(1233) Perceptions and Attitudes of Social Determinants of Health Program Facilitators Within Community Pharmacies: A Mixed Methods Study

Objectives: Social determinants of health (SDoH) are increasingly recognized as major drivers of health outcomes. However, medical providers and practices have not fully embraced SDoH programs due to their reticence attributable to overwork and the complexities of solving social challenges. Community pharmacy social needs programs create an opportunity to leverage their accessibility and connect with local resources. Currently, there is little knowledge available on best practices for implementing SDoH programs within community pharmacies. Additional information is needed to better understand the barriers and facilitators for successful program implementation and sustainability. Therefore, the objective of this study is to explore program facilitator’s perceptions and attitudes towards implementing a social needs program within community pharmacy settings.

Methods: This was a mixed methods sequential design using survey and focus groups interviews with program facilitators from a clinically integrated network of community pharmacies, Community Pharmacy Enhanced Services Network of New York (CPESN NY). We identified community pharmacies participating in an ongoing SDoH screening and navigation program between January – May 2023. An online survey tool was sent to all program facilitators and focus group interviews were conducted in 2 groups among those of the survey participants who agreed to partake in focus groups. The survey and focus group tools were developed using the consolidated framework for implementation research. The survey measured contextual factors including: 1) training and education 2) leadership engagement, and 3) workflow staffing and time assessment. Qualitative data were collected through focus groups that explored facilitators’ experiences prior to and during program implementation. Descriptive statistics were used to analyze data obtained from the survey. A deductive rapid analysis of the qualitative data was used to evaluate the focus group transcripts. Transcripts were summarized on a structured template by one research member and validated by a second research member. The validated summaries were consolidated, and major themes were identified by the research team.

Results: Survey participants included 12 program facilitators consisting of 3 pharmacists and 9 technicians from 11 pharmacies. Most participants (83%) felt that their training helped them to recognize and approach individuals to discuss social needs. Nine (75%) participants felt that pharmacy leadership provided enough time, encouragement, and the necessary equipment to complete tasks. All (100%) participants felt that CPESN NY leadership was adequately engaged and provided sufficient resources. Most participants (83%) felt that the workflow steps were clearly defined and straightforward enough to be integrated into a daily pharmacy routine. Only 5 participants (42%) felt that another pharmacy personnel could cover program responsibilities when needed.

Focus groups participants included 9 program facilitators composed of 2 pharmacists and 7 technicians. Three major themes were identified. First, community health worker training helped increase empathy. Participants learned to engage individuals with an understanding that the challenges they face may not always be apparent. Second, online referral platform training was essential. Participants reported that the one-on-one referral training reinforced their understanding of the workflow. They recommended that the initial training be in-person and include hands-on learning experiences. Finally, engaging individuals on social needs is challenging. Program facilitators found limited space and individuals’ lack of trust in outside organizations as barriers to intervention uptake.

Conclusions: Program facilitators felt empowered by program leadership by being provided sufficient training and ongoing social needs screening resources. There was consensus that engaging individuals to address social needs was challenging. These findings can be utilized to understand the importance of gaining insight from program facilitators and further assess gaps in implementing social needs programs within community pharmacies.