; PRAPARE, protocol for responding to and assessing patients’ assests, risks, and experiences; p-SINCERE, screener for intensifying community referrals for health, paediatric version; SEEK, safe environment for every kid parent questionnaire; SRS, social risk screening questionnaire-EHR-embedded; WECARE, well child care, evaluation, community resources, advocacy, referral, education system; YCLS, your current life situation.