Gravity-Accepted Social Risk Screening Assessment Instruments

Exciting News! 🌟

As part of our commitment to establishing consensus-driven standards for exchanging social risk data across various care settings, Gravity Project is pleased to announce the release of a table that includes all screening assessment instruments that have been accepted as face-valid by Gravity Project. The collection of social risk data is pivotal in advancing health equity by identifying unmet health-related social needs, facilitating the planning and execution of targeted interventions, and supporting the development of quality measures. Social risk data is also a critical resource for identifying community and population needs and monitoring the effectiveness of interventions. Additionally, social risk data can be used to support advocacy for policy updates and new initiatives.

🌐 Gravity Project Standards: In our commitment to upholding and advancing social risk data standards, Gravity Project prioritizes LOINC encoding for social risk screening assessment instruments that achieve gold standard, federal, or national recognition; Gravity-accepted instruments falling outside of these criteria can still be submitted to LOINC by others for inclusion in Gravity's value sets.

The table below provides Gravity-accepted social risk screening assessment instruments, their associated SDOH domains, web links where readily available, and the status of LOINC encoding (eg. Already in LOINC & in VSAC, Submitted to LOINC, Working on LOINC Submission, Not Yet Submitted to LOINC, but Gravity Accepted).

If you are in the process of submitting a LOINC request for a screening instrument that is in the "Not Yet Submitted to LOINC, but Gravity Accepted" column, please contact Gravity Project at gravityproject@hl7.org. Your collaboration will assist us in updating our Gravity value sets.

Please find a downloadable Excel version of the Social Risks Screening Assessment Instruments Tool below.

Screening Assessments Instruments Tool Version (click to download)	Date
V2 (current)	10/18/2023
V1	09/19/2023

Note: Screening instruments identified during the Gravity public consensus process for which references are not available are not included in the table (currently, those instruments include: Providence St. Joseph Health Internal, Total Health Quick Check, Community Health Center Snohomish County Quick Check).

