Supporting adoption of enabling technologies to advance clinical–community linkages to address patient social needs: Protocol

institution integrated Community Health Workers (CHWs) to provide support in addressing identified needs.Objective: This study aimed to identify barriers and facilitators to HRSNs referrals and the integration of CHWs within clinical teams.Methods: This qualitative study explored perspectives from CHWs, program staff, and clinicians.Semi-structured interview guides were developed using the 2022 Consolidated Framework for Implementation Research.Interviews were conducted via Zoom (November 2023-February 2024), audio recorded, and transcribed.Two analysts independently coded transcripts, reconciling discrepancies using rapid qualitative methodology.Themes were identified using matrix tools and analytic memoing.Results: CHWs report that effective framing of the CHW role by clinicians during patient visits likely led to increased patient acceptance of referrals.Clinicians believe CHW integration into the clinical space improves continuous clinician education on CHW utilization.Program staff cited strong leadership, clear role delineation, and high levels of clinician interaction with CHWs leading to successful referral workflows.Despite strong support for CHWs, clinicians experience time constraints during visits, likely leading to missed referrals and insufficient patient discussions about CHWs.Clinicians cited misunderstandings on CHW versus social worker referrals and poor clinical integration of CHWs.Clinicians admitted to missing team meetings regarding CHW communications.Program staff believe a power dynamic exists between CHWs and clinicians, likely leading to CHWs feeling unable to advocate for themselves when receiving inappropriate referrals.CHWs find that sites with high clinician turnover are challenging to continually re-educate.CHWs experience limitations in timely patient follow-up after the referral resulting in delayed patient contact possibly leading to patients declining assistance.Conclusion: Enhancing CHW integration into clinical teams is crucial for addressing HRSNs.This study provides insights for improving CHWs' role in assisting patients with HRSNs.