Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor

Dr. Kim Hawkins


Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of chronic diseases and lead to improved patient outcomes (Frier et al., 2019). However, there are no current policies or structured procedures for screening and addressing social determinants of health in many primary care settings (Page-Reeves et al., 2016). To address the lack of screening for social determinants of health, the Core 5 Social Risk Screening Tool is a five question, evidence-based tool that provides a comprehensive evaluation of social determinants of health (Bechtel et al., 2022; Bradywood et al., 2021). This DNP scholarly project aimed to increase patient self-reporting of social determinants of health in a primary care office using the Core 5 Social Risk Screening Tool from 0% to 50% within a 30-day period.