- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07278401
Community Pharmacies as Social Determinant of Health Navigators (SDoH)
December 1, 2025 updated by: David Matthew Jacobs, State University of New York at Buffalo
Type 1 hybrid effectiveness-implementation study using a quasi-experimental, difference-in-difference (DID) design to deliver a comprehensive social needs screening and navigation program by integrating Community Health Workers (CHWs) into community pharmacies across under-resourced areas in Western New York (WNY).
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
1600
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: David Jacobs
- Phone Number: 716-829-2134
- Email: dmjacobs@buffalo.edu
Study Contact Backup
- Name: Christopher Daly
- Phone Number: 716-645-2828
- Email: cjdaly@buffalo.edu
Study Locations
-
-
New York
-
Buffalo, New York, United States, 14207
- Recruiting
- Black Rock Pharmacy
-
Buffalo, New York, United States, 14213
- Recruiting
- Vital Pharmacy
-
Buffalo, New York, United States, 14226
- Recruiting
- Riverview Professional Pharmacy
-
Middleport, New York, United States, 14105
- Recruiting
- Middleport Family Health Center
-
Niagara Falls, New York, United States, 14304
- Recruiting
- Niagara Apothecary
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Adult subjects ≥ 18 years
- English speaking
- Presenting to one of the participating pharmacies. For the pharmacies to be included, they must be enrolled within the Community Pharmacy Enhanced Services Network - NY (CPESN-NY) or associated with Tops Pharmacies. The pharmacies must have the ability to collaborate with Healthelink and referring partners (e.g., Wellconnected) and the staffing capacity to have a SDoH screening program with Community Health Worker Training. The pharmacies' physical address must be located within Erie County
Exclusion Criteria:
- Subjects ≤ 18 years
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
No Intervention: Social needs screenings control group
Individuals within the same healthcare system that are matched based on similar characteristics.
|
|
|
Other: Social needs screenings and referrals participants
Patients who have been identified to have needs via the screening survey who are referred to a community based organization by the pharmacist navigator.
|
Community pharmacies will distribute social needs screening surveys to patients and refer them to local community based organizations based off of identified needs.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Effectiveness Outcomes
Time Frame: 12 months
|
Primary effectiveness outcomes in composite healthcare utilization including hospital admissions and ED visits at 12 months, and we hypothesize that utilization will be reduced in subjects who receive a pharmacy social needs intervention.
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cost Analysis
Time Frame: 12 months
|
We will calculate interventions costs combined with cost savings from reduced utilization to calculate the net costs from a health system perspective.
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016 Feb;50(2):129-35. doi: 10.1016/j.amepre.2015.08.024. Epub 2015 Oct 31.
- Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7.
- Gundersen C, Ziliak JP. Food Insecurity And Health Outcomes. Health Aff (Millwood). 2015 Nov;34(11):1830-9. doi: 10.1377/hlthaff.2015.0645.
- Feldstein AC, Glasgow RE. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf. 2008 Apr;34(4):228-43. doi: 10.1016/s1553-7250(08)34030-6.
- Ruiz Escobar E, Pathak S, Blanchard CM. Screening and Referral Care Delivery Services and Unmet Health-Related Social Needs: A Systematic Review. Prev Chronic Dis. 2021 Aug 12;18:E78. doi: 10.5888/pcd18.200569.
- Morse JM. Determining sample size. Qual Health Res. 2000;10(1):3-5. doi: Doi 10.1177/104973200129118183. PubMed PMID: WOS:000084385600001.
- Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Method. 2006;18(1):59-82. doi: 10.1177/1525822x05279903. PubMed PMID: WOS:000242853100004.
- Daly CJ, Costello J, Mak A, Quinn B, Lindenau R, Jacobs DM. Pharmacists' perceptions on patient care services and social determinants of health within independent community pharmacies in an enhanced services network. J Am Coll Clin Pharm. 2021;4(3):288-95. doi: 10.1002/jac5.1398. PubMed PMID: WOS:000710530900005.
- LaForge K, Gold R, Cottrell E, Bunce AE, Proser M, Hollombe C, Dambrun K, Cohen DJ, Clark KD. How 6 Organizations Developed Tools and Processes for Social Determinants of Health Screening in Primary Care: An Overview. J Ambul Care Manage. 2018 Jan/Mar;41(1):2-14. doi: 10.1097/JAC.0000000000000221.
- Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records; Board on Population Health and Public Health Practice; Institute of Medicine. Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1. Washington (DC): National Academies Press (US); 2014 Jun 23. Available from http://www.ncbi.nlm.nih.gov/books/NBK195994/
- Buitron de la Vega P, Ashe EM, Xuan Z, Gast V, Saint-Phard T, Brody-Fialkin J, Okonkwo F, Power J, Wang N, Lyons C, Silverstein M, Lasser KE. A Pharmacy Liaison-Patient Navigation Intervention to Reduce Inpatient and Emergency Department Utilization Among Primary Care Patients in a Medicaid Accountable Care Organization: A Nonrandomized Controlled Trial. JAMA Netw Open. 2023 Jan 3;6(1):e2250004. doi: 10.1001/jamanetworkopen.2022.50004.
