710-P: Social Determinants of Health (SDOH)-The Importance of Screening, Resource Delivery, and Follow-up

• Published in: Diabetes (New York, N.Y.) Vol. 73; p. 1
• Main Authors: Holly, Sarah L, Segawa, Mai, Deanna, Lauren, Velasquez, Roxanna E, Roberts, Jasmine, Majidi, Shideh
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01.06.2024
• Subjects: Caregivers; Diabetes; Diabetes mellitus; Diagnosis; Disease management; Food security; Literature reviews; Resource utilization
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db24-710-P

Introduction: The significant transition that a family must undergo after a diabetes diagnosis can be particularly difficult for families facing other barriers and disparities. Patients with adverse SDOH may endure negative impacts to their diabetes care and management. Assessing and addressing these underlying determinants, particularly during new diagnosis, is critical to identifying barriers to care as early as possible and working towards equitable care. SDOH screening, resource delivery, and follow-up were established in a large academic center. Methods: A literature review of SDOH screens was conducted with subsequent edits by the diabetes social workers (SW). The screen targets 10 domains of SDOH and is administered by the SW to caregivers at time of diabetes diagnosis. Caregivers who identify a barrier(s) are provided with a list of tailored resources by the SW. One week after resources are provided, the diabetes health coach (HC) checks in via phone to assess resource utilization and/or if additional help is needed. Results: Thirty SDOH screens have been completed to date with 11 caregivers identifying a barrier(s). Twenty-six total barriers were identified across all domains with 22 subsequent resources provided. Food insecurity and mental health were among the most identified SDOH barriers. The HC assessed resource utilization and/or provided additional assistance to 9 of the 11 caregivers. All 9 caregivers reported successful utilization of the SDOH resource(s). Conclusions: Health disparities in care must be and can be addressed as early as diagnosis so proper care, resources, and follow-up can be put in place to meet the needs of families and improve diabetes outcomes. The combination of a comprehensive set of SDOH resources and supportive follow-up is necessary to offsetting disparities. Further expansion of this initiative will include periodic screening beyond the time of diagnosis, continued resource follow-up, and impact evaluation on diabetes outcomes.