Visual Abstract

Objective: Novel Interventions in Children’s Healthcare (NICH), a systems intervention for youth with T1D and high social risk, is associated with improved A1c and fewer DKAs. NICH youth of racial/ethnic minority (referred to here as “BIPOC”) show improved access to care, but prior studies did not include a control group.

Methods: Youth with T1D and high social risk were referred to NICH (n=144), with 51 receiving NICH and 93 denied by insurance (“Unserved”). EHR review included demographic and outpatient attendance data for the years prior to and following NICH initiation. Youth mean age was 13.7 years; 58% female; 81% non-Hispanic White.

Results: There were no significant differences between NICH and Unserved youth regarding outpatient attendance over time (see figure). BIPOC youth (n=28) had significantly worse care access (p<.05) prior to referral. BIPOC youth in NICH demonstrated improved access compared to Unserved BIPOC youth, with mean yearly changes of 1.9 more appointments and 0.5 fewer appointments attended, respectively (p=.03).

Conclusions: While NICH is not associated with increased appointment attendance for all youth, NICH participation is associated with improvements in care access for BIPOC youth, especially when compared to similarly referred population. These findings further demonstrate the need for intensive, ecologically-based services to reduce health inequities.


D. V. Wagner: None. C. Jenisch: None. W. C. Cadiz: None. J. Lely: None. A. Cantu: None. S. Balthazaar: None. M. A. Harris: None.


The Leona M. and Harry B. Helmsley Charitable Trust; BUILD EXITO Foundation

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