Perceptions and attitudes of health-related social needs program facilitators within community pharmacies: A mixed methods study

Background: Community pharmacy health-related social needs (HRSN) programs leverage pharmacy accessibility and connect patients to local resources, but the contextual factors influencing implementation are not fully understood. This study explored program facilitators' perceptions and attitudes towards implementing a HRSN program within pharmacy settings using the updated Consolidated Framework for Implementation Research (CFIR). Methods: This concurrent mixed methods study used a survey and focus groups with program facilitators from the Community Pharmacy Enhanced Services Network of New York, a clinically integrated network of pharmacies. We identified 15 pharmacies participating in an ongoing HRSN screening and navigation program between January and May 2023. An online survey was sent to all program facilitators, and two focus groups were conducted. Both data collection instruments were developed using the CFIR. A rapid analysis of the focus group transcripts was conducted to evaluate the qualitative data and CFIR was utilized to deductively map themes to relevant domains and constructs. Results: Participants included 12 program facilitators consisting of 3 pharmacists and 9 technicians (response rate 75%). Most participants (83%) agreed that the abbreviated Community Health Worker course, focused on cultural competency and effective communication, improved their ability to engage patients about social needs. Nine (75%) participants agreed that pharmacy leadership provided sufficient time, encouragement, and equipment to support program tasks. Focus groups identified 3 major themes (training, leadership engagement, and patient engagement challenges), which encompassed 8 subthemes. Conclusion: Implementation success was influenced by constructs across CFIR domains, including, Access to Knowledge, Leadership Engagement, Structural Characteristics, and Complexity. Training, implementation strategies, and multilevel leadership were identified as critical enablers. Addressing staffing, workflow, and referral system challenges may enhance integration and sustainability of HRSN programs in community pharmacies.