PULSE - BRIDGE-C2: DeveloPing a Pragmatic GUide to ImpLementing Social RiSk AssistancE

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PROJECT SUMMARY This supplement is a collaborative effort across four ISC3 Centers: BRIDGE-C2, Harvard ISCCCE, University of Washington OPTICC, and Washington University-ISC3. The BRIDGE-C2 Center Implementation Laboratory is a network of community health centers (CHCs), which face particularly difficult implementation challenges as they primarily serve socioeconomically vulnerable patients with high rates of social needs (adverse social determinants of health). Addressing social needs through `Assistance' interventions can be critical to ensuring patients' ability to access evidence-based cancer screening and prevention interventions. Well-documented challenges in addressing social needs include determining how best to maintain up-to-date information about available service agencies to which persons with social needs may be referred, and developing and adopting optimal workflows for doing so. Methods for doing so range from having a clinic social worker maintain a hard- copy binder of resources, to using social service resource locators (informatics platforms integrated into the electronic health record) to identify available resources and enable bidirectional communication with local organizations about patients' receipt of services (also called community resource referral platforms). Building on findings from the Phase I supplement, we propose to: (1) develop a pragmatic, applied guidebook (the Guide) for clinics seeking to implement or expand efforts to address patient-reported social risks using Assistance strategies; (2) use rapid-cycle testing to identify best practices for implementing the Guide; and (3) iterate and disseminate the refined Guide.