Social History Template

Domains: Economic Stability
Neighborhood and Physical Environment
Food
Constructs: Expenses
Economic Support
Safety, Crime and Violence
Quality of Housing
Hunger/Food (In)security
Year Created: 2012
Number of Items: 7
Administration Time (Minutes): Not Reported
Administration Setting: Pediatrics
Primary Care
Population Screened: All ages
Administration Methods: Not Reported

About the Tool

The Social History Template is a 7- or 8-item questionnaire that addresses needs in 3 domains (economic stability, neighborhood/physical environment, and food).

Read about development of the tool:
Identifying and treating a substandard housing cluster using a medical-legal partnership

Related Articles 

Beck AF, Klein MD, Schaffzin JK, Tallent V, Gillam M, Kahn RS. Identifying and treating a substandard housing cluster using a medical-legal partnership. Pediatr. 2012;130(5):831-8.

Beck AF, Klein MD, Kahn RS. Identifying social risk via a clinical social history embedded in the electronic health record. Clin Pediatr. 2012;51(10):972-7.

Klein MD, Beck AF, Henize AW, Parrish DS, Fink EE, Kahn RS. Doctors and lawyers collaborating to HeLP children--outcomes from a successful partnership between professions. J Health Care Poor Underserved. 2013;24(3):1063-73.

Tool Ratings

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Psychometric Ratings of Social History Template Tool Pragmatic Ratings of Social History Template Tool