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Instrument ID	Screening Assessment Instrument	Gravity Domain(s) in which Instrument is Referenced	Already in LOINC & in VSAC	Submitted to LOINC	Working on LOINC Submission	Not Yet Submitted to LOINC, but Gravity Accepted	Instrument Outdated	Gravity Note
1	American Academy of Family Physicians (AAFP) Social Needs Screening tool	Food Insecurity Inadequate Housing Housing Instability Material Hardship Transportation Insecurity Employment Status (Unemployment) Educational Attainment (Less Than High School Education)	x
2	American Academy of Family Physicians (AAFP) Social Needs Screening tool (Short)	Food Insecurity Inadequate Housing Material Hardship Transportation Homelessness	x
3	Behavioral Approach to Screening for Elder Mistreatment	Elder Abuse	x
4	BRIEF health literacy screening tool [BRIEF]	Health Literacy	x
5	CHW Housing Stability Vital Sign	Housing Instability Homelessness	x					This screener is resubmitted to LOINC by Gravity to include additional follow-up question on an existing question i.e., 98978-0: At any time in the past 12 months, were you homeless or living in shelter [including now]?
6	Clinical Care Classification (CCC)	Social Connection	x
7	Comprehensive Universal Behavior Health Screen [CUBS]	Employment Status (Unemployment) Transportation insecurity	x					Proprietary instrument please contact author/location for versions and references.
8	END STAGE RENAL DISEASE MEDICAL EVIDENCE REPORT MEDICARE ENTITLEMENT AND/OR PATIENT REGISTRATION	Employment Status (Unemployment)	x
9	Functional Assessment of Chronic Illness Therapy (FACIT) Social - family well-being	Social Connection	x
10	General Well-Being Schedule - 18 item [NHANES]	Stress	x
11	HealthLeads	Food Insecurity Housing Instability Transportation Insecurity Material Hardship Health Literacy	x
12	Humiliation, Afraid, Rape, and Kick Questionnaire	Intimate Partner Violence	x
13	Identifying Core behavioral and psychosocial data elements for the electronic health record [SAMHSA]	Stress Veteran Status Employment Status (Unemployment)	x
14	Inpatient Rehabilitation Facility - Patient Assessment Instrument	Transportation Insecurity	x
15	NAM (NHANES) Social connection and isolation panel- social isolation score	Social Connection	x
16	Norwalk Community Health Center Screening Tool [NCHC]	Inadequate Housing	x
17	Occupational Stress Questionnaire (OSQ)	Stress	x
18	Outcome and assessment information set (OASIS) form - version E - Discharge from Agency	Transportation Insecurity	x
19	Outcome and Assessment Information Set (OASIS) form - version E - Resumption of Care	Transportation Insecurity	x
20	Outcome and assessment information set (OASIS) form - version E - Start of Care [CMS Assessment]	Transportation Insecurity	x
21	Patient Centred Assessment Method (PCAM)	Health Literacy	x					This screener represents an electronic (paper copy) assessment.
22	Perceived Stress Scale	Stress	x
23	PhenX - chronic stress protocol 181301	Material Hardship	x
24	PhenX domain - Physical activity and physical fitness	Social Connection	x
25	PRAPARE	Food Insecurity Homelessness Housing Instability Transportation Insecurity Material Hardship Employment Status (Unemployment) Educational Attainment (Less Than High School Education) Veteran Status Stress Social Connection Intimate Partner Violence Medical Cost Burden Health Insurance Coverage Status	x
26	PROMIS emotional support	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
27	PROMIS instrumental support- version 2.0 T score	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
28	PROMIS item bank - social isolation - version 2.0	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
29	PROMIS short form - social isolation 6a - version 2.0	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
30	PROMIS short form - social isolation 8a - version 2.0	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
31	PROMIS short form- social isolation 4a- version 2.0	Social Connection	x					For PROMIS screeners, please search via healthmeasures.net.
32	PhenX Protocol - Current Employment Status	Employment Status (Unemployment)	x
33	PhenX Protocol - Educational Attainment - Individual	Educational Attainment (Less Than High School Education)	x
34	SEEK	Food Insecurity Stress	x
35	The Accountable Health Communities (AHC) Health-Related Social Needs (HSRN) Screening Tool	Food Insecurity Housing Instability Homelessness Inadequate housing Transportation Material Hardship Financial Insecurity Stress	x