- Handley MA, Lyles CR, McCulloch C, Cattamanchi A. Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research. Annu Rev Public Health. 2018 Apr 1;39:5-25. doi: 10.1146/annurev-publhealth-040617-014128. Epub 2018 Jan 12.
- Daly CJ, Quinn B, Mak A, Jacobs DM. Community Pharmacists' Perceptions of Patient Care Services within an Enhanced Service Network. Pharmacy (Basel). 2020 Sep 16;8(3):172. doi: 10.3390/pharmacy8030172.
- Martinez LS, Russell B, Rubin CL, Leslie LK, Brugge D. Clinical and translational research and community engagement: implications for researcher capacity building. Clin Transl Sci. 2012 Aug;5(4):329-32. doi: 10.1111/j.1752-8062.2012.00433.x. Epub 2012 Jun 28.
- Wheat L, Roane TE, Connelly A, Zeigler M, Wallace J, Kim JH, Segal R. Using a pharmacist-community health worker collaboration to address medication adherence barriers. J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):1009-1014. doi: 10.1016/j.japh.2020.08.021. Epub 2020 Sep 14.
- Berkowitz SA, Hulberg AC, Hong C, Stowell BJ, Tirozzi KJ, Traore CY, Atlas SJ. Addressing basic resource needs to improve primary care quality: a community collaboration programme. BMJ Qual Saf. 2016 Mar;25(3):164-72. doi: 10.1136/bmjqs-2015-004521. Epub 2015 Nov 30.
- Austin CP. Opportunities and challenges in translational science. Clin Transl Sci. 2021 Sep;14(5):1629-1647. doi: 10.1111/cts.13055. Epub 2021 Jul 8.
- Foster AA, Daly CJ, Leong R, Stoll J, Butler M, Jacobs DM. Integrating community health workers within a pharmacy to address health-related social needs. J Am Pharm Assoc (2003). 2023 May-Jun;63(3):799-806.e3. doi: 10.1016/j.japh.2023.01.006. Epub 2023 Jan 11.
- Foster AA, Daly CJ, Logan T, Logan R Jr, Jarvis H, Croce J, Jalal Z, Trygstad T, Jacobs DM. Implementation and evaluation of social determinants of health practice models within community pharmacy. J Am Pharm Assoc (2003). 2022 Jul-Aug;62(4):1407-1416. doi: 10.1016/j.japh.2022.02.005. Epub 2022 Feb 11.
- Foster AA, Daly CJ, Logan T, Logan R Jr, Jarvis H, Croce J, Jalal Z, Trygstad T, Bowers D, Clark B, Moore S, Jacobs DM. Addressing social determinants of health in community pharmacy: Innovative opportunities and practice models. J Am Pharm Assoc (2003). 2021 Sep-Oct;61(5):e48-e54. doi: 10.1016/j.japh.2021.04.022. Epub 2021 May 4.
- Berenbrok LA, Gabriel N, Coley KC, Hernandez I. Evaluation of Frequency of Encounters With Primary Care Physicians vs Visits to Community Pharmacies Among Medicare Beneficiaries. JAMA Netw Open. 2020 Jul 1;3(7):e209132. doi: 10.1001/jamanetworkopen.2020.9132.
- Guadamuz JS, Alexander GC, Zenk SN, Qato DM. Assessment of Pharmacy Closures in the United States From 2009 Through 2015. JAMA Intern Med. 2020 Jan 1;180(1):157-160. doi: 10.1001/jamainternmed.2019.4588.
- Qato DM, Zenk S, Wilder J, Harrington R, Gaskin D, Alexander GC. The availability of pharmacies in the United States: 2007-2015. PLoS One. 2017 Aug 16;12(8):e0183172. doi: 10.1371/journal.pone.0183172. eCollection 2017.
- Andermann A. Screening for social determinants of health in clinical care: moving from the margins to the mainstream. Public Health Rev. 2018 Jun 22;39:19. doi: 10.1186/s40985-018-0094-7. eCollection 2018.
- Fraze TK, Brewster AL, Lewis VA, Beidler LB, Murray GF, Colla CH. Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals. JAMA Netw Open. 2019 Sep 4;2(9):e1911514. doi: 10.1001/jamanetworkopen.2019.11514.
- Adler NE, Glymour MM, Fielding J. Addressing Social Determinants of Health and Health Inequalities. JAMA. 2016 Oct 25;316(16):1641-1642. doi: 10.1001/jama.2016.14058. No abstract available.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
October 1, 2025
Primary Completion (Estimated)
December 1, 2026
Study Completion (Estimated)
June 1, 2027
Study Registration Dates
First Submitted
December 1, 2025
First Submitted That Met QC Criteria
December 1, 2025
First Posted (Actual)
December 12, 2025
Study Record Updates
Last Update Posted (Actual)
December 12, 2025
Last Update Submitted That Met QC Criteria
December 1, 2025
Last Verified
November 1, 2025
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 8733
- UM1TR005296 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
IPD Plan Description
Sharing IPD will be based on specific agreements between the institution, community partners, and the local health information exchange.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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