Community Review of Systems Tool
A thorough social history helps to assess a patient’s connection to the community and the support services and resources available. It also can provide information about the expectations and benefits of membership in the community. An approach modeled on the review of systems (ROS) will help ensure that you have addressed the important topics related to community. The categories below are meant to serve only as examples and include questions that can be used for each category. You may wish to expand the “ROS” to include topics specific to the communities in which your patients live and work. If time does not allow a thorough review of all the categories, asking the simple question, “Who do you turn to if you come across a difficulty in your life?” will give you a good start.
Family/Household – Who does the individual live with? Who is considered “family”? Who is the head of the family? Who makes decisions in the family?
Religion – What religious affiliation does the patient or family hold, if any? Does religious observance (e.g. by regular attendance at services or by adherence to specific practices) play an important role for the patient or family? Do religious beliefs also affect health and healthcare?
Education/schools – How important is education for the family, community, or culture? Do the children attend public or private school or are they home-schooled? How involved is the individual/family with the school?
Employment – If the patient is an adolescent or adult, is he/she employed? If the patient is a child, are parents employed? In either case, where is the individual employed and in what occupation?
Extracurricular activities – What do patients and family members do during their free time? What activities do they enjoy? With whom do they do these activities?
Country of origin – What country is the family originally from? Were children born in the US?
Language preference and English proficiency – What language is spoken at home? Do parents and/or children speak English or another language? What language does the patient or parent prefer to use when communicating with you? Would use of an interpreter help with communication?