Impact of Community Health Workers in High Risk Pediatric Patients with Newly Diagnosed Type 1 Diabetes
Lower socioeconomic status (SES) is associated with adverse outcomes in children with type 1 diabetes. (T1D)1. These children have poorer glycemic control, lower quality of life, and increased healthcare utilization. Previous efforts to improve outcomes in this patient population have focused on high-cost, high-intensity educational interventions. These efforts have been ineffective in improving clinical outcomes in patients with low SES2. Adverse social determinants of health (SDOH) including food insecurity, parental unemployment and housing insecurity are extremely prevalent in under-resourced patients and their families.
Community health workers (CHWs) are trained non-medical members of the community who are empowered to address adverse SDOH through performing home visits and connecting patients to community resources. CHWs can assist in navigating healthcare and social services systems, reducing family stress, and breaking down community barriers to positive health behavior.
We hypothesize that interventions focused on addressing adverse SDOH will reduce these barriers to optimal diabetes outcomes in this patient population. Through providing the support of a CHW at onset of T1D, we aim to improve outcomes from the outset of this chronic disease. We will enroll newly diagnosed children with low SES in this randomized controlled pilot study.
The proposed research represents a significant departure from the status quo by identifying and addressing SDOH challenges in pediatric patients with T1D. By adding a CHW to the care of high-risk patients at the time of diagnosis, when families are both at their most receptive and vulnerable, we will be taking the first step towards eliminating the socioeconomic disparities in diabetes outcomes.