Implementation Support for a Social Risk Screening and Referral Process in Community Health Centers
Rachel Gold, Jorge Kaufmann, Erika Cottrell, Arwen Bunce, Christina R. Sheppler, Megan Hoopes, Molly Krancari, Laura M. Gottlieb, Meg Bowen, Julianne Bava, Ned Mossman, Nadia Yosuf, Miguel Marino
Abstract
rates during the intervention or postintervention periods. The intervention was associated with greater blood pressure control among patients with diabetes and lower rates of diabetes biomarker screening postintervention. All results must be interpreted considering that the Covid-19 pandemic began midway through the trial, which affected care delivery generally and patients at CHCs particularly. Finally, the study results show that adaptive implementation support was effective at temporarily increasing social risk screening. It is possible that the intervention did not adequately address barriers to sustained implementation or that 6 months was not long enough to cement this change. Underresourced clinics may struggle to participate in support activities over longer periods without adequate resources, even if lengthier support is needed. As policies start requiring documentation of social risk activities, safety-net clinics may be unable to meet these requirements without adequate financial and coaching/technical support.