Perspectives on standardized screening for social needs in primary care: a qualitative study

Abstract

Abstract Aim: This study aimed to explore patient perspectives on standardized screening for social needs within the context of primary care in Canada. Background: Social determinants of health significantly influence patient health outcomes. While standardized screening for patient social needs has gained momentum, patient perspectives on the utility of said screening, particularly within the Canadian context, remains underexplored. Methods: Semi-structured interviews were conducted with participants aged 18 and older (n = 195), recruited from a larger multi-site study, using purposive maximum-variation sampling across four Canadian provinces (Ontario, Manitoba, Saskatchewan, and Newfoundland and Labrador). Questions asked during the interviews focused on financial well-being (ability to afford basic needs), housing status, social well-being, transportation, ability to afford utilities, and employment status. These interviews followed another study component where participants were asked to complete a short social needs questionnaire (the SPARK tool). Data was analysed using a thematic content analysis. Five themes were generated, including (1) openness to screening for social needs, (2) value in healthcare providers knowing patients’ social needs, (3) overall scepticism and trust/distrust in the healthcare system and professionals; (4) potential for harm; (5) meaningful engagement and provider training on social needs. Findings: Participants were generally comfortable being asked about their social needs but stressed the importance of privacy, especially regarding financial well-being (ability to afford basic needs and extended health-care related expenses), as well as clear usefulness of the data and building physician-patient trust. Participants were generally open to social needs screening, though discomfort emerged when discussing race, employment, housing, and financial well-being, largely driven by concerns about privacy, trust, and data use. These findings highlight the importance of transparent communication, robust data governance, and explicit informed consent to support acceptable and effective implementation of social needs data collection.