Date of Award

Summer 8-2-2022

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Theresa Pape, PhD, MSN, RN, CNOR-E, CNE

Second Advisor

Sarah M. I. Cartwright, DNP, MSN-PH, BAM, RN-BC, CAPA, FASPAN


Despite an increase in healthcare expenditure, racial and ethnic disparities remain a substantial concern among adult primary care patients in the United States. This is largely due to the focus on medical intervention and disregard for the underlying factors that contribute significantly to health outcomes such as economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. The PICOT question that guided this program evaluation review project is: In adult clients seeking care at a primary care clinic (P), how does a SDOH toolkit based on the CDC framework (I) compared to no SDOH toolkit (C) affect identification of unmet health related social needs (O)? The evidence suggests that screening for SDOH identifies unmet social needs, improves provider referrals to relevant resources, and improves overall health outcomes. In addition, the literature supports the use and development of nursing toolkits to influence evidence-based interventions in healthcare. A detailed and thorough program evaluation review of the Centers for Disease Control and Prevention, Healthy People 2030, and the Health Leads Network SDOH programs revealed that the evaluated SDOH programs meet the requirements of a program per the CDC Program Evaluation framework. Additionally, the evidence supported the use of these programs as established to support the development of an SDOH screening toolkit for the specialty population of adult primary care patients. Screening for SDOH in adult primary care is a necessary component for improving health outcomes and use of an SDOH screening toolkit in the clinical practice setting will help assist in the smooth and successful implementation of SDOH screening for all adult primary care patients.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.