# Social Needs Screening Tools for Clinical Populations in Australia and New Zealand: A Scoping Review and Critical Analysis

## TL;DR

This study reviews social needs screening tools used in clinical care in Australia and finds they lack comprehensiveness and clear next steps for addressing identified needs.

## Contribution

The paper provides the first scoping review of social needs screening tools in Australia and New Zealand, highlighting gaps in their design and implementation.

## Key findings

- Five Australian screening tools were identified, but none from New Zealand.
- Most tools lacked comprehensive coverage of social need domains and actionable steps.
- No tools included referral pathways for addressing identified social needs.

## Abstract

Social determinants of health account for approximately 50% of health outcomes, yet social needs are rarely assessed as part of routine clinical care. We aimed to conduct a scoping review of screening tools for assessing social needs within clinical practice in Australia and New Zealand.

This scoping review was conducted according to our preregistered protocol (https://osf.io/d6evu). We searched scientific and grey literature for Australian or New Zealand studies that developed and/or evaluated social needs screening tools for adult patients. Extracted data included tool characteristics, validity, comprehensiveness, and proposed interventions. Actionability, that is, detailed specification of behaviour, was assessed using the Action, Actor, Context, Target and Time framework.

Eight studies were included, describing five Australian screening tools (none from New Zealand), with varied characteristics and validity measures. Tools frequently screened for employment, economic stability, housing, support systems, and social and community context. Two tools covered all social need domains, and one provided detailed behavioural specifications. However, none outlined referral pathways for identified needs.

We identified five social needs screening tools. Most lacked comprehensiveness and actionability, and none integrated referral pathways. While these tools may represent a first step in identifying social needs in clinical care, addressing these gaps is essential for meaningful impact.

Our research team comprised people living with chronic health conditions, clinicians, researchers, and social epidemiologists who all contributed to study design, conduct and interpretation of data.