2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Social determinants of health (SDOH) significantly influence health outcomes, healthcare utilization, and long-term patient well-being, especially among underserved populations. Community clinics frequently serve individuals experiencing barriers such as housing instability, food insecurity, transportation challenges, financial strain, and restricted access to preventive and behavioral health services. Although SDOH screening is now widely acknowledged as essential to whole-person care, inconsistent workflows and limited integration into routine practice hinder sustainable implementation.

This quality improvement and implementation-focused project evaluates strategies to enhance SDOH screening processes in community clinics serving vulnerable populations in Arizona. The project aims to increase the consistency, feasibility, and sustainability of SDOH screening during patient intake and follow-up encounters through workflow redesign and evidence-based implementation strategies. Guided by implementation science frameworks and quality improvement methodologies, the proposed intervention incorporates a standardized screening tool, clearly defined staff roles and responsibilities, structured training protocols, referral pathways, and ongoing monitoring processes to facilitate continuous improvement.

The primary objectives are to increase screening completion rates, improve provider and staff adoption, enhance workflow acceptability, and strengthen the identification and referral of unmet social needs that affect health outcomes and treatment adherence. This project contributes to the expanding evidence base supporting integrated, patient-centered, and equitable care models.