36	Accountable Health Communities (AHC) HSRN Screening Tool Supplemental Questions	Financial insecurity Social Connection	x
37	The Hunger Vital Sign	Food Insecurity	x
38	US household food security 18 item	Food Insecurity	x
39	US Household Food Security Survey: Six-Item Short Form	Food Insecurity	x
40	USDA Child Food Security Survey	Food Insecurity	x
41	USDA to Assess Household Food Security 10 Items	Food Insecurity	x
42	We Care Survey	Food Insecurity Housing Instability Financial Insecurity Educational Attainment (Less Than High School Education) Employment Status (Unemployment)	x
43	WellRx	Food Insecurity Homelessness Employment Status (Unemployment) Housing Instability Transportation Insecurity Material Hardship	x
44	American Community Survey (ACS)	Food Insecurity Material Hardship Educational Attainment (Less Than High School Education) Housing Instability Veteran Status Digital Access Health Insurance Coverage Status		x
45	Berkman-Syme Social Network Index (SNI)	Social Connection		x
46	CUES	Intimate Partner Violence		x
47	Medical Expenditure Panel Survey (MEPS) - Access to Health Care (for Material Hardship)	Material Hardship		x
48	Medical Expenditure Panel Survey (MEPS) - Health Insurance (HX) Section (for Medical Cost Burden)	Medical Cost Burden		x
49	Perceived Stress Scale 14 item	Stress		x
50	The UCLA Three-Item Loneliness Scale	Social Connection		x
51	Transportation Barriers Measure	Transportation Insecurity		x
52	DSSI-10 (Duke Social Support Index-10)	Social Connection			x
53	LUBBEN SOCIAL NETWORK SCALE – 6 (LSNS-6)	Social Connection		x
54	National Health Interview Survey (NHIS) Questionnaire	Food Insecurity Material Hardship Medical Cost Burden Social Connection Veteran Status Health Insurance Coverage Status Transportation Insecurity			x
55	Medical Outcomes Study (MOS) Social Support Survey	Social Connection		x
56	ALL ASPECTS OF HEALTH LITERACY SCALE (AAHLS)	Health Literacy				x
57	American Academy of Nursing	Veteran Status				x
58	American Housing Survey	Housing Instability Inadequate Housing Financial insecurity Material Hardship Transportation Insecurity Educational Attainment (Less Than High School Education) Veteran Status Homelessness				x
59	Assessing Circumstances & Offering Resources for Needs (ACORN) Screener	Digital Literacy Digital Access				x
60	Boston Medical Center Thrive	Material Hardship				x
61	Brief Questions to Identify Patients with Inadequate Health Literacy Chew 2004	Health Literacy				x		Three screening questions from this screener are covered in BRIEF health literacy screening tool [BRIEF] and have existing LOINC codes. Hence, this screener will not be submitted to LOINC.
62	Children’s HealthWatch	Material Hardship Housing Instability Homelessness Educational Attainment (Less Than High School Education)				x
63	Computer proficiency questionnaire (CPQ)	Digital Literacy				x
64	CURRENT POPULATION SURVEY (CPS) - Demographics	Veteran Status Educational Attainment (Less Than High School Education)				x
65	DeJong Gierveld Loneliness Scale	Social Connection				x
66	Development of a Tool to Identify Poverty in a Family Practice Setting: A Pilot Study	Financial Insecurity				x
67	Digital Health Literacy Instrument (DHLI)	Digital Literacy				x
68	DIGITAL LITERACY QUESTIONNAIRE – Language Learners (DLQ-LL)	Digital Literacy				x
69	DUKE SOCIAL SUPPORT AND STRESS SCALE (DUSOCS)	Social Connection				x
70	Duke Social Support Index (DSSI) 11	Social Connection				x
71	Duke Social Support Index (DSSI) 23	Social Connection				x
72	Duke Social Support Index (DSSI) 35	Social Connection				x
73	Duke-UNC Functional Social Support Questionnaire	Social Connection				x
74	Educational impact due to COVID-19 panel	Digital Access				x
75	eHealth Literacy Scale	Digital Literacy				x
76	Elder Abuse Senior Abuse Identification Tool (ED Senior AID)	Elder Abuse				x
77	Elder Abuse Suspicion Index (EASI)	Elder Abuse				x
78	ELDER ASSESSMENT INSTRUMENT (EAI)	Elder Abuse				x
79	Elder Mistreatment Screening and Response Tool (EM-SART)	Elder Abuse				x
80	ENRICHD Social Support	Social Connection				x
81	Extended - Hurt, Insult, Threaten, Scream (E-HITS) screening tool	Intimate Partner Violence				x
82	Food Insecurity Experience Scale (FIES)	Food Insecurity				x
83	Foundational Community Supports: Supported Housing Assessment	Housing Instability Homelessness				x
84	Health Information National Trends Survey	Food Insecurity				x
85	Health Literacy Assessment Tool - HLAT-8	Health Literacy				x
86	Household Food Insecurity Access Scale (HFIAS)	Food Insecurity				x
