Under-resourced youth with diabetes in a community-based intervention show improved diabetes outcomes, technology use, and psychosocial functioning.

Abstract

Objective: The primary objective of this study was to evaluate the first full scale implementation of the behavioral health program Novel Interventions in Children's Healthcare (NICH) in racially and ethnically diverse youth with diabetes and high degrees of social risk. We hypothesized that youth would demonstrate improved health outcomes and psychosocial functioning following program involvement.

Methods: Youth with diabetes who enrolled in NICH (n=26) and their caregivers completed measures of diabetes distress, depression, and diabetes strengths prior to and following program enrollment. Electronic health records were reviewed to describe change in hemoglobin A1c (HbA1c), change in continuous glucose monitoring (CGM) use, and change in number of hospital admission days from baseline to the time following program participation. Parametric and non-parametric tests were used to compare data.

Results: Youth (mean age 13.7 ± 3.5 years, 92% from historically marginalized racial or ethnic groups, 96% with public insurance) demonstrated significant (p<0.01) mean HbA1c reduction of -1.1% (-12 mmol/mol) and increase in CGM use (27% to 73%) one year following NICH enrollment, and they had significantly fewer hospital admission days over time. Youth reported significant reductions in depressive symptoms, and caregivers reported significant reductions in diabetes distress after participation in NICH (p<0.05).

Discussion: This study is the first to show successful full scale implementation of NICH in a new geographic location with unique racial and ethnic diversity and social challenges, demonstrating associations with improved health and well-being.