School-Based Screening of Social Determinants of Health: A Scoping Review

Abstract

School-based screening instruments have traditionally focused on assessing within-child factors, such as a student’s academic, social, emotional, behavioral, or physical development. This emphasis in school-based screening may be a missed opportunity to assess and ameliorate contextual factors (i.e., social determinants of health) influencing child development. In this scoping review, we aim to describe the current landscape of screening for social determinants of health (SDOH) in school settings. Following established practices for scoping reviews, we searched PsycInfo, ERIC, and CINAHL Plus in December 2022 for articles describing the development or use of an SDOH measure in a school setting. From each eligible article, two coders independently extracted (1) study characteristics, (2) measure characteristics, (3) available psychometric or usability information, and (4) reported outcomes of measure implementation. Descriptive and content analyses were used to examine data. We identified six articles describing the development or use of SDOH measures in elementary, high school, or university settings. These articles yielded six unique SDOH measures, intended for either adolescent or young adult self-report, caregiver proxy-report, or both. Measures included 6–25 SDOH items, with additional items assessing demographics, health behaviors, or mental health (e.g., depression). Reported outcomes included increased referrals to services and implementation of school-based supports to reduce social risk (e.g., school food pantry). We discuss next steps for research evaluating the feasibility and social consequences of school-based SDOH screening.