Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model
Background: Social care, the assessing and addressing of patients’ health-related social needs, may expand primary care’s impact. However, more information is needed about what primary care teams require to succeed in social care. The aim of this systematic review was to understand facilitators and...
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Elsevier
2025-12-01
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| Series: | SSM - Health Systems |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949856225000741 |
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| author | Laura Porterfield Christen M. Walcher Forrest Jones Mary E. Jones Cathy Z. Xie Quratulanne H. Jan Zuleica M. Santiago Delgado Elizabeth M. Vaughan |
| author_facet | Laura Porterfield Christen M. Walcher Forrest Jones Mary E. Jones Cathy Z. Xie Quratulanne H. Jan Zuleica M. Santiago Delgado Elizabeth M. Vaughan |
| author_sort | Laura Porterfield |
| collection | DOAJ |
| description | Background: Social care, the assessing and addressing of patients’ health-related social needs, may expand primary care’s impact. However, more information is needed about what primary care teams require to succeed in social care. The aim of this systematic review was to understand facilitators and barriers to social care in adult primary care settings through the lens of the social-ecological model. Methods: Six online databases were searched for studies in adult primary care contexts that addressed facilitators and barriers to social care and were published 2014 to present. Two authors assessed independently for inclusion using a priori criteria. Data was extracted independently by two authors. Study results were assigned and organized by social-ecological model level (individual, interpersonal, organizational, community, policy). Results: 3895 articles were screened and 86 studies included. Organizational factors were the most common level for facilitators (77 %) and barriers (79.1 %). Lack of clinician time, excess workload, lack of community resources, and fee-for-service payment were prominent barriers. Facilitators included social care team members, workflow optimization, EHR integration, resource databases, team training, and community resources. Conclusions: Barriers to social care in primary care are numerous but surmountable through investments in teams, training, infrastructure, and resources. Investing in social services, healthcare structures, and payment systems that support social care work could empower primary care to partner with patients for better health. Registration: The review protocol is registered with the International Prospective Register of Systematic Reviews: Protocol Registration: CRD42024553413 |
| format | Article |
| id | doaj-art-486dab300d9540a19a07ab03d737b9d1 |
| institution | Kabale University |
| issn | 2949-8562 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM - Health Systems |
| spelling | doaj-art-486dab300d9540a19a07ab03d737b9d12025-08-23T04:50:18ZengElsevierSSM - Health Systems2949-85622025-12-01510012210.1016/j.ssmhs.2025.100122Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological modelLaura Porterfield0Christen M. Walcher1Forrest Jones2Mary E. Jones3Cathy Z. Xie4Quratulanne H. Jan5Zuleica M. Santiago Delgado6Elizabeth M. Vaughan7Department of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123 USA; Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA; Corresponding author at: Department of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123, USA.Department of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123 USASchool of Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USASchool of Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USADepartment of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123 USADepartment of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123 USADepartment of Family Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1123 USADepartment of Internal Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USABackground: Social care, the assessing and addressing of patients’ health-related social needs, may expand primary care’s impact. However, more information is needed about what primary care teams require to succeed in social care. The aim of this systematic review was to understand facilitators and barriers to social care in adult primary care settings through the lens of the social-ecological model. Methods: Six online databases were searched for studies in adult primary care contexts that addressed facilitators and barriers to social care and were published 2014 to present. Two authors assessed independently for inclusion using a priori criteria. Data was extracted independently by two authors. Study results were assigned and organized by social-ecological model level (individual, interpersonal, organizational, community, policy). Results: 3895 articles were screened and 86 studies included. Organizational factors were the most common level for facilitators (77 %) and barriers (79.1 %). Lack of clinician time, excess workload, lack of community resources, and fee-for-service payment were prominent barriers. Facilitators included social care team members, workflow optimization, EHR integration, resource databases, team training, and community resources. Conclusions: Barriers to social care in primary care are numerous but surmountable through investments in teams, training, infrastructure, and resources. Investing in social services, healthcare structures, and payment systems that support social care work could empower primary care to partner with patients for better health. Registration: The review protocol is registered with the International Prospective Register of Systematic Reviews: Protocol Registration: CRD42024553413http://www.sciencedirect.com/science/article/pii/S2949856225000741Social careHealth-related social needsSocial determinantsPrimary careSocio-ecological model |
| spellingShingle | Laura Porterfield Christen M. Walcher Forrest Jones Mary E. Jones Cathy Z. Xie Quratulanne H. Jan Zuleica M. Santiago Delgado Elizabeth M. Vaughan Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model SSM - Health Systems Social care Health-related social needs Social determinants Primary care Socio-ecological model |
| title | Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model |
| title_full | Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model |
| title_fullStr | Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model |
| title_full_unstemmed | Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model |
| title_short | Facilitators and barriers to social care in adult primary care: A systematic review using the social-ecological model |
| title_sort | facilitators and barriers to social care in adult primary care a systematic review using the social ecological model |
| topic | Social care Health-related social needs Social determinants Primary care Socio-ecological model |
| url | http://www.sciencedirect.com/science/article/pii/S2949856225000741 |
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