Compass rose for generating community–based referrals: Best practices and lessons learned

Background: Originally developed and psychometrically evaluated in English, the 10-item Screener for Intensifying Community Referrals for Health (SINCERE) was developed as a practical tool for assessing health-related social needs (HRSNs) that was translated into Spanish (SINCERE-Sp).Objective: To assess the psychometric properties of SINCERE-Sp within a Spanish-speaking population.Method: We analyzed screening data collected between September 27, 2021, and September 27, 2022 as part of an ongoing trial.Among 464 Spanish-speaking participants screened for HRSNs, 373 completed SINCERE-Sp.We conducted exploratory factor analysis (EFA) to identify underlying factor structures and used Cronbach's alpha and McDonald's omega reliability tests to assess internal consistency.Results: EFA revealed that the SINCERE-Sp items grouped into two factors, which together explained 56% of the variance.Factor 1, "healthcare and housing access needs," accounted for 34% of the variance and comprised six items: Transportation for medical care, medical expenses, medication expenses, unstable housing, lack of job, and childcare or eldercare.Factor 2, "essential living needs," explained 22% of the variance and included four items: food, household items, utilities, and mortgage or rent.Essential healthcare and housing access needs demonstrated strong internal consistency with a Cronbach's alpha of 0.83 and McDonald's omega of 0.83.Essential living needs showed acceptable internal consistency with a Cronbach's alpha of 0.69 and McDonald's omega of 0.72.Conclusions: Our initial findings indicate that SINCERE-Sp is a valid and reliable instrument for assessing the HRSNs of the Spanish-speaking population, but exhibits two vs. one factor (as demonstrated in the English version).Further validity tests will be conducted to deepen our understanding of its effectiveness and applicability in various settings and research contexts.A valid and reliable HRSN screener in the Spanish language is critical to identify unmet needs and offer service referrals, and may improve the health of the Spanish-speaking population.