Social risk assessment tools for adults and their potential applicability to acquired neurological disability

A systematic review

Authors

DOI:

https://doi.org/10.30827/tsg.v16.36505

Keywords:

Social Determinants of Health, Social Work, Risk Factors, Neurological Rehabilitation, Persons with Disabilities, Surveys and Questionnaires, Systematic Review

Abstract

Introduction: Social risk is a relevant operational category in health social work because it focuses on individual-level conditions associated with poorer health outcomes that may be amenable to intervention. Although numerous social screening tools have been developed in recent years, uncertainty remains as to which instruments specifically assess this construct, which domains they cover, and the extent to which they can be used in complex clinical settings. This review aimed to identify and describe structured instruments for assessing social risk in adults, analyze their characteristics, and examine their potential applicability to health social work and neurorehabilitation.

Methods: A systematic review was conducted in accordance with Joanna Briggs Institute guidance and the PRISMA 2020 statement. The initial search was conducted in Dialnet, PsycINFO, and PubMed in September 2025. During peer review, the searches were updated in the same databases and expanded to Scopus, Web of Science, and CINAHL on 11 July 2026. Reports in English or Spanish describing structured tools used with adults in clinical, healthcare, or community settings were included. A two-stage selection process was applied, first to reports and then to tools. Only tools whose primary construct was social risk and that covered at least two domains were retained. Data were synthesized using descriptive, categorical, and comparative analyses. Methodological quality was assessed using the relevant Joanna Briggs Institute critical appraisal tools, and potential applicability was examined in terms of content coverage, operational characteristics, and the available evidence on validity and reliability.

Results: Seventy-five reports were included, and 48 tools were identified, of which 10 met the eligibility criteria. Four were developed in Spain, five in the United States, and one in Singapore. The instruments showed considerable heterogeneity in target population, intended clinical use, structure, administration time, and measurement properties. Content analysis identified 23 domains. Housing instability was the most frequently represented domain, followed by mobility and income. PRAPARE had the broadest coverage, encompassing 15 domains. Five instruments reported at least one reliability estimate, although the evidence was uneven and, in several cases, limited to previously validated items or components. None of the instruments had been developed or validated specifically for adults with acquired neurological disabilities.

Discussion: The findings confirm conceptual and operational fragmentation in the measurement of social risk. The tools may support risk identification and the systematic collection of information, but their usefulness depends on the fit between the target population, intended purpose, and context of use. In neurorehabilitation, architectural barriers and the need for support with basic activities of daily living were underrepresented.

Conclusions: The identified tools may complement professional social work assessment and social diagnosis in healthcare, but they should not be used in isolation or directly transferred to populations other than those for which they were developed. These findings provide a basis for the future adaptation, development, and validation of social risk assessment tools specifically designed for neurorehabilitation.

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Author Biographies

  • Hèctor Cussó-Bertran, Guttmann Hospital de Neurorehabilitació

    Graduado en Trabajo Social por la Universitat de Barcelona, máster en Trabajo Social Sanitario por la Universitat Oberta de Catalunya. Actualmente doctorando en trabajo social en la Universitat Rovira i Virgili. Trabajador Social Sanitario en Guttmann Hospital de neurorrehabilitación, miembro del comité de ética, investigación e innovación. La principal línea de investigación es el riesgo social y su impacto en personas con discapacidad adquirida de origen neurológico.

  • Alejandro García-Rudolph, Guttmann Hospital de Neurorehabilitació

    Doctor en Inteligencia Artificial por la Universidad Politécnica de Cataluña. Gerente de Proyectos en la Oficina de Investigación, Docencia e Innovación del Hospital de Neurorrehabilitación Institut Guttmann desde 2004. Su línea de especialización se encuentra en la intersección de las tecnologías de la información y las neurociencias, con más de veinte años de experiencia en el campo de las TIC y el sector de la salud. Ha participado en más de 50 artículos publicados en revistas especializadas y arbitradas del sector. Co-investigador en múltiples proyectos centrados en el diseño, implementación técnica, validación clínica e implantación en la práctica clínica de soluciones tecnológicas, que actualmente están integradas en la práctica clínica de más de 30 centros de salud, hospitales de día y hospitales en todo el país.

  • Ramona Torrens-Bonet, Universitat Rovira i Virgili

    Doctora en Antropología Social, Licenciada en Antropología Social, Potsgrado en proyectos socieducativos, Diplomada en Trabajo Social, Miembro del Grupo de Investigación de Antropología Social de la Universitat Rovira i Virgili, Directora de tesis del Doctorado Interuniversitario en Trabajo Social. Las principales líneas de investigación desarrolladas en diferentes proyectos de investigación, publicaciones y congresos están relacionadas con las políticas sociales y los sistemas de cuidados a las personas. En concreto: el estudio de las entidades del tercer sector de atención a las personas con discapacidad intelectual, las mujeres migrantes cuidadoras en entornos rurales, los cuidados de larga duración en personas dependientes, la brecha de género en la ocupación laboral de mujeres con trastorno mental y los sistemas de intervención en casos de feminicidio. Ha desarrollado asesoramiento a equipos interdisciplinarios que trabajan con pobreza infantil en Valencia y Tarragona.

  • Víctor M. Giménez-Bertomeu, University of Alicante

    Diploma in Social Work, BA in Sociology and PhD from the University of Alicante. Associate Professor in the Department of Social Work and Social Services at the University of Alicante. His research activity focuses on Social Work and Social Services, with numerous publications, competitive research projects and contracts, two recognised six-year research periods, and the First Rafael Altamira Prize for Social Research. His main research interests include Social Work practice and organisational contexts; user participation at both macro and micro levels; the development and validation of standardised instruments for assessment and evaluation in Social Work; the teaching and learning of Social Work; and Social Work research.

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Social risk assessment tools for adults and their potential applicability to acquired neurological disability: A systematic review. (2026). Trabajo Social Global-Global Social Work, 16, 1-34. https://doi.org/10.30827/tsg.v16.36505