Screening and Implementation Tools
AHRQ's web page on SDOH & Practice Improvement links to social needs screening and other tools, including Identifying and Addressing Social Needs in Primary Care Settings.
The Joint Commission's Health Equity Resource Center links to resources for assessing health-related social needs.
The Gravity Project has assembled a collection of social risk screening assessment instruments considered to have face validity and other implementation resources.
The Social Interventions Research and Evaluation Network (SIREN) links to:
- Screening and implementation tools, such as the Guide to Implementing Social Risk Screening and Referral-making
- The PRAPARE Implementation and Action Toolkit
- A Guide to Using the Accountable Health Communities Health-Related Social Needs Screening Tool: Promising Practices and Key Insights
NCQA's Social Determinants of Health Resource Guide describes the strategies used by health plans and clinically integrated networks to address social determinants of health (SDOH), including decisions around screening, using the data, and metrics. Since publishing the guide, NCQA has issued a new Social Needs Screening and Intervention measure.
The Health Leads Screening Toolkit includes language to foster meaningful and effective dialogue between providers and patients around social needs and a screening template in English and Spanish.
Tools for Linking to Resources
Social health referral platforms include 2-1-1– Information & Referral Search, findhelp, and one degree.
The Medical-Legal Partnership Toolkit provides guidance on addressing health-harming legal needs that disproportionately affect people living in poverty.
Community Resource Referral Platforms: A Guide for Health Care Organizations describes community resource referral platforms and shares lessons from organizations that use them.
Benefits.gov lets you search for Federal and State benefit programs.
Uninsured people can apply for insurance, including Medicaid and subsidized private insurance, at your State's Marketplace. To find your Marketplace website, which will have information about local navigator programs.
The Affordable Connectivity Program (ACP) and Lifeline are Federal Government programs that help eligible households pay for internet services and internet-connected devices.
The Patient Advocate Foundation's National Financial Resource Directory helps people quickly generate a list of national and regional resources that fit their situation.
