Addressing Social Determinants of Health in Clinical Practice: Utilizing an SDOH Toolkit for WHNP students
Arazu Kian, BSN, RN, WHNP DNP Student
Advisor: Diana Drake, APRN, WHNP-BC, FNAP, FAAN


The aim of this project was to increase skills and confidence of APRN WHNP students in assessing and addressing social determinants of health (SDOH) in a women’s health clinic setting.


  1. Define the Social Determinants of Health and their impact on health outcomes for women.
  2. Describe 3 effective interview methods to assess SDOH in clinical practice at point of care.
  3. Describe 3 essential components of the Toolkit that support WHNP students in addressing SDOH at point of care.

Methods and Results

Summary: Studies identify a healthcare provider gap in understanding and addressing SDOH in clinical practice. The American Association of Colleges of Nursing (AACN) asserts that by increasing the integration of SDOH into nursing curricula and clinical experiences, students will be better prepared to positively impact health equity as future providers. This project was an expansion of a faculty-led SDOH experiential workshop for APRN students and it provided an SDOH Toolkit for students to use in clinical practice. The Toolkit was developed in response to a baseline student needs assessment and the SDOH practice gap identified in national data. It provides support for assessment, local resources specific to women’s health, and resources that are intersectional between SDOH and women’s health. The Toolkit was implemented and evaluated in clinical rotations over the summer semester.

Outcomes: Pre/post survey evaluations occurred at 3 intervals, 1) student understanding and confidence at baseline, 2) during the SDOH Toolkit implementation period in clinical practice, 3) at the conclusion of the semester-long implementation period. Survey #1 was completed 4/10, Survey #2 was distributed April 21 and Survey #3 was distributed in August. When assessing and addressing SDOH in the clinic setting, this intervention resulted in a 55% overall increase in confidence, a 76% increase in knowledge of resources available, and an 83% confidence increase when accessing resources.

Implications for Women’s Health: The World Health Organization reports that the gender inequities women and girls face increase their overall health risks. Gender-based health risks are amplified by the impact of social determinants of health (SDOH) and it is estimated that 30-55% of health outcomes are directly related to SDOH in the United States. The AACN states that SDOH education is an essential component of nursing practice and WHNPs on the frontline of healthcare are in a unique position to address SDOH. Implementing an SDOH Toolkit to assist WHNP students in confidently addressing SDOH in clinical practice encounters can help improve care for women.