Department of Family and Community Medicine, University of California, San Francisco, Box 0900, San Francisco, CA, 94143, USA.
Kaiser Permanente Center for Health Research, Portland, OR, USA.
Curr Diab Rep. 2019 Apr 29;19(6):30. doi: 10.1007/s11892-019-1149-y.
Patient social and economic risk information can guide diabetes care through social risk-targeted care (directly intervening on social risk factors) or social risk-informed care (modifying or tailoring care to accommodate social risks). We review evidence supporting these approaches and highlight critical gaps in the current evidence.
Literature is scarce on isolated social care interventions and the impact on glycemic control is unclear, while blended social-behavioral interventions more consistently point to reductions in HbA1c. Social risk-informed care naturally occurs at low rates, yet holds potential to improve care. Momentum is building around programs designed to intervene on social risk factors and/or to contextualize care based on social context. Future work will need to isolate the impacts of these programs, clarify the pathways through which social care programs can improve outcomes, and identify provider barriers and facilitators to using social risk information in care.
患者的社会经济风险信息可以通过社会风险针对性护理（直接干预社会风险因素）或社会风险知情护理（调整或定制护理以适应社会风险）来指导糖尿病护理。我们回顾了支持这些方法的证据，并强调了当前证据中的关键差距。
关于孤立的社会护理干预及其对血糖控制影响的文献很少，而混合的社会行为干预则更一致地表明 HbA1c 降低。社会风险知情护理自然发生的频率较低，但具有改善护理的潜力。旨在干预社会风险因素和/或根据社会背景调整护理的计划正在逐渐增多。未来的工作需要分离这些计划的影响，阐明社会护理计划可以改善结果的途径，并确定在护理中使用社会风险信息的提供者障碍和促进因素。
