Structured programs facilitating healthcare transition of young adults (YA) (18-30 yrs) have shown improved A1c and loss to follow-up. However, generalizability of these models is lacking. We previously published on a transition program (SEAD) based in an adult diabetes center in Philadelphia, PA that improved A1c, glucose monitoring adherence, and loss to follow-up. We have since moved SEAD to a new health system in the Bronx, NY, expanding care to economically vulnerable and minority YA. We were interested in examining whether the SEAD model was generalizable to a new health system and population. We prospectively followed YA with T1D in the first year of SEAD and collected standardized data on sociodemographic, visit attendance, and clinical factors for 1 year prior to and during care. The program involved an adult endocrinologist and nurse practitioner, and focused on topics including pediatric care coordination, self-management re-education, adult healthcare orientation, behavioral support, and engagement in care efforts. We used multilevel linear and logistic regression with repeated measures to examine visit attendance, A1c, and diabetes technology use. Of 79 YA with a scheduled SEAD visit (mean age at transition 23 yrs, 46% female, 93% Hispanic or Black, 89% Medicaid), 30% (n=24) never attended SEAD or re-established care. Of the 55 YA who attended SEAD, 74% (n=41) returned for at least 1 follow-up within 3 months. Mean A1c improved by 0.97% from 9.81% to 8.84% (n=41, p<0.05). For diabetes technology use, 29% (n=14) were initiated while 66% (n=27) continued use (p<0.05). SEAD preliminary results from a new health system and population demonstrate retention of YA after initial establishment of care, rapid improvement in glycemic control, and robust technology use. More efforts to promote establishing care are needed. The SEAD program is promising as a generalizable model for healthcare transition of YA with T1D.
C. Lopez-Prieto: None. A. Jang: None. M. Greenberg: None. S. Agarwal: None.
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK115896)