Presenter Status
Resident/Psychology Intern
Abstract Type
Research
Primary Mentor
Kelsee Halpin
Start Date
16-5-2024 12:15 PM
End Date
16-5-2024 12:30 PM
Presentation Type
Oral Presentation
Description
Screening for health-related social needs (HRSNs) is recommended as part of routine diabetes care given the impact of social factors on health outcomes.
Youth presenting to a tertiary diabetes center will have different diabetes-related health outcomes based on positive or negative HRSNs screenings at routine clinic visits.
Baseline data were collected from patients whose parent/guardian completed a HRSN screen as part of their child’s diabetes clinic intake from 9/1/21 to 8/30/22. The screen is a 6-item questionnaire adapted from the Accountable Health Communities HRSNs Screening Tool to screen for HRSNs in 4 domains (housing, utilities, transportation, and food). Longitudinal data were analyzed from the time of first screen through 8/30/23. A positive screen was defined as any positive response to a HRSN. Comparisons were made using chi-square or t-test.
Among 1880 unique respondents, 14% were positive for at least one HRSN. The most common HRSN was food insecurity (72%). A positive HRSN screen was more likely in non-white minorities (22% vs. 11% non-Hispanic white youth), publicly insured (22% vs. 8% privately insured), and youth with a type 2 diabetes diagnosis (32% vs. 12% with type 1 diabetes), all p10% (32% vs. 19%), any A1c >13% (9% vs. 4%), at least one no-showed appointment (41% vs. 26%), a positive PHQ4 screen for anxiety/depression (22% vs. 11%), and a second positive HRSN screen (29% vs. 5%), all p < 0.001, during the follow up period (mean 14.8 =/- 2.0 months). They were more likely to have an ED visit (17% vs. 12%, p 0.025), but DKA admissions were not significantly different between the groups (6% vs. 4%, p=0.15). Insulin pumps (58% vs. 75%) and continuous glucose monitors (CGMs) (58% vs. 76%) were also less utilized throughout the study period in those screening positive for a HRSN at baseline, p < 0.001.
Youth with positive HRSN screenings during diabetes clinic appointments experience suboptimal diabetes-related outcomes, including higher A1c levels, increased rates of missed appointments, anxiety/depression, ED visits, and less utilization of diabetes technologies. This highlights the importance of addressing social risk factors and utilizing them to inform clinical treatment plans when treating youth with diabetes to enhance equity in delivery of care, decrease health care costs, and improve health outcomes.
Additional Files
ABSTRACT-The Impact of Health-Related Social Needs on Health Outcomes Amon.pdf (295 kB)Abstract
Included in
The Impact of Health-Related Social Needs on Health Outcomes Among Youth Presenting to a Midwest Pediatric Diabetes Clinic Network
Screening for health-related social needs (HRSNs) is recommended as part of routine diabetes care given the impact of social factors on health outcomes.
Youth presenting to a tertiary diabetes center will have different diabetes-related health outcomes based on positive or negative HRSNs screenings at routine clinic visits.
Baseline data were collected from patients whose parent/guardian completed a HRSN screen as part of their child’s diabetes clinic intake from 9/1/21 to 8/30/22. The screen is a 6-item questionnaire adapted from the Accountable Health Communities HRSNs Screening Tool to screen for HRSNs in 4 domains (housing, utilities, transportation, and food). Longitudinal data were analyzed from the time of first screen through 8/30/23. A positive screen was defined as any positive response to a HRSN. Comparisons were made using chi-square or t-test.
Among 1880 unique respondents, 14% were positive for at least one HRSN. The most common HRSN was food insecurity (72%). A positive HRSN screen was more likely in non-white minorities (22% vs. 11% non-Hispanic white youth), publicly insured (22% vs. 8% privately insured), and youth with a type 2 diabetes diagnosis (32% vs. 12% with type 1 diabetes), all p10% (32% vs. 19%), any A1c >13% (9% vs. 4%), at least one no-showed appointment (41% vs. 26%), a positive PHQ4 screen for anxiety/depression (22% vs. 11%), and a second positive HRSN screen (29% vs. 5%), all p < 0.001, during the follow up period (mean 14.8 =/- 2.0 months). They were more likely to have an ED visit (17% vs. 12%, p 0.025), but DKA admissions were not significantly different between the groups (6% vs. 4%, p=0.15). Insulin pumps (58% vs. 75%) and continuous glucose monitors (CGMs) (58% vs. 76%) were also less utilized throughout the study period in those screening positive for a HRSN at baseline, p < 0.001.
Youth with positive HRSN screenings during diabetes clinic appointments experience suboptimal diabetes-related outcomes, including higher A1c levels, increased rates of missed appointments, anxiety/depression, ED visits, and less utilization of diabetes technologies. This highlights the importance of addressing social risk factors and utilizing them to inform clinical treatment plans when treating youth with diabetes to enhance equity in delivery of care, decrease health care costs, and improve health outcomes.
