Health System Preparedness for Social Needs Screening Tool Implementation Among Prostate Cancer Patients in Nigeria

PURPOSE There is a particular need for strategic planning to support the sustainable screening of unmet social needs among cancer patients in Nigeria. This study aimed to evaluate the health system preparedness for the implementation of an adapted social needs screening tool among prostate cancer patients in Nigeria. METHODS The study was carried out at three government teaching hospitals in different geopolitical zones of Nigeria. Ethical approval and informed consent were obtained. A stakeholder engagement meeting, comprising moderated education sessions on the adapted social needs screening tool and a health system preparedness assessment for the use of the tool, was conducted across the three study sites. The stakeholders included 30 purposively sampled participants (9 oncology doctors, 9 social workers, and 12 nurses). The assessment was done on a 5-point Likert scale using the six domains of the hexagon readiness tool as the conceptual framework. Descriptive statistics were conducted. Positive implementation preparedness was defined as a score of ≥3 in ≥50% of stakeholders. RESULTS Median age of the stakeholders was 41.5 (34.8-50.0) years, and 19 (63.3%) were males. In terms of need, 29 (96.7%) agreed that available data demonstrate significant health inequities that the social needs screening tool was intended to address. Regarding capacity, 28 (93.3%) indicated that hospitals would need to adjust current procedures to support the implementation, and 26 (86.7%) agreed that their hospitals have trained staff to support and sustain the use of the tool. Twenty-six (86.7%) felt motivated to adopt the tool, and 27 (90.0%) agreed that their leadership felt motivated to adopt the tool. For resources, 21 (70.0%) perceived that there are suitable hospital resources to support social needs screening tool implementation. In terms of fit, the tool aligned with community values in 27 (90.0%), with the current hospital mission in 25 (83.3%), and with the government's priorities in 22 (73.3%). In terms of evidence, 27 (90.0%) of stakeholders expected positive change in outcomes following the use of this screening tool. CONCLUSION Despite a relatively lower perception of resource preparedness, stakeholders expressed strong implementation preparedness across the need, capacity, motivation, fit, and evidence domains.