Abstract B098: Evaluation of a screening tool to identify and address medically-related social needs in cancer prevention and treatment
Authors: Carreon E. Madeline , Montoya Emilee J. , de la Rosa Ivan , Ceballos Rachel , Scott Mary Alice T. 
Published: January 2023

Due to the lack of research on the practical implementation of social needs (SN) screening tools, we conducted a study to evaluate the implementation of such a tool at a primary healthcare clinic. The goal is to improve patients’ overall health and facilitate studies of SN screening tools for cancer prevention and treatment. In a medical setting, a person’s health is often evaluated purely biologically. However, other social factors, such as housing, transportation, and finances, affect a person’s health, including cancer-related outcomes. The tool under evaluation is a 4-question, yes/no survey administered by a healthcare professional who uses the information to refer patients to appropriate services. Data collection included 81 patient interviews, 14 provider interviews, and a review of 81 patient medical records. Interviews focused on how patients and providers felt about the use and effectiveness of an SN screening tool in primary care. Medical record review documented “yes” responses to SN questions and any referrals that physicians made to address SN. Qualitative data analysis utilized the PRECEDE-PROCEED model to identify predisposing, enabling, and reinforcing factors that either facilitate or impede addressing SN. Quantitative data analysis uses descriptive statistics to determine the screening rate and the number of referrals made. Analysis demonstrates that many patients and health care professionals found the tool useful to start conversations about SN. Still, some physicians felt unsure of the proper steps to help patients following a positive screening. Interviews indicated the presence of SN, but documentation of yes responses in the medical record did not correspond to interviews. In many interviews, patients stated that they felt comfortable being asked questions about SN and felt that it demonstrated the physician’s care for them. While patients and providers recognize the importance of addressing SN in primary care, given their close connection to medical needs, our analysis demonstrates limitations to using a screening tool as the critical step in addressing SN. This limitation is also reflected in the quantitative analysis, which showed a small number of referrals. Our results are consistent with other similar studies that also find limited effectiveness of screening tools to address patient SN, highlighting this issue as a potential area for intervention. One recommendation that also is relevant to our study is implementing an outreach program with staff, such as community health workers, tasked explicitly with SN care coordination. Comparison across studies remains challenging as there is no standard screening tool used across primary care clinics, given the need to customize screening tools to address the needs of each clinic’s patient population. Given these findings, we recommend developing a toolkit of best practices from which clinics can draw that go beyond the sole use of screening tools to address SN.

Citation Format: E. Madeline Carreon, Emilee J. Montoya, Ivan de la Rosa, Rachel Ceballos, Mary Alice T. Scott. Evaluation of a screening tool to identify and address medically-related social needs in cancer prevention and treatment [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B098.