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. 2019 Aug 2;7(3):e13802. doi: 10.2196/13802

Table 3.

Characteristics of electronic health record questionnaires for selected social and behavioral determinant of health domains.

Questionnaire template Content area Administered questionnairesa, completed, n (%)
Social support

Nursing assessment (nb=1,026,988) Psychological-social relationship 944,829 (92.00)

Emergency department assessment


Head-to-toe (n=237,143) Psychological-social relationship 92,486 (39.00)


Nursing 1 (n=217,954) Psychological-social relationship 204,877 (94.00)


Nursing 2 (n=278,084) Psychological-social relationship 169,631 (61.00)


Pediatrics (n=131,134) Psychological-social relationship 93,105 (71.00)


Social work suicide/homicide (n=15,101) Relationship and social support status 14,648 (97.00)


Social work (n=14,481) Support system’s name and information 12,743 (88.00)

Operation room and post anesthesia care unit flowsheet (n=147,694) Psychological-social relationship 82,709 (56.00)

Inpatient


Occupational therapy new home setup (n=131,948) Social support available at discharge 47,501 (36.00)


Obstetrics postpartum assessment (n=135,587) Recent loss or change in status 120,672 (89.00)


Spiritual care interventions (n=116,719) Spiritual/social network 68,864 (59.00)

Pediatrics screening (n=144,659) Personal-social relationship or socially withdrawn and decreased interaction 85,349 (59.00)

Social history; screening, brief intervention, and referral to treatment (n=2015) Marital status/need to improve relationships with family/social network and participation in social activities 1995 (99.00)
Housing issues

Housing/utility voucher (n=217) Housing assistance screening and referral 97 (44.00)

Abuse/neglect screen (n=12,058) Homelessness assessment 11,575 (96.00)

Social history questionnaire (n=1900) Screening for assistance with finding housing 1824 (96.00)

Emergency department triage abuse indicators and resource planning (n=713,702) Information on shelter, transportation, and clothing 39,254 (5.50)

Chemical dependence unit admission screen (n=15,056) Homelessness 2258 (15.00)

Ambulatory priority access primary care screen (n=1116) Housing situation 78 (7.00)

Adult admission general intake form (n=77,230) Homelessness 27030 (35.00)

Pediatric/newborn general intake form (n=1067) Homelessness 587 (55.00)

Psychiatry social work assessment (n=4913) Living arrangement 4422 (90.00)

aRepresents completed questionnaires (count and % of answered questions related to social and behavioral domain of interest). The timeframe for questionnaires was January 1, 2003 to June 26, 2018, with approximately 5.4 million unique patients.

bRepresents total number of questionnaires available on electronic health record.