Psychometric Evaluation of the Screener for Intensifying Community Referrals for Health

Eval Health Prof. 2022 Sep;45(3):270-276. doi: 10.1177/01632787211029360. Epub 2021 Jul 8.


This study examined the psychometric properties of the Screener for Intensifying Community Referrals for Health (SINCERE), a 10-item, low literacy screening tool developed to elicit social needs (e.g., transportation, housing) impacting patients' ability to engage in health-related activities. Patients seeking care in a tertiary care emergency department (ED) were invited to complete the SINCERE as part of registration processes, and were asked about their desire for follow-up by a partnering service provider offering low- and no-cost community resource referrals. A total of 5,081 patients completed screenings were included in this sample. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) identified and verified one-factor structure, suggesting that the SINCERE's 10-items are homogenous and measure one construct. The reliability of Cronbach's α and McDonald's ω were 0.89. Item Response Theory (IRT) suggested the SINCERE can effectively identify patients wishing referrals, or who have social needs. Moreover, patients who had two or more social needs were those willing to receive referrals after discharge. The SINCERE is a valid and reliable tool for measuring social needs for health, and should be considered as a screening option for practice interventions seeking to address social needs.

Keywords: United Way 211; factor analysis; needs assessment; nursing; referral and consultation; social determinants of health; surveys and questionnaires.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Factor Analysis, Statistical
  • Humans
  • Psychometrics
  • Referral and Consultation*
  • Reproducibility of Results
  • Surveys and Questionnaires