Collection of social determinants of health in the community clinic setting: a cross-sectional study

BMC Public Health. 2018 Apr 24;18(1):550. doi: 10.1186/s12889-018-5453-2.


Background: Addressing social and behavioral determinants of health (SBDs) may help improve health outcomes of community clinic patients. This cross-sectional study explored how assessing SBDs can be used to complement health data collection strategies and provide clinicians with a more in-depth understanding of their patients.

Methods: Adult patients, ages 18 and older, at an urban community health care clinic in Tennessee, U.S.A., were asked to complete a questionnaire regarding health status, health history and SBDs while waiting for their clinic appointment. The SBD component included items from the National Academy of Medicine, the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences instrument, and the Survey of Household Economics and Decisionmaking. Data collection and analysis occurred in 2017.

Results: One hundred participants completed the study. The questionnaire took approximately 11 min to complete, and the response rate was 90% or higher for all items except annual household income (unanswered by 40 participants). The median number of negative SBDs was 4 (IQR 2.75-7.0), 96 participants had at least one unmet need, and the most common negative SBD was physical activity (75%; 75/100).

Conclusions: The hybrid questionnaire provided insight into a community clinic population's SBDs and allowed for a more complete understanding than a single questionnaire alone. The brief questionnaire administration time and low non-response rate support the questionnaire's feasibility in the community clinic setting, and results can be used by clinicians to further the personalization goals of precision medicine. Next steps include evaluating how to connect patients with appropriate resources for addressing their SBDs.

Keywords: Community health clinic; PRAPARE; Social determinants of health.

MeSH terms

  • Adult
  • Ambulatory Care Facilities*
  • Cross-Sectional Studies
  • Data Collection*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Social Determinants of Health*
  • Surveys and Questionnaires
  • Tennessee
  • Urban Health Services*