National Collaboration Advances Diabetes Equity
Research By: Nana-Hawa Yayah Jones, MD
Post Date: January 2, 2024 | Publish Date: Winter 2024
Diabetes and Endocrinology | Top Scientific Achievement
Social and economic challenges—like housing insecurity, food access, and financial hardship—can directly affect diabetes outcomes.
To close that gap, Cincinnati Children’s, ranked No. 1 by the U.S. News & World Report for pediatric diabetes and endocrinology care, joined forces with six endocrinology centers across the country through the T1D Exchange Quality Improvement Collaborative (T1DX-QI). Their shared goal: make screening for social determinants of health (SDOH) a standard part of diabetes care.
Using iterative Plan-Do-Study-Act cycles, teams introduced new processes to identify and address patients’ nonmedical needs. Interventions ranged from staff training and electronic health record prompts to multilingual screening tools and partnerships with community resource organizations. Over 27 months, overall SDOH screening rates across the six sites increased from 1% to 70%—a 69-point rise.
Details were published in Winter 2024 in a special edition of Clinical Diabetes.
“This project demonstrates that when we intentionally look beyond clinical measures, we can uncover barriers that profoundly shape health,” says Nana-Hawa Yayah Jones, MD, a Cincinnati Children’s endocrinologist and co-author. “By connecting patients to community resources, we can help create a foundation for better outcomes and more equitable care.”
The collaborative’s work also revealed practical lessons. Centers that customized workflows to fit their patient populations and invested in regular team communication saw the most sustainable results. Translating screening tools into languages, such as Spanish, Arabic, and Nepali, further boosted participation.
Researchers plan to examine how these screenings affect long-term outcomes, such as glycemic control and reduced complications, and to identify best practices for referring patients to community support services. The success of this effort offers a roadmap for healthcare systems nationwide to integrate social care into routine diabetes management.
About the study
Additional collaborators represented the T1D Exchange; Baylor College of Medicine, Hassenfeld Children’s Hospital at NYU Langone, Children’s Mercy Research Institute, and SUNY Upstate Medical University.
This research was supported by the Leona M. and Harry B. Helmsley Charitable Trust.
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| Original title: | Increasing Social Determinants of Health Screening Rates Among Six Endocrinology Centers Across the United States: Results From the T1D Exchange Quality Improvement Collaborative |
| Published in: | Clinical Diabetes |
| Publish date: | Winter 2024 |
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