Development and initial validation of the addressing client needs with social determinants of health scale (ACN: SDH)

Background The purpose of this study was to validate a scale that can be used by healthcare service professionals, healthcare systems, educators, and researchers to assess health service professionals’ social determinants of health (SDOH) competency; with competency defined as their knowledge, awareness-biases, skills, and actual preparedness to address SDOH challenges. Methods An Exploratory Factor Analysis (EFA) was conducted with a sample of 220 health service professionals, and 6 factors were identified. A Confirmatory Factor Analysis (CFA) was conducted with 303 health service professionals and the 6-factor solution was supported, with 22 items. Results The reliability estimates for the 6 factors are as follows: Factor 1, Action Toward Addressing SDOH ( a = .85); Factor 2, SDOH Knowledge (a = .94); Factor 3, Negative Attitude toward Addressing SDOH ( a = .79); Factor 4, Systemic Accountability ( a = .81); Factor 5, School Preparation ( a = .86); and Factor 6, Perception of the Cause of SDOH ( a = .94). Conclusion The ACN:SDH scale is the first validated measure that can be used to systematically appraise health service professionals’ SDOH competency.