87	Homeless Management Information System (HMIS)	Housing Instability Homelessness				x
88	Household Food Security Survey Module (HFSSM)	Food Insecurity				x
89	Hwalek-Sengtock Elder Abuse Screening Test (H-S/East)	Elder Abuse				x
90	IHELP Social History Tool	Food Insecurity Financial Insecurity				x
91	Interpersonal Support Evaluation List (ISEL)	Social Connection				x
92	Intimate Partner Violence 4 (IPV-4)	Intimate Partner Violence				x
93	Kleinman (hunger question)	Food Insecurity				x
94	Lubben Social Network Scale 12	Social Connection				x
95	Medical Expenditure Panel Survey (MEPS) - Health Literacy	Health Literacy				x
96	Medical Expenditure Panel Survey (MEPS) : Your Experiences with Cancer	Medical Cost Burden				x
97	Medical-Legal Partnership Screening	Inadequate Housing				x
98	Multidimensional Scale of Perceived Social Support (MSPSS)	Social Connection				x
99	My Own Health Report	Housing Instability Homelessness				x
100	NC Healthy Opportunities Screening	Food Insecurity Housing Instability Transportation Insecurity Homelessness				x
101	OARS Social Resources Scale	Social Connection				x
102	OECD/INFE TOOLKIT FOR MEASURING FINANCIAL LITERACY AND FINANCIAL INCLUSION May 2018	Material Hardship				x
103	Oslo social support scale (OSSS-3)	Social Connection				x
104	PERSONAL RESOURCE QUESTIONNAIRE (PRQ2000)	Social Connection				x
105	PhenX Data Collection Worksheet	Health Insurance Coverage Status				x
106	Rapid Estimate of Adult Literacy in Medicine—Short Form (REALM-SF)	Health Literacy				x
107	Upstream Risk Screening Tool	Housing Instability Inadequate Housing Homelessness Transportation Insecurity Financial Insecurity Material Hardship Educational Attainment (Less Than High School Education) Employment Status (Unemployment)				x
108	Short Assessment of Health Literacy-English(SAHL-E)	Health Literacy				x
109	Short Assessment of Health Literacy-Spanish(SAHL-S)	Health Literacy				x
110	Single-Item Literacy Screener (SILS)	Health Literacy				x
111	Survey of Well-Being of Young Children (SWYC)	Food Insecurity				x
112	SWAN Sleep Study	Financial Insecurity				x		The screening question has an existing LOINC Code, i.e., 76513-1. Hence, this screener will not be submitted to LOINC.
113	Zuckerberg San Francisco General Hospital Digital Needs Screening tool	Digital Access			x
114	Digital Health Readiness Questionnaire	Digital Literacy			x
115	Digital Health Care Literacy Scale	Digital Literacy			x
116	The Mobile Device Proficiency Questionnaire (MDPQ)	Digital Literacy				x
117	Urban Lifestyle Stress Scale (ULSS)	Financial Insecurity				x
118	VA Homelessness Screening Clinical Reminder (HSCR)	Housing Instability Homelessness				x
119	Vulnerability To Abuse Screening Scale (VASS)	Elder Abuse				x
120	VA Community Provider Toolkit Military Screening Questions	Veteran Status					x
121	Your Current Life Situation (YCLS) V2.0	Food Insecurity Housing Instability Material Hardship Homelessness					x
122	Transportation Security Index (Long Form)	Transportation Insecurity			x
123	CHCW Internally developed SDoH Tool	Food Insecurity Housing Instability Inadequate Housing Transportation Insecurity Homelessness				x
124	CHFC SDH All Domains	Inadequate Housing Transportation Insecurity Homelessness				x
125	CommunityConnect Social Needs Screening Tool	Food Insecurity Housing Instability Homelessness				x
126	Consumer Financial Protection Bureau (CFPB) Financial Well Being Scale Short	Financial Insecurity				x
127	Cowlitz Family Health Center Internally Developed tool	Financial Insecurity Employment Status (Unemployment) Material Hardship				x		Proprietary instrument please contact author/location for versions and references.
128	Help Steps Core Screening Questionnaire	Material Hardship				x
129	Medicare THA	Food Insecurity Inadequate Housing				x
130	Occupational Data for Health (ODH)	Employment Status (Unemployment)				x
131	Pulse Outcome Survey	Housing Instability				x
132	Social Needs Survey	Transportation Insecurity				x
133	Upstream Social Isolation Risk Screener (U-SIRS)	Social Connection				x
134	Wellness and Life Experience Survey	Financial Insecurity Material Hardship Housing Instability				x
135	PhenX-social isolation protocol (UCLA Loneliness Scale)	Social Connection	x
136	Burden & Consequences screening tool	Medical Cost Burden				x
137	Patient Centred Assessment Method (PCAM)	Health Literacy	x					This screener represents a non-electronic (paper copy) assessment.

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