578-P: School-Partnered Type 1 Diabetes (T1D) Interventions—A Path to Successful Implementation

School-partnered interventions with clinical diabetes centers may help optimize child T1D health outcomes. Such interventions are under-studied and published examples are short-term with mixed benefit. We aimed to discover factors affecting implementation of T1D interventions in school to better design future programs. We conducted semi-structured interviews with school nurses (SN) in Pennsylvania (n=20) and West Virginia (n=10). Transcripts were coded by two reviewers using a consensus-driven approach. Major themes were aligned with an implementation science framework. SN represented various geographic settings (52% rural, 41% suburban, 7% urban) and years of experience (24% <5, 21% 5-10, 28% 11-20, 27% >20 years). SN from both states perceived factors to influence implementation of T1D interventions in school related to four themes. Theme 1 Motivating Factors: T1D interventions are prioritized as these students have complex medical needs and there is a dearth of available resources for school staff. Theme 2 Facilitators: Schools have existing structures which could support T1D interventions, including procedures to assemble multidisciplinary teams and expanded use of video conferencing since the pandemic. Theme 3 Challenges: Variable parent engagement and limited school health staffing may interfere with schools’ ability to participate in interventions. Theme 4 Peer Influence: Communication between school districts can influence adoption of interventions and should be considered when approaching school leaders. Differences in state policy for school health and insulin administration affected SN perceptions for who should lead interventions and funding for SN. Individual, school, and state-level factors will affect implementation of school-partnered T1D interventions. Understanding the unique systems for school health and working with key stakeholders may help tailor strategies to promote sustainable interventions in schools and improve T1D outcomes.