- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07706803
Screening For Social Determinants Of Health In Routine Diabetes Care (SDOH)
Social determinants of health (SDOH) exert a powerful influence on the everyday management of type 1 diabetes (T1D) and short and long term outcomes of T1D. Experts agree that identifying and addressing negative social determinants of health (SDOH) may help accomplish numerous T1D care goals and promote health equity in treatment. However, fundamental research gaps in achieving these goals remain, including optimal screening and management processes for identification of negative social determinants of health (SDOH) , and how to develop robust partnerships with community-based organizations (CBOs) that address social determinants of health (SDOH) with high potential for sustainability and scalability. This project will generate new knowledge regarding how to implement a social work-led social determinants of health (SDOH) screening and referral program designed to aid families of youth with T1D who face several vulnerabilities, including food insecurity. The team will implement a single arm, pragmatic clinical trial with contemporaneous, non- randomized controls; whereby all families with a child enrolled in the California Children's Services (CCS) program (which provides specialized medical care for low-income families of youth with a qualifying chronic medical condition) will receive access to a novel social work-led social determinants of health (SDOH) screening and referral program.
Outcomes will be compared against youth with T1D who are also seen in our Westwood Pediatric Endocrinology clinic but who are not enrolled in the CCS program and will not receive access to the social determinants of health (SDOH) intervention. The study team has established partnerships with several community-based organizations (CBOs) across Los Angeles County that provide social services, including food-related services, to receive referrals for CCS families who screen positive for having a social need. The study team will assess the feasibility and acceptability of this screening and referral protocol among families, CBOs, and providers (Aim 1) by measuring key implementation outcomes (comprehensive documentation of social determinants of health (SDOH) screening, result, and referral in the patients' medical record) and acceptability outcomes (self-reported satisfaction with the program by families and barriers and facilitators by CBOs and providers). The team will additionally estimate the effect of this intervention (Aim 2) by measuring changes (pre/post intervention) in families reported social needs, diabetes-related quality of life, and in the child's glycemic control (measured by HbA1c). Results from this work can provide a roadmap for sustainable and scalable social determinants of health (SDOH) interventions with potential to improve outcomes for youth with T1D in an equity-informed manner.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lauren Wisk, PhD
- Phone Number: 310-267-5308
- Email: lwisk@mednet.ucla.edu
Study Locations
-
-
California
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Los Angeles, California, United States, 90095
- University of California, Los Angeles
-
Contact:
- Lauren Wisk, PhD
- Phone Number: 310-267-5308
- Email: lwisk@mednet.ucla.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1) patients who are 0-21 years old, diagnosed with T1D, and receive T1D care from the UCLA Pediatric Diabetes program at the Westwood clinic, and/or 2) parents/legal guardians of a child with T1D and whose child is 21 years old or under and receives T1D care from the UCLA Pediatric Diabetes program at the Westwood clinic.
Exclusion Criteria:
- 1) patients who are over 21 years old and diagnosed with Type 2 Diabetes or prediabetes, and 2) parents/legal guardians of a child with type 2 diabetes or prediabetes and whose child is over 21 years old.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
No Intervention: Treatment as Usual
|
|
|
Experimental: SDOH Screening and Intervention Program
|
This study is proposing a social work-led SDOH screening and intervention program.
Social workers will screen patients/families for SDOH and respond based on the results of the screen.
Patients/families identified as "low risk" (i.e., do not screen positive on the SDOH screener) will receive information about 1degree.org and phone follow-up two weeks after visit to see if there are any questions about the platform or any changes to their social circumstances that they wish to discuss with the social work team.
Patients/families identified as "high risk" (i.e., screen positive on the SDOH screener) will receive the 1degree.org
information sheet as well as receive specific agency referrals to our partner food bank organizations and two week phone follow-up to assess referral success; these patients/families will subsequently receive follow-up calls every two weeks until the referral is complete or the patient/family discloses that their identified food insecurity is resolved.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Documentation of SDOH screening
Time Frame: Baseline visit, final follow-up (6 months post-baseline)
|
The primary feasibility outcomes include documentation of SDOH screening (performed vs not), result (positive vs negative), and referrals (made vs not, completed vs not) in the medical record.
The study will quantify the prevalence of each of these individually, as well as collectively to identify the extent to which documentation was comprehensive (i.e., screening and result, plus referral when appropriate, all documented).
|
Baseline visit, final follow-up (6 months post-baseline)
|
|
Family-reported satisfaction with screening (acceptability)
Time Frame: All three survey time points (pre, immediate post, 6-month post)
|
A 3-item measure of patient satisfaction with care, rated on a 10-point Likert scale, will be assessed in an immediate post-visit survey, and the in-depth Consumer Assessment of Healthcare Providers and Systems (CAHPS) will be used in the pre/post surveys.
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All three survey time points (pre, immediate post, 6-month post)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Hemoglobin A1c
Time Frame: baseline and 6 months follow-up
|
For our secondary clinical outcome of change in HbA1c, a continuous variable, we will compare the change in HbA1c, as documented in the clinical record, from baseline to that of 6 months post-intervention.
|
baseline and 6 months follow-up
|
Collaborators and Investigators
Investigators
- Principal Investigator: Lauren Wisk, PhD, Lauren Wisk
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Endocrine System Diseases
- Metabolic Diseases
- Autoimmune Diseases
- Immune System Diseases
- Glucose Metabolism Disorders
- Diabetes Mellitus
- Nutritional and Metabolic Diseases
- Diabetes Mellitus, Type 1
- Professional Practice
- Organization and Administration
- Health Services Administration
- Health Care Quality, Access, and Evaluation
- Investigative Techniques
- Epidemiologic Methods
- Diagnostic Techniques and Procedures
- Diagnosis
- Data Collection
- Health Care Evaluation Mechanisms
- Quality of Health Care
- Public Health
- Environment and Public Health
- Health Services
- Health Care Facilities Workforce and Services
- Preventive Health Services
- Population Characteristics
- Health Status
- Demography
- Diagnostic Services
- Health Surveys
- Surveys and Questionnaires
- Public Health Practice
- Health
- Referral and Consultation
- Mass Screening
- Social Determinants of Health
Other Study ID Numbers
- IRB#25-0333
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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