Objective: Novel Interventions in Children’s Healthcare (NICH) is a community-based, family-focused intervention for youth with T1D and is associated with improved glycemic control and lower rates of acute care utilization. This study examines whether NICH is associated with changes in preventative outpatient attendance, with specific attention to the role of social determinants of health (SDoH) as potential moderators.
Methods: Youth in NICH with T1D were included if they had SDoH and electronic health record (EHR) data available (n=52). Retrospective EHR review included outpatient attendance (endocrinology, primary care) for the years prior to and following NICH initiation and social risk endorsement (e.g., food and housing security). Youth mean age was 14.5 years; 59% were female; and 77% were non-Hispanic Caucasian.
Results: More than half of NICH families (52%) endorsed food insecurity, with 49% and 40% reporting housing insecurity and unreliable transportation, respectively. Prior to NICH services, minority youth and those experiencing food insecurity attended significantly fewer preventative outpatient appointments (p<.05). There were no significant differences in total number of outpatient visits attended while in NICH for the overall sample; however, following NICH initiation, minority youth demonstrated a significant increase in attendance, from 2.4 to 4.9 per year, and a significantly larger increase in attendance when compared to youth of majority race (p=.01).
Conclusions: This is the first study to examine the impact of NICH on preventative care access. There were no significant differences in total number of appointments attended while in NICH, which is unsurprising given that families are already attending additional weekly home sessions during program participation. However, minority youth seem to particularly benefit from NICH services, demonstrating more equitable access to preventative outpatient care during program involvement.
A. Cantu: None. D.V. Wagner: None. C. Jenisch: None. H. Luzod: None. H. Gottfried-Lee: None. M.A. Harris: None.
JDRF; The Leona M. and Harry B. Helmsley Charitable